Abstract
Aim: To identify and better understand the factors that influence nurses' assessment in the acute care environment.
Background: High-acuity patients, older patients with complex care requirements, staff shortages, pressure on bed availability and shorter patient stays means the healthcare environment is increasingly demanding. To meet the demands of this changing environment, nurses' assessments are critical if they are to detect early deterioration and provide patient centered care. Much of the research in regards to nurses' assessment in the hospital setting has focused on physical examination skills as opposed to a holistic, patient-centred nurse assessment. While these skills have their place, physical examination is only one aspect of a nurse's assessment.
Design: A qualitative descriptive design was employed to answer the research question. Seventeen nurses working in the acute care setting took part in one of three focus groups. Data were transcribed and analysed using a thematic analysis approach.
Results: The findings revealed that the changing patient demographic, organizational factors and personal factors impacted the nurses' assessments. An ideal nursing assessment was often difficult to complete in the acute care setting.
Conclusion: The business-like model of the current healthcare system with a focus on 'patient flow' has created a pressured, task-focussed environment where care rationing is a daily norm and assessing patients holistically is challenging. Despite constant barriers, most nurses still upheld a core nursing value of holism, which reflects a sense of strength and provides hope to nursing as a profession.