Physical assessment competencies for nurses: A quality improvement initiative

Area of Science:

• Nursing Practice
• Patient Safety
• Quality Improvement

Background:

• Nurses are crucial for hospitalized patient safety, with physical assessment being a fundamental skill.
• Early recognition of patient deterioration is vital and traditionally relies on vital signs and technology.
• Contemporary nursing relies on technology, but basic physical assessment remains essential for patient safety.

Purpose of the Study:

• To describe the Methodist Proficient Assessment Competency (MPAC) quality improvement initiative.
• To evaluate the impact of the MPAC initiative on nursing physical assessment practices.
• To assess improvements in the completeness, timeliness, and accuracy of patient physical assessments.

Main Methods:

• Utilized surveys and directly observed patient assessment data to evaluate attitudes and practices.
• Conducted pre-MPAC audits (n=179) and post-MPAC audits (n=1391).
• Compared physical assessment documentation completeness, timeliness (within 4 hours), and accuracy before and after the MPAC initiative.

Main Results:

• Significant improvements were observed in complete physical assessments (78% vs. 94%, p < .001).
• Timeliness of assessments significantly improved (64% vs. 91%, p < .001).
• Accuracy of documentation also showed significant improvement (67% vs. 95%, p < .001).

Conclusions:

• Nurses play a critical role in identifying patient condition changes to prevent adverse events.
• Performing thorough physical assessments and accurate documentation facilitates early recognition of patient deterioration.
• The MPAC initiative successfully enhanced nursing physical assessment skills, contributing to improved patient safety.