title: 'Hands-on' assessment: A useful strategy for improving patient safety in emergency departments.
abstract: BACKGROUND
  Patient assessment is an essential nursing intervention that reduces the incidence and impact of errors and preventable adverse events in emergency departments (EDs). This paper reports on a key finding of the ED nurse component of a larger study investigating how registered nurses manage 'discontinuities' or 'gaps' in patient care.
  
  
  METHODS
  The larger study was undertaken as a naturalistic inquiry using a qualitative exploratory descriptive approach. Data were collected from a criterion-based purposeful sample of 71 nurses, of which 19 were ED nurses, and analysed using content and thematic analysis strategies.
  
  
  RESULTS
  The component of the study reported here revealed that ED nurses used 'hands-on', head-to-toe assessment to manage gaps in patient care. Examination of the data revealed three key dimensions of patient assessment in the ED: (i) assessment is the 'bread and butter' of emergency nursing; (ii) 'hands-on' assessment techniques are irreplaceable and, (iii) patient assessment is undervalued in EDs.
  
  
  CONCLUSIONS
  The findings of this study reaffirm the role of 'hands-on' observation and assessment in creating safety in EDs. Further research and inquiry is needed to determine how health care systems can provide the conditions for ensuring that 'hands-on' assessment occurs.
authors: Deakin University, School of Nursing and Midwifery, 221 Burwood Highway, Burwood, Victoria 3125, Australia. Electronic address: angela.jones1@deakin.edu.au.
authors: Angela
authors: A
authors: Jones
authors: Deakin University, School of Nursing and Midwifery, 221 Burwood Highway, Burwood, Victoria 3125, Australia.
authors: Megan-Jane
authors: MJ
authors: Johnstone
authors: Deakin University, School of Nursing and Midwifery, 221 Burwood Highway, Burwood, Victoria 3125, Australia.
authors: Maxine
authors: M
authors: Duke
mesh_terms: D001291:Attitude of Health Personnel; D016529:Emergency Nursing / Q000379:methods*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D024802:Nurse's Role; D009741:Nursing Staff, Hospital; D061214:Patient Safety; D036301:Qualitative Research
keywords: Continuity of patient care; Hospital emergency service; Nurses; Nursing assessment; Patient safety