What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Critical care nursing (n=101). Primary outcome: Correct performance of physical assessment components.

What does this research mean for the field?

Critical care nurses correctly perform basic assessments like vital signs, orientation, and skin checks in over 90% of cases, but a majority incorrectly assess more complex parameters such as neck veins, breath sounds, heart sounds, and bowel sounds. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

March 1, 2025Open Access

An investigation into the physical assessment abilities of critical care nurses in an internationally recognized hospital

GVGideon VictorUniversity of Rome Tor Vergata FAFaisal AzizPennsylvania State University JHJamal HussainPakistan Atomic Energy Commission

Key Result

Critical care nurses correctly performed vital signs, orientation, and skin assessments in ≥90% of cases, but ≥60% incorrectly assessed neck veins, breath sounds, heart sounds, and bowel sounds.

Study Design

Type

Cross-Sectional (n=101)

Multicenter

Structured PICO

Population

101 critical care nurses (56.4% female, 43.6% male; 71.0% diploma, 29.0% BSN) employed at a private internationally accredited tertiary care hospital in Islamabad, Pakistan.

Outcome

Physical assessment skills measured using a standard comprehensive physical assessment checklist in a simulated environment

Critical care nurses demonstrated proficiency in basic physical assessments but significant gaps in specialized assessments like auscultation and neck vein evaluation, highlighting a need for targeted training.

Limitations

Data collection was conducted solely in a single private-sector hospital, which restricts the generalizability of the study findings to a broader population.

Abstract

Abstract Objective Physical assessment is an indispensable and pivotal skill that nurses must aptly monitor, evaluate, and deliver timely care, particularly in the context of critically ill patients. However, studies have revealed instances where nurses demonstrate inaccurate practices. This study is aimed to measure the physical assessment skills of critical care nurses and the differences between levels of nursing education. Methods A descriptive cross-sectional study was conducted involving a simple random sample of 101 nurses employed in critical care units. Results Of the 101 participants, 56.4% were identified as female and 43.6% were male. In the sample, 71.0% held a diploma in nursing, while 29.0% held a Bachelor of Science in Nursing (BSN). Vital signs, orientation, and skin assessments were performed correctly in ≥90% of cases, whereas the majority (≥60%) did not correctly assess neck veins, Homan’s signs, breath sounds, heart sounds, and bowel sounds. Only ≤10% of participants accurately executed these assessments. Significant associations were found between sex and pain ( P =0.034), as well as between the type of education and closure of the health assessment ( P =0.041). Further, female nurses scored 10.0 ± 2.3, and male nurses 8.5 ± 2.5, diploma holders scored 9.4 ± 1.8, and BSN holders scored 9.3 ± 2.7 at the global rating. Conclusions The presence of an existing gap in the accurate assessment of patients poses a potential risk to patient care. It is essential to investigate the factors contributing to this gap and to develop strategies to address it, thereby enhancing the quality of physical assessment and ultimately improving patient care.

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