Members of the RBWH Patient Assessment Research Council: Kathleen Richter (Chair), Kate Mason, Catriona Booker, Dale Dally-Watkins, Elizabeth Main, Robyn Fox, Kathrin Peisker, Margaret Buda, Thea-Grace Collier, Peter Groom, Sandy Jamieson, Melanie Foster. Responsibility for this article rests with the named authors.
What factors influence nurses' assessment practices? Development of the Barriers to Nurses' use of Physical Assessment Scale
Article first published online: 6 APR 2014
© 2014 John Wiley & Sons Ltd
Journal of Advanced Nursing
Volume 70, Issue 11, pages 2683–2694, November 2014
How to Cite
Members of the RBWH Patient Assessment Research Council (2014) What factors influence nurses' assessment practices? Development of the Barriers to Nurses' use of Physical Assessment Scale. Journal of Advanced Nursing 70(11), 2683–2694. doi: 10·1111/jan.12408, , , , , &
- Issue published online: 13 OCT 2014
- Article first published online: 6 APR 2014
- Manuscript Accepted: 8 MAR 2014
- QUT School of Nursing
- barriers scale;
- health assessment;
- instrument development;
- nursing assessment;
- nursing observation;
- patient assessment;
- physical assessment
To develop and psychometrically test the Barriers to Nurses' use of Physical Assessment Scale.
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.
Instrument development study.
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.
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.
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.