Nursing Process

1. UNIT-5
Th
NURSINGPROCESS
By-
DeveshwarP.D.

2. NURSINGPROCESS
DEFINITION:-
Itmaybedefinedasasystematicmethodofassessingthehealthstatus,
diagnosinghealthcareneeds,formulatingaplanofcare,initiatingtheplanand
evaluatingtheeffectivenessoftheplan.Theterm "NursingProcess"was
introducedbyHALLin1955.
Or
Asystematicproblem-solvingapproachusedtoidentify,preventandtreatactualor
potentialhealth problems and promote wellness.A systematic way to plan,
implementandevaluatecareforindividuals,families,groupsandcommunities.
PURPOSESOFNURSINGPROCESS
Primarypurposeofnursingprocessistohelpthenursetomanageeach
patient's nursing care intelligently,scientifically and judiciously.Other
purposesare:
1.Tohelpthepatientinmaintaininghealth.
2.Toprotectclientfromillness.
3.Toidentifyclient'shealthstatus.
4.Toidentifyclient'sactualandpotentialhealthproblems.
5.Todeterminepriorities.
6.Toinitiate/establishplanofcareformeetingtheidentifiedneeds.

3. 7.Todeliverthespecificnursinginterventionstomeetthoseneeds.
8.Toprovideanindividualized,holistic,effectiveandefficientnursingcare.
9.Toevaluateeffectivenessofcareprovided.
10.Topromoterecoveryfromillness.
11.Topromotereturntoastateofmaximumfunctioning.
12.Duringterminalillness,helptheclienthaveapeacefuldea
CHARACTERISTICSOFNURSINGPROCESS
1.-Problemoriented:
Nursingpr«essisalwaysfocusingonclient'sproblems.Problemmaybeactual/current
orpotentialproblem.Actualproblemsmeanstheneed/problemfromwhichclientisalready
suffering.
E.g.:lossofappetite,lossofsleepinwholenight,constipation,pain,vomiting,lossof
consciousness,dyspnea(breathingdifficulty).
Potentialproblem:Meansproblemswhicharenotpresently,clienthave,butin
future,therearechances/probabilityfortheiroccurrence.e.g.incaseclientisbed
ridden,obese Potentialproblem:t»velopmentofbed sore,muscle wastage,
constipationetc.
Nurseisexploringtheproblem oftheclienteitherthroughsubjectivedata*or
objectivedata.
2.-Universallyapplicable:
Itmeansinformationcollectedinonesettingwillbeunderstoodsimilarlyinothersetting
(city)worldwide.

4. 3.-Dynamic:
Itisadynamicactivitythatbeginswhenthenursecollectssubjectivedataand
objectivedata.Dynamicmeanschangable.
Thedatabasegrowsasnurseusesnursingprocess.Newdataisaddedifthepatient's
conditionchangesorpatientrevealsmoreinformation.
4.-Cyclic:
Nursingprocessinvolvesinter-relatedsteps.Nursecan'tprocessbyomittingonestep.
Iftheproblemisnotsolved,nursehastofollowtheassessmentsteportheplanningstep
orhavetochangethenursingstratetgic.
Fig:-Depictsthestepsofnursingprocess.
A-Assessment
N-NursingDiagnosis
P-Plannmg
I--Implementation
E-Evaluation
Justlikeawheel,nursingprocesscontinuouslyproceedsuntilproblem issolvedor
goalisachieved.

5. 5.-InterpersonalandCollaborativeapproach:
Nursingprocessinvolvesinterpersonalandcollaborativeapproachinthesense
thaFnursecan'tgiveindependentcaretoclientinhospital.
6.-Creativity
Nursingprocessinvolvescreativityindesigningways•Intheeverystepofnursing
process,nursefollowscriticalthinkingtoassess/identifytheclient'sproblem.
Shedevelopstherapportwithclientandacquiresinformation.
Intheplanningphaseagainshethinksaboutvariouswaystosolveclient's
problem.
7.-Goaloriented:
Nursingprocessisalwaysgoaloriented.Whileapproachingtheclient,nursekeepsin
mindherprofessionalgoali.e.
 Topromotehealth.
 Topreventtheoccurrenceofdisease.
Toprotectclientfromcomplications.
Toenhanceearlyrecoveryfromdiseasecondition.
8.-OpenandFlexible:
Openmeansinformationisgatheredthroughclient'scooperation.Itisdiscussed
withtheclient.Asnursingprocessisdynamic,itchangesastheclient'sneeds
changeorproblemisresolved.Bykeepinginmindtheclient'snature,values,feelings,
beliefs,nursingcareisprovided.

6. 9.-Clientoriented:
Nursingprocessinvolvesidentifyingandsolvingtheclient'sproblem not
thenurse's.Itdoesnotmeanthatnursewilldothework/careasperher
desires.Nursingprocessisalwaysclientcentred/oriented.Everystepof
nursingprocessinvolvesclient'sproblem.
Forexample:Givingmouthcaretounconsciouspatientistotallydifferent
from theconsciOUSpatient.Nursingprocessinvolvesindividualizedapproach
whiledealingwithclient.
10.-Systematicandplanned:
Nursingprocessalwaysfollowsseriesofactions/5steps.Nursecan't
proceedto3rdstepuntilshefollowsfirsttwostepsinsequence.Nursing
processisalwaysaplannedactivity.
11.-Feedback:
Nursingprocessgivesmuchweightagetothefeedbacki.e.client's
reactiontotheidentified/potentialproblem.Ifthefeedbackispositive,
meansproblem issolved,givessatisfactiontonurseforheractivities.If
thefeedbackisnegative,sheagainfollowsthenursingstepstoresolve
theproblem.

7. 12.-NursingStepsareInter-related:
Everystepofnursingprocessiscloselyrelated.Eachstepisdependenton
otherstep.
e.g.Nurse can'tframe nursing diagnosis untilthe assessmentstep is
completed.From thefig.,itisclearlyseenthatthesestepsareslightly
overlappedalso:Thisisbecauseintheassessmentphase,whilegatheringthe
information,usingcriticalthinkingnursebeginsearlyinterpretationandalso
analysesthedatatomakenursingdiagnosis.
Inthisphase,nursecheckswhethertheproblemisresolvedandsetgoalisachieved.

8. Ifnotso,thensheevaluatesagainwhethernewproblemisaroused,planningwas
good,nursingactionsaretakenaspernursingplan.Thusinevaluationphaseof
nursingprocess,Nurse
•Evaluateswhetherthegoalisachieved.
•Evaluateseachstepofnursingprocesstoidentifythecontributoryfactorfor
thesuccessorfailureofplanofcare.
•Terminatenursingcareifitisnotrequired.
STEPSOFNURSINGPROCESS
Nursingprocesshelpsthenursetoorganiseanddelivereffectivenursing
care.ItincludesfivestepwhichareImplementatioPlanningPerform thenursin
Setgoalsofcareandactionsidentifiedin desired outcomes and planning
phaseidentifyappropriatenursingactions.