The use of physical assessment skills by registered nurses in Australia: Issues for nursing education

School of Nursing and Midwifery, Learning and Teaching Education Research Centre, Central Queensland University, Noosa Campus, Queensland 4566, Australia.
Collegian Journal of the Royal College of Nursing Australia (Impact Factor: 1.18). 03/2013; 20(1):27-33. DOI: 10.1016/j.colegn.2012.02.004
Source: PubMed

ABSTRACT The purpose of pre-service nursing education programs is to prepare competent graduates who are able to function as safe, professional registered nurses. An extensive element of these programs is the teaching of physical assessment skills, with most programs educating students to perform over 120 such skills. Previous research from North America suggests that the majority of skills taught to nurses in their pre-service programs are not used in practice. As part of a larger study, an online survey was used to explore use of 121 physical assessment skills by Australian nurses. Recruitment occurred via mailed invitation to members of the Australian Nursing Federation. Data were extracted from 1220 completed questionnaires returned by nurses who were mostly employed in New South Wales, were female and experienced nurses. Respondents indicated that they used only 34% of skills routinely. Results reinforce evidence found in the literature that many of the skills taught to nurses are either not used at all (35.5%) or are used rarely (31%). These findings have implications for the teaching of physical assessment skills in pre-service nursing programs, and raise questions about the value of extensive skills teaching in the context of contemporary health care. Further research into barriers to the use of physical assessment skills in nursing and the need for comprehensive skills preparation for the generalist nurse is likely to offer some solutions to these questions.

935 Reads
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Health assessment skills are of the most important skills which nurses require. The more precise assessment, the better results would be obtained and the quality of patient care would be improved. However, in Iran, few studies have investigated nurses' assessment skills. This study was aimed to assessnurses' evaluation of the learned skills of health assessment and their use. This cross-sectional study was conducted on 200 nurses in Isfahan province hospitals. Data was collected by a questionnaire including demographic data and 120 health assessment skills. Nurses scored their frequency of using and proficiency in skills. Statistical analysis was conducted by ANOVA, Tukey test and independent sample T-tests. The highest level of using and proficiency in skills was related to taking history. Nurses received 87.25% of score in this field. The lowest level of application was in assessment of the urogenital system so that nurses received 16.37% of score in this area. Also the lowest proficiency was in assessment of the nervous system and nurses received 34.58% of score in this area. The level of nurses' proficiency in the health assessment skills was not satisfactory. Modifying the curriculum and cooperating of nurse managers and nursing schools can help to improve the situation.
    09/2013; 2(3):39-43. DOI:10.5812/nms.13316
  • [Show abstract] [Hide abstract]
    ABSTRACT: AimTo develop and psychometrically test the Barriers to Nurses’ use of Physical Assessment Scale.Background There is growing evidence of failure to recognize hospitalized patients at risk of clinical deterioration, in part due to inadequate physical assessment by nurses. Yet, little is known about the barriers to nurses’ use of physical assessment in the acute hospital setting and no validated scales have been published.DesignInstrument development study.Method Scale development was based on a comprehensive literature review, focus groups, expert review and psychometric evaluation. The scale was administered to 434 acute care Registered Nurses working at a large Australian teaching hospital between June and July 2013. Psychometric analysis included factor analysis, model fit statistics and reliability testing.ResultsThe final scale was reduced to 38 items representing seven factors, together accounting for 57·7% of the variance: (1) reliance on others and technology; (2) lack of time and interruptions; (3) ward culture; (4) lack of confidence; (5) lack of nursing role models; (6) lack of influence on patient care; and (7) specialty area. Internal reliability ranged from 0·70–0·86.Conclusion Findings provide initial evidence for the validity and reliability of the Barriers to Nurses’ use of Physical Assessment Scale and point to the importance of understanding the organizational determinants of nurses’ assessment practices. The new scale has potential clinical and research applications to support nursing assessment in acute care settings.
    Journal of Advanced Nursing 04/2014; 70(11). DOI:10.1111/jan.12408 · 1.74 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Tertiary nurse education programmes aim to produce novice nurses able to meet the Nursing and Midwifery Board of Australia competency standards for registration. On the other hand, employers expect graduate nurses to not only be competent and able to function safely and independently but also to be ready to “hit the ground running” in relation to providing clinical care. Aims The study aimed to explore the perceptions of third-year nursing students enrolled in their final semester with regard to their preparedness for practice. Method Following their last clinical placement, all third-year nursing students at a regional northern Australian university were emailed a link to an online version of the Casey-Fink Readiness for Practice Survey tool and invited to participate in the study. A total of 113 questionnaires were completed from the sample of 235, giving a response rate of 48%. Results The majority of students reported feeling prepared for practice and felt that simulation experiences were helpful in attaining this state. Confidence in caring for multiple patients was inversely associated with age indicating higher levels of confidence in younger nursing students. Expanded placements, increased use of simulation for clinical skills practice, smaller clinical skills class sizes and modern equipment were identified as areas for improvement to facilitate and enhance students’ levels of confidence and readiness for practice. Conclusions Students in this study highly valued clinical placements as a method of increasing their levels of perceived preparedness to practice independently after graduation. Caring for multiple patients involves a high level of complexity and a learning curve is indicated in which confidence and competence is likely to grow with experience.
    Collegian Journal of the Royal College of Nursing Australia 07/2014; DOI:10.1016/j.colegn.2014.05.003 · 1.18 Impact Factor
Show more