A qualitative study of advanced nurse practitioners’ use of physical assessment skills in the community: shifting skills across professional boundaries

Aim
To explore multiple perspectives on the use of physical assessment skills by Advanced Nurse Practitioners in the UK
Background
Physical assessment skills practices are embedded in advanced nursing practice roles in the UK. There is little evidence on how these skills are used by Advanced Nurse Practitioners' on the community.
Design
Case study
Methodology and methods.
A qualitative interpretative single-embedded case study of 22 participants from South of England. A framework method analysed interview data collected by the researcher between March and August 2013. Participants included nurses, doctors, nurse educators and managers
Findings
Physical assessment skills education at Universities are part of a policy shift to develop a flexible workforce in the UK. Shared physical assessment practices are less to do with role substitution and more about preparing practitioners with skills that are fit for purpose. Competence capability and performance with physical assessment skills are an expectation of advanced nursing practice.
Conclusions
These skills are used successfully by community Advanced Nurse Practitioners to deliver a wide range of services in response to changing patient need. The introduction of physical assessment skills education to undergraduate professional preparation would create a firm foundation to develop these skills in post-graduate education.
Relevance to clinical practice.
• Physical assessment education prepares nurses with the clinical competencies to carry out healthcare reforms in the UK
• Shared sets of clinical assessment competencies between disciplines have better outcomes for patients
• Levels of assessment competence can depend on the professional attributes of individual practitioners
• Unsupportive learning cultures can hinder professional development of advanced nursing practice

This is the peer reviewed version of the following article: Raleigh, M. and Allan, H. (2017), A qualitative study of advanced nurse practitioners’ use of physical assessment skills in the community: shifting skills across professional boundaries. J Clin Nurs, 26: 2025–2035. doi:10.1111/jocn.13613, which has been published in final form at http://doi.org/10.1111/jocn.13613. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.