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Clinical assessment: When assessing the patient in the health care workplace, what are the major? Problems and barriers experienced in effectively completing an assessment. What strategies can be used to overcome these difficulties in practice? Use ex Essay Example

  • Category:
    Nursing
  • Document type:
    Essay
  • Level:
    Undergraduate
  • Page:
    3
  • Words:
    1746

Clinical Assessment 7

Clinical Assessment

Introduction

In the nursing process, assessment is the initial stage and it encompasses carrying out a comprehensive and holistic nursing evaluation for all patients. It is an essential constituent in the nurses’ responsibility and role while offering safe and right care to their patients. Clinical assessment can be defined as the evaluation of a patient’s prognosis and physical condition (Nayer, 1993). This is based on data and information obtained from laboratory and physical examinations and from the medical history of the patient. A nursing evaluation contains a physical examination. This can be defined as the measurement of signs or observation that can be measured or observed or such symptoms as vertigo or nausea which the patient can feel (Hanley & Higgins, 2005). A nurse can employ such techniques as inspection, auscultation, palpation and percussion among others. The implication of a nursing assessment is to improve a patient’s health. Health can be defined as the level of metabolic or functional efficiency of a person. This paper seeks to discuss the purpose of carrying out a nursing assessment and the major problems and barriers experienced in effectively completing an assessment for a patient in the health care workplace. The paper will also point out the strategies which can be used to overcome these problems.

Need for clinical assessment in nursing

Clinical assessment in nursing is very significant as the assessment results can be used by the medical specialists in enhancing a patient’s wellbeing. Such results can be used by the health care practitioners to improve the productivity and health of the patients. Clinical assessment usually offer results which only take into account the patient who is being assessed, rather than assessing the patients based on the information which is obtained from other multiple sources. Furthermore, clinical assessments carried out by medical practitioners are employed in determining the cause, nature and potential impacts of a patient’s illness, injury or wellness. This is important as it enables the practitioners to compile the best possible treatment options for their patients based on various mental, physical, and medical factors (Nayer, 1993). Habitually, this offers a more accurate and detailed treatment and diagnosis for patients. In some cases, some clinical assessments are authorized by the federal agencies to guarantee safe medical practices. Generally, federally authorized clinical assessments characteristically make certain that medical treatment and diagnosis options are in the interest of the patient. In the United States (US) the Centers for Medicare and Medicaid Services necessitates a clinical evaluation known as a minimum data set (MDS) for all the patients who are admitted to long-term care facilities and who are certified to obtain Medicaid or Medicare benefits (McGuire, 1985).

Major problems experienced in effectively completing an assessment and strategies to overcome these difficulties in practice

Under trained staff

The kind of training given to service deliverers has a huge influence on the service provision of any expert. From past researches, it is evident that most sectors today hire staff who are either under trained or simply lack the right training unknowingly. This as a result leads to lack of the required skills and competencies among the medical specialists. In our case, studies have shown that most hospitals are facing this problem which is always as a result of the lack of conformity in the regulation of practitioners. The care givers have been found studying anywhere even in areas or institutions not qualified to give health care service training hence they end up being mislead and thus are not able to give a comprehensive assessment by the use of the knowledge and history of the patient to determine the real problem. In addition, staff technological backwardness also poses a problem during a clinical assessment. For instance the staff may not be knowledgeable on the use of a certain facility which he requires to use when carrying out an assessment on the patient. This means that he will only deliver inadequate or the wrong information regarding the patient’s problem. Consequently the patient receives the wrong treatment and this could be very dangerous to both the patient and the hospital at large. As a strategy, hospitals should ensure that they offer training to their staff to ensure that they are up to date with the ever changing technology (McCarthy, 1981). Moreover, regulations should be put in place to ensure that the medical practitioners get the relevant training required for service delivery.

Cultural diversity

Culture is a good thing if approached on a positive front. However, studies have shown that cultural differences sometimes lead to discrimination in the provision of services in most sectors. Hospitals are designed to care for all forms of patients regardless of race or class. This is not always the case and one’s culture might influence the quality and level of care one receives at a hospital facility. This is because nurses and doctors are ordinary people and are victims of the same bias which afflicts the larger society. These discriminations might arise from racial preference where some races might be discriminated due to certain attributes associated with them. While it might not be common, a racist might offer poor patient assessment due to his perceived inferiority of the patient. Moreover, language barriers which may lead to communication problems might make it hard for the assessor to make the right diagnosis due to communication failure (Kasch & Dine 1988; Anderson & Stickley, 2002). What can be done to ensure that our cultural diversity does not act as deterrent for the provision of qualitative and unbiased health care? Promotion of equality in all sectors and a creation of awareness regarding the negative impacts of racism to any given society is one strategy. Society should also create mechanisms to check against disparities in care provision and act upon them to discourage further neglect and abuse. As for language barrier, hiring bi-lingual staff might solve this problem once and for all.

Hospital policies

Nurses’ work under a framework designed by hospital administration and enforced by assigned supervisors. This means that the competence of care givers and the quality of care is largely influenced by hospital policies. This also means that policies which hamper qualitative care provision act as barriers for the realization of nurse’s objectives. Understaffing leads to low patient-nurse ratio which reduces the amount of time a nurse has to devote to any particular patient. The amount of time a nurse works also affects her ability to cope with any situation. This means that overworked nurses are likely to be complacent due to exhaustion. Under paid nurses might also lack the right motivation to give their best to serving patients. This coupled with the stress of high living standards might impair their ability to assess patients. This is just but a few examples of how hospital policies can create barriers for the right patient assessment by nurses and other care givers. Hospital administration must create policies that are both beneficial to nurses and the patients they attend to. In addition, they should do their best to offer them good pay packages so they can devote all their efforts towards providing patients with quality care. Moreover, hospitals must create a code of conduct which must be followed strictly by all nurses to ensure best standards in all their duties.

Patient anxiety, fear and discomfort

Another problem experienced while carrying out a nursing assessment is patient’s anxiety, discomfort and fear. Studies have revealed that, this is a major barrier experienced by nurses while performing a patient evaluation. It is apparent that the initial stages of the assessment will encompass the general practitioner asking the patient some questions related to the disease. In most circumstances, many patients are very anxious or are not comfortable with this, while others may fear the unknown. This fear may be linked to stigma. In order to mitigate this barrier, the medical practitioner should explain to the patient that the information obtained will be treated with confidentiality (Hanley & Higgins, 2005). Furthermore, the nurse should prepare the patient psychologically before carrying out the assessment (Tanner et al., 1993).

Insufficient test facilities/resources

The right assessment is determined by the use of the right facility to carry out the test. According to studies, the lack of sufficient test facilities and the right resources in many hospitals to cater for certain patients for instance the cancer patients consequently cause a major set back to health care service delivery. The lack of the necessary facility is as a result of lack of funds to purchase them or a practitioner with the knowledge of on the use of these facilities. To address this problem the hospital should ensure that they hire competent practitioners on this field. In addition the hospital should ensure that no patient is discriminated from getting the right treatment regardless of the patient’s problem by ensuring the availability of the right facilities and resources say through charity for example.

Conclusion

It is true from the discussion that nursing assessment is very significant in nursing. However, various barriers and problems are experienced while completing a nursing assessment. These problems include patient anxiety, fear and discomfort, under-trained practitioners, lack of essential facilities, hospital policies, and cultural diversity including communication barriers. Nevertheless strategies have been discussed to counter these problems. It is therefore apparent that effective nursing assessment which is intended to promote a patients well-being can be attained by mitigating the problems and barriers identified above by using the strategies mentioned.

References

Anderson, M., Stickley, T. (2002). Finding Reality: the use of objective structured clinical examination (OSCE) in the assessment of mental health nursing students’ interpersonal skills. Nurse Education in Practice; 2, 160-168.

Hanley, E., and Higgins, A. (2005). Assessment of clinical practice in intensive care: a review of the literature. Intensive and Critical Care Nursing, 21 (5), 268-275.

Jenny, J. & Logan J. (1992). Knowing the patient: one aspect of clinical knowledge. The Journal of Nursing Scholarship 24(4), 254-258.

Kasch, C.R. & Dine J. (1988). Person-centered communication and social perspective-taking. Western Journal of Nursing Research 10, 317-326.

McCarthy, M.M. (1981). The nursing process: application of current thinking in clinical problem solving. Journal of Advanced Nursing 6, 173-177.

McGuire, C.H. (1985). Medical problem-solving: a critique of the literature. Journal of Medical Education 60, 587-595.

Nayer, M. (1993). An Overview of the Objective Structured Clinical Examination. Physiotherapy Canada; 45(3), 171-178.

Tanner, C.A., Benner P., Chesla C. & Gordon, D.R. (1993). The phenomenology of knowing the patient. The Journal of Nursing Scholarship 25(4), 273-280.