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steps of nursing process, Planning
The planning phase of the nursing process involves setting priorities, establishing goals and desired outcomes, and selecting appropriate nursing interventions. Key steps include: 1) Setting priorities by considering factors like the client's health issues, values, and available resources. High priority issues are addressed first. 2) Establishing goals and desired outcomes that are client-centered, measurable, realistic and time-limited. Goals provide direction for interventions and criteria for evaluating progress. 3) Selecting nursing interventions that are safe, achievable, congruent with the client's situation, and based on nursing standards. Interventions are then written on the client's individualized care plan.
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Similar to steps of nursing process, Planning
steps of nursing process, Planning
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- 2. Planning “Planning is adeliberative ,systematic phase of the nursing process that involves decision making and problem solving” • Formulating client goals and designing the nursing interventions required to prevent ,reduce or eliminate the client’s health problems
- 3. Nursing interventions “ Anytreatment , bared upon clinical judgment and knowledge ,that a nurse performs to enhance patient or client outcomes” • Product of planning phase is a clients care plan
- 4. Types of planning •Initial planning • Ongoing planning • Discharge planning
- 5. The planning process 1.Setting priorities 2. Establishing client goals /desired outcome 3. Selecting nursing interventions 4. Writing individualized interventions on care plan
- 6. 1. Setting priorities –Priority setting is the process of establishing a preferential sequence for addressing nursing diagnosis and interventions – High priority – Medium priority – Low priority • Nurses use frequently use Maslow’s hierarchy of needs when setting priorities
- 7. Setting priorities • Factorseffecting priorities – Client health values and beliefs – Client’s priorities – Resources available to the nurse and client – Urgency of health problem – Medical treatment plan
- 8. 2. Establishing clientgoals /desired outcome • Goals or desired outcomes – Nurses hope to achieve by implementing the nursing interventions • Expected outcome • Predicted outcome • Outcome criterion • Objective • Goals are broad statement of client status • Desired outcomes as more specific, observable criteria used to evaluate whether the goals have been met Goal (broad): improved nutritional status Desired outcomes (specific): gain 5lb by April 15
- 9. 2. Establishing clientgoals /desired outcome • Purposes of desired goals and outcomes – Provide direction for planning nursing interventions – Serve as a criteria for evaluating client progress – Enable the client and nurses to determine when the problem has been resolved – Help to motivate the client and nurse by providing a sense of achievement
- 10. 2. Establishing clientgoals /desired outcome Short term goal Long term goal
- 11. 2. Establishing clientgoals /desired outcome Components of goal •Subject : a noun ,is the client ,any part of client or some attribute to client •Verb: the verbs specifies an action the client is to perform Eg: show, walk and drink •Condition or modifiers :are added to the verb to explain the circumstances under which the behavior is to be performed. Eg: walks wit the help of cane •Criterion of desired performance :the criterion indicates the standard by which performance is evaluated Eg: walks one block per day
- 12. 2. Establishing clientgoals /desired outcome Subject Verb Conditions/ Modifiers Criterion For Desired Performance Client Drinks 2500ml of fluid Daily(time) Client Administers Correct insulin dose Using aseptic technique (quality standard) Client Performs Leg ROM exercises as taught Every 8 hours(time)
- 13. Guidelines for writinggoals and outcomes • Client centered • Singular goal and outcome • Observable • Measurable • Realistic • Time limited • Mutual factors • Compatible • Make sure client considers the goals important and value
- 14. 3. Selecting nursinginterventions Nursing interventions are the actions that a nurse performs to achieve the client goals • Nurse chooses interventions to treat the signs and symptoms Eg: pain, anxiety • Interventions for risk nursing diagnoses should focus on measures to reduce the client risk factors
- 15. Types of nursinginterventions Nursing interventions Independent interventions Dependent interventions Collaborative interventions
- 16. Types of nursinginterventions • Independent interventions: are those activities that nurses are licensed to initiate on the basis of their knowledge and skills – Physical care – Teaching – Counseling – Emotional support – Ongoing assessment – Making referrals other health care professionals
- 17. Types of nursinginterventions • Dependent interventions :Are activities carried out under the physician orders or supervision or according to specific routine – Medications – Treatments – Intravenous therapy – Diagnostic tests – Diet and activity
- 18. Types of nursinginterventions • Collaborative interventions : are actions the nurse carries out in collaboration with other health team members such as physical therapists, social workers, dietitians and physicians.
- 19. Criteria for choosingnursing interventions • Safe, appropriate for individuals age and health condition • Achievable with the resources available • Congruent with the client’s values ,beliefs and culture • Congruent with other therapies • Based on nursing knowledge and experience • Written established standards of care as determined by state laws , professional association and policies of the institution
- 20. 4. Writing individualizednursing interventions • After choosing appropriate interventions the nurse write them on the care plan • The format of written interventions – Verb – Conditions and modifiers – Plus time element • The action verb starts the intervention and must be precise
- 21. Relationship of nursing interventions to problemstatus Observation Prevention interventions Treatments Health promotion interventions
- 22. Nursing intervention classification (NIC)taxonomy • NIC taxonomy was first published in 1992 and been updated every 4yrs after then….. • Consist of three levels – Level 1 –Domains – Level 2 – Classes – Level 3 – Interventions • All NIC interventions are linked to NANDA nursing diagnostic label
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- 24. The nurses choosesthe activities appropriate for the client and individualizes them to fit the supplies equipment , and other resources available in the agency THANK YOU