Methods: A cross-sectional survey of RNs was undertaken. Data collectioninstruments included the validated Physical Assessment Skills Inventory, Barriers to Registered Nurses’ Use of Assessment Skills Scale and demographic data.
Results: A minimum data-set of seven skills were used by most nurses most of the time: temperature, oxygen saturation, blood pressure, evaluation of breathing effort, skin assessment, wound assessment, and mental state/level of consciousness assessment. Multivariable modelling controlling for specialty area and role revealed reliance on others and technology (p=0.001) and lack of confidence (p=0.019) were associated with use of physical assessment skills (p=0.001).
Conclusion: Results show the majority of nurses regularly assess those physiological markers that typically form the core of early warning and rapid response protocols. Furthermore, nurses lack confidence in using the full breadth of assessment practices and indicate a reliance on technology and other clinicians. These factors pose barriers to nursing assessment practices. This, together with the assessment focus on overt signs of deterioration, may well be distracting nurse attention away from holistic patient assessment and surveillance that could detect more subtle signs of change in health status earlier; thus, possibly preventing patients spiral down the clinical deterioration pathway.