What factors influence nurses' assessment practices? Development of the Barriers to Nurses' use of Physical Assessment Scale.
OBJECTIVE
To develop and psychometrically test the Barriers to Nurses' use of Physical Assessment Scale.


BACKGROUND
There is growing evidence of failure to recognize hospitalized patients at risk of clinical deterioration, in part due to inadequate physical assessment by nurses. Yet, little is known about the barriers to nurses' use of physical assessment in the acute hospital setting and no validated scales have been published.


METHODS
Instrument development study.


METHODS
Scale development was based on a comprehensive literature review, focus groups, expert review and psychometric evaluation. The scale was administered to 434 acute care Registered Nurses working at a large Australian teaching hospital between June and July 2013. Psychometric analysis included factor analysis, model fit statistics and reliability testing.


RESULTS
The final scale was reduced to 38 items representing seven factors, together accounting for 57·7% of the variance: (1) reliance on others and technology; (2) lack of time and interruptions; (3) ward culture; (4) lack of confidence; (5) lack of nursing role models; (6) lack of influence on patient care; and (7) specialty area. Internal reliability ranged from 0·70-0·86.


CONCLUSIONS
Findings provide initial evidence for the validity and reliability of the Barriers to Nurses' use of Physical Assessment Scale and point to the importance of understanding the organizational determinants of nurses' assessment practices. The new scale has potential clinical and research applications to support nursing assessment in acute care settings.
School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
Clint
C
Douglas
Sonya
S
Osborne
Carol
C
Reid
Mary
M
Batch
Olivia
O
Hollingdrake
Glenn
G
Gardner
D006801:Humans; D009730:Nursing Assessment; D009736:Nursing Process; D011594:Psychometrics; D011793:Queensland
barriers scale; health assessment; instrument development; nursing assessment; nursing observation; patient assessment; physical assessment