The document outlines the implementation phase of the nursing process, which includes developing and executing a care plan through evidence-based nursing interventions aimed at improving patient outcomes. Key aspects of implementation are critical thinking, planning, and resource organization, along with direct and indirect care measures. The process emphasizes ensuring patient comfort, evaluating risks, and using established clinical guidelines and protocols for effective nursing practice.

1. Implementation
Deblina Roy
M.Sc Nursing 1st Year
K.G.M.U. Institute of Nursing

2. INTRODUCTION
• Implementation, the fourth step of the nursing process,
formally begins after the nurse develops a plan of care. With
a care plan based on clear and relevant nursing diagnoses.

3. Nursing Intervention
• A nursing intervention is any treatment based on clinical
judgment and knowledge that a nurse performs to
enhance patient outcomes (Bulechek et al., 2008).
• Ideally the interventions a nurse uses are evidenced based
,providing the most current, up-to-date, and effective
approaches for managing patient problems. Interventions
include direct and indirect care measures aimed at individuals,
families, and/or the community.

4. TYPES OF INTERVENTION
•Direct care
•Indirect care.

5. Domains of Nursing practice
• The Helping Role
• The Teaching-Coaching Function
• The Diagnostic and Patient-Monitoring
Function
• Effective Management of Rapidly Changing
Situations
• Administering and Monitoring Therapeutic
Interventions and Regimens
• Monitoring and Ensuring the Quality
of Health Care Practices
• Organizational and Work-Role Competencies

6. CRITICAL THINKING IN
IMPLEMENTATION
• Before implementing a planned intervention, use critical
thinking to confirm whether the intervention is correct and
still appropriate for the patient’s clinical situation
• you have to exercise good judgment and decision making
before actually delivering each intervention
• Review the set of all possible nursing interventions for the
patient’s problem
• Review all possible consequences associated with each
possible nursing action
• of all possible conditions determine the probability
sequences

7. STANDARD NURSING
INTERVENTIONS
•Clinical Practice Guidelines and
Protocols.
•Standing Orders

8. Purposes of implementation
1.Standardization of the nomenclature
(e.g.,labeling, describing) of nursing
interventions; standardizes the
language nurses use to describe sets
of actions in delivering patient care

9. 2.Expanding nursing knowledge about
connections among nursingdiagnoses,
treatments,and outcomes; connections
determined through the study of actual
patient care using a database that the
classification generates

10. 3.Developing nursing and health care
information systems
4.Teaching decision making to nursing
students; defining and classifying
nursing interventions to teach beginning
nurses how to determine a patient’s
need for care and to respond appropriately

11. 5.Determining the cost of
services provided by nurses
6.Planning for resources needed in
all types of nursing practice
settings

12. 7.Language to communicate the
unique functions of nursing
8.Link with the classification
systems of other health care
providers

13. Process of Implementation
• Reassessing the Patient
• Reviewing and Revising the Existing Nursing
Care Plan
• Organizing Resources and Care Delivery
• Anticipating and Preventing Complications
• Identifying Areas of Assistance.
• Implementation Skills

14. Implementation
•Cognitive Skills
•Interpersonal Skills
•Psychomotor Skills

15. DIRECT CARE
• Activities of Daily Living
• Instrumental Activities of Daily Living
• Physical Care Techniques
• Lifesaving Measures
• Counseling
• Teaching
• Controlling for Adverse Reactions
• Preventive Measures

16. INDIRECT CARE
•Communicating Nursing
Interventions
•Delegating, Supervising, and
Evaluating the Work of Other Staff
Members

18. ACHIEVING PATIENT GOALS
• Regardless of the type of interventions, you
implement nursing care to achieve patient goals
and outcomes. In most clinical situations
multiple interventions are necessary to achieve
select outcomes.
• Another way to achieve patient goals is to help
them adhere to their treatment plan

19. Key Points
• Implementation is the fourth step of the nursing process in
which nurses initiate interventions that are designed to
achieve the goals and expected outcomes of the patient’s
plan of care.
• A direct-care intervention is a treatment performed through
interactions with a patient that can include nurse-initiated,
physician-initiated, and collaborative approaches.
• Always think first and determine if an intervention is correct
and appropriate and if you have the resources needed to
implement it.
•

20. • Clinical guidelines or protocols are evidence-based
documents that guide decisions and interventions for
specific health care problems.
• When preparing to perform an intervention, reassess the
patient, review and revise the existing nursing care plan,
organize resources and care delivery approaches, anticipate
and prevent complications, and implement the intervention.
• The implementation of nursing care often requires
additional knowledge, nursing skills, and personnel
resources.

21. • Before beginning to perform interventions, make sure that
the patient is as physically and psychologically comfortable
as possible.
• Use good judgment and sound clinical decision making when
performing any intervention to ensure that no nursing action
is automatic.
• To anticipate and prevent complications, identify risks to the
patient, adapt interventions to the situation, evaluate the
relative benefit of a treatment versus the risk, and initiate
risk prevention measures.

22. • Methods used to ensure that you administer physical care
techniques appropriately include protecting you and the
patient from injury, using proper infection control practices,
staying organized, and following applicable practice
guidelines.
• When you delegate aspects of a patient’s care, you are
responsible for ensuring that each task is assigned
appropriately and completed according to the standard of
care.
• To complete any nursing procedure, you need to know the
procedure, its frequency, the steps, and the expected
outcomes.

23. Example
• Assessed the sign and symptoms of dehydration.
• Assessed the vital signs
• Hand washing is done
• Knowledge and explanation is given before and after every
procedure.
• Provided oral fluids
• Provided ORS
• Provided the IV Fluids
• Intake output chart is maintained
• Monitored the urine output .
• Monitored the bowel pattern
• Provided anti emetic medications according to the Doctor’s order .
• Provided antidiarrheal according to the Doctor’s order
• Sent the stool for RE
• Explained the patient and the family members about the present
condition .

24. Thank You