A head-to-toe assessment entails a health assessment or physical examination that plays a crucial role in helping medical practitioners in understanding their patients' problems and needs. A holistic head-to-toe assessment is carried out on a patient upon their admission, at the start of every shift, and any time it is deemed relevant by the context and patient's hemodynamics ( Louwers et al., 2014; Popovich, 2011 ). The assessment covers all systems of the patient’s body. The results of the assessment play a crucial role in informing the health care professions on the overall condition of their patients. Any finding that is deemed unusual is followed up on using a focused assessment that is specific to the body system in question.
Typically, there are two types of assessments. These include a complete health assessment and a problem-focused assessment ( Popovich, 2011 ). The complete assessment is detailed and entails a comprehensive health history coupled with a head-to-toe physical exam. This assessment may be executed by registered nurses operating in community-based contexts such as home visits. It may also be performed in acute settings once a patient is admitted. Often, such advanced practice nurses as nurse practitioners are only likely to conduct complete assessments during annual physical examinations. The problem-focused assessment, on the other hand, is based on specific care goals. For instance, different nursing care goals and patient populations are focussed on by nurses working in the ICU and those doing maternal-child home visits.
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A psychiatric nurse is not likely to routinely examine several components of the head-to-toe physical assessment. These components include evaluation of the nails, skin, and hair for bruising, lesions, and rashes. The nurse is also not likely to check the neck and head, as well as inspect, auscultate, and palpate the chest. Moreover, a psychiatric nurse is not concerned about the abdomen and extremities. Nevertheless, the psychiatric nurse needs to be familiar with and skilled at executing these elements. Competence in these components is vital, given that a mental status examination is an integral part of a patient's overall physical assessment ( Shattell & Apostolopoulos , 2010). This implies that a patient’s physical examination cannot be decoupled from his or her mental assessment. In particular, while conducting a mental status assessment, a psychiatric nurse is likely to cover aspects related to the general physical assessment of a patient.
References
Louwers, E. C., Korfage, I. J., Affourtit, M. J., Ruige, M., van den Elzen, A. P., de Koning, H. J., & Moll, H. A. (2014). Accuracy of a screening instrument to identify potential child abuse in emergency departments. Child abuse & neglect , 38 (7), 1275-1281.
Popovich, D. (2011). 30-Second Head-to-Toe tool in pediatric nursing: cultivating safety in handoff communication. Pediatric Nursing , 37 (2).
Shattell, M., & Apostolopoulos, Y. (2010). Strengthening mental health promotion: Zeroing in on the workplace. Issues in mental health nursing , 31 (7), 494-495.
