RNs accurately conduct comprehensive and systematic assessments. They analyse information and data and communicate outcomes as the basis for practice.
The registered nurse:
4.1 conducts assessments that are holistic as well as culturally appropriate
4.2 uses a range of assessment techniques to systematically collect relevant and accurate information and data to inform practice
During my placement in Day Center Unit, I developed different communication skills of collecting information from the patient. Considering different health literacy of the patient, we need to make our questions easy to be understood and less confusion. For example, some patient do not understand some medical terminologies, we can try with simple description for them.
4.3 works in partnership to determine factors that affect, or potentially affect, the health and wellbeing of people and populations to determine priorities for action and/ or for referral, and
4.4 assesses the resources available to inform planning.
The purpose of nursing assessment is to make a judgment about the patient's health. Assessment is considered the first step in the care process, and should continue throughout the care process. Depending on the clinical guidance of nursing, there are many different forms of assessment, such as admission assessment, fall risk assessment and delirium assessment.
Nurses need to accurately record the results of these assessments and carefully analyze the assessment results to make an appropriate care plan.
I have practised plenty of admission assessment (including some fall risk assessments, waterlow assessments and delirium assessment) and A to G assessment/ Head to Toe assessment.