Registered general nurses' health assessment practices in a tertiary hospital: A focused ethnography study.

Aim: To explore the assumptions and values that influence nursing health assessment practices among registered general nurses in general medical and surgical wards.

Design: The study was designed as a focused ethnography.

Methods: A semi-structured interview guide was used to explore prevailing nursing health assessment practices of 13 registered general nurses in an attempt to explore the assumptions and values influencing health assessment practices in the study setting. Data were analysed inductively using an interpretive qualitative content analysis method.

Results: Nursing health assessment practices, and underlying assumptions and values were underpinned by a central theme of a culture of low expectation relating to nursing health assessment. The culture of low expectation was highlighted in five themes: (1) Unsystematic Assessment of Health Status, (2) Purpose of Nursing Health Assessment, (3) The Role of Nursing Educational and Regulatory Institutions, (4) Ward Ethos and (5) The Role of Organizational and Ward Leadership.

Implication: The adoption of a holistic nursing health assessment framework with a clearly defined purpose of aiding nursing diagnoses can guide patient-centred care delivery and facilitate early recognition of physiological deterioration.

Patient or public contribution: Thirteen registered general nurses were interviewed, and the initial findings returned to them for validation.

Conclusion: The potential contribution of nursing health assessment to nursing practice and patient outcomes may not be fully realized if nursing health assessment is not situated within a holistic health assessment model with a clearly defined purpose for nursing practice.