Factors which influence nurse practitioners ability to carry out physical examination skills in the clinical area after a degree level module – an electronic Delphi study


  • Evelyn McElhinney

    1. Author: Evelyn McElhinney, MSc, BSc, SPQ, LPE, RN, FHEA, Lecturer, Post-Registration Nursing, School of Health, Glasgow Caledonian University, UK
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Evelyn McElhinney, Lecturer Post-Registration Nursing, Room A516, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 OBA, UK. Telephone: 0141 331 8791.
E-mail: Evelyn.McElhinney@gcal.ac.uk


Aims and objectives.  The aim of the study was to identify the factors that influence nurse practitioners ability to practice physical examination skills in the clinical area.

Background.  The changing health care needs of the population require new ways of working for many health professionals. Physical examination (core skills of inspection, palpation, percussion and auscultation) of patients is a fairly new role for nurses in secondary care in the United Kingdom. However, implementing new roles in the clinical area can be challenging for the practitioners involved, and several factors have been identified which are seen to help or hinder their success.

Design.  A Delphi study was undertaken using blind copy email over six weeks in 2008.

Method.  The participants included a purposive sample of 21 nurses from 10 clinical areas who had completed a degree level module in physical examination as part of a nurse practitioner pathway.

Results.  This study generated valuable opinion of factors that can help or hinder the ability of nurses to practice physical examination in the clinical area. The results highlight the importance of individual self-confidence, role clarity, effective educational preparation and support from other disciplines to the nurse practitioners ability to carry out this new role.

Conclusion.  Several factors reported by the participants concur and add to factors reported in previous studies of new role implementation. There appears to be a continued need for clear job descriptions, role clarity, authority and autonomy to practice for nurse practitioners undertaking physical examination.

Relevance to clinical practice.  Physical examination knowledge and skills are part of the role of nurse practitioners. This study highlights several factors which need to be addressed to ensure practitioners are able to carry out this new role on return to the clinical area.