The first assessment begin in (1992) by American medical association In (1995) health assessment considered as basic human right Preventive health care divided in three categories, primary, secondary and tertiary prevention periodic health assessment needed to be performed by a physician, or nurses

Objectives and types of assessment surveillance of health status, identification of occult disease, screening, and follow-up care The periodic assessment, at regular intervals Increasing client participation in health care

Accurately define the health and risk care needs for individuals Health assessment is shared with the client in a clearly and understandable manner The client must share in decision making for his own care.

Frequency of assessment The persons under (35) years every (4 – 5) years The persons from (35 – 45) every (2 – 3) years. Persons from (45-55) years of age undergo a thorough health assessment every year. Persons over (55) years may needs assessment every 6 months or less

Importance of nursing health assessment 1. systematic and continuous collection of client data 2. It focus on client responses to health problems. 3. The nurse carefully examine the client ’ s body parts to determine any abnormalities

4. The nurse relies on data from different sources which can indicate significant clinical problems. 5. Health assessment provides a base line used to plan the clients care 6. Health assessment helps the nurse to diagnose client ’ s problem & the intervention

8. Health assessment influence, the choice of therapies & client's responses 7. Complete health assessment involves a more detailed review of client’s condition.

Purposes of health assessment 1. Gather data 2. confirm, or refuse data obtained in the health history. 3. To confirm identify nursing diagnoses

4. To make clinical judgments about client's changing health 5.To evaluate bio-psycho-social and spiritual outcomes of care.

Nursing and medical diagnosis There is a big Difference * Nursing diagnosis independent role of the nurse * Nursing diagnoses depends on the client's problems associated with specific disorder

* Any problem must notice from a holistic view e.g. bio-psycho- social and spiritual relations * Medical diagnoses depends on clinical picture and laboratory findings

*The specialist doctor has a right to diagnose not else Example: DM is medical diagnoses (hypo or hyperglycemia ) * Nursing diagnoses in this case e.g. Impaired skin integrity R/T poor circulation, Knowledge deficit R/T…

Health history 1.The interview 2.Psychosocial assessment 3.Nutritional assessment 4.Assessment of sleep- wakefulness patterns 5.The health history.

Interview *Definition: communication process focuses on the client's development, psychological, physiological, socio cultural, and spiritual

Major purpose: To obtain health history & to identify development of symptoms Components of nursing interview 1. Introductory phase 2. working phase and 3. termination phase

Introductory phase: Introduce yourself and explains the purpose of the interview to the client. Before Asking questions Let client to feel Comfort, Privacy and confidentiality

working phase: *The nurse must listen and observe cues in addition to using critical thinking skills to validate information received from the client. *The nurse identify client's problems and goals.

Termination phase: 1.The nurse summarizes information obtained during the working phase 2. validates problems and goals with the client. 3.Making plans to resolve the problems

Communications techniques during interview 1.Types of questions : Use open ended questions to assess client's feelings e.g. what, how, which “ Use closed ended question to obtain facts e.g." when, did … etc.

Use list to obtain specific answers e.g. "is pain sever, dull sharp Explore all data that deviate from normal e.g. “ increase or decrease the problem 2. Types of statements to use: clarify information, and encourage verbalization

3. Accept the client use silence to recognize thoughts. 4. avoid some communication styles e.g. * Excessive or not enough eye contact. *Doing other things during getting history.

Biased or leading questions e.g. "you don't feel bad" - Relying on memory to recall information 5.specific age variations :- - Pediatric clients: validate information from parents. - Geriatric clients: use simple words, &assess hearing acuity

6. Emotional variations: * Be calm with angry clients *simply with anxious *interest with depressed client

7. cultural variations:" In the communication of self and clients” 8. You can use culture broker : In different languages. And use pictures for non reading clients