In-Depth Notes on Health Assessment and Nursing Practice

Introduction to Registered Nursing (RN) in Alberta

• Goal of RN Practice: Provide safe, competent, and ethical nursing care.
• Accountability: Registered nurses are accountable and responsible for their practice.

RN Objectives (Schedule 24 of the HPA, 2000, s 3)

• Care Application: Use nursing knowledge to assist with health and wellbeing for individuals, families, and communities.
  • Examples:
  • Assess and diagnose health conditions.
  • Provide treatment and interventions.
  • Prevent or treat injury and illness.
  • Teach and advocate for health.
  • Supervise and evaluate health services.
  • Engage in nursing research.
• Restricted Activities: Provide certain activities as authorized by regulations.

Canadian Nurses Association (CNA) Code of Ethics (2017)

Core Principles:

• A. Provide safe, compassionate, competent, and ethical care.
• B. Promote health and well-being.
• C. Respect informed decision-making.
• D. Honor dignity of individuals.
• E. Maintain privacy and confidentiality.
• F. Promote justice.
• G. Be accountable for actions.

Health Promotion Frameworks

• Prevention Levels:
  • Primordial: Mitigating population-level risk factors.
  • Primary: Preventing disease before it occurs.
  • Secondary: Early detection and intervention.
  • Tertiary: Managing and improving outcomes for those with existing conditions.
  • Quaternary: Preventing unnecessary interventions or harm.

Purpose of Health Assessment

• Definition: Integrates subjective and objective data through various methods.
• Components:
  • General survey.
  • Health history.
  • Review of systems.
  • Physical examination.
  • Outcome: Comprehensive health assessment for patient care.

Knowledge Development Areas for RNs

• Critical Topics:
  • Anatomy, physiology, pathophysiology, and pharmacology.
  • Psychomotor skills and their rationale.
  • Theoretical frameworks that guide nursing practice.
  • Critical thinking and clinical judgment skills.
  • Communication and therapeutic relationships.
  • Importance of health assessment as foundational to nursing practice.

Effective Study Strategies for Health Assessment

• Recommended Actions:
  • Review weekly outcomes and lab content correlations.
  • Complete quizzes after reading chapters.
  • Use of Resources: Bate’s Videos for practical demonstrations.
  • Understand and apply anatomy and physiology knowledge.
  • Reflect on classroom engagement and practical experiences.
  • Prepare for exam formats that assess both memorization and application of knowledge.

Grades and Assignments

• Assessment Breakdown:

  • Reading Knowledge Checks: 10%
  • Lab Learning Assessment: 10%
  • In-class Quizzes: 45% (3 quizzes, 15% each)
  • Final Exam: 35%

• Letter Grade Scale:

  • A+: 94.95-100.00
  • A: 90.95-94.94
  • A-: 86.95-90.94
  • (Other grades down to F: 0.00-54.94)

Nursing Process and Health Assessment Components

• Stages:
  • Assessment: Data collection, organization, validation.
  • Diagnosis: Data analysis to identify health problems.
  • Planning: Goal setting and formulating nursing interventions.
  • Implementation: Executing the care plan and documenting actions.
  • Evaluation: Ongoing assessment of patient status and outcomes.

Tanner's Clinical Judgment Model

• Key Components:
  • Noticing, interpreting, responding, and reflecting throughout patient care.
  • Critical for developing sound clinical judgments in nursing.

Types of Health Assessments

• Categories:
  • Urgent Assessment: Immediate care needs.
  • Comprehensive Assessment: Broad overview of health.
  • Focused Assessment: Specific issues or concerns.

Communication Skills in Health Assessment

• Effective Techniques:
  • Active listening and guided questioning.
  • Empathy in responses and maintaining patient dignity.
  • Respect for cultural differences and utilizing interpreters as necessary.

Interview Process Phases

1. Pre-interaction Phase: Preparation for meeting.
2. Beginning Phase: Establishing rapport.
3. Working Phase: Engaging in the main conversation.
4. Closing Phase: Summarizing and concluding the session.

Special Communication Considerations

• Tailoring communication strategies for:
  • Hearing impaired patients.
  • Patients with cognitive impairments or mental health issues.
  • Recognizing non-verbal cues and using touch appropriately.

Lifespan Considerations

• Adaptation of communication techniques for:
  • Newborns and infants
  • Older children and adolescents
  • Older adults

Dependencies in Assessment Frequency

• Varies by:
  • Patient’s needs and healthcare context.
  • Type of care setting: long-term, acute, intensive, outpatient/community.
  • Chronic conditions requiring regular health assessments based on specific issues (e.g. diabetes).

References

• Giddens, J.F. (2017). Concepts for nursing practice: Second edition. Elsevier.
• Stephen, T.C., & Skillen, D.L. (2021). Canadian nursing health assessment: A best practice approach. Second edition. Wolters Kluwer.
• Tanner, C.A. (2006). Thinking like a nurse: a research-based model of clinical judgement in nursing. Journal of Nursing Education, 45 (6), 204-211. https://doi.org/10.3928/01484834-20060601-04.