Paper
Friday, July 23, 2004
This presentation is part of : Decision-Making and Role Development
Development of a Clinical Assessment Framework to Guide Nephrology Nurse Clinicians
Michaela M.B. Kelleher, MN, Nephrology, The Prince of Wales Hospital, Sydney, Australia and Sandra West, Int, Care, Cert, BSc, PhD, Department of Clinical Nursing, University of Sydney, Sydney, Australia.
Learning Objective #1: Identify the key competencies required by nurses to perform a comprehensive clinical assessment
Learning Objective #2: Identify the components that constitute clinical assessment
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 events can be measured. As such clinical assessment is arguably the most important aspect of nursing care delivery, in particular systematic and on going assessment, which is vital to monitoring the effectiveness of nursing care, is rarely achieved. Clinical assessment establishes the patient as a person, and therefore facilitates the individualisation of nursing care.

Objective: It is the objective of this study to design and validate a clinical assessment model which may be used by Nephrology nurse clinicians to guide their clinical practice.

Design: This study uses a multistage iterative process employing the Delphi technique whereby group consensus was derived from expert opinion.

Sample: The sample consisted of nurse clinicians and academics with expert knowledge of clinical nursing assessment.

Method: The methodology chosen for this study was a three round Delphi technique. The first round consisted of open ended questions asking the panellists to identify the components of clinical assessment and the key competencies required to adequately perform a clinical assessment. The subsequent rounds asked the panellists to rate the importance of each of the components to a clinical assessment framework.

Findings: The components identified by the panellists were grouped into thirteen domains. From the results, a Nephrology clinical nursing assessment framework was developed.

Implications: It is envisaged that this study will provide a valuable insight into the components of clinical assessment and assist in guiding nurses through the difficult process of performing a clinical assessment.

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