Rachel Clarke

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1307 – Transitioning to practice: New graduate use of health assessment skills. An update on findings

Background
In the first year of practice, new graduate nurses are expected to incorporate health assessment skills (HAS) into their practice to fully assess a patient’s health status.  In 2006, I explored the “New graduate nurse experiences of using HAS in practice” (Clarke, 2006)  using a qualitative descriptive approach.  Interviews were conducted with six newly graduated nurses working within a New Zealand setting. Future research suggestions included recommendations to explore: a) graduate health assessment philosophies, and b) experiences of using HAS amongst registered nurses with varying clinical experience.  A decade on, it is timely to review the current literature in relation to experiences of using HAS in clinical practice.

Findings
Original findings noted that new graduates included HAS into their nursing practice with varying levels of integration. Firstly, two types of health assessment experience were described and aligned with Benner’s model of skill acquisition Advanced Beginner and Approaching Competent. The use of HAS was found to be influenced by the clinical situation and practice setting, and consequently, a second contextual model was developed to explain this phenomenon. Recent literature focuses on the physical examination skill use of nurses, and suggests that use of these skills is influenced by the ward environment.

Conclusion
To date, nursing literature focuses on types of physical examination skills and their pertinence to practice. There is a paucity of studies that examine graduate health assessment philosophies, and some qualitative research in relation to nurses’ experiences of using physical assessment skills.

Key words: health assessment; physical examination; qualitative; descriptive; new graduate nurse; philosophy.