Nurses' Views On Physical Examination Use and Related Factors

Abstract

Aim: This study aimed to determine the views of nurses regarding the use of physical examination methods and related factors affecting these views. Background: Although nurses have long been expected to use physical examination methods in clinical practice, these techniques have not always been regularly used. Factors affecting the use of physical examination are nurses’ negative views about physical examination and the institutional features they work in. Methods: The study was conducted as descriptive study between July 2017 and February 2018 in adult clinical and intensive care units. The study sample comprised 606 nurses. Data were collected using the Nurses’ Views of the Use of Physical Examination Questionnaire. Results: The mean age of nurses was 35.05 ± 7.59 years. Of the nurses, 64.69% had a bachelor’s degree, 82.51% had taken training on physical examination on undergraduation, 28.71% had received in-service training. Overall, 88.10% agreed with “physical examination is important tool that provides information on patients’ clinical status.” Conclusion:The views of nurses on physical examination methods are affected by the hospital they work in, their education level and education about physical examination methods. According to the results, although nurses stated the necessity of using physical examination methods, it can be said that institutional policies affect the use in practice.

Keywords

• Nurses’ views
• Physical examination and nursing
• Physical examination methods

References

1. Adib-Hajbaghery, M., & Safa, A. (2013). Nurses' Evaluation of Their Use and Mastery in Health Assessment Skills: Selected Iran's Hospitals. Nursing and Midwifery Studies, 2(3), 39-43.
2. Aydın, D., & Dörtbudak, Z. (2004). Nurse's knowledge and use of physical assessment methods within the context of patient assessment. Journal of Education and Research in Nursing, 1(1), 29-33.
3. Baid, H., Bartlett, C., Gilhooly, S., Illingworth, A., & Winder, S. (2009). Advanced physical assessment: the role of the district nurse. Nursing Standard, 23(35).
4. Bauer, M., Fetherstonhaugh, D., & Winbolt, M. (2018). Perceived barriers and enablers to conducting nursing assessments in residential aged care facilities in Victoria, Australia. Australıan Journal Of Advanced Nursıng 36(2), 14-22.
5. Bayer, L. (2016). Patient Clinical Examination of Adults: Learning Videos in English. (Degree Programme Bachelor’s Thesis). Lahti University, Lahti University of Applied Sciences Retrieved from https://pdfs.semanticscholar.org/fdcb/e5b4b8b8bfd985efefd865404051bfb919ec.pdf
6. Birks, M., Cant, R., James, A., Chung, C., & Davis, J. (2013). The use of physical assessment skills by registered nurses in Australia: issues for nursing education. Collegian, 20(1), 27-33. doi:10.1016/j.colegn.2012.02.004
7. British Columbia College of Nursing Professionals. (2018). Professional Standards for Registered Nurses and Nurse Practitioners. Canada: Granville St Vancouver Retrieved from www.bccnp.ca
8. Choi, J., Lee, S. E., Bae, J., Kang, S., Choi, S., Tate,. A., & Yang, Y. L. (2020). Undergraduate nursing students' experience of learning respiratory system assessment using flipped classroom: A mixed methods study. Nurse Educ Today, 104664. doi:10.1016/j.nedt.2020.104664

9. Chua, W. L., & Liaw, S. Y. (2016). Assessing beyond vital signs to detect early patient deterioration. Evid Based Nurs, 19(2), 53. doi:10.1136/eb-2015-102092
10. Cicolini, G., Tomietto, M., Simonetti, V., Comparcini, D., Flacco, M. E., Carvello, M., & Manzoli, L. (2015). Physical assessment techniques performed by Italian registered nurses: a quantitative survey. J Clin Nurs, 24(23-24), 3700-3706. doi:10.1111/jocn.12997
11. D'Antonio, P., Fairman, J. A., & Whelan, J. C. (2013). Routledge handbook on the global history of nursing. U.S.A: Routladge.
12. Donnelly, M., & Martin, D. (2016). History taking and physical assessment in holistic palliative care. British Journal of Nursing,, 25(22), 1251-1255.
13. Douglas, C., Osborne, S., Reid, C., Batch, M., Hollingdrake, O., Gardner, G., & Members of the, R. P. A. R. C. (2014). What factors influence nurses' assessment practices? Development of the Barriers to Nurses' use of Physical Assessment Scale. J Adv Nurs, 70(11), 2683-2694. doi:10.1111/jan.12408
14. Egilsdottir, H. O., Byermoen, K. R., Moen, A., & Eide, H. (2019). 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, 18, 41. doi:10.1186/s12912-019-0364-9
15. Estes, M. E. Z. (2013). Health Assessment & Physical Examination (5th ed., pp. 241-871).
16. Fennessey. (2019). Physical Assessments are Essential to Patient Outcomes: Are RNs Really Performing Them. Paper presented at the Creating Healthy Work Environments, New Orleans, USA. https://stti.confex.com/stti/chwe19/webprogram/Paper93716.html
17. Fennessey, A., & Wittmann-Price, R. A. (2011). Physical Assessment: A Continuing Need for Clarification. Nursing Forum, 46(1), 45-50.
18. Fuller, J., & Schaller-Ayers, J. (2000). Health Assesment a Nursing Approach (3rd ed.): Lippincott.
19. Hartigan, I., Murphy, S., Flynn, A. V., & Walshe, N. (2010). Acute nursing episodes which challenge graduate's competence: perceptions of registered nurses. Nurse Educ Pract, 10(5), 291-297. doi:10.1016/j.nepr.2010.01.005
20. Hendrich, H., Chow, M. P., Skierczynski, B. A., & Lu, Z. (2008). A 36-Hospital Time and Motion Study: How Do Medical-Surgical Nurses Spend Their Time? The Permanente Journal/ Summer, 12(3), 25-34.
21. Hogan, J. (2006). Why don't nurses monitor the respiratoiy rates of patients? British Journal of Nursing, 15(9), 489-492.
22. Fennessey. L. (2004). From Handmaiden to Riaht Hand-World War I rl and Advancements in Medicine. AORN Journal 80(5), 911-923.
23. Holzemer, W., Barkauskas, V., & Ohlson, V. (1980). A program evaluation of four workshops designed to prepare nurse faculty in health assessment. The Journal of nursing education, 19(4), 7-18.
24. Implementing Regulation Amending the Nursing Regulation/ Hemşirelik Yönetmeliğinde Değişiklik Yapılmasına Dair Yönetmelik. (2011). T.R Official Newspaper. Retrieved from http://www.turkhemsirelerdernegi.org.tr/menu/yasa-ve-yonetmelik/hemsirelik-yonetmeligi-2010-2011.
25. Jamerson, L. (2019). Skills Checklist Utilization and the Impact on Nursing Student Skill Acquisition of the Pediatric Physical Assessment. (The DNP Project). American Sentinel University,
26. Khoran, Alhani, F., & Hajizadeh, E. (2018). Nurses challenges in health assessment skills in Iran and another country: An integrative review. Journal of Nursing and Midwifery Sciences, 5(1). doi:10.4103/jnms.Jnms_3_18
27. Khoran, M., Alhani, F., & Hajizadeh, E. (2016). Nurses Self- Assessment in Pediatric Physical Examination skills. Journal of Pediatric Nursing, 3(2), 1-9. doi:10.21859/jpen-03021
28. Lesa, R., Cert, P. G., & Dixon, A. (2007). Physical assessment: implications for nurse educators and nursing practice. International Nursing Review 54, 166-172.
29. Liyew, B., Dejen Tilahun, A., & Kassew, T. (2020). 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, 9145105. doi:10.1155/2020/9145105
30. Maejima, S., & Ohta, R. (2019). Physical assessment by Japanese community hospital nurses compared to that performed overseas: A cross-sectional study. J Gen Fam Med, 20(2), 55-61. doi:10.1002/jgf2.230
31. Majczak, J. A., & Hohl, M. (2015). he Physıcal Nursıng Examınatıon Of The Hospıtalızed Older Adult. Cogitare Enferm, 20(2), 314-322.
32. McElhinney, E. (2010). Factors which influence nurse practitioners ability to carry out physical examination skills in the clinical area after a degree level module--an electronic Delphi study. J Clin Nurs, 19(21-22), 3177-3187. doi:10.1111/j.1365-2702.2010.03304.x
33. Mitoma, R., & Yamauchi, T. (2018). Effectiveness of a learning support program for respiratory physical assessment: A quasi-experimental study. PLoS One, 13(9), e0202998. doi:10.1371/journal.pone.0202998
34. Neville, S. J., Gillon, D., & Milligan, K. (2011). New Zealand registered nurses' use of physical assessment skills: A pilot study. Research and Reviews. Retrieved from https://www.researchgate.net/publication/43506106.
35. Olgun, N., & Tosun, N. (2017). Health Assessment Clinical Decision Making (F. Eti Aslan Ed.). İstanbul: Akademisyen Bookstore.
36. Osborne, S., Douglas, C., Reid, C., Jones, L., & Gardner, G. (2015). The primacy of vital signs--acute care nurses' and midwives' use of physical assessment skills: a cross sectional study. Int J Nurs Stud, 52(5), 951-962. doi:10.1016/j.ijnurstu.2015.01.014
37. Raleigh, M., & Allan, H. (2017). A qualitative study of advanced nurse practitioners' use of physical assessment skills in the community: shifting skills across professional boundaries. J Clin Nurs, 26(13-14), 2025-2035. doi:10.1111/jocn.13613
38. Rushforth, H., Warner, J., Burge, D., & Glaspe, G. E. (1998). Nursing physical assessment skills: implications for UK practice. British Journal of Nursing 7(16). Rylance, R., Chapman, H., & Harrison, J. (2012). Who Assesses the Physical Health of Inpatients? MENTAL HEALTH PRACTICE, 16(2), 14-20.
39. Sandelowski, M. (2000). Nursing History Review (J. E. Lynaugh Ed.). New York: Springer Publishing Company.
40. Schmitt, M. D., Maia, J. C., Almeida, M. A., & Adamy, E. K. (2015). Obstacles Reported by Nurses feom the service of Primary Care in Health at Data Collection J Nurs UFPE on line, 9(3), 7688-7694. doi:10.5205/reuol.7049-61452-1-ED.0903supl201523
41. Shi, G., He, G. F., Zhang, L. L., Morrow, M. R., & Zhao, Y. (2020). Barriers to Physical Assessment: Registered Nurses in Mainland China. Nurs Sci Q, 33(1), 65-72. doi:10.1177/0894318419881809
42. Singapore Nursing Board. (2018). Core Competencies of Registered Nurse. Retrieved from https://www.healthprofessionals.gov.sg/docs/librariesprovider4/publications/core-competencies-generic-skills-of-rn_snb_april-2018.pdf
43. Sushmitha, A.V.S., Krishnan, A., Tessy John N, & Jose, G. (2020). Effectiveness of peer teaching on physical assessment among student nurses in selected nursing college, Mangalore. Manipal Journal of Nursing and Health Sciences, 6(1).
44. Tan, M. W., Lim, F. P., Siew, A., Levett-Jones, T., Chua, W. L., & Liaw, S. Y. (2021). Why Are Physical Assessment Skills Not Practiced? A Systematic Review with Implications For Nursing Education. Nurse Education Today, 104759. doi:https://doi.org/10.1016/j.nedt.2021.104759
45. Weber, J. R., & Kelley, J. H. (2014). Health Assesment in Nursing (5th ed.). China: LippinCott Williams & Wilkins.
46. Wheeldon, A. (2005). Exploring nursing roles: Using physical assessment in the respiratory unit. Britishjournal of Nursing, 14(10), 571-574. nSSevinç
47. Wombeogo, M., Azongo, T. B., & Abugre, D. (2018). A Study on the Perspective of Integrating Comprehensive Physical Assessment in to Nursing Practice in
48. Ghana. IOSR Journal of Nursing and Health Science, 7(1), 65-74. doi:10.9790/1959-0701016574
49. Zambas, S. I., Smythe, E. A., & Koziol-Mclain, J. (2016). The consequences of using advanced physical assessment skills in medical and surgical nursing: A hermeneutic pragmatic study. Int J Qual Stud Health Well-being, 11, 32090. doi:10.3402/qhw.v11.32090