What factors influence nurses' assessment practices? Development of the Barriers to Nurses' use of Physical Assessment Scale

Douglas, Clint; Osborne, Sonya; Reid, Carol; Batch, Mary; Hollingdrake, Olivia; Gardner, Glenn

doi:10.1111/jan.12408

Cited by 53 publications

(93 citation statements)

References 32 publications

(58 reference statements)

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“…) and therefore they must be able to undertake physical assessment effectively and escalate patient care needs accordingly (Douglas et al . ). Recognizing and responding to the deteriorating patient is complex, challenging and multifaceted.…”

Section: Discussionmentioning

confidence: 97%

What factors influence ward nurses’ recognition of and response to patient deterioration? An integrative review of the literature

2016

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AimIn this integrative review, we aimed to: first, identify and summarize published studies relating to ward nurses' recognition of and response to patient deterioration; second, to critically evaluate studies that described or appraised the practice of ward nurses in recognizing and responding to patient deterioration; and third, identify gaps in the literature for further research.DesignAn integrative review.MethodsThe Cumulative Index to Nursing and Allied Health Literature (CINAHL) Ovid Medline, Informit and Google Scholar databases were accessed for the years 1990–2014. Data were extracted and summarized in tables and then appraised using the Mixed Method Appraisal Tool. Data were grouped into two domains; recognizing and responding to deterioration and then thematic analysis was used to identify the emerging themes.ResultsSeventeen studies were reviewed and appraised. Recognizing patient deterioration was encapsulated in four themes: (1) assessing the patient; (2) knowing the patient; (3) education and (4) environmental factors. Responding to patient deterioration was encapsulated in three themes; (1) non‐technical skills; (2) access to support and (3) negative emotional responses.ConclusionIssues involved in timely recognition of and response to clinical deterioration remain complex, yet patient safety relies on nurses’ timely assessments and actions.

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Section: Discussionmentioning

confidence: 97%

What factors influence ward nurses’ recognition of and response to patient deterioration? An integrative review of the literature

2016

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“…The Barriers to Nurses' use of Physical Assessment Scale was recently developed and validated with a sample of Australian acute care nurses (Douglas et al ., ). In the current sample, factor analysis replicated a seven‐factor structure and the internal consistency of subscales ranged from 0.73–0.88.…”

Section: Methodsmentioning

confidence: 97%

Too much knowledge for a nurse? Use of physical assessment by final‐semester nursing students

Douglas

Windsor

Lewis

2015

Nursing & Health Sciences

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There is debate around the scope of physical assessment skills that should be taught in undergraduate nursing programs. Yet this debate is largely uninformed by evidence on what is learned and practiced by nursing students. This study examined the pattern and correlates of physical assessment skill utilization by 208 graduating nursing students at an Australian university, including measures of knowledge, frequency of use, and perceived barriers to physical assessment skills during clinical practice. Of the 126 skills surveyed, on average, only five were used every time students practiced. Core skills reflected inspection or general observation of the patient; none involved complex palpation, percussion, or auscultation. Skill utilization was also shaped by specialty area. Most skills (70%) were, on average, never performed or learned and students perceived nursing physical assessment was marginalized in both university and workplace contexts. Lack of confidence was, thus, a significant barrier to use of skills. Based on these findings, we argue that the current debate must shift to how we might best support students to integrate comprehensive physical assessment into nursing practice.

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“…These barriers include the perception that physical assessment is not a nursing responsibility, [17] lack of confidence, [22] and lack of time. [16,22] However, our study also showed for the first time that training can change nurses' attitudes toward physical assessment skills. …”

Section: Frequency Of Use and Influencing Factorsmentioning

confidence: 99%

“…Several factors have been found to constrain nurses' use of physical assessment skills, including lack of confidence, [22,23] lack of time, [16,22] lack of support from others, [23] and a perception that physical assessment is not a nursing responsibility. [17,23] One study revealed several barriers to nurses' use of physical assessment skills in acute hospitals, [22] including reliance on others and technology, ward culture, lack of nursing role models, and lack of influence on patient care.…”

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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What factors influence nurses' assessment practices? Development of the Barriers to Nurses' use of Physical Assessment Scale

Cited by 53 publications

References 32 publications

What factors influence ward nurses’ recognition of and response to patient deterioration? An integrative review of the literature

What factors influence ward nurses’ recognition of and response to patient deterioration? An integrative review of the literature

Too much knowledge for a nurse? Use of physical assessment by final‐semester nursing students

Effect of a physical assessment educational program on clinical practice

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