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Consensus on core skills for physical assessment on wards

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The core skills needed to carry out physical assessments of patients on general wards have been set out in new research based on the views of acute care nurses.

A team of nursing experts in Australia set out to identify the key elements of physical assessments in an effort to tackle inconsistency and boost patient safety.

“Current approaches to physical assessment are inconsistent and have not evolved to meet increased patient and system needs,” said their research paper, published in the Journal of Clinical Nursing.

“New models of assessment are needed in general wards that ensure a proactive and patient safety approach,” it added.

”Current approaches to physical assessment are inconsistent and have not evolved to meet increased patient and system needs”

Research paper on physical assessment skills

The team from the school of nursing at Queensland University of Technology and the Royal Brisbane and Women’s Hospital interviewed 150 acute care nurses establish a set of fundamental physical assessment skills.

Overall 40 different core skills were highlighted, which were then reviewed by a panel of 35 senior acute care nurses to decide which were the most important.

The panel agreed on 16 core skills, which include assessing a patient’s airway and level of consciousness, taking their temperature, measuring their respiratory rate, checking blood pressure with a stethoscope, checking their pulse, inspecting skin integrity, and assessing for pain.

”Despite decades of research and hospital resources invested…to prevent patient deterioration, outcomes have fallen short of expectations”

Research paper on physical assessment skills

The researchers said this was the first time the Delphi research method – which involves experts reaching a consensus – had been used to ask acute professionals about the assessment skills needed on general wards to spot signs of deterioration in a patient’s condition early on.

While the skills identified may seem obvious to clinicians, they argued nursing assessment was an area of practice, which has to date “been guided more by ritual than evidence”.

“Despite decades of research and hospital resources invested in current strategies to prevent patient deterioration, outcomes have fallen short of expectations and there is growing evidence of suboptimal care,” said the research paper, called Nursing physical assessment for patient safety in general wards: reaching consensus on core skills.

However, the authors suggested improving the quality of nursing assessments was one way to reverse this trend.

“Given that registered nurses are the professional group that carry the highest level of responsibility for patient assessment, we argue that supporting the quality of bedside nursing physical assessments will have the greatest impact on patient outcomes,” the paper concluded.

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Readers' comments (1)

  • And the planned 'Associate Nurse' will be carrying out these assessments. What does the Registered Nurse do?

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