| dc.description.abstract | Physical assessment is an essential part of the overall health assessment which
constitutes the first phase of nursing process. Physical assessment competence of nurse
interns has been observed as insufficient in evaluation and solving patients’ health
problems in the clinical environment. This has negatively influenced their ability to
make better clinical decisions, thus contributing to poor quality of patient care. The
aim of this study was to investigate nurse interns’ competence in physical assessment
for adult patients in Western region of Kenya. A cross-sectional research design using
mixed methods of data collection was used with the target population being nurse
interns in health facilities in Western region of Kenya. A sample size of 117 interns
was used. A self-administered questionnaire was used to collect data on physical
assessment knowledge and factors influencing physical assessment competence of
nurse interns while an observation checklist was used to assess their physical
assessment skills. Key informant interview was used to obtain information from nurse
managers on factors influencing physical assessment competence of nurse interns.
Quantitative data was analyzed using SPSS, version 26 using both descriptive and
inferential data analysis techniques while qualitative data was analyzed thematically
guided by the study objectives. For inferential statistics, multiple regression was
applied, with a p value of ≤ 0.05considered as statistically significant. Adjusted Odds
Ratio (AOR) was used to test the strength of association between independent and
dependent variables. The findings of the study revealed that 62% (n=72) of nurse
interns were knowledgeable on physical assessment. They had knowledge in taking
vital signs (≥90%, n=106), preparation for physical assessment (≥85%, n=99),
inspection (89.7%, n=105) and palpation (88%, n=103). 35% (n=41) of the interns
performed very well in physical assessment skills. ≥90% (n=106) of them performed
very well in measurement of vital signs, assessment of the airway and inspection of
body systems. The study revealed that 35% (n=41) of the interns were competent as
they scored 90% in both knowledge and physical assessment skills. Factors that were
statistically associated with higher competence scores (≥ 90%) were year of
completion of 2016 – 2019 (OR: 3.1; 95% CI [1.1, 8.5]; p = 0.02), internship period
of 9 – 12 months (OR: 0.2; 95% CI [0.1, 0.5]; p = 0.0002),>7 months previous clinical
experience prior to internship (OR: 0.4; 95% CI [0.2, 1.0]; p = 0.05), self-confidence
(OR: 4.5; 95% CI [1.9, 10.5]; p = 0.003) and motivation (OR: 0.4; 95% CI [0.2, 1.0];
p = 0.042). In conclusion, nurse interns' competence in physical assessment is low, as
shown by around one third of study participants achieving a score of 90% and above
in both knowledge and physical assessment skill performance. Key factors that
influence physical assessment competence are year of completion, a longer period of
internship, previous clinical experience before internship, self confidence in
performing physical assessment accurately, motivation of nurse interns to learn more
and perform physical assessment and regulatory body factors. This study therefore
recommends the Schools of Nursing to put more emphasis on theoretical teaching of
physical assessment and provide adequate supervision for student nurses during
clinical practicum to enable them develop their physical assessment skills before
internship. The study also recommends hospitals to train nurse mentors to provide
ongoing professional development opportunities and mentorship programmes for
nurse interns. This will improve their motivation and confidence, thus enhancing their
competence in physical assessment. | en_US |
