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Nursing Physical Assessment: Current Practice Requires a Paradigm Shift Back to Basics

Shannan K. Hamlin*, Hsin-Mei Chen, Nicole Fontenot, Andrei Ionut Cucu, Steven Jay Hooker

Nurse ongoing surveillance is a core principle of nursing practice that involves a specific patient observation process, physical assessment, continuous patient monitoring, recognition of patient status changes, interpretation of clinical data, and decision-making. Twenty-four-hour presence, including a core responsibility of gathering baseline data through systems-based physical assessment and ongoing surveillance, gives nursing the strategic advantage and obligation to identify and intervene early when a patient's condition deteriorates. Current evidence suggests nurses perform a limited number of assessment skills on their patients, most of which are vital signs. Utilizing a systems-based physical assessment in daily practice allows nurses to think holistically about their patients’ current health status. Subsequent early and most often subtle signs of deterioration can then be quickly detected and acted upon. Early recognition of a change in patient condition stemming from a systems-based physical assessment is the pre-requisite to the 24-hour surveillance solution to keeping patient’s safe and preventing adverse patient events.