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Choueiry J, Chartrand J, Harrison D, Don A. Pain care for children with cognitive impairment: A parent-nurse partnership. J Pediatr Nurs 2024; 77:e139-e149. [PMID: 38599999 DOI: 10.1016/j.pedn.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 03/14/2024] [Accepted: 04/01/2024] [Indexed: 04/12/2024]
Abstract
PURPOSE To explore nurses' experiences of establishing partnerships with parents for pain care of hospitalized children with cognitive impairment (CI) and identify related facilitators and barriers. DESIGN AND METHODS In this qualitative, interpretive descriptive study, individual semi-structured interviews were conducted via videoconferencing with pediatric nurses from inpatient wards in a Canadian pediatric quaternary hospital. Verbatim transcripts were analyzed using an inductive, data-driven thematic analysis approach. RESULTS Eleven nurses were interviewed. The overarching theme was Assessing Pain as an Outsider: "A Complete Guessing Game". Seven major themes were identified.: Relying on Parent Expertise for Pain Assessment, Brainstorming with Parents for Pain Treatment, Supporting Parents as Advocates for Pain Care, Individualizing Pain Care with Parents, Involving the Child in Pain Care: A Spectrum, Barriers to Partnership in Pain Care and Facilitators to Partnership in Pain Care. CONCLUSIONS Nurses described the many ways they involve parents as partners in pain care. However, nurses shared strong feelings of uncertainty associated with pain care in children with CI. Consequently, nurses felt the need to rely on parents for appropriately assessing and treating pain in children with CI. Findings highlighted the practice and education gaps that may contribute to nurses' uncertainty and reliance on parents. PRACTICE IMPLICATIONS By identifying related practice and education gaps, healthcare organizations can implement strategies to further support nurses in establishing partnerships and potentially optimize pain care practices.
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Affiliation(s)
- Juliana Choueiry
- School of Nursing, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada; Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario K1H 8L1, Canada; Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario K1H 8L1, Canada.
| | - Julie Chartrand
- School of Nursing, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada; Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario K1H 8L1, Canada
| | - Denise Harrison
- School of Nursing, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada; Department of Nursing, Melbourne School of Health Sciences, The University of Melbourne, 161 Barry Street, Carlton, Victoria 3053, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria 3053, Australia
| | - Anna Don
- School of Nursing, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada; Department of Nursing, School of Health, and Community Studies, Algonquin College, 1385 Woodroffe Ave, K2G 1V8 Ottawa, Ontario, Canada
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Salifu MA, Salifu DA, Gross J. Registered general nurses' health assessment practices in a tertiary hospital: A focused ethnography study. Nurs Open 2024; 11:e2237. [PMID: 38957916 PMCID: PMC11220405 DOI: 10.1002/nop2.2237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 01/01/2024] [Accepted: 06/21/2024] [Indexed: 07/04/2024] Open
Abstract
AIM To explore the assumptions and values that influence nursing health assessment practices among registered general nurses in general medical and surgical wards. DESIGN The study was designed as a focused ethnography. METHODS A semi-structured interview guide was used to explore prevailing nursing health assessment practices of 13 registered general nurses in an attempt to explore the assumptions and values influencing health assessment practices in the study setting. Data were analysed inductively using an interpretive qualitative content analysis method. RESULTS Nursing health assessment practices, and underlying assumptions and values were underpinned by a central theme of a culture of low expectation relating to nursing health assessment. The culture of low expectation was highlighted in five themes: (1) Unsystematic Assessment of Health Status, (2) Purpose of Nursing Health Assessment, (3) The Role of Nursing Educational and Regulatory Institutions, (4) Ward Ethos and (5) The Role of Organizational and Ward Leadership. IMPLICATION The adoption of a holistic nursing health assessment framework with a clearly defined purpose of aiding nursing diagnoses can guide patient-centred care delivery and facilitate early recognition of physiological deterioration. PATIENT OR PUBLIC CONTRIBUTION Thirteen registered general nurses were interviewed, and the initial findings returned to them for validation. CONCLUSION The potential contribution of nursing health assessment to nursing practice and patient outcomes may not be fully realized if nursing health assessment is not situated within a holistic health assessment model with a clearly defined purpose for nursing practice.
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Affiliation(s)
| | | | - Janet Gross
- Mother Patern College of Health SciencesStella Maris Polytechnic UniversityMonroviaLiberia
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3
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Möller M, Grosse UC, Waldboth V. [The implementation of clinical assessment by nurses in Switzerland: A cross-sectional study from the nursing perspective]. Pflege 2024. [PMID: 38778756 DOI: 10.1024/1012-5302/a001000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
The implementation of clinical assessment by nurses in Switzerland: A cross-sectional study from the nursing perspective Abstract: Background: Clinical assessment is a core competency of BSc and MSc prepared nurses in Switzerland. However, influencing factors of its implementation and the experience in the interprofessional team has been studied little so far. Objective: The aim of this study was to explore how often clinical assessment skills are used by BSc and MSc graduated nurses in Switzerland, to identify facilitating and hindering factors for implementation and to investigate the nurses experience of the implementation in the interprofessional team. Method: We used an exploratory, descriptive research design employing a cross-sectional study of the convenience sample of BScN and MScN graduates in Switzerland. 264 questionnaires were analysed quantitatively and 149 written statements as part of the survey qualitatively. Results: Respondents indicated that they routinely only use 18.9% of the 53 assessment skills they were trained in. The "respiratory system", "abdomen", "skin" and "mental status" were used most frequently. MScN graduates use respiratory assessments and BScN graduates use abdominal assessments more frequently. Lack of time and interruptions, lack of influence on patient care and specialty specific skills are hindering factors for the implementation. Better conditions at the institutional level and appreciation within the interprofessional team can make an encouraging contribution in future. Conclusion: This study illustrates, that the theory-practice transfer of clinical assessment in Switzerland needs to be further promoted.
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Affiliation(s)
- Marius Möller
- Institut Pflege, Departement Gesundheit, Zürcher Hochschule für Angewandte Wissenschaften, Winterthur, Schweiz
| | - Uta Christine Grosse
- Institut Pflege, Departement Gesundheit, Zürcher Hochschule für Angewandte Wissenschaften, Winterthur, Schweiz
| | - Veronika Waldboth
- Institut Pflege, Departement Gesundheit, Zürcher Hochschule für Angewandte Wissenschaften, Winterthur, Schweiz
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Byermoen KR, Brembo EA, Egilsdottir HÖ, Eide T, Heyn LG, Moen A, Eide H. Newly graduated nurses use and further development of assessment skills-An in-depth qualitative study. J Adv Nurs 2023; 79:3286-3298. [PMID: 36876732 DOI: 10.1111/jan.15631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/29/2023] [Accepted: 02/19/2023] [Indexed: 03/07/2023]
Abstract
AIMS To explore in-depth nurses' use and further development of assessment skills in different nursing contexts in the first 2 years after graduation, and factors that influenced their use and development of assessment skills. DESIGN The study had explorative qualitative design. METHODS Eight nurses who previously had been interviewed about their learning of physical assessment skills in clinical rotation as students participated in this follow-up study. Individual in-depth interviews were conducted, where the nurses spoke freely about their experiences after graduation. RESULTS Four prominent features influencing the nurses' use and development of assessment skills were identified: (a) assessment approaches and readiness for practice, (b) the primacy of communication, (c) recognition related to performing assessments, and (d) the influence of organizational factors on their assessment applications. CONCLUSION Newly graduated nurses' use of assessment skills is an important part of providing holistic care. This study suggest that assessment skills is not only an assessment task but is central in relationship building and in supporting the professional development of nursing competence. PATIENT OR PUBLIC CONTRIBUTION No Patient or Public Contribution, due to study design.
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Affiliation(s)
- Kirsten Røland Byermoen
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Espen Andreas Brembo
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - H Ösp Egilsdottir
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Tom Eide
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Lena Günterberg Heyn
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Anne Moen
- Faculty of Medicine, Department of Public Health Sciences, Institute for Health and Society, University of Oslo, Oslo, Norway
| | - Hilde Eide
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
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Bradley CS, Bliss DZ, Becker A, Olson ET, Flaten C, Gurvich OV, Muehlbauer M, Condon J, Bauer J. Development and Evaluation of a Wearable Simulator System. Clin Simul Nurs 2023; 81:101428. [PMID: 38053582 PMCID: PMC10695350 DOI: 10.1016/j.ecns.2023.101428] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
Background Peer physical examination is a clinical teaching-learning approach used for decades because of the convenient sample of peers for practicing. However, this approach has limitations when learning to assess abnormalities and threatens psychologically safe learning. A wearable simulator system was designed for learning physical examination skills to minimize ethical and learning challenges. Sample The sample consisted of fifty prelicensure nursing students and ten faculty in an upper Midwest university. Method The wearable simulator was constructed into a vest with RFID tags and ribcage landmarks. An observational, evaluative design was used for participants to rate seven categories during a one-hour evaluation session of the wearable simulator worn by a standardized patient trained to portray an individual with pneumonia. Results Satisfaction was rated highly among participants. More than 80% of student participants indicated the wearable simulator promotes privacy and reduces embarrassment. Conclusion The wearable simulator system offers a promising teaching-learning alternative with scenario-specific auscultation and palpation feedback to provide a safe, repeatable, and consistent simulation experience.
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Affiliation(s)
| | - Donna Z Bliss
- University of Minnesota School of Nursing, 308 Harvard Street S.E., Minneapolis, MN 55455, USA
| | - Adam Becker
- Innovative Design Labs, Inc., Minneapolis, Minnesota, USA, 861 E Hennepin Ave Suite 350, Minneapolis, MN 55414, USA
| | - Erica Timko Olson
- University of Minnesota School of Nursing, 308 Harvard Street S.E., Minneapolis, MN 55455, USA
| | - Carol Flaten
- University of Minnesota School of Nursing, 308 Harvard Street S.E., Minneapolis, MN 55455, USA
| | - Olga V Gurvich
- University of Minnesota School of Nursing, 308 Harvard Street S.E., Minneapolis, MN 55455, USA
| | - Marshall Muehlbauer
- University of Minnesota School of Nursing, 308 Harvard Street S.E., Minneapolis, MN 55455, USA
| | - John Condon
- Innovative Design Labs, Inc., Minneapolis, Minnesota, USA, 861 E Hennepin Ave Suite 350, Minneapolis, MN 55414, USA
| | - Jeremiah Bauer
- Realityworks Inc., 2709 Mondovi Rd, Eau Claire, WI 54701, USA
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Egilsdottir HÖ, Heyn LG, Falk RS, Brembo EA, Byermoen KR, Moen A, Eide H. Factors associated with changes in students' self-reported nursing competence after clinical rotations: a quantitative cohort study. BMC MEDICAL EDUCATION 2023; 23:107. [PMID: 36774493 PMCID: PMC9922443 DOI: 10.1186/s12909-023-04078-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The quality of nursing care in different healthcare contexts can be associated with the level of available nursing competence. Physical assessment skills are vital in nurses' assessment of patient care needs. However, in nursing education, using physical assessment skills is challenging for nursing students who struggle to apply these skills comprehensively in a clinical rotation. Therefore, this study explores changes in nursing competence, factors associated with changes after clinical rotations, and whether a Suite of Mobile Learning Tools supports changes in confident use of basic physical assessment skills. METHODS A quantitative cohort study with an explorative pre-and post-test design. During autumn 2019 and spring 2020, 72 s-year nursing students and 99 third-year students participated in the study. The Nurse Professional Competence scale short form was used to investigate students' self-reported changes in nursing competence, and a study-specific questionnaire was used to investigate students' confidence concerning performing physical assessments. The students voluntarily used the Suite of Mobile Learning Tools for the learning of physical assessment. Linear regression analysis was used to identify factors associated with changes in nursing competence after clinical rotation. The STROBE guidelines for cohort studies were followed for study reporting. RESULTS After the clinical rotation, both student groups reported changes in nursing competence and confidence in performing physical assessment skills, with statistically significant moderate or large changes in all areas. The Suite of Mobile Learning Tools was evaluated as being useful for learning physical assessment. The regression analysis showed that confidence in performing physical assessment skills, the usefulness of the Suite of Mobile Learning Tools, and a higher nursing competence at the start of clinical rotation were positively associated with overall nursing competence. CONCLUSION Basic physical assessment skills are an important component of nursing competence and can be considered one of the pillars of person-centered care, as proposed by the Fundamentals of Care framework. Spaced repetition and access to digital resources are suggested pedagogical approaches to enhance student confidence in the use of assessment skills within academic and clinical contexts.
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Affiliation(s)
- H Ösp Egilsdottir
- Centre for Health and Technology, Faculty of Health and Social Sciences, Institute for Nursing and Health Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway.
| | - Lena Günterberg Heyn
- Centre for Health and Technology, Faculty of Health and Social Sciences, Institute for Nursing and Health Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway
| | - Ragnhild Sørum Falk
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
- Faculty of Health and Social Sciences, Institute for Nursing and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway
| | - Espen Andreas Brembo
- Centre for Health and Technology, Faculty of Health and Social Sciences, Institute for Nursing and Health Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway
| | - Kirsten Røland Byermoen
- Centre for Health and Technology, Faculty of Health and Social Sciences, Institute for Nursing and Health Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway
| | - Anne Moen
- Institute for Health and Society, Faculty of Medicine, University of Oslo, Forskningsveien 2B, 0371, Oslo, Norway
| | - Hilde Eide
- Centre for Health and Technology, Faculty of Health and Social Sciences, Institute for Nursing and Health Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway
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Currie J, Thompson C, Grootemaat P, Andersen P, Finnegan A, Carter M, Halcomb E. A scoping review of clinical skill development of preregistration registered nurses in Australia and five other English-speaking countries. J Clin Nurs 2023; 32:283-297. [PMID: 35146817 PMCID: PMC10078692 DOI: 10.1111/jocn.16239] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/06/2022] [Accepted: 01/14/2022] [Indexed: 12/14/2022]
Abstract
AIM The aim of this scoping review is to synthesise current evidence around the clinical skill development of preregistration registered nurses (RNs) in Australia, United Kingdom (UK), Ireland, United States (US), Canada and New Zealand, to inform nurse education, policy and clinical practice. BACKGROUND Nursing is a practical profession, and registered nurses require specific skills, knowledge and attributes in order to care for patients safely. The context for health care delivery is shifting, and the education of nurses must adapt to effectively equip the registered nurse of the future. DESIGN A scoping review was conducted of clinical skill development in preregistration nurses. CINAHL Plus, MEDLINE, Health Source (Nursing/Academic edition) and Scopus were searched. Included studies were primary Australian studies and international literature reviews, which focussed on preregistration nursing education. Papers were written in the English language and focussed on clinical skill development. Results were synthesised narratively. The review is reported here in accordance with the Preferred Reporting Items for Systematic Review and Meta-analyses Scoping Review extension (PRISMA-ScR) guidelines. RESULTS One hundred fifty-five Australia studies and 89 international reviews were included in the review. Six key themes were identified, namely clinical skills, approaches to teaching and learning, interprofessional education, assessment of learning, clinical placement and simulation. CONCLUSION There is substantial variation in strategies and programmes to facilitate clinical skill development both within Australia and internationally, indicating a genuine shift away from traditional didactic pedagogy. New graduate registered nurses were expected to be "work-ready," albeit at a novice level, when they enter the workplace. Future research should consider measures of impact on actual clinical practice and focus on developing work-ready graduates for the range of clinical settings in which they may practice. Educators, policymakers and educational institutions can use these findings to inform curriculum developments to ensure that clinical skill development is evidence-based.
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Affiliation(s)
- Jane Currie
- Queensland University of Technology, Kelvin Grove Campus, Brisbane, Queensland, Australia.,Susan Wakil School of Nursing & Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Cristina Thompson
- Centre for Health Service Development, Australian Health Services Research Institute, University of Wollongong, New South Wales, Australia
| | - Pam Grootemaat
- Centre for Health Service Development, Australian Health Services Research Institute, University of Wollongong, New South Wales, Australia
| | - Patrea Andersen
- Centre for Health and Social Practice, Waikato Institute of Technology, Hamilton, New Zealand.,School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Queensland, Australia.,School of Nursing, Midwifery and Social Science, CQ University, Queensland, Australia
| | - Alan Finnegan
- University of Chester, Riverside Campus, Chester, UK
| | - Michael Carter
- University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Elizabeth Halcomb
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
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Qi Tan AJ, Chua WL, McKenna L, Chin Tan LL, Lim YJ, Liaw SY. Enablers and barriers to nurse-facilitated geriatric teleconsultations in nursing homes: a qualitative descriptive multi-site study. Age Ageing 2022; 51:6936403. [PMID: 36580553 DOI: 10.1093/ageing/afac268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 08/25/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Nurses play a major role in facilitating teleconsultations in nursing homes with remote physicians. Currently, evidence explicating their role in teleconsultations is lacking. As telemedicine usage grows, understanding the factors that enable or impede nurses' role in teleconsultations allows for more support in the provision of patient care through this modality. OBJECTIVE This study sought to explore enablers and barriers nurses faced in facilitating geriatric teleconsultations in nursing homes. METHODS A qualitative descriptive study using semi-structured interviews was conducted in Singapore, from July to November 2021. Purposive sampling of nursing home nurses was undertaken. Data were inductively analysed using Braun and Clarke's thematic analysis approach. RESULTS Twenty-two nursing home nurses participated in the study. Six key themes were identified as enablers and barriers in nurse-facilitated geriatrics teleconsultations. Enablers included nurses' acknowledgement of teleconsultations as needs-orientated service, close partnership with the hospital-based geriatric service for training and workflow support and nurses' sense of empowerment in teleconsultation involvement. Barriers that existed were the nurses' lack of confidence in physical assessment and communication competencies, role conflict due to nurses' perceived inability to meet physicians' expectations and limited scope of practice in performing teleconsultation-related tasks and the presence of technology-related challenges. CONCLUSION The identification of enablers and barriers in teleconsultations for nursing home residents provides insights for future research and development in telemedicine-related implementation and educational interventions in long-term care. Developing strong partnerships between telemedicine providers and nursing homes, further enhancement of nurses' telemedicine competencies and optimising digital infrastructure are warranted.
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Affiliation(s)
- Apphia Jia Qi Tan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wei Ling Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lisa McKenna
- School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
| | - Laurence Lean Chin Tan
- Division of Palliative and Supportive Care, Department of Geriatric Medicine, Yishun Health, Singapore.,GeriCare@North, Yishun Health, Singapore
| | - Yu Jun Lim
- GeriCare@North, Yishun Health, Singapore
| | - Sok Ying Liaw
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Hansen MT, Olsen RM, Brynhildsen S, Leonardsen A. Nursing students' perceived stress, self-efficacy, control and evaluation of a course in systematic clinical observation, physical assessment and decision-making: An observational study in Norway. Nurs Open 2022; 10:1007-1015. [PMID: 36126110 PMCID: PMC9834509 DOI: 10.1002/nop2.1368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 12/14/2021] [Accepted: 08/30/2022] [Indexed: 01/16/2023] Open
Abstract
AIM Simulation-based nursing education interventions have a strong educational effect on psychomotoric skills, but students may experience physiological stress and anxiety during simulation. The aims of this study were to explore (1) nursing students' perceived stress, self-efficacy, control and evaluation before and after simulation as part a structured course in physical assessment, (2) whether factors such as gender, age or previous work experience were associated with perceived stress during simulation and (3) nursing students evaluation of the course. DESIGN An observational, cross-sectional study before and after simulation and a course in physical assessment. METHODS We utilized "the Self-Assessment Manikin for measuring emotion" before and after simulation, a questionnaire to identify symptoms of stress after simulation, and a questionnaire to evaluate the physical assessment course. RESULTS A total of 59 students participated. Students perceived stress before simulation but reported a lower degree of activation, a more positive mood, increased feeling of control and self-efficacy after the simulation. They also felt more secure about their assessments. Even though students reported of several symptoms of stress before simluation, the course increased students' self-reported competence and feeling of security.
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Affiliation(s)
| | | | - Siri Brynhildsen
- Department of Health and WelfareØstfold University CollegeHaldenNorway
| | - Ann‐Chatrin Linqvist Leonardsen
- Department of Health and WelfareØstfold University CollegeHaldenNorway,Department of AnesthesiaØstfold Hospital TrustGrålumNorway
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10
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Yang TY, Huang CH, An C, Weng LC. Construction and evaluation of a 360 degrees panoramic video on the physical examination of nursing students. Nurse Educ Pract 2022; 63:103372. [DOI: 10.1016/j.nepr.2022.103372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 04/22/2022] [Accepted: 05/20/2022] [Indexed: 12/01/2022]
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Byermoen KR, Eide T, Egilsdottir HÖ, Eide H, Heyn LG, Moen A, Brembo EA. Nursing students' development of using physical assessment in clinical rotation-a stimulated recall study. BMC Nurs 2022; 21:110. [PMID: 35538573 PMCID: PMC9087917 DOI: 10.1186/s12912-022-00879-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 04/19/2022] [Indexed: 11/10/2022] Open
Abstract
Background The overall aim of this study was to explore third-year bachelor nursing students’ stimulated recall reflections on their physical assessment competence development. The choice of learning strategies in nursing education seems to have great impact on nursing students’ use of physical assessment skills while in clinical rotation. There is a need to explore nursing students’ learning processes related to the use of physical assessments. Methods Explorative qualitative design using a triangulation of data collection methods. Nine final-year nursing students’ physical assessment performances during patient encounters were audio-taped and observed. Shortly after, an individual stimulated recall interview based on the audio-recorded patient encounter and observation notes was conducted. A two-fold analysis was conducted: 1) analysis of students’ performed assessments, and 2) phenomenological hermeneutical analysis of the stimulated recall interviews. Results Nursing students assessments shifted from a checklist approach to a symptom-based, more holistic and person-centred approach, emphasizing conversation as part of their assessments. The nursing students also reported that a safe and stimulating learning environment was a prominent feature for their continuing development. Learning from skilled role models with expectations to them using physical assessment skills facilitated their continuing skills appliance, interprofessional communication and reflective practice. Conclusions This study contribute with a novel, comprehensive and in-depth description of what influenced nursing students’ learning processes experiences of using physical assessment skills during clinical rotation. The results reveal the need for targeted course designs by implementing scaffolded learning activities in practical and theoretical courses aimed at strengthening students’ learning of physical assessment skills—building upon and emphasizing their prior knowledge and competence, which may lead to more confident registered nurses and promote patient safety in different health care contexts. We propose using stimulated recall systematically as a novel reflective learning activity in nursing education to foster clinical reasoning and metacognition skills and achieve deep learning.
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Affiliation(s)
- Kirsten Røland Byermoen
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway.
| | - Tom Eide
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway
| | - H Ösp Egilsdottir
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway
| | - Hilde Eide
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway
| | - Lena Günterberg Heyn
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway
| | - Anne Moen
- Department of Nursing Science, Faculty of Medicine, University of Oslo, Forskningsveien 2B, 0371, Oslo, Norway
| | - Espen Andreas Brembo
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway
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12
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Baixinho CL, Ferreira Ó, Medeiros M, de Oliveira ESF. From Evidence Synthesis to Transfer: Results from a Qualitative Case Study with the Perspectives of Participants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095650. [PMID: 35565044 PMCID: PMC9105498 DOI: 10.3390/ijerph19095650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/03/2022] [Accepted: 05/05/2022] [Indexed: 12/04/2022]
Abstract
The increase in health research brings challenges to the production, synthesis, and use of research findings in clinical practice. In the case of undergraduate training in nursing, it is necessary to think about the curricular contents and create opportunities to develop skills for learning evidence-based practice. The objective of this study was to analyze nurses’ perspectives regarding the effects of their participation in a project of translation of knowledge into clinical practice during undergraduate nursing education, specifically involving knowledge, attitudes, and competencies related to the use of evidence. This is a qualitative case study grounded in the knowledge-to-action theoretical framework. The participants were 13 nurses who were involved in a project about the translation of knowledge into clinical practice during the last term of their undergraduate course. The data were collected by applying interviews between December 2020 and April 2021. Content analysis was carried out by using the qualitative data analysis software tool webQDA®. The following categories emerged from the content analysis carried out on the material gathered during the interviews: understanding evidence; learning how to use evidence; transferring evidence; adjusting to the context; and observing the advantages of evidence-based practice. Extracurricular activities were perceived as an opportunity to understand what evidence is and observe in loco the advantages of health care for clients, teams, and services. During the project, the participants developed cross-sectional competencies and envisaged changes to their professional activity as a result of changes in their attitude regarding evidence and its use. We concluded that the opportunity to develop evidence-related activities allows for the development of skills and influences the attitude towards evidence-based practice and knowledge use.
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Affiliation(s)
- Cristina Lavareda Baixinho
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, 1900-160 Lisbon, Portugal;
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, 2410-541 Leiria, Portugal
- Correspondence: ; Tel.: +351-933254269
| | - Óscar Ferreira
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, 1900-160 Lisbon, Portugal;
| | - Marcelo Medeiros
- Nursing School, Federal University of Goiás, Goiânia 74690-900, Brazil;
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Nasaif H, Alaradi M, Alansari A, Jassim G. Validation of Physical Examination Perceived Self-Efficacy Instrument for Undergraduate Nursing Students. J Nurs Educ 2022; 61:36-40. [PMID: 35025674 DOI: 10.3928/01484834-20211130-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Numerous studies have revealed that nursing students perceive lack of confidence as one of the key barriers to performing physical examination; however, it is not empirically measured. This study aimed to test the psychometric properties of the Physical Examination Perceived Self-Efficacy Instrument. METHOD The study included three phases: in Phase 1, 51 items were constructed; in Phase 2, 7 field experts rated items for relevancy; and in Phase 3, the instrument was piloted to a convenience sample of 238 students. RESULTS The analysis yielded six factors with a factor loading >0.40. The corrected item-total correlation ranged from 0.6 to 0.87. Cronbach's alpha ranged from .84 to .98. The interscale correlation of the instrument was statistically significant (p < .001). CONCLUSION We found that the instrument is a psychometrically robust measure of self-efficacy of performing physical examination. The instrument could provide a better understanding of the association between perceived self-efficacy and students' academic performance. [J Nurs Educ. 2022;61(1):36-40.].
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Chen SL, Liu CC. Development and evaluation of a physical examination and health assessment course. NURSE EDUCATION TODAY 2021; 107:105116. [PMID: 34481313 DOI: 10.1016/j.nedt.2021.105116] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/09/2021] [Accepted: 08/24/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Physical examination and health assessment skills are essential components of nursing practice, and the critical elements to be taught merit further investigation. OBJECTIVES To develop and evaluate a physical examination and health assessment course based on a self-directed learning framework. DESIGN An action research design was employed. SETTINGS A baccalaureate nursing program of the university of science and technology in central Taiwan. PARTICIPANTS A convenience sample comprising 23 teaching faculty members and 41 enrolled second-year students was recruited. METHODS Structured questionnaires were developed for data collection. A paired t-test and the Kruskal-Wallis test were used for data analysis. RESULTS The course consisted of four parts: health history taking from a holistic perspective, examination skills in diverse systems, case exercise and discussion, and final objective structured clinical examination. Statistical significance was found in the areas of physical examination skills, critical thinking, and case analysis. Participants with mid-to high-level self-directed learning had significantly higher scores than those with low-level self-directed learning on physical examination skills and problem assessment. Internal and discriminant validity were supported. CONCLUSION The study results provide evidence supporting the use of self-directed learning framework in curriculum design. The course integrated necessary knowledge and skills enabled students to practice physical examination, and assessment skills may enhance student confidence in approaching patients in clinical encounters. However, the study was a descriptive design. The generalization of the results needs to be further validated by an experimental study.
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Affiliation(s)
- Shiah-Lian Chen
- Department of Nursing, National Taichung University of Science and Technology, Room 415-4, 193, Sec. 1, Sanmin Rd., Taichung 403, Taiwan.
| | - Chien-Chi Liu
- Department of Nursing, National Taichung University of Science and Technology, Room 415-4, 193, Sec. 1, Sanmin Rd., Taichung 403, Taiwan.
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Morrell S, Giannotti N, Pittman G, Mulcaster A. Physical assessment skills taught in nursing curricula: a scoping review. JBI Evid Synth 2021; 19:2929-2957. [PMID: 34100826 DOI: 10.11124/jbies-20-00086] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This scoping review sought to establish the current state of knowledge regarding physical assessment skills taught globally in undergraduate nursing curricula. Explicitly, the review aimed to determine which skills are being taught via curricula and which skills are performed by students in clinical placements, as well as what physical assessment skills are being used by registered nurses in practice. INTRODUCTION Nursing programs are expected to teach the physical assessment skills required for entry-level registered nurses to practice competently. The discrepancy lies in determining which skills are essential to teach entry-level nurses and which are unessential. INCLUSION CRITERIA Studies that examined physical assessment skills taught to students in any undergraduate registered nursing program or used by registered nurses in practice were considered. Physical assessments included all techniques or skills taught in any year of a university or college teaching global registered nursing curricula. METHODS Databases searched included MEDLINE (Ovid), CINAHL Complete (EBSCO), Scopus, and Cochrane Central Register of Controlled Trials (Ovid). Sources of unpublished studies included ProQuest Dissertations and Theses Global, OpenGrey, Open Access Theses and Dissertations, and Google Scholar. Studies published in English between January 2008 and November 2019 were included. Two independent reviewers screened titles and abstracts. Studies meeting the inclusion criteria were imported into the Covidence systematic review manager. Extracted data were presented in a descriptive format, including characteristics of included studies and relevant key findings. RESULTS Thirteen records were extracted for synthesis: one integrated review, one author reflection, one mixed methods study, and 10 quantitative studies. The sources represented a global context: the United States, New Zealand, Turkey, Australia, Norway, Korea, Italy, and one of unknown origin. Three studies examined physical assessment skills routinely taught in global nursing curricula. Three studies explored physical assessment skills routinely used by students during nursing programs. Seven studies examined which physical assessment skills were routinely performed by registered nurses in practice. In the studies, there were 98 to 122 physical assessment skills taught in global nursing programs. However, only 33 skills were routinely taught in curricula, and of those, only 20 were the same across all studies (core skills). Students in nursing programs routinely performed 30 physical assessment skills, and six of the 30 skills were the same across all studies (core skills). Of the six core skills routinely performed by students, five were also routinely taught in nursing curricula in the included studies. Registered nurses routinely performed 39 physical assessment skills, and 11 skills were the same across all studies (core skills). Ten of the physical assessment skills taught in curricula were routinely performed by registered nurses in practice. CONCLUSION This scoping review provides insight into physical assessment skills taught in nursing curricula and used by registered nurses in practice. This knowledge is essential for curriculum revisions and planning as it provides insight on how to best meet the needs of future nursing students.
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Affiliation(s)
- Sherry Morrell
- Faculty of Nursing, University of Windsor, Windsor, ON, Canada.,Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada
| | | | - Gina Pittman
- Faculty of Nursing, University of Windsor, Windsor, ON, Canada.,Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada
| | - Adam Mulcaster
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada.,Leddy Library, University of Windsor, Windsor, ON, Canada
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Kinyon K, D’Alton S, Poston K, Navarrete S. Improving Physical Assessment and Clinical Judgment Skills without Increasing Content in a Prelicensure Nursing Health Assessment Course. NURSING REPORTS 2021; 11:600-607. [PMID: 34968335 PMCID: PMC8608134 DOI: 10.3390/nursrep11030057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 11/19/2022] Open
Abstract
One hundred twenty-six assessment skills are taught in prelicensure nursing health assessment courses, yet 30 skills are used on a routine basis in practice. New nurses struggle to apply their acquired knowledge in clinical settings. Method: A literature review was completed. Based on the results, a first semester health assessment course in a southeastern accelerated baccalaureate nursing program was redesigned. Lectures and skills labs were adjusted to focus on the most critical assessment skills. To foster critical thinking and clinical judgement, a health assessment post conference was added where students completed concept maps, system specific case studies, nursing priority setting, and patient teaching plans. Results: Outcome surveys were completed by second semester faculty. Prior to course adjustments, 33 percent of students did not meet the benchmark. Following course changes, all students met or exceeded the benchmark. Conclusion: Focusing on critical assessment skills will increase student nurses’ ability to deliver safe patient care.
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Practices and Barriers towards Physical Assessment among Nurses Working in Intensive Care Units: Multicenter Cross-Sectional Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5524676. [PMID: 34337020 PMCID: PMC8294977 DOI: 10.1155/2021/5524676] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 06/05/2021] [Accepted: 07/01/2021] [Indexed: 12/03/2022]
Abstract
Background In the intensive care units, patients need special consideration and monitor frequently with appropriate physical assessment skills. Nurses working in the intensive care units play a fundamental role in detecting patients at risk of deterioration through ongoing assessment and action in response to changing health status. Most of the nursing activities were poorly assessed in low-income countries including Ethiopia. Therefore, this study was aimed to assess the nurses' practice and barriers to physical assessment among critically ill patients in Northwest Ethiopia. Methods An institution-based multicenter cross-sectional study was conducted at Amhara regional state referral hospitals from March to September 2019. A total of 299 nurses working in the intensive care units were recruited through the convenience sampling method. A 30-item physical assessment practice and 36-item barriers to nurses' use of the physical assessment scale inventory were used. The linear regression analysis model was fitted, and the adjusted unstandardized beta (β) coefficient with a 95% confidence interval was used. A p value < 0.05 was considered statistically significant. Results The mean score of the nurses' practice towards physical assessment among critically ill patients was 101.26 ± 24.99. Greater perceived reliance on others and technology (β = −0.78, 95% CI (-1.07, -0.48)), ward culture (β = −0.48, 95% CI (-0.85, -0.11)), specialty area (β = −1.46, 95% CI (-2.01, -0.90)), lack of nursing role model (β = −0.54, 95% CI (-1.06, -0.02)), being unmarried (β = −6.10, 95% CI (1.75, 10.46)), taken training (β = 11.53, 95% CI (6.34, 16.72)), and knowledge score (β = 2.81, 95% CI (2.00, 3.63)) were the factors significantly associated with the nurses' practice score towards physical assessment. Reliance on others and technology towards physical assessment practice was the most important barrier followed by ward culture and specialty area. Conclusion Nurses working in the intensive care units had a good practice towards physical assessment among critically ill patients. Hence, to increase the practice towards physical assessment in intensive care settings, especially for married nurses, experienced critical care nurses, and specialist professionals, practice support training, modifying ward environment, and educational support care are recommended.
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Turan N, Özsaban A, Aydın GÖ, Türkoğlu M, Kaya H, Acaroğlu R. Reliability and validity of the Turkish version of the Barriers to Nurses' Use of Physical Assessment scale. Int J Nurs Pract 2021; 28:e12935. [PMID: 33893700 DOI: 10.1111/ijn.12935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 02/24/2021] [Accepted: 02/26/2021] [Indexed: 11/30/2022]
Abstract
AIM This study aimed to translate the Barriers to Nurses' Use of Physical Assessment Scale into Turkish and assess the new version's validity and reliability. METHODS This was a methodological study to verify the linguistic equivalence of the scale through the translation/back-translation method. Twelve experts in health assessment confirmed the scale's content validity. Along with the Barriers to Nurses' Use of Physical Assessment Scale, an information form, including socio-demographic features, was distributed to 380 nurses, who consented to participate in the research. Data were collected between July 2017 and April 2018. Internal consistency, factor analysis and test-retest reliability were used to determine consistency over time and intraclass correlations. RESULTS The content validity index of the scale (0.963) was calculated following confirmation of its language equivalence. With the confirmatory factor analysis, it was determined that the fit index values were at an acceptable level and the model was suitable. The factor analysis clustered factors in seven domains. The overall internal consistency coefficient was 0.822. All subscales and the overall scale showed high intraclass correlations. CONCLUSION The Turkish version of the Barriers to Nurses' Use of Physical Assessment Scale is a valid and reliable instrument. SUMMARY STATEMENT What is already known about this topic? Nursing assessment is a critical step in the nursing process. A holistic and systematic approach is key to improving the quality of nursing care, which may be hindered by barriers to the performance of physical assessment. Several international studies have examined the barriers encountered by nurses; however, there is a lack of both instruments and research on this subject in Turkish literature. What this paper adds? The findings confirmed that the Turkish version of the Barriers to Nurses' Use of Physical Assessment Scale is a valid and reliable instrument and can be used to determine the barriers to nurses' ability to perform physical assessments. Nurses and clinic managers will be able to use the scale to identify the factors preventing assessment and develop strategies to overcome them. The questionnaire can help eliminate assessment barriers to create an effective and systematic assessment environment. The implications of this paper: Nurses and clinical managers should work together to identify and eliminate assessment barriers. Barriers to nurses' use of physical assessments can be objectively identified through a valid and reliable tool, providing opportunities for the elimination of such barriers and the development of nursing assessment activities.
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Affiliation(s)
- Nuray Turan
- Department of Fundamentals of Nursing, Florence Nightingale Nursing Faculty, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Aysel Özsaban
- Department of Fundamentals of Nursing, Faculty of Health Sciences, Karadeniz Technical University, Ortahisar, Trabzon, Turkey
| | - Gülsün Özdemir Aydın
- Nursing Department, Health of School, Tekirdağ Namık Kemal University, Tekirdağ, Turkey
| | - Meryem Türkoğlu
- University of Health Sciences Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Hatice Kaya
- Department of Fundamentals of Nursing, Florence Nightingale Nursing Faculty, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Rengin Acaroğlu
- Department of Fundamentals of Nursing, Florence Nightingale Nursing Faculty, Istanbul University-Cerrahpaşa, Istanbul, Turkey
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Chenault C. [Moqet, a tool for collecting clinical data]. REVUE DE L'INFIRMIÈRE 2021; 70:43-46. [PMID: 34024585 DOI: 10.1016/j.revinf.2021.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Data collection is the preliminary and essential step in clinical nursing judgment. Certain theories and models of the nursing discipline are used in initial training to conduct this operation. Clinical nursing examination requires theoretical, methodological and experiential learning. The Moqet tool was created to help nursing students with this learning.
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Affiliation(s)
- Céline Chenault
- Ifsi Périgueux, centre hospitalier de Périgueux, 80, avenue Georges-Pompidou, 24000 Périgueux, France.
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Tan MW, Lim FP, Siew AL, Levett-Jones T, Chua WL, Liaw SY. Why are physical assessment skills not practiced? A systematic review with implications for nursing education. NURSE EDUCATION TODAY 2021; 99:104759. [PMID: 33540350 DOI: 10.1016/j.nedt.2021.104759] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 12/15/2020] [Accepted: 01/04/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Physical assessment skills are taught in pre-registration nursing programs to equip nurses with the competencies to provide holistic nursing care. However, only a fraction of the skills they acquired during training are routinely performed in clinical practice thus highlighting a disconnect between learning and practicing. OBJECTIVE To better understand the issues surrounding the teaching and practice of physical assessment skills among nurses as described in the literature. DESIGN A systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was used. REVIEW METHOD A search of databases including PubMed, EMBASE, CINAHL and Scopus was conducted from January 1970 to December 2019. Two independent researchers performed the methodological quality assessment using the Joanna Briggs Institute's Critical Appraisal Checklists. Twenty-one papers, including two qualitative studies, 17 quantitative studies and two mixed methods study, were selected in this review. Data were synthesised narratively. RESULTS The review identified six overarching themes: (1) role ambiguity, (2) reliance on technology, (3) collegial support and culture, (4) practice variations across specialties, (5) a lack of confidence and knowledge, and (6) over-teaching using biomedical model. CONCLUSION This review identified the need to improve the teaching of the physical assessment skills. There is also a need to evaluate the physical assessment content taught within nursing curricula, with emphasis on depth rather than breadth of skills. The ability to interpret physical assessment observations and develop clinical judgement need to be incorporated into the curriculum. To aid in the development of an effective care plan, the physical assessment framework should move away from a biomedical framework to include nursing models such as nursing process and clinical reasoning model. This revised framework can be used in future studies in the development and testing of teaching and evaluation tools for physical assessment skills.
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Affiliation(s)
| | - Fui Ping Lim
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | | | - Tracy Levett-Jones
- School of Nursing & Midwifery, Faculty of Health, University of Technology Sydney, Australia.
| | - Wei Ling Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Sok Ying Liaw
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Maniago JD, Feliciano EE, Santos AM, Agunod CL, Adolfo CS, Vasquez BA, Albougami A, Almazan JU. Barriers in performing physical assessment among nursing students: An integrative review. Int J Nurs Sci 2021; 8:120-129. [PMID: 33575452 PMCID: PMC7859548 DOI: 10.1016/j.ijnss.2020.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 12/07/2020] [Accepted: 12/16/2020] [Indexed: 11/28/2022] Open
Abstract
Objectives This study aimed to identify barriers in performing physical assessments among nursing students through integrative review study. Methods The literature were searched in Medline, CINAHL, ScienceDirect, Web of Science, ProQuest, and Taylor & Francis Online using the descriptors barrier, physical assessment, nursing student et al. Only English-language and peer-reviewed journal articles were included, and there were no year restrictions. Results Twelve articles were selected for review. Two aspects were extracted: the barriers included personal challenges, challenges related to nursing education, challenges related to clinical practice; establishing competency-based education learning as a method to reduce physical assessment barriers. Student competencies and experiences were influenced by various factors that collectively hindered their successful performance of physical assessments. Conclusions The review findings provide valuable insights into the complex issues involved in the performance of physical assessments and guidance for improvement in practice. A collaborative effort should be made to address the issues often faced by nursing students in performing routine physical assessments. Also, more constructive and competency-based teaching methods should be integrated into academic and clinical settings.
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Affiliation(s)
- Jestoni D Maniago
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Al-Majmaah, 11952, Kingdom of Saudi Arabia
| | - Evelyn E Feliciano
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Al-Majmaah, 11952, Kingdom of Saudi Arabia
| | - Adelina M Santos
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Al-Majmaah, 11952, Kingdom of Saudi Arabia
| | - Cyrelle L Agunod
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Al-Majmaah, 11952, Kingdom of Saudi Arabia
| | - Cris S Adolfo
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Al-Majmaah, 11952, Kingdom of Saudi Arabia
| | - Brian A Vasquez
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Al-Majmaah, 11952, Kingdom of Saudi Arabia
| | - Abdulrhman Albougami
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Al-Majmaah, 11952, Kingdom of Saudi Arabia
| | - Joseph U Almazan
- Nazarbayev University School of Medicine, Nazarbayev University, Nur-Sultan, 010000, Republic of Kazakhstan
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Byermoen KR, Brembo EA, Egilsdottir HÖ, Heyn LG, Moen A, Eide H. Reflection on actions: Identifying facilitators of and barriers to using physical assessment in clinical practice. Nurse Educ Pract 2020; 50:102913. [PMID: 33321269 DOI: 10.1016/j.nepr.2020.102913] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 09/11/2020] [Accepted: 10/26/2020] [Indexed: 10/23/2022]
Abstract
Current research suggests that nursing students do not apply all sets of physical assessment skills (PAS) learned in their nursing education. The aim of this study was to evaluate third-year nursing students' process of clinical judgment using PAS in clinical rotation. Specific focus was on how the process of clinical judgment affected when the nursing students performed physical assessment, and which types of knowledge were implied in their practice. Ten nursing students performed PAS independently while in clinical rotation; these performances were audiotaped and observed. Shortly after, individual semi-structured stimulated recall interviews (SRI) took place. Regardless of the nursing students' stated level of PAS utilization, self-efficacy or scientific knowledge, clinical judgment was primarily based on contextual factors and personal prerequisites. This study contributes to in-depth knowledge about how nursing students perform physical assessment, how they describe their clinical judgment process and their strategies towards systematically and confidently using PAS. We conclude the paper with pedagogical strategies and learning activities that can facilitate reflection-in-action and reflection-on-action.
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Affiliation(s)
- Kirsten Røland Byermoen
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway.
| | - Espen Andreas Brembo
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway.
| | - H Ösp Egilsdottir
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway.
| | - Lena Günterberg Heyn
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway.
| | - Anne Moen
- University of Oslo, Institute for Health and Society, Faculty of Medicine, Nedre Ullevål 9, 0850, Oslo, Norway.
| | - Hilde Eide
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045, Drammen, Norway.
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Liyew B, Dejen Tilahun A, Kassew T. Knowledge, Attitude, and Associated Factors towards Physical Assessment among Nurses Working in Intensive Care Units: A Multicenter Cross-Sectional Study. Crit Care Res Pract 2020; 2020:9145105. [PMID: 32850150 PMCID: PMC7436285 DOI: 10.1155/2020/9145105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 07/27/2020] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Nurses working in the intensive care unit play an essential role in detecting patients at risk of deterioration through ongoing assessment and action in response to changing health status. OBJECTIVES To assess knowledge, attitude, and associated factors towards physical assessment on critically ill patients among nurses working in the intensive care unit at Amhara regional state referral hospitals, Northwest Ethiopia, 2019. The research hypothesis: there is poor physical assessment knowledge, poor physical assessment attitude, and there are factors that are likely to affect nurses' knowledge and attitude towards physical assessment providing this care to critically ill patients at Amhara regional state referral hospitals, Northwest Ethiopia, 2019. METHODS Institution-based cross-sectional study was conducted among 299 nurses from March to September 2019. A convenience sampling method was used. Data were entered by using Epi Info 7.2.2 and analyzed by using STATA 14. The result was computed by descriptive statistics and to explore predictors of knowledge, and attitude linear regression analysis models were fitted, and the adjusted unstandardized beta (β) coefficient at 95% CI was used. A p-value <0.05 was considered significant. Result and conclusion: the knowledge mean scores were 9.93 ± 2.99 [95% CI (9.59, 10.31)]. The proportion of nurse's knowledge who score above the mean was 167 (55.9%) [95% CI (50.2, 61.5)] and below the mean 132 (44.1%) [95% CI (38.5, 49.8)]. Attitude means scores were 36.85 ± 6.21 [(36.16, 37.51)]. The proportions of nurse's attitudes who score above the mean were 158 (52.8%) [95% CI (47.5, 58.5)] and below the mean 141 (47.2) [95% CI (41.5, 52.5)]. Regarding predictor variables, being male [β = 0.84, 95% CI (0.16, 1.52)] and taken training [β = 1.85, 95% CI (1.14, 2.56)] were factors positively associated with knowledge, whereas has taken training [β = 4.13, 95% CI (2.82, 5.44)], total years of experience [β = 0.59, 95% CI (0.25, 0.93)], and knowledge [β = 0.92, 95% CI (0.0.72, 1.12)] were factors positively associated with attitude towards physical assessment. CONCLUSION Based on the result of this study, the knowledge and attitude towards physical assessment regarding critically ill patients among nurses working in intensive care units were good. Hence, training, educational support services, and awareness are recommended to encourage nurse's knowledge and attitude towards physical assessment.
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Affiliation(s)
- Bikis Liyew
- School of Nursing, Department of Emergency and Critical Care Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ambaye Dejen Tilahun
- School of Nursing, Department of Emergency and Critical Care Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tilahun Kassew
- School of Medicine, Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Lee H, Lee YJ, Lee J, Kim S. Physical examination competence as a predictor of diagnostic reasoning among new advanced practice nurse students: a cross-sectional study. Contemp Nurse 2019; 55:360-368. [PMID: 31544601 DOI: 10.1080/10376178.2019.1670707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Aim: To investigate levels of diagnostic reasoning among new APN students as well as students' characteristic affecting such reasoning levels.Design: a descriptive correlational design.Methods: One hundred fourteen APN students in an advanced health assessment course self-assessed their competene in performing examination. The students' self-reported Diagnostic Reasoning Assessment scores were used to categorize them into pre-novice, novice, advanced beginner, and competent levels. Ordinal logistic regression analysis was used.Results: Only physical examination competence significantly predicted the students' diagnostic reasoning levels. Being in a higher diagnostic reasoning level relative to being in a pre-novice, novice, or advanced beginner level was 16.1, 2.6, and 1.9 times greater in the physical examination competence, respectively.Conclusions: Promoting physical examination competence can be an effective teaching strategy for enhancing the diagnostic reasoning of newly enrolled APN students, especially for students who have poor diagnostic reasoning performance.
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Affiliation(s)
- Hyejung Lee
- Mo-Im Kim Nursing Research Institute & College of Nursing, Yonsei University, Seoul, South Korea
| | - Young Joo Lee
- College of Nursing, Daegu Catholic University, 33, Duryugongwon-ro 17-gil, Nam-gu, Daegu, 42472, Daegu, South Korea
| | - JuHee Lee
- Mo-Im Kim Nursing Research Institute & College of Nursing, Yonsei University, Seoul, South Korea
| | - Sanghee Kim
- Mo-Im Kim Nursing Research Institute & College of Nursing, Yonsei University, Seoul, South Korea
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Egilsdottir HÖ, Byermoen KR, Moen A, Eide H. Revitalizing physical assessment in undergraduate nursing education - what skills are important to learn, and how are these skills applied during clinical rotation? A cohort study. BMC Nurs 2019; 18:41. [PMID: 31516382 PMCID: PMC6728957 DOI: 10.1186/s12912-019-0364-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 08/16/2019] [Indexed: 02/08/2023] Open
Abstract
Background The preparedness of newly graduated registered nurses for a demanding work environment and care practices takes form during nursing education. Norwegian nursing education at one university has implemented a selection of basic physical assessment skills (B-PAS) in the nursing curriculum in order to prepare nursing students for a demanding work environment post-graduation. Methods A mixed-method cohort design. We evaluated nursing students’ self-reported use of B-PAS during their clinical rotation using the “Survey of Examination Techniques Performed by Nurses” questionnaire (30 items). In addition, two focus group interviews elicited factors that hinder or facilitate the actual use of B-PAS during clinical rotation. We recruited students from a bachelor’s degree programme for nursing at a Norwegian university. Three hundred and sixty-three of 453 eligible nursing students in the first, second, and third year of the bachelor’s degree programme participated in the study (80%). Results ANOVA showed a significant progression (p < 0.016) in students’ self-reported use of B-PAS. Auscultation and percussion skills were graded below the median score of 3, which indicates that these skills were less used throughout the programme. The nursing students highlighted contextual factors for their use of B-PAS when in clinical rotation. Preceptors are important gatekeepers for successful implementation, and there is a need for close collaboration between the university and clinical practice. Conclusion Despite the reduced PAS taught in the curricula, there is still a lack of application of such skills in clinical rotations. This study highlights that research should explore how different work environments influence the utilisation of learned skills, and which learning strategies are appropriate or most successful for stimulating clinical reasoning and the extensive use of physical assessment.
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Affiliation(s)
- H Ösp Egilsdottir
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045 Drammen, Norway
| | - Kirsten Røland Byermoen
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045 Drammen, Norway
| | - Anne Moen
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045 Drammen, Norway.,2Institute for Health and Society, Faculty of Medicine, University of Oslo, Kirkeveien 166, Fredrik Holsts hus, 0450 Oslo, Norway
| | - Hilde Eide
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, 3045 Drammen, Norway
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Morrell S, Ralph J, Giannotti N, Dayus D, Dennison S, Bornais J. Physical assessment skills in nursing curricula. ACTA ACUST UNITED AC 2019; 17:1086-1091. [DOI: 10.11124/jbisrir-2017-003981] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Maejima S, Ohta R. Physical assessment by Japanese community hospital nurses compared to that performed overseas: A cross-sectional study. J Gen Fam Med 2019; 20:55-61. [PMID: 30873305 PMCID: PMC6399597 DOI: 10.1002/jgf2.230] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 11/22/2018] [Accepted: 12/11/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Japanese nurses may not be adequately trained to perform physical assessments compared to nurses overseas due to differences in accessibility to education; currently, research investigating this discrepancy is limited. This study investigated the current performance levels of Japanese community nurses in physical assessments and compared their performance to that of nurses overseas. METHODS In this cross-sectional study, we examined the practical application of physical assessments conducted by nurses at a Japanese community hospital. We used a questionnaire based on one used in a similar prior study conducted overseas. The results were also compared with the overseas data. A chi-squared test and analysis of variance were used to analyze the variables in each question. RESULTS We distributed the questionnaires to 171 nurses working in the hospital. The return rate was 97.6% (167 out of 171). There was no significant difference in the methods used to perform a physical assessment based on the number of years of experience. Compared to nurses overseas, Japanese community hospital nurses differed in one area of assessment: A physical assessment of the chest was more likely conducted via auscultation rather than inspection. CONCLUSIONS When Japanese community hospital nurses performed a physical assessment of patients, auscultation was more frequently implemented than inspection. This approach contrasts with nurses overseas, who were more likely to use inspection when performing physical assessment. Japanese community nurses should improve their skills related to inspection, as inspection is an important process in the recognition of early stages of emergency.
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Affiliation(s)
- Satoko Maejima
- Department of NursingUnnan City HospitalUnnanShimaneJapan
| | - Ryuichi Ohta
- Community CareUnnan City HospitalUnnanShimaneJapan
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Verkuyl M, Hughes M, Fyfe MC. Using Think Aloud in Health Assessment: A Mixed-Methods Study. J Nurs Educ 2019; 57:684-686. [PMID: 30388291 DOI: 10.3928/01484834-20181022-10] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 08/18/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND Health assessment courses are foundational to prepare students in nursing baccalaureate programs for clinical practice. Nurse educators are interested in testing strategies to improve students' ability to perform physical assessment techniques. METHOD A mixed-methods design was used to examine nursing students' experiences with the Think Aloud (TA) approach and its affect on their ability and perceived self-efficacy when performing physical assessment skills. RESULTS The participants in the TA intervention group made significant pre-post self-efficacy score gains and had higher focused physical examination marks. There was no significant difference in pre-post self-efficacy scores with the control group. A focus group yielded the following themes: benefits of TA, student challenges, and transferring physical assessment skills to practice. CONCLUSION The TA approach encourages students to focus on the critical steps in physical assessment skills aiding memory, knowledge gains and preparation for practical testing, and transition to clinical practice. [J Nurs Educ. 2018;57(11):684-686.].
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Hsu L, Hsiang H, Tseng Y, Huang S, Hsieh S. Nursing students' experiences of using a smart phone application for a physical assessment course: A qualitative study. Jpn J Nurs Sci 2018; 16:115-124. [DOI: 10.1111/jjns.12215] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 01/21/2018] [Accepted: 04/09/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Li‐Ling Hsu
- Department of NursingOriental Institute of Technology New Taipei City Taiwan
| | - Hsiu‐Chuan Hsiang
- Refinery affiliated Medical ClinicCPC Corporation Refining Business Division Taoyuan Taiwan
| | - Yi‐Hua Tseng
- Miaoli General HospitalMinistry of Health and Welfare Miaoli Taiwan
| | - Siang‐Yun Huang
- Department of NursingChang Gung University of Science and Technology Taoyuan City Taiwan
| | - Suh‐Ing Hsieh
- Department of NursingChang Gung University of Science and Technology Taoyuan City Taiwan
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ÇEVİK B, UĞURLU Z, AKYÜZ E, KAV S, ERSAYIN A. Hemşirelerin Fiziksel Değerlendirme Becerileri ve Uygulamaya İlişkin Görüşleri. ACTA ACUST UNITED AC 2018. [DOI: 10.31125/hunhemsire.431127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Relationship between Knowledge-Skill and Importance of Physical Examination for Children Admitted to Infectious Wards: Examining Nurses’ Points of View. ACTA ACUST UNITED AC 2018. [DOI: 10.5812/compreped.63292] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Zambas SI, Smythe EA, Koziol-Mclain J. The consequences of using advanced physical assessment skills in medical and surgical nursing: A hermeneutic pragmatic study. Int J Qual Stud Health Well-being 2016; 11:32090. [PMID: 27607193 PMCID: PMC5015639 DOI: 10.3402/qhw.v11.32090] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/16/2016] [Indexed: 12/01/2022] Open
Abstract
Aims and objectives The aim of this study was to explore the consequences of the nurse's use of advanced assessment skills on medical and surgical wards. Background Appropriate, accurate, and timely assessment by nurses is the cornerstone of maintaining patient safety in hospitals. The inclusion of “advanced” physical assessment skills such as auscultation, palpation, and percussion is thought to better prepare nurses for complex patient presentations within a wide range of clinical situations. Design This qualitative study used a hermeneutic pragmatic approach. Method Unstructured interviews were conducted with five experienced medical and surgical nurses to obtain 13 detailed narratives of assessment practice. Narratives were analyzed using Van Manen's six-step approach to identify the consequences of the nurse's use of advanced assessment skills. Results The consequences of using advanced assessment skills include looking for more, challenging interpretations, and perseverance. The use of advanced assessment skills directs what the nurse looks for, what she sees, interpretation of the findings, and her response. It is the interpretation of what is seen, heard, or felt within the full context of the patient situation, which is the advanced skill. Conclusion Advanced assessment skill is the means to an accurate interpretation of the clinical situation and contributes to appropriate diagnosis and medical management in complex patient situations. Relevance to clinical practice The nurse's use of advanced assessment skills enables her to contribute to diagnostic reasoning within the acute medical and surgical setting.
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Affiliation(s)
- Shelaine I Zambas
- Department of Nursing, Auckland University of Technology, Auckland, New Zealand;
| | - Elizabeth A Smythe
- Department of Nursing, Auckland University of Technology, Auckland, New Zealand
| | - Jane Koziol-Mclain
- Department of Nursing, Auckland University of Technology, Auckland, New Zealand
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Douglas C, Booker C, Fox R, Windsor C, Osborne S, Gardner G. Nursing physical assessment for patient safety in general wards: reaching consensus on core skills. J Clin Nurs 2016; 25:1890-900. [DOI: 10.1111/jocn.13201] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Clint Douglas
- School of Nursing; Queensland University of Technology (QUT); Kelvin Grove Qld Australia
- Institute of Health and Biomedical Innovation (IHBI); Kelvin Grove Qld Australia
| | - Catriona Booker
- Royal Brisbane and Women's Hospital (RBWH); Herston Qld Australia
| | - Robyn Fox
- Royal Brisbane and Women's Hospital (RBWH); Herston Qld Australia
| | - Carol Windsor
- School of Nursing; Queensland University of Technology (QUT); Kelvin Grove Qld Australia
- Institute of Health and Biomedical Innovation (IHBI); Kelvin Grove Qld Australia
| | - Sonya Osborne
- School of Nursing; Queensland University of Technology (QUT); Kelvin Grove Qld Australia
- Institute of Health and Biomedical Innovation (IHBI); Kelvin Grove Qld Australia
- Royal Brisbane and Women's Hospital (RBWH); Herston Qld Australia
| | - Glenn Gardner
- School of Nursing; Queensland University of Technology (QUT); Kelvin Grove Qld Australia
- Institute of Health and Biomedical Innovation (IHBI); Kelvin Grove Qld Australia
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