Contact us at CNREPHelp@houstonmethodist.org
Questions or comments?
© 2022. Houston Methodist, Houston, TX. All rights reserved.
NURSING SCIENCE
Physical assessment competencies for nurses: A quality improvement initiative
By Joanne Muyco, DNP, RN, NE-BC, CNOR
By Joanne Muyco, DNP, RN, NE-BC, CNOR
4 MIN READ
Title:
Physical assessment competencies for nurses: A quality improvement initiativePublished: July 2022 in Nursing Forum
AACN Level of Evidence: Level C: Quality Improvement
Does the review have clear objectives?
Nurses must perform physical assessments to recognize early signs of clinical deterioration and initiate early interventions to prevent negative patient outcomes. This article discusses the Methodist Proficient Assessment Competency (MPAC) quality improvement initiative to improve the completeness of head-to-toe physical assessment, timeliness, and accuracy of documentation in the electronic health record (EHR), and availability of essential assessment equipment. The goal of this initiative was to assess current practice, develop a standardized head-to-toe physical assessment, educate, and perform follow-up audits to determine sustained nursing practice.
What was the population studied?
The population studied in this article were all inpatient and select outpatient nurses at Houston Methodist Hospital (HMH). These nurses attended MPAC and subsequent audits were performed to evaluate the impact and effectiveness of MPAC on the completeness of the physical assessment, use of physical assessment equipment (i.e., penlight, pupilometers, and stethoscope) and timeliness and accuracy of documentation.
Are the methods they used to find the evidence clearly defined and adequate?
The team performed a literature search and reviewed the Texas Nurse Practice Act and HMH’s policy on assessment. The MPAC curriculum was developed using information and evidence obtained from these reviews. In addition, the authors conducted a two-part gap analysis to understand the current practice of physical assessments. Surveys were sent to nurses to identify barriers to completing physical assessments and to understand attitudes surrounding nurses conducting full physical assessments. The gap analysis also evaluated whether nurses currently performed full physical assessments in their practice. These methods were adequate in finding and synthesizing the evidence to develop the MPAC curriculum.
What were their findings?
The results from the review and gap analysis demonstrated a gap between actual nursing practice, the hospital’s policy and recommended best practices. The MPAC initiative helped to address these opportunities for improvement. After implementing MPAC, the authors found that the MPAC course successfully improved the nurses’ completeness of the physical assessment, use of physical assessment equipment and timeliness and accuracy of physical assessment documentation in the electronic record. Furthermore, the number of rapid response team (RRT) calls occurring within 60 minutes of the first sign of clinical deterioration also improved. This demonstrated that nurses were better at performing physical assessments and recognizing early signs of clinical deterioration sooner after they attended MPAC.
Do their findings make sense?
The findings of this article were logical and reasonable. The authors identified an opportunity to improve nurses’ ability to recognize clinical signs of deterioration through improved physical assessment skills and knowledge. MPAC, a targeted quality improvement initiative to assess, evaluate, educate, and audit physical assessment practices, was successful in improving all outcome measures.
How is this important to nursing?
Nurses are the only healthcare providers that provide patient care around the clock. A strong foundation in basic physical assessment skills and practices is essential in recognizing early signs of clinical deterioration and initiating early interventions. Moreover, timely and accurate documentation enhances the effectiveness of early warning signs in the EHR to further promote optimal patient outcomes.
Read the full study ›
Reference:
