Implications and Outcomes of Advanced Health Assessment

The advanced nursing practitioner reliance on the health assessment models comes with implications and outcomes to the nursing practice as well as health assessment process (Coyne et al., 2016). To begin with, advanced health assessment directs the intervention and care accorded to the patients. By the capacity vested in the advanced nursing professionals, they are able to treat and recommend medication to patients following the advanced assessment of the patient’s conditions. In this case therefore, the patient is accorded fast attention and treatment which aids in their recovery. In the normal system where nurses perform physical assessment and refer clients to the doctor for further medication and treatment, the patients would benefit from the services of the advanced nursing professional (Anderson et al 2014). Additionally, the education level and effective assessment of the patients allows advanced nursing professionals to holistically treat and provide care to the patients. However, there are instances where miss-assessments are conducted and they can lead to serious impacts on the patients. For instance, much as the advanced nursing practice can have the ability to diagnose pronounced diseases, they are limited in the clinical treatment that can offer to patients. Certain procedures such as surgeries may be difficult to perform and with this the patient may not fully benefit from the services offered by the advanced nursing practitioner. A case in point is where Mr. P, a 52 year old male was admitted at the hospitals manifesting symptoms of shortness of breath, and difficulties in breathing. Following the assessment of the Advanced nursing practitioner, the patient was diagnosed of Asthmatic condition and the nurse recommended medication for the Asthmatic condition. However, during the physical assessment, the nurse failed to consider the full history of the patients and missed the information of the long history of tobacco use and due to this, spirometry analysis identified that the patient was actually suffering from chronic obstructive pulmonary disease. Medical conditions often manifest common symptoms and this requires the advanced nursing practitioner to consider a comprehensive assessment to understand the condition of the patients (Coyne et al 2016).

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Secondly, advanced nursing practitioners involvement in the health assessment helps to manage the influx of the patients seeking medical attention in the hospital. The Advanced nursing practitioner's role in the health assessment aids the patients to get the crucial services in the hospital (Feo et al., 2018). This allows the hospital to attend to many patients without straining the health professionals in the hospital. In an instance where the hospital lacks advanced nursing professional the nurses will generally conduct basic assessment to the patients, and refer them to the doctors and physician for further medical attention. This strains the health services since the doctors will be burdened with a big number of patients seeking their attention and assistance. However, in the presence of advanced nursing practitioners who also double up as doctors, they are able to assess, diagnose and treat some patients, reducing the need for the patients to wait for the doctor.

Patient-centered care is one of the models that has been attributed to effective healthcare. This principle advocated for adoption of individualized approach in the provision of healthcare to the patients. The healthcare providers have a role of attending to the patients. Health assessment that adopts the individualized approach is focused on managing all the needs of the patients in a focused way that enables the advanced nursing practitioner to understand the patient and manage the patient better (Hill 2017). Additionally, the emphasis of value-based care and adhering to the rights and dignity of the patients not only enhances the effectiveness of health assessment, but also maximizes the outcomes associated with the assessment. Thus, the advanced nursing practitioner will have the ability to understand the patients, as well as provide quality assessments that enhance the patients’ experience. Patients on the other hand will be able to experience positive healthcare in a timely and holistic manner that will enhance the recovery of the patients. A case in point, Mr John, a 70 year old male was admitted to the hospital seeking medical attention, upon assessment, the advanced nursing practitioner identified that the patient was suffering from dementia and has associated diabetes condition. In the course of treatment, the patients experienced instabilities in the behaviour and was aggressive towards the nursing practitioner and other staff involved in caring for the patients. This behaviour cannot be generalized to other patients with similar conditions. In this case, care accorded to Mr. John should be tailored to meet the needs of the patients. For instance, in addition to the recommended medications, the advanced nursing practitioner may have to rely on effective communication skills, and people management skills to understand the patient and manage their aggression towards the healthcare practitioner.

In acute care settings, the advanced nursing practitioner plays a crucial role in physically assessing the patients admitted in the hospital. Occasionally, advanced nursing practitioners have the ability to diagnose more serious health conditions compared to the other level of nurses (Cowan et Al 2005). Diagnosis is often based on the effectiveness of health assessment.

In a hospital setting, patients often complain about various physical health related conditions such as headaches, pneumonia, injuries and other chronic diseases which are identified following physical health assessments. The advanced nursing practitioner can conduct these physical health examinations to establish the conditions experienced by the patients. However, patients often manifests symptoms of two or more health complications and thus, comprehensive physical examination is the ideal solution for identifying such conditions (Hill 2017).

Comprehensive physical examination is a holistic approach adopting a head-to-toe examination aimed at ensuring that the patient’s entire physical being is free from infections, injuries and complications and should any part of the body be identified to have a problem, effective mitigation measures are put in place to manage the condition and enhance total physical wellbeing of the patients (Andrew et al 2014)

Comprehensive physical health assessment can be achieved through a number of methods, two of which are discussed herein. First, complete health assessment is an approach that can be relief upon by advanced nursing practitioners when examining patients with acute health complications or seeking medical assistance in the hospital setting (Coyne et al 2016). This is performed as part of the diagnosis procedure and unlike the general diagnosis which is focused on the case and the patient's explanations of their experience, as well as some bit of medical history, comprehensive physical assessment covers all aspects of physical health and wellbeing of the patient. The practitioner obtains as much information about the medical and physical life history of the patients as well as perform a head-to-toe physical examination of the body parts (Halcomb et al 2016). This procedure is mostly performed by advanced nursing professionals during the annual check-up on the individuals who wish to know their health status better, and it is also crucial to patients exhibiting medical complications and can enable the advanced health practitioner to signpost cases of patients living with two or more related medical conditions, a fact that is increasingly becoming common (Coyne et al.,2016). For instance, people with obesity may equally be suffering from cardiovascular conditions such as high blood pressure. On the other hand, diabetic patients may also be suffering from coronary heart diseases. This is equally the case for patients with chronic obstructive pulmonary diseases who may also be suffering from asthma. In these cases, to relate medical conditions that may be exhibiting similar symptoms and may be mistaken as one condition therefore, advanced nursing practitioner may rely on conducting a complete physical health assessment to identify the presence of other clandestine conditions (Feo et al 2018). Technologies such as x-ray machines may be used to aid in the physical examination especially of the internal organs and tissues

Secondly, problem focused assessment is another way in which physical assessments can be fully conducted on the patient. In this type of the assessment, the advanced nursing practitioner undertakes a comprehensive physical assessment of the patient based on an identified need or problem that the patient is facing (Jensen 2018). Ideally, different patients are presented with different problems affecting their physical health and well-being thus, physical assessment will help to identify, diagnose and treat the condition.

There are crucial benefits associated with comprehensive physical health assessment. First, physical health assessment is crucial in identifying possible diseases through appraisal of the manifestations of the condition that are identified during physical examinations (Ferrell 2015). Secondly, physical health assessment can enable the advanced nursing practitioner to identify issues of medical concerns. During comprehensive physical health assessment, especially in the annual assessments, the advanced nursing practitioner is able to identify predisposing factors for the medical conditions (Feo et al 2018). This early identification helps in diagnosis of the condition early and helps the patients to be effectively managed and for the medical conditions to be effectively managed. Early identification of most chronic medical condition can lead to effective treatment and management thus prevent the progression of the conditions of the patients

Comprehensive physical examination also enhances the relationship between the patient and the advanced nursing practitioner (Jensen 2018). An established and strong relationship between the patient and the practitioner helps ensuring that patients adopt healthy living behaviours such as eating balanced diets and maintaining a healthy exercise routine. These behaviours are crucial in enhancing healthy living and the patient’s, through comprehensive physical assessment manages to learn how to balance between healthy feeding and exercise in order to keep a healthy lifestyle (Coyne et al 2016).

Conclusion

The role of the advanced nursing practitioners in the healthcare setting is undoubted. This paper has identified that advanced nursing practitioners are equipped with crucial skills and education that allows them to manage more serious complications of the patients compared to the primary care nurses. As hospital grapple with the influx of patients and with increasing statistics on the prevalence of medical conditions, some which are so chronic and severe places a pressure on the inadequate number of doctors in the hospitals to manage patients, which impacts their productivity. As a result, advanced nursing practitioners are increasingly playing a crucial role of enhancing the health and we’ll being of patients by providing assessments, diagnosis and the treatment of patients without them having to see the doctors. In doing so, the advanced nursing practitioners rely on clinical assessment models when examining the patients and the outcome of their practice as identified in this paper include effective management of the conditions, quick detection and response to the common medical conditions and increased application of the patient-centered healthcare. Furthermore, the use of comprehensive physical assessment by the advanced nursing practitioner helps in the management of the patients, and the benefits of physical health assessment include early detection of diseases and increased rapport between the patient and the practitioner. By and large, advanced nursing practitioners fill the gaps between the specialized doctors and primary nursing practitioners.

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References

0’ Sullivan, ED and Schofield, SJ. (2018) ‘Cognitive bias in clinical medicine’. Journal of the Royal College of Physicians of Edinburgh 48 (3), 225-232

Anderson, C., 2018. Exploring the role of advanced nurse practitioners in leadership. Nursing Standard, 33(2).

Andrew Scanlon, D.N.P., Denise Hibbert, R.G.N., Freda DeKeyser Ganz PhD, R.N., Linda East PhD, R.N. and Debbie Fraser MN, R.N., 2014. Addressing issues impacting advanced nursing practice worldwide. Online journal of issues in nursing, 19(2), p.1.

Cowan, D.T., Norman, I. and Coopamah, V.P., 2005. Competence in nursing practice: a controversial concept–a focused review of literature. Nurse education today, 25(5), pp.355-362.

Coyne, I., Comiskey, C.M., Lalor, J.G., Higgins, A., Elliott, N. and Begley, C., 2016. An exploration of clinical practice in sites with and without clinical nurse or midwife specialists or advanced nurse practitioners, in Ireland. BMC health services research, 16(1), p.151.

Davies, J., Lynch, F., Nyman, A. and Riphagen, S., 2016. The role and scope of retrieval nurse practitioners in the UK. Nursing in critical care, 21(4), pp.243-251.

Farrell, C., 2015. Advanced nursing practice and clinical leadership. In Advanced Nursing Practice and Nurse-led Clinics in Oncology (pp. 41-55). Routledge.

Feo, R., Kitson, A. and Conroy, T., 2018. How fundamental aspects of nursing care are defined in the literature: A scoping review. Journal of clinical nursing, 27(11-12), pp.2189-2229.

Halcomb, E., Stephens, M., Bryce, J., Foley, E. and Ashley, C., 2016. Nursing competency standards in primary health care: an integrative review. Journal of clinical nursing, 25(9-10), pp.1193-1205.

Hill, B., 2017. Exploring the development and identity of advanced practice nursing in the UK. Nursing Management, 24(5).

Jensen, S., 2018. Nursing health assessment: A best practice approach. Lippincott Williams & Wilkins.

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