Health Assessment: Overview of Definition, Purpose, and Process

This essay provides a comprehensive overview of health assessment, a critical component of healthcare. It begins by defining health assessment as the evaluation of an individual's mental or physical condition, emphasizing the importance of regular checkups. The essay then explores the purpose of health assessments, highlighting their clinical significance in determining patient health status and developing treatment plans, including the use of the clinical reasoning cycle. Furthermore, the essay details the health assessment process, which involves analyzing patient health history and conducting physical examinations. The essay also includes case studies to illustrate the practical application of health assessment techniques, such as focused assessments for patients post-surgery and comprehensive assessments for infants. The conclusion reinforces the value of health assessment in identifying symptoms, formulating treatment plans, and providing individualized patient care. The essay references key sources to support its claims and provides a solid foundation for understanding the role of health assessment in healthcare practice.

Health Assessment
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Table of Contents
Introduction................................................................................................................................3
Discussion..................................................................................................................................3
Section A: Definition of Health Assessment.........................................................................3
Section B: Purpose of Health assessment..............................................................................4
Section C: Process of Health Assessment..............................................................................5
Conclusion..................................................................................................................................7
References..................................................................................................................................7
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Introduction
In the present time, with the increasing number of illness and health issues, it is highly
recommended for an individual to opt for the regular health checkups or assessments in order
to prevent themselves from any severe illness. These checkups highlight the special needs of
the people which need to be addressed by the healthcare systems or the nursing facilities. The
history of the patient as well as the physical analysis of the patient is conducted in order to
assess the health needs. Use of frameworks such as Clinical reasoning cycle or Nursing
process is quite common while conducting these examinations (The Royal Children's
Hospital Melbourne, 2019). This essay will highlight the major aspects of health assessment
with reference to two case studies provided.
Discussion
Section A: Definition of Health Assessment
Health assessment is composed of two major terms, health, which can be defined as the
mental or physical condition of an individual and, assessment, which can be defined as the
examination or analysis. Thus, the combination of these two terms suggests that the health
assessment is the examination of the mental or physical condition of an individual. According
to the Nursing and Midwifery Board of Australia (NMBA), the health assessment of an
individual or patient can be described as the evaluation of the health status of a patient by
performing his/her physical examination after obtaining the health history (AMN Healthcare,
2014). These health assessments serve as a tool for the nurses to obtain the descriptions about
the symptoms of a patient’s health, history of development of these symptoms and carry out
the processes to discover the associated physical findings, which will help in development of
differential diagnoses. However, the nurses need to ensure that “All assessments consider the
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patient’s privacy and foster open, honest patient communications”. The objectives of the
nurses behind conducting health assessments include obtaining baseline data of the patients
and enhancing the nurse-patient relationship (AMN Healthcare, 2014).
The health assessments can be classified into four major types including comprehensive or
complete health assessment; abbreviated assessment; problem-focused assessment and
assessments for special populations. These health assessments allow the nurses to plan the
treatment or individualised care of the patientssuch as elderly people, infants and children.
The results allow them to develop a planner for the patients, to provide them individualised
care and develop a treatment plan for them in coordination with the senior healthcare
professionals or doctor. For instance, detection of a neurological condition might
involvechecking the history of the head injury, checking the frequency of headaches and
vertigos, checking for difficulty in swallowing food or liquids, coordination problems,
numbness or tingling and such other issues. These symptoms are checked for their possible
causes and the treatment or individualised care plan is developed (Hickey, 2015).
Section B: Purpose of Health assessment
The health assessments conducted by the nurses have huge clinical significance in
determining the present status of patient’s health and developing a treatment plan for them.
The nursing assessment helps in detecting the patient’s health history and the physical
examination gives an idea of the symptoms of the disease a patient may suffer from and
hence, it allows the practitioners to stabilize the health conditions of the patients at the correct
time and ensure better patient outcomes. The health assessment allows for recognition of a
life-altering condition, formulation of nursing diagnoses, initiation of appropriate treatment
interventions, and rendering stabilizing care of the patient at the correct time. It helps in
identifying physiological abnormalities manifested by alterations in vital signs and level of
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consciousness and thus, a prompt intervention can be adopted to forego any adverse health
outcome. The SBAR model can be used by the nurses (Situation, Background, Assessment,
and Recommendation) to facilitate the communication between the members of healthcare
team (Toney-Butler & Unison-Pace, 2019).
The role of clinical reasoning cycle is very prominent in conducting the heath assessments. It
is the process used by the nurses as well as other clinical practitioners to collect the
indications, process the data collected by patient history and physical examination and
comprehend the problem which the patient might face. On the basis of the results, they plan
the interventions, gauge the outcomes and reflect upon the entire process (Hunter & Arthur,
2016). The clinical reasoning cycle consists of eight major steps including collection of
patient’s information; processing the collected information; identifying the problem;
establishing the treatment goals; taking required action; evaluating the effectiveness of the
course of action; and reflecting on the actions taken during the course of treatment (European
Heart Association, 2019).
Section C: Process of Health Assessment
The process of health assessment consists of two major steps: the analysis of the patient’s
health history, and physical examination of the patient. The aim of obtaining the health
history of the patient is to get an idea about the patient’s symptoms and the way they are
developed. Apart from this, it also helps in gathering information about the physical status of
the patient including his cultural idiosyncrasies, spiritual needs, and functional living status.
The basic components of the health history of the patient include collection of the
information by the nurses about chief complaint, present health status of patient, past health
history, current lifestyle, psychosocial status, family history and review of systems. The
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communication during the collection of health history must be respectful and privacy of
patient’s information is vital (Shen, 2015).
The physical assessment of the patient is conducted using the four basic techniques including
inspection (includes observing conditions with eyes, ears, or nose); auscultation (involved
with abdominal assessment); palpation (includes touching patient with different parts of hand
using different strength pressures); and percussion (eliciting tenderness or sounds providing
clues to underlying problems) (Wilson & Giddens, 2016).
Case studies
Mr. C, who had bowel operation the same day, will receive focussed assessment. The history
of patient has been already taken and hence, there isno need for collecting it. He will be
checked for the abnormalities using the palpation technique to locate any pain or tension in
any abdominal part post operation. Second, auscultation will be performed for bowel motility
studying the four quadrants (RUQ, RLQ, LUQ, LLQ). Third, he will be continuously
monitored even after the discharge as the frequency of bowel cancer is high in Torres Strait
Islander people (National Bowel Cancer Screening Program , 2019).
When Mr. B, the 6 month old male child visited a healthcare centre with no problems
associated, he would first be checked for any sort of health history by asking questions from
his parents about his health history or any family history of diseases. Second, he will be
assessed for the presence of any mood and affect issues, appropriateness of speech and
developmental milestones. third, he will be checked for any changes in the vital signs such as
respiratory rate, temperature, heart rate, pain, blood pressure and such others and comparing
them to the general genetic make-up of population and family history. Fourth, he will be
taken for focussed systems assessment in a case any abnormality is observed through above
tests (The Royal Children's Hospital Melbourne, 2019).
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Conclusion
The above essay gives an account of the health assessment and the importance of the health
assessment conducted by the nurses. The heath assessment helps in the identification of the
causes of the symptoms displayed by the patient and formulation of an effective patient
treatment plan and individualised care plan. Its two major steps include determining patient’s
history and physical examination of a patient. It can be conducted in collaboration with
clinical reasoning cycle to get better assessment statistics. The case studies give the examples
of the steps which might be adopted for nursing assessment in practical.
References
AMN Healthcare. (2014). Overview of Nursing Health Assessment. Retrieved from
Lms.rn.com: https://lms.rn.com/getpdf.php/2051.pdf
European Heart Association. (2019). The Clinical Reasoning Cycle: The 8 Phases and their
Significance. Retrieved from Heartassociation.eu:
https://www.heartassociation.eu/the-clinical-reasoning-cycle-the-8-phases-and-their-
significance/
Hickey, J. V. (2015). Clinical Practice of Neurological and Neurosurgical Nursing.
Lippincott Williams & Wilkins.
Hunter, S., & Arthur, C. (2016). Clinical reasoning of nursing students on clinical placement:
Clinical educators' perceptions. Nurse Education in Practice, 18(1), 73-79.
National Bowel Cancer Screening Program . (2019). Bowel screening and Aboriginal and
Torres Strait Islander people. Retrieved from Cancerscreening.gov.au:
http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/
2D3622CFF7859059CA258199000D8F68/$File/Information%20for%20Health
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%20Workers%20-%20Bowel%20Screening%20and%20Aboriginal%20and
%20Torres%20Strait%20Islander%20People.pdf
Shen, Z. (2015). Cultural competence models and cultural competence assessment
instruments in nursing: A literature review. Journal of Transcultural Nursing, 26(3),
308-321.
The Royal Children's Hospital Melbourne. (2019). Clinical Guidelines (Nursing). Retrieved
2019, from
https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Nursing_assessment
/
Toney-Butler, T. J., & Unison-Pace, W. J. (2019). Nursing Admission Assessment and
Examination. StatPearls Publishing.
Wilson, S. F., & Giddens, J. F. (2016). Health Assessment for Nursing Practice - E-Book.
Elsevier Health Sciences.
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