Nurse perceptions of physical assessment skills for detecting acute progression of heart failure.

ABSTRACT

PURPOSE: The study purpose was to investigate whether years of clinical experience and experience of encountering heart failure affect perceptions of the need for physical assessment, and the nature of the association between perceptions and years of clinical experience. METHODS: This study was survey-based. Of hospitals in Japan with ≥200 beds, 298 hospitals were randomly selected as candidate research sites. Ultimately, 44 hospitals agreed to participate in this study. A self-administered questionnaire measuring 48 physical assessment skills was developed and distributed to nurses. The questionnaire rated the perceived need for 48 skills assessing acute progression of heart failure. RESULTS: Of 1,113 nurses sampled, 373 (33.5%) responded. Of these, 347 completed questionnaires (response rate 93.0%). Nurses' perceived need for skills involving systematic or cardiovascular system assessment decreased with clinical experience. Nurses' perceived need for skills involving cardiovascular symptoms and circulatory failure assessment increased with clinical experience. We found four patterns of change for nurses' perceptions of physical assessment skills according to clinical experience. CONCLUSIONS: The findings showed that differences in nurses' perceived need for physical assessment skills were associated with differences in clinical experience. Nurses with more experience selected more suitable skills for detecting acute progression of heart failure. Nurses' perceptions of the need for specific skills were proportional to years of clinical experience, and there may be a threshold value of years of experience.