The primacy of vital signs – Acute care nurses’ and midwives’ use of physical assessment skills: A cross sectional study

Osborne, Sonya; Douglas, Clint; Reid, Carol; Jones, Lee; Gardner, Glenn

doi:10.1016/j.ijnurstu.2015.01.014

Cited by 103 publications

(148 citation statements)

References 34 publications

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“…Despite it being essential to patient safety, surveillance has been reported along with other nursing activities (i.e., ambulation, oral hygiene) that are frequently missed in hospital settings (Osborne et al., 2015). While we found mixed evidence about the relationship between nurse‐reported measures of missed care and mortality, the potential of such negative outcome calls for an in‐depth look of the issues surrounding missed care in the form of inadequate patient surveillance and its consequences.…”

Section: Discussionmentioning

confidence: 99%

What impact does nursing care left undone have on patient outcomes? Review of the literature

Recio‐Saucedo

Dall’Ora

Maruotti

et al. 2017

Journal of Clinical Nursing

292

291

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Aims and objectivesSystematic review of the impact of missed nursing care on outcomes in adults, on acute hospital wards and in nursing homes.BackgroundA considerable body of evidence supports the hypothesis that lower levels of registered nurses on duty increase the likelihood of patients dying on hospital wards, and the risk of many aspects of care being either delayed or left undone (missed). However, the direct consequence of missed care remains unclear.DesignSystematic review.MethodsWe searched Medline (via Ovid), CINAHL (EBSCOhost) and Scopus for studies examining the association of missed nursing care and at least one patient outcome. Studies regarding registered nurses, healthcare assistants/support workers/nurses’ aides were retained. Only adult settings were included. Because of the nature of the review, qualitative studies, editorials, letters and commentaries were excluded. PRISMA guidelines were followed in reporting the review.ResultsFourteen studies reported associations between missed care and patient outcomes. Some studies were secondary analyses of a large parent study. Most of the studies used nurse or patient reports to capture outcomes, with some using administrative data. Four studies found significantly decreased patient satisfaction associated with missed care. Seven studies reported associations with one or more patient outcomes including medication errors, urinary tract infections, patient falls, pressure ulcers, critical incidents, quality of care and patient readmissions. Three studies investigated whether there was a link between missed care and mortality and from these results no clear associations emerged.ConclusionsThe review shows the modest evidence base of studies exploring missed care and patient outcomes generated mostly from nurse and patient self‐reported data. To support the assertion that nurse staffing levels and skill mix are associated with adverse outcomes as a result of missed care, more research that uses objective staffing and outcome measures is required.Relevance to clinical practiceAlthough nurses may exercise judgements in rationing care in the face of pressure, there are nonetheless adverse consequences for patients (ranging from poor experience of care to increased risk of infection, readmissions and complications due to critical incidents from undetected physiological deterioration). Hospitals should pay attention to nurses’ reports of missed care and consider routine monitoring as a quality and safety indicator.

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Section: Discussionmentioning

confidence: 99%

What impact does nursing care left undone have on patient outcomes? Review of the literature

Recio‐Saucedo

Dall’Ora

Maruotti

et al. 2017

Journal of Clinical Nursing

292

291

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“…The finding that nurses were routinely using vital sign-related physical assessment skills before the educational program is consistent with a previous study. [14,18] In their study on registered nurses and midwives, Osborne [18] identified a set of core skills that most nurses used all the time, including assessment of temperature, oxygen saturation, blood pressure, breathing effort, and skin, wound, and mental status.…”

Section: Frequency Of Use and Influencing Factorsmentioning

confidence: 99%

“…Recent studies on physical assessment in Austraria [16] and in Italy [17] skills have shown that about one-third of the skills learned in basic nursing education are used daily. Osborne [18] found that the core skills for acute care nurses and midwives mainly covered vital signs. The skills used also depend on nurses' areas of specialty.…”

Section: Introductionmentioning

confidence: 99%

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Effect of a physical assessment educational program on clinical practice

Mitoma¹,

Yamauchi

2018

JNEP

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Objective: This study aimed to investigate the effect of an educational program on physical assessment skills for registered nurses focusing on respiratory and cardiovascular systems. Methods: Design: Survey research using a self-administered questionnaire was used. Methods: The study was conducted in the physical assessment education program and the clinical settings. The study involved 104 registered nurses who completed a self-administered questionnaire, distributed immediately and 2 months after the physical assessment education program. The data were analyzed using the Wilcoxon signed-rank test. Results: The usage frequencies of 19 physical assessment skills increased after the educational program. The most frequently cited barrier to using these skills changed from a lack of knowledge to a lack of confidence and insufficient time. Before the program, the hospital nurses used their physical assessment skills more frequently than the home-visit nurses, but the reverse became true afterward. Nurses who recognized that they needed physical assessment skills that were learned through education showed a tendency to use these skills in nursing practice. Conclusions: These results suggest that the educational program on physical assessment skills affected the use of these skills in clinical practice for this study cohort for this study cohort.

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“…S4, S5, S6, and S9 are in line with this idea, indicating that observation, touch, and hearing are used as monitoring methods by assessing the patient's skin color, temperature, and respiratory pattern (depth and sounds). According to Osborne, Douglas, Reid, Jones, and Gardner (2015), although clinical deterioration requires other nursing interventions beyond the monitoring of vital signs, this was the most widely used nursing intervention. The authors believe that this finding is associated with the current focus on parameters specified by the RRSs, which could lead nurses to undervalue the performance of a more comprehensive patient assessment.…”

Section: Results and Interpretationmentioning

confidence: 99%

Nursing interventions for the early detection of ward patients’ clinical deterioration: an integrative review

Freitas¹,

Preto²,

Nascimento³

2017

Rev. Enf. Ref.

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Intervenções de enfermagem na monitorização da deterioração clínica da pessoa em enfermaria hospitalar: uma revisão integrativa Intervenciones de enfermería en la monitorización del deterioro clínico de la persona en enfermería hospitalaria: una revisión integradora Catarina Moura Freitas*; Emídio Polónio Preto**; Carla Alexandra Fernandes Nascimento*** AbstractBackground: Clinical deterioration is sometimes mishandled in hospital wards resulting in increased likelihood of cardiorespiratory arrest, unplanned intensive care admissions, and death. Objectives: To identify nursing interventions aimed at the early detection of the clinical deterioration of ward patients. Methodology: Integrative literature review through the search for published and gray literature in CINAHL, MEDLINE, and ScienceDirect databases. Results: A total of 534 documents were identified, of which 11 were selected for data extraction and analysis. Conclusion: The monitoring of vital signs, either individually or in combination or to obtain an early warning score, is the most widely performed nursing intervention identified in the literature.

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The primacy of vital signs – Acute care nurses’ and midwives’ use of physical assessment skills: A cross sectional study

Cited by 103 publications

References 34 publications

What impact does nursing care left undone have on patient outcomes? Review of the literature

What impact does nursing care left undone have on patient outcomes? Review of the literature

Effect of a physical assessment educational program on clinical practice

Nursing interventions for the early detection of ward patients’ clinical deterioration: an integrative review

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