nurse staffing issues - nursing skills
A nurse's quick assessment of an acute change in the condition
of a nursing home resident, for example, development of breathing
problems or a fever, can make the difference between a mild
illness and a serious decline in health, or between a quick
recovery with simple treatment and hospitalization and prolonged
recovery. Although patient assessment and documentation are basic
nursing practices, they are not always performed by nurses called
on to assess the status of nursing home residents, according to a
study supported in part by the Agency for Healthcare Research and
Quality (HS08551).
If a resident develops an acute change in his or her
condition—for example, difficulty breathing or an abrupt change in
mental status or mobility—it is the responsibility of the nurse to
perform and document an assessment. This assessment includes, but
is not limited to, measurement of vital signs (temperature, pulse,
and respiration) and examination of body systems, and it is
supposed to be documented as a retrievable record of nursing care.
Missouri researchers evaluated the prevalence of vital sign
assessments of 4,959 residents who developed symptoms of acute
illness in 36 urban and rural nursing homes over a period of 38
months. They also evaluated the prevalence of body system
assessments performed by nurses in a convenience sample of 289
residents at 12 nursing homes that participated in the larger
study. Overall, 31 percent of residents did not have any vital
sign assessments performed at the time of an acute change in
condition, and only 36 percent had a complete set of vital signs
taken (excluding blood pressure). About half (52 percent) of
residents identified by the nursing home staff as acutely ill
received some type of nursing physical assessment. Nurses
documented 88 percent of lung assessments and 94 percent of body
system assessments.
See "Nursing assessment of ill nursing home residents," by
Cathy R. Barry, R.N., M.S.N., Kathy Brown, R.N., B.S.N., Debbie
Esker, R.N., G.N.P., and others, in the May 2002 Journal of
Gerontological Nursing 28(5), pp. 4-7.
Reprints available from the AHRQ Publications Clearinghouse.
These are excerpts from the AHRQ Research Activities,
you can read the full report at
http://www.ahrq.gov/research/oct02/1002RA19.htm |