‘Hands-on’ assessment: A useful strategy for improving patient safety in emergency departments

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• 作者：Angela Jones ; RN ; PhD ; ^{angela.jones1@deakin.edu.au" class="auth_mail" title="E-mail the corresponding author} ; Megan-Jane Johnstone ; RN ; PhD ; FACN ; Maxine Duke ; RN ; PhD ; FACN
• 关键词：Patient safety ; Nurses ; Hospital emergency service ; Nursing assessment ; Continuity of patient care
• 刊名：Australasian Emergency Nursing Journal
• 出版年：2015
• 出版时间：November 2015
• 年：2015
• 卷：18
• 期：4
• 页码：212-217
• 全文大小：470 K

文摘

Patient assessment is an essential nursing intervention that reduces the incidence and impact of errors and preventable adverse events in emergency departments (EDs). This paper reports on a key finding of the ED nurse component of a larger study investigating how registered nurses manage ‘discontinuities’ or ‘gaps’ in patient care.

Methods

The larger study was undertaken as a naturalistic inquiry using a qualitative exploratory descriptive approach. Data were collected from a criterion-based purposeful sample of 71 nurses, of which 19 were ED nurses, and analysed using content and thematic analysis strategies.

Results

The component of the study reported here revealed that ED nurses used ‘hands-on’, head-to-toe assessment to manage gaps in patient care. Examination of the data revealed three key dimensions of patient assessment in the ED: (i) assessment is the ‘bread and butter’ of emergency nursing; (ii) ‘hands-on’ assessment techniques are irreplaceable and, (iii) patient assessment is undervalued in EDs.

Conclusions

The findings of this study reaffirm the role of ‘hands-on’ observation and assessment in creating safety in EDs. Further research and inquiry is needed to determine how health care systems can provide the conditions for ensuring that ‘hands-on’ assessment occurs.