NBHS 1104

NURSING HEALTH ASSESSMENT

Topic 2
Nursing Assessment-Part II
DR Tan Beng Geok
 Learning Outcomes
By the end of this topic, you should be able to:
• Identify six skills needed in the assessment
process;
• Explain two processes in cognitive(intellectual)
skills;
• Discuss four various methods of problem
solving in clinical practice; and
• Differentiate between the three phases
 Introduction
To achieve nursing goals successfully, one may
require high-quality doing and thinking. The
intertwining of thinking and doing in nursing is
part of the nursing process.
Nurses identify patients’ strengths and responses
to health and illness situations, design ways to
assist patients in dealing with those situations,
implement the needed nursing care and
determine the effectiveness of that care by looking
for changes in the patient’s behaviour.
SKILLS NEEDED IN ASSESSMENT PROCESS
The Purposes of Assessment are:
• To collect data pertinent to the patient’s
health status, to identify deviations from the
norm;
• To discover the patient’s strengths and coping
resources; and
• To pinpoint actual problems, and to spot
factors that place the patient at risk for health
problems.
Assessment Requires:
Cognitive
Skill

Technical Problem-
Skill solving skill

Assessment

Psychomoto
Ethical skill
r skill

Affective/In
terpersonal
Skill
 Cognitive (Intellectual) Skills
• Critical Thinking
– Is a complex thinking process
– Involves mental skills
• Determining
• Evaluating
• Reflective and reasonable thinking
• Clinical Decision Making
– is the process of choosing the best actions
• Deliberation/discussion
• Judgment
• Choice
 Problem-Solving Skills
There are four methods of problem-solving:
1. Reflexive Thinking- automatic, without
conscious deliberation and come with
experience.
2. Trial-and-error Approach – hit or miss
thinking, random, not systematic and
inefficient.
3. Scientific Method – systematic, critical
thinking approach.
4. Intuition- develops through experience,
theory and practice are intertwined.
 Psychomotor Skills

• Gain patient’s trust

• Achieve desired patient outcome
• Is needed during physical assessment
– Inspection
– Palpation
– Percussion and
– Auscultation
 Affective/Interpersonal Skills
• Affective skills are essential in developing
caring, therapeutic nurse-patient
relationships.
• Interpersonal skills include both verbal and
non-verbal communication skills.
• Quality of your assessment depends on your
communication skills and the relationship
with your patient.
 Affective/Interpersonal Skills
A good relationship can be promoted:
• By having a positive attitude and sense of
humour; by being open, honest, patient and
frank;
• By demonstrating humility, accountability and
reliability;
• By admitting when you are wrong; and
• By giving credit to others who deserve it.
 Ethical Skills
1. Responsible
2. Accountable
3. must respect your patientÊs rights and
ensure patient confidentiality.
 Technical Skills
• Use computerised information systems to
facilitate data collection.
• To be able to use and interpret the data
correctly.
 Summary
• There are six skills needed in the assessment process. They
are cognitive (intellectual) skills, problem-solving skills,
psychomotor skills, affective/ interpersonal skills, ethical
skills and technical skills.
• There are two processes in cognitive skills namely critical
thinking and clinical decision making.
• There are four methods of problem-solving skills: reflexive
thinking, trial and-error approach, scientific method and
intuition.
• The phases of interview are divided into three phases
namely introductory phase, working phase and termination
phase.