Sample Research Paper on The Importance of Baseline Observation in Nursing Practice

Executive Summary

Nursing is one of the careers that require a lot of care and compassion. This paper
provides evaluation and analysis of the importance of baseline observations in the nursing
profession while looking at how it improves care. This importance will be identified by
analyzing the benefits of baseline observations, its influence on future clinical practice and how
it is influenced by various codes of conduct. In the evaluation, one will also find how baseline
observations have an impact on various aspects of the author’s nursing profession, including how
they have made a difference in her life, and how she will develop her observation skills.
The paper finds that baseline observations are very important in the nursing profession.
Additionally, the author’s personal values and beliefs are in line with the basics of baseline
observations. When baseline observations are evaluated against various codes of conduct,
specifically, the NMC code, the NHS constitution and the 6Cs, it is found that baseline
observations are important under the codes. The paper also finds that efficient baseline
observations require effective communication.
The paper finds that effective baseline observations are crucial in the health care facilities
to ensure that quality care is provided to the patients and reduce the rates of deterioration.
Finally, it highlights the importance of communication during these observations and
recommends that nurses should improve their observation skills to enhance healthcare.

Nursing is a profession that not everybody can join. Nursing profession requires independent
decision making together with specialized skills and knowledge. The profession takes broad

divergent ways. The practice differs by the kind of client, by setting, rehabilitation, therapeutic
approach and by different disease. Additionally, nurses work in a society that is changing,
encompassing a lot of mobility and sophistication. The outcome of this is that there is a high risk
of harm in the process of delivering nursing care. Since the profession poses a risk of harm to the
public if it is practiced by individuals who are not competent or not prepared, the state has the
mandate of protecting its citizens from harm. Nurses manage the patients’ daily schedules and
are the most crucial part of any healthcare system. These people work as a direct link between
the patients’ family and the doctor. Generally, they work in hospitals, nursing centers, medical
centers and outpatient clinics. Along with the fundamental educational requirements, nurses
should possess certain skills and qualities to become successful. These skills can be acquired in
class or during clinical training. In the current society, where the education system has gone up,
it is necessary to have additional skills that can make a difference in a nurse’s effectiveness. One
such skill is baseline observation skills. This paper will assess why it is important for a nurse to
have baseline observation skills. It will also analyze how this topic is related to the NMC code,
the NHS constitution, and the 6Cs.
Clearly identify your new learning, giving a rationale for your choice.
Baseline observation in nursing is collecting information about a patient and the situation.
The data gathered is necessary to develop a plan for taking care of the patient. Baseline
observation can also be defined as a thoughtful search carried out with forethought and care.
Constantly, people can observe their surroundings, but these actions are mostly passive rather
than planned or deliberate. Often they cannot be communicated or recalled to others. In nursing,
it is the control and deliberation of the observation process that is distinctive. The purpose of
baseline observation is to gather information, which will play a significant part in the following

phases of diagnosis or inquiry, to formulate a problem, to institute therapy or intervene and in
evaluating the intervention. Baseline observation can be used to identify a patient’s condition,
like the stability, deterioration or improvement (Markedbyteachers, 2016).
The reason for picking baseline observation as the new learning is because it is a crucial
part in the treatment of a patient. Additionally, failure by a nurse to recognize or act on a
patient’s deterioration has led to an implementation of critical care outreach programs and early
warning scoring systems (Odell, Victor, and Oliver, 2009). However, evidence on the
effectiveness of these systems is still unclear. Possible mechanisms for the reduced effectiveness
could be inconsistent observations by nurses or poor communication even after recording
It is obvious that patients require different degrees of observation. This depends on the
patient’s identified behavior, need and current risk assessment. Baseline observation should not
be viewed just as a custodial activity but also an opportunity for a nurse to interact with a patient
in a therapeutic manner. Skilled observation enhances a nurse’s engagement, empathy and
his/her readiness to act. Efficient baseline observation makes the nurse more efficient in the
profession. In addition to increasing the nurse’s efficiencies, it can also give the nurse a sense of
inner-peace and satisfaction when the patient is treated appropriately because of the nurse’s
Whether in a hospital facility, community care facility or a long-term care center if an
individual is a nurse who is registered and works as a nurse, baseline observation is vital.
Observation is important since it can help the nurse to know when the patient’s condition is
deteriorating. Therefore, effective baseline observation is vital for the patient’s outcome and
safety since this is the main step in identifying the signs of clinical concern (Atkinson, 2013).

Baseline observation is also important for the community since if the community has effective
nurses with great observation skill, then detection and prevention of diseases will be easy.
Additionally, community members can expect to find competent nurses who can observe them
and detect problems they did not know once they go to health care facilities.
How has this learning made a difference to you?
The learning of the baseline observational skills has helped me appreciate the importance
of effective communication and professionalism.

Effective Communication

By closely watching changes in physiological observations, patients with deteriorating
conditions can be identified before anything serious happens. Early identification is critical to
avoid morbidity, reduce mortality and various healthcare costs. According to one report that
analyzed a case of deteriorating patients, it is evident that lack of observation or communication
was the main problem (Luettel, Beaumont and Healey, 2007). Most of these incidents are
attributed to the patient having little observation for prolonged periods thus changes to various
vital signs were not detected. The other attributing factor is that there is no recognition of the
significance of the deterioration and action was not taken other than recording the observations.
The final attributing factor is that the patient delayed in receiving medical attention even after the
deterioration was detected. In the above-mentioned scenarios, communication would have
prevented the conditions of patients from deteriorating.
For example, nurses might be sensitive to a doctor’s availability and be reluctant to cause
extra work or ‘lose face’ when it is unnecessary. This makes them reluctant to communicate with
the doctor if they think the situation is not serious enough. On the other hand, when doctors are
called on a phone, they find it hard to make difficult decisions about how urgent a patient needs

assistance from a phone call (Luettel, Beaumont and Healey, 2007). It is especially difficult if the
doctor does not know the patient. Finally, in written communication a doctor might not be able to
follow what is written if it is not written clearly if the management plan is not clear or if the
handwriting is poor. This clearly shows the need for effective communication in the hospital.
Once a nurse observes and notices something wrong with the patient, he/she should
communicate effectively to a doctor. Good observational skill, therefore, calls for effective
communication skills. Therefore, once one has excellent observational skills, it goes without
saying that, he/she must sharpen his/her communication skills. This shows that baseline
observational skills have a direct impact on communication skills.
Professionalism (Personal Values and Beliefs)

One scholar argues that values are beliefs, which are considered to be personally and
socially desirable, thus are recognized as significant in organizations. As such, moral values
contribute greatly to the way nurses act and think and therefore have a crucial role in patient
care. When values differ, conflict can occur, resulting in anxiety, burn-out, stress and even
resignation (Butterworth et al.,). An organization can be greatly affected by this thus resulting in
failure to meet standards and targets and poor patient care. The values of nurses are linked to
components contributing to whether one is satisfied or dissatisfied with the job. Once a nurse is
dissatisfied with work, he/she often distances himself/herself from nursing tasks and patients
(Sheward et al., 2005). This information shows that managers should focus more on assisting
employees to achieve their moral values; there would be an increase in the retention figures. In
England, high staff turnover and shortage of nurses are compromising the ability of nurses to
provide the compassionate and competent care, which is core to their moral value system. It also

reflects the nurses’ responsibility towards observing patients, and why ethical values are
embedded in the code of conduct (Itzhaky, Geber & Dekel, 2004).
Research has shown that personal values greatly influence a person’s professional
lifestyle. When this is applied to nurses, it indicates that their personal value systems greatly
influence the actions they take (Horton, Tschudin & Forget, 2007). Observation influences my
values and beliefs depending on how the value is defined. One of my values is defined by
theology. This can be a great defining factor of a nurses’ value system. When one makes
decisions he/she can be influenced by his/her religious belief system. One can always be
conscious while trying to do the correct thing (Orford, 2012). One of my most rated values is
concerned with my responsibility towards patients. Additionally, my three basic professional
values involve human dignity, prevention of suffering and equality among patients. According to
these values and beliefs, one can find that baseline observation greatly influences them since it
helps eliminate human suffering and is expected of human beings, from a theological
How will this learning influence your future clinical practice?
Understanding the role of baseline observation in health care is vital since it will help me
prioritize patient care. Popular belief is that newly qualified nurses lack the skill of priority
setting (Watson, 2006). The objective of baseline observations is to monitor the patient’s
progress, thus making sure that delays in recovery and adverse events are promptly detected.
Learning this skill will enhance my prioritizing skill and will be in line with my core values and
beliefs. Baseline observation will also impact my decision-making skill greatly since most of the
decisions on a patient are made after observations. This is because decisions made by a nurse can
be questioned, particularly if the nurse’s observation skills are lacking (Thompson, 2004).

However, having baseline observation skills is not sufficient in the nursing profession. In today’s
climate of value for money and clinical effectiveness, a greater skills set is required from nurses.
They require a sound knowledge of basic physiology and anatomy to facilitate the correct
interpretation of observations and the nursing management and pathology of common injuries
and illnesses (Watson, 2006).
Describe how you will continue to develop this learning after this module.
Extensive research suggests that visual arts can enhance a person’s observation skills.
According to Staricoff, visual arts develops a nurse’s observational skills, increases the
individual’s awareness of handing various health problems across cultures while strengthening
his/her confidence in the person’s nursing abilities (2004). This according to an experiment
where nurse trainees are introduced to selected pieces of art and told to provide health
assessment of the mental and physical state of characters in the paintings. Therefore, in order to
develop my baseline observation skill, I will enroll in an art appreciation class since this
significantly improves a person’s observational skills. It will also be important to improve my
communication skills since, after observation, I will have to communicate the information to a
How does this personal/professional development relate to the NMC Code?
Baseline observations are guided by NMC code from the time students are preparing to
become nurses. The NMC code expects education institutions to offer students the best learning
experience in both practice and learning settings (Smith, 2016). This could involve encouraging
them to perform baseline observation once a patient enters the hospital. In their standards, they
expect that practice teachers should support only one student at a time to enhance the learning
process. This recommendation was made because the practice teachers are expected to be able to

commit to supporting assessment and learning in practice. With this recommendation, baseline
observation should be crucial since students can be taught how to observe a patient and evaluate
him/her once the patient enters the hospital. NMC code also recommends that educational
institutions should regularly review how they support students in their practice settings in order
to continue fitting their purpose (Sutcliffe, 2011). This insistence on supporting students in their
practice setting is an efficient way to broaden the student’s knowledge on baseline observations.
How does your topic relate to the NHS Constitution and the 6Cs?
Patients admitted to hospitals believe that they are entering a safe place and that they are
in the correct place to receive effective and prompt treatment (Nice, 2007). In order to notice
early changes in the patient’s conditions, it is vital to carry out physiological observations when
the patient is admitted. Observation must continue throughout the patient’s stay since clinical
deterioration can happen at any stage of the patient’s illness (Buist et al., 2004). NHS recognizes
the significance of ensuring that all adult patients’ physiological observations are promptly and
correctly recorded by well-trained staff. The organization is also committed to making sure that
when the observations are outside of the normal parameters or find signs of deterioration,
appropriate action will be taken to closely monitor the patient. Throughout the NHS, professional
bodies are promoting flexible options of delivering care that is patient-centered (Spilsbury &
Meyer, 2005). According to the NHS constitution, it aspires to the best standards of
professionalism and excellence in providing health care that is effective, safe and focused on a
patient’s experience. NHS does this through the people it gives employment and through
training, education and support it gives them. Therefore, since they care that much for the
patients and this is done by people like nurses, they are expected to be very observant to ensure
the safety of patients (NHS).

In the values of NHS, it is evident that they value respect and dignity. This further
enforces the issue of baseline observation since it is a respectable thing to observe the patient
once he/she enters into the hospital. Improving lives is also part of their values (Myhealthlondon,
n.d.). This highly promotes observation since, without it, the conditions of patients might
continue deteriorating. NHS is also committed to quality care. This is because they earn the trust
placed on them by insisting on quality. Quality care greatly involves observation since when one
goes into a hospital, and the condition deteriorates because of lack of efficient observation, it will
not be quality care. Finally, in the rights section, the constitution claims that a patient has the
right to be professional treatment by appropriately experienced and qualified staff, in an
organization that meets the required levels of quality and safety (Citizensadvice, 2016). This call
for efficient observation since it is the right of the patient to be taken care of professionally.
Every nurse needs to clearly understand what constitutes good nursing. After that, the
nurse should consider his/her personal behaviors and values. Among the area most patients and
relatives complain are addressed in the CARE campaign. C stands for communicating with
passion; A stands for Assist with toileting while ensuring dignity, R stands for relieving pain
effectively and e for encouraging adequate nutrition (Watterson, 2013). This recognizes that
every person entering a care facility has a right to these four elements of care. It encourages
nursing directors, nurses, non-executive directors and chief executive directors of NHS to
struggle to make them true. As seen, this campaign clearly states that patients should be under
constant observation since a nurse has also to ensure that the patient is on the right diet and is
relieved pain effectively (The patients Association, n.d.). The chief nursing officer of England
claims that nurses should provide quality care and quality treatment. The led her to propose the
6cs for care staff, nursing, and midwifery, which focuses on placing patients in the middle of

everything they do (Watterson, 2013). The 6Cs outlines enduring beliefs and values, which
underpin care everywhere.
Baseline observation is also directly related to the 6Cs since they mainly endorse the
aspect of care. The first C, which is care, is the core business of all nurses and health institutions
(Dougan, 2014). Care delivered helps a person and improves the welfare of the community.
Baseline observations are all about care. A caring nurse will ensure that the patient is observed at
all times to make sure that the patient’s condition does not deteriorate. The second C is
compassion (Clarke, 2014). This refers to how care is administered, through relationships based
on dignity empathy and respect (Watterson, 2013). This can also be termed as intelligent
kindness, and this is central to the way patients perceive their care. Baseline observation is also a
form of intelligent kindness since it requires that the nurse discerns the patient’s condition to
know how to prioritize observation among patients. The third C is competence. This means that
all nurses must be able to understand the patient’s social and health needs. They should also have
the expertise, technical and clinical knowledge to deliver the best care (Dougherty and Lister,
2008). This technical and clinical expertise will make a nurse observe the patient on regular
intervals to reduce the deterioration and mortality rate among patients.
Communication is the next C, and it’s central to effective team working and fruitful
caring relationships (Watterson, 2013). Communication is essential to a good workplace and has
benefits for both the patients and staff. As mentioned earlier, communication is a crucial part of
baseline communication since whatever is observed must be communicated to the relevant
person. The next C is courage (Clarke, 2014). This enables the nurses to do the appropriate thing
for the patient, to speak up in case of any concern. This goes hand in hand with communication
since a nurse must have the courage to approach a doctor and tell him/her about everything

observed. Therefore, baseline observation requires a nurse to be courageous and an effective
communicator. The last C is commitment. Building on commitment improves the experience and
care of patients and helps nurses meet and face social and health challenges ahead (Dougan,
2014). Baseline observations also require commitment since a committed nurse will ensure that
the patient is observed at all times. This will help the nurse know whether the patient’s condition
is improving or deteriorating.
Baseline observation is very important in the health care industry. Nurses should be
extremely vigilant with observation since this will help them know whether the patient’s
condition is improving or deteriorating. However, effective observation should be followed
closely with effective communication to improve the welfare of the patient. Expressing oneself is
one of the qualities of a good communicator, and this is also very important during observation.
Additionally, a good nurse should have personal values that are in line with care for patients to
make him/her efficient in observation. I believe having the values of human dignity, prevention
of suffering and equality among patients is good for my patients since I will be vigilant in
observing them. Nurses are bound by various codes of conduct and a nurse who adheres to these
codes will also be attentive to baseline observations. Finally, this paper has clearly linked
baseline observation to caring for patients, and nursing is all about care. Therefore, it
recommends that all nurses be very keen on baseline observations, to ensure quality health care.



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