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Congress Abstracts 2006
295
ASSESSMENT: WHAT IS IT AND HOW DO I DO IT? Virginia Bowman, RN, MSN, AOCNS, Rosanne Arlington, RN, CNS Med-Surg, Elizabeth Fogarty, RN, Maisha Amusa, RN, Kuristeen Turner, RN, OCN® , Diana Botello, RN, BSN, Lindsay Gaido, RN, MS, and Jennifer Suasin, RN, University of Texas M.D. Anderson Cancer Center, Houston, TX.
At our comprehensive cancer center, nurses receive a classroom orientation focused on care of the oncology patient, including a review of laboratory values, management of oncologic emergencies, and policies and procedures. Physical assessment skills are evaluated by the clinical coach at the bedside during unit orientation and any specific needs are addressed. Informal feedback was received from both clinical coaches and new employees stating that some nurses lacked confidence in their assessment skills or were using poor technique when conducting physical assessments.
To enhance and improve physical assessment skills of medical-surgical oncology nurses on four inpatient units by increasing the confidence level of the nurses performing the assessments. It is believed that improved confidence and skill will support improved patient outcomes.
A survey was conducted to evaluate confidence levels among clinical nurses regarding physical assessment skills. Information was collected using a 10 cm visual analog scale. Nurses rated their confidence level with assessment of individual organ systems and emergency situations. Based on the findings, classes were developed and taught by various APNs and a nursing instructor. The methods utilized were in-services on individual systems and one-on-one training at the bedside with the nursing instructor. Each in-service was recorded on video so that all nurses on these units could access the information. The institutional e-mail system was also utilized to send brief "System of the Month" questions and answers to the clinical nurses involved.
Pre- and Post-test evaluations were completed for each educational session; at the end of the program, we will repeat the survey on confidence with assessment skills and perform an overall program evaluation.
Nurses bring a wide variety of skills and experience to the job, and a thorough physical assessment is a key component. After listening to the concerns of clinical coaches and new orientees, a group of APNs and clinical nurses joined together to define the issues and develop strategies to address them. The result was an educational program designed to enhance both the assessment skills and confidence levels of clinical nurses. Components of this program will become part of the orientation for new nurses.