HA

• Assessment is the entry point towards quality, comprehensive, evidence-based patient care.
• The process of assessment involves the formation of a database on the individual's health state.
• Emergency Assessment is a rapid assessment performed in life-threatening situations such as choking, cardiac arrest, and drowning, where an immediate assessment is needed to provide prompt treatment.
• From this database, the nurse makes a clinical judgment or nursing diagnosis about the individual's health state or risk health problems.
• The novice nurse (nursing student) is expected to develop knowledge, skills, and an appropriate attitude on health assessment and physical examination.
• The future professional nurse will achieve competency, proficiency and expert levels of performance in promoting the optimal health of patients.
• The role of the nurse in assessment and diagnosis is more prevalent than ever before in the history of nursing.
• Nurses from numerous countries are expanding their assessment and nursing diagnosis skills.
• The rapidly evolving roles of nursing require extensive focused assessments and the development of related nursing diagnoses.
• Rising educational costs and focus on primary care affect the numbers and availability of medical students.
• The increasing complexity of acute care, a growing aging population with complex comorbidities, expanding health care needs of single parents, intensifying mental health issues, expanding health service networks, and increasing reimbursement for health promotion and preventive care services, will continue to promote opportunities for nurses with advanced assessment skills.
• Physical assessment has been an integral part of nursing since the days of Florence Nightingale.
• In the late 1800s and early 1900s, nurses relied on their natural senses to observe changes in color, temperature, muscle strength, upper limbs, body output, and degrees of nutrition, and hydration.
• Palpation was used to measure pulse rate and quality and locate the fundus of the puerperal woman.
• Examples of independent nursing practice using inspection, palpation, and auscultation have been recorded in nursing journals since 1901.
• The American Journal of Nursing (1901 - 1938) documents routine client and home inspection by public health nurses in the 1930s.
• This role of case finding, prevention of communicable diseases, and routine use of assessment skills in poor inner-city areas was performed through the Frontier Nursing Service and the Red Cross.
• The Initial Comprehensive Assessment is the collection of subjective data about the client's perception of his or her health of all body parts or systems, past health history, family history, and lifestyle and health practices, as well as objective data gathered during a step-by-step physical examination.
• Continuous Assessment is performed on a regular basis, typically daily, to monitor the client's health status and detect any changes.
• Over the last 20 years, the movement of health care from the acute care setting to the community and the proliferation of baccalaureate and graduate education solidified the nurses' role in holistic assessment.
• The nurse collects physiologic, psychological, sociocultural, developmental, and spiritual data about the client, as well as how clients interact within their family and community, and how the clients' health status affects the family and community.
• Critical pathways or care maps guided the client's progression in the 1990s, with each stage based on specific protocols that the nurse was responsible for assessing and validating.
• Advanced practice nurses have been increasingly used in the hospital as clinical nurse specialists and in the community as nurse practitioners.
• Focused or Problem-Oriented Assessment is performed when a comprehensive database exists for a client who comes to the healthcare agency with a specific health concern, consisting of a thorough assessment of a particular client problem and does not address areas not related to the problem.
• On-going or Partial Assessment consists of data collection that occurs after the comprehensive database are established, reassessing any problems initially detected in the client's body system or holistic health patterns.
• Downsizing and budget cuts were the priorities of the 1990s, leading to a demand for documentation of client assessments by all healthcare providers to justify healthcare services.
• The four basic types of health assessment are: Initial Comprehensive Assessment, On-going or Partial Assessment, Focused or Problem-Oriented Assessment, and Continuous Assessment.
• The purpose of nursing health assessment is to collect holistic subjective and objective data to determine a client's overall level of functioning to make a professional clinical judgment.
• Health assessment is the first and most critical phase of the nursing process, it is ongoing and continuous throughout all phases of the nursing process, and it is more than just gathering information about the health status of the client.
• In the 1950s, nurses were hired to conduct pre-employment health stories and physical examinations for major companies.
• The early 1970s prompted nurses to develop an active role in the provision of primary health services and expanded the professional nurse role in conducting health histories and physical, psychological assessments.
• Acute care nurses in the 1980s employed the "primary care" method delivery of care.