Friday, July 13, 2007
This presentation is part of : Measurement Outcomes & Instrument Development
Use of a structured clinical assessment tool to inform nursing practice
Michaela M. B. Kelleher, MN, (Res), Nephrology, Prince of Wales Hospital, Sydney, Australia, Sandra West, Int, Care, Cert, BSc, PhD, Department of Clinical Nursing, University of Sydney, Sydney, Australia, and Murray Fisher, Int, cert, MHPubEd, BHSc, CCES, MRCNA, Faculty of Nursing and Midwifery, University of Sydney, Sydney, Australia.
Learning Objective #1: demonstrate an understanding of whether clinical tools assist nurses with their nursing practice
Learning Objective #2: identify the benefits of using factor analysis as a data reduction method

Use of a structured clinical assessment tool to inform nursing practice



Clinical assessment is the crux of good nursing practice, yet it has become an all but extinct art and the components which constitute clinical assessment have been poorly articulated in the literature. A comprehensive clinical assessment should form the basis for any planned nursing intervention and provide a baseline against which any subsequent event can be measured. As such, clinical assessment is arguably the most important aspect of nursing care delivery and systematic and on going assessment is vital to monitoring the effectiveness of nursing care.


Objective: It is the objective of this study to assess whether the introduction of a structured daily clinical assessment tool assists nurses in identifying actual and potential patient problems.


Design: An exploratory correlational design was used for this study.


Sample: As the data was analysed using exploratory factor analysis the sample size was based on the use of the tool, the tool contained 103 items therefore the sample size for this study was 1030.


Method: The clinical assessment tool was completed daily by the nurse, who indicated whether or not the patient was exhibiting a particular clinical sign. From the structured assessment the nurse then identified and documented any actual or potential patient problems.


Results: For data reduction purposes an exploratory factor analysis was conducted and a series of multiple regression analyses then calculated to determine if the patient problems which the nurses identified could be explained by a cluster of clinical indicators.


Implications: This initial testing of the assessment tool demonstrated that it has assisted the nurse in identifying patient problems. From the analysis the tool will be refined and a larger study will be conducted to determine whether the assessment tool can be used as a predictor of patient outcome.