The Nursing Process

The Nursing Process An organizational framework for the practice of nursing Orderly, systematic Central to all nursing care Encompasses all steps taken by the nurse in caring for a patient

An organizational framework for the practice of nursing

Orderly, systematic

Central to all nursing care

Encompasses all steps taken by the nurse in caring for a patient

The Nursing Process Assessment Nursing Diagnosis Planning Implementation Evaluation

Assessment

Nursing Diagnosis

Planning

Implementation

Evaluation

The Nursing Process Assessment Data collection (subjective, objective, environmental) Medication history Nursing assessment Data analysis

Assessment

Data collection (subjective, objective, environmental)

Medication history

Nursing assessment

Data analysis

The Nursing Process Nursing Diagnosis Judgment or conclusion about the risk for—or actual—need/problem of the patient NANDA format

Nursing Diagnosis

Judgment or conclusion about the risk for—or actual—need/problem of the patient

NANDA format

The Nursing Process Planning Identification of goals and outcome criteria Prioritization Time frame

Planning

Identification of goals and outcome criteria

Prioritization

Time frame

The Nursing Process Implementation Initiation and completion of the nursing care plan as defined by the nursing diagnoses and outcome criteria Follow the “five rights” of medication administration

Implementation

Initiation and completion of the nursing care plan as defined by the nursing diagnoses and outcome criteria

Follow the “five rights” of medication administration

The “Five Rights” of Medication Administration Right drug Right dose Right time Right route Right patient

Right drug

Right dose

Right time

Right route

Right patient

The “Sixth Right”—System Analysis The entire “system” of medication administration: Ordering, dispensing, preparing, administering, documenting

The entire “system” of medication administration:

Ordering, dispensing, preparing, administering, documenting

The Nursing Process Evaluation Ongoing part of the nursing process Determining the status of the goals and outcomes of care Monitoring the patient’s response to drug therapy

Evaluation

Ongoing part of the nursing process

Determining the status of the goals and outcomes of care

Monitoring the patient’s response to drug therapy

Instructors may wish to use EIC Image #9: Nursing Process and Holistic Needs

Instructors may wish to use EIC Image #9: Nursing Process and Holistic Needs