Nursing physical assessment skills: implications for UK practice

Abstract

The physical assessment skills of inspection, palpation, percussion and auscultation currently have only minimal recognition in UK nursing practice. Authors attest to perceived benefits in terms of continuity of care, holistic care delivery, rapidity of emergency intervention and reduction in junior doctors' hours and workload. However, the use of such skills by nurses has been subject to little in the way of formal outcome-based evaluation, and there is a clear need for such research to be carried out within the UK. Important guidelines exist within the literature to underpin educational programmes in physical assessment; these are reviewed and their implications for UK practice are considered. It is concluded that while generation of a UK evidence base is required, there is a persuasive argument to underpin continued development of physical assessment skills within UK nursing practice.

Physical assessment: whose role is it anyway?

“…The omission of physical assessment by nurses was noted in Australia in the late 1970s ( James and Reaby, 1987), when Australian nursing bodies established standards for nurse education, which included physical assessment, as assessment was seen as the vital phase of the nursing process. This also reflects similar experiences in America (Rushforth et al ., 1998). In UK, nursing has been slower to realize its importance.…”

“…Price et al . (2000) link the skill of physical assessment to advanced nursing practice, however, the author supports the view of Rushforth et al . (1998) in that physical assessment is now perhaps a natural progression of the nurses' role.…”

Advanced physical assessment skills: implementation of a module

“…Most felt that the last time they had done anatomy was in their pre-registration nursing. They all accepted that they required more on anatomy, physiology and patho-physiology as fundamental to the module (Rushforth et al, 1998). This highlighted that the students' educational needs were not considered at the start of the module, and that this had caused some participants considerable anxiety (Hudson and Moore, 2006).…”

Physical assessment: implications for nurse educators and nursing practice

“…In the United Kingdom, there is an ongoing debate on the appropriateness of physical assessment for RNs, with the argument centring on whether this is role expansion or role extension. Rushforth et al. (1998) warn ‘advocating an expansion of nurses physical assessment skills touches professional boundaries and sensitivities’ (p. 966) and nursing role expansion should be limited to the best interest of the client group as each nurse has only a ‘finite amount of time in which to deliver client care’ (p. 968).…”

“…. possible psychological benefits for patients/clients in being assessed by practitioners with whom they have developed a rapport’ (Rushforth et al. 1998, p. 970) and ‘nurse assessors can contribute effectively towards immediate patient management by rationalizing their “gut instincts”, and communicating clinical information in a standard format’ (Price et al.…”