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What factors influence nurses' assessment practices? Development of the Barriers to Nurses' use of Physical Assessment Scale
Author(s) -
Douglas Clint,
Osborne Sonya,
Reid Carol,
Batch Mary,
Hollingdrake Olivia,
Gardner Glenn
Publication year - 2014
Publication title -
journal of advanced nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.948
H-Index - 155
eISSN - 1365-2648
pISSN - 0309-2402
DOI - 10.1111/jan.12408
Subject(s) - scale (ratio) , acute care , medicine , specialty , nursing , reliability (semiconductor) , psychometrics , test (biology) , risk assessment , nursing assessment , medline , health care , family medicine , clinical psychology , power (physics) , paleontology , physics , quantum mechanics , economics , biology , economic growth , computer security , computer science , political science , law
Aim To develop and psychometrically test the Barriers to Nurses' use of Physical Assessment Scale. Background There is growing evidence of failure to recognize hospitalized patients at risk of clinical deterioration, in part due to inadequate physical assessment by nurses. Yet, little is known about the barriers to nurses' use of physical assessment in the acute hospital setting and no validated scales have been published. Design Instrument development study. Method Scale development was based on a comprehensive literature review, focus groups, expert review and psychometric evaluation. The scale was administered to 434 acute care Registered Nurses working at a large Australian teaching hospital between June and July 2013. Psychometric analysis included factor analysis, model fit statistics and reliability testing. Results The final scale was reduced to 38 items representing seven factors, together accounting for 57·7% of the variance: (1) reliance on others and technology; (2) lack of time and interruptions; (3) ward culture; (4) lack of confidence; (5) lack of nursing role models; (6) lack of influence on patient care; and (7) specialty area. Internal reliability ranged from 0·70–0·86. Conclusion Findings provide initial evidence for the validity and reliability of the Barriers to Nurses' use of Physical Assessment Scale and point to the importance of understanding the organizational determinants of nurses' assessment practices. The new scale has potential clinical and research applications to support nursing assessment in acute care settings.