The Nursing Process enables nurses to systematically organize and deliver patient care by assessing patients, diagnosing issues, planning and implementing interventions, and evaluating outcomes in a continuous and cyclic manner. It involves collecting both subjective and objective data to understand a patient's health issues and needs in order to establish individualized plans and deliver targeted nursing care. The ultimate goals of the Nursing Process are to identify and address any actual or potential health problems patients may have.
Florence nightingale’s environment theoryShrooti Shah
The foundation of Nightingale’s theory is the environment- all the external conditions and forces that influence the life and development of an organism.
According to her, external influences and conditions can prevent, suppress, or contribute to disease or death.
Her goal was to help the patient retain his own vitality by meeting his basic needs through control of the environment.
The 11 areas of nursing responsibility.
1. Safe quality nursing care
2. Management of Resources and Environment
3. Health Education
4. Legal Responsibility
5. Ethico-moral Responsibility
6. Personal and Professional Development
7. Quality improvement
8. Research
9. Records Management
10. Communication
11. Collaboration and Teamwork
Virginia henderson's theory of nursingMandeep Gill
Virginia Henderson was born in Kansas City, Missouri in 1897, the fifth of eight children in her family. During the World War 1, Henderson developed an interest in nursing. So in 1918 she entered the Army school of Nursing in Washington D.C. Henderson graduated in 1921 and accepted a position as a staff nurse with the Henry Street Visiting Nurse Service in New York. After 2 years, in 1923, she started teaching nursing at the Norfolk Protestant Hospital in Virginia. She has enjoyed a long career as an author and researcher. She is known as, “The Nightingale of Modern Nursing” & “The 20th century Florence Nightingale."
Florence nightingale’s environment theoryShrooti Shah
The foundation of Nightingale’s theory is the environment- all the external conditions and forces that influence the life and development of an organism.
According to her, external influences and conditions can prevent, suppress, or contribute to disease or death.
Her goal was to help the patient retain his own vitality by meeting his basic needs through control of the environment.
The 11 areas of nursing responsibility.
1. Safe quality nursing care
2. Management of Resources and Environment
3. Health Education
4. Legal Responsibility
5. Ethico-moral Responsibility
6. Personal and Professional Development
7. Quality improvement
8. Research
9. Records Management
10. Communication
11. Collaboration and Teamwork
Virginia henderson's theory of nursingMandeep Gill
Virginia Henderson was born in Kansas City, Missouri in 1897, the fifth of eight children in her family. During the World War 1, Henderson developed an interest in nursing. So in 1918 she entered the Army school of Nursing in Washington D.C. Henderson graduated in 1921 and accepted a position as a staff nurse with the Henry Street Visiting Nurse Service in New York. After 2 years, in 1923, she started teaching nursing at the Norfolk Protestant Hospital in Virginia. She has enjoyed a long career as an author and researcher. She is known as, “The Nightingale of Modern Nursing” & “The 20th century Florence Nightingale."
Nursing audit assists in:
1. Evaluating Nursing care given,
2. Achieving deserved and feasible quality of nursing care,
3. Stimulating better nursing records maintenance,
4. Focuses on patient care provided and not on care provider,
5. Contributes to research in nursing.
Steps in nursing process, Specific to the nursing profession
A framework for critical thinking
It’s purpose is to:
“Diagnose and treat human responses to actual or potential health problems”
NURSING PROCESS AND CRITHICAL THINKING
Purposes of nursing process
To identify a client’s health status and actual or potential health care problems or needs.
To establish plans to meet the identified needs.
To deliver specific nursing interventions to meet those needs
nursing process is the base or heart of complete nursing and nursing process gives the framework for the nurses in giving care to the patient the knowledge of nursing process is must to become a licensed nurse or to practice nursing this ppt give nurses a brief idea what all thing are including in nursing process and to determine efficiency, knowledge, skills and attitude of personnel and can make best use of their skills into clinical practice.
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Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
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Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
Normal Labour/ Stages of Labour/ Mechanism of LabourWasim Ak
Normal labor is also termed spontaneous labor, defined as the natural physiological process through which the fetus, placenta, and membranes are expelled from the uterus through the birth canal at term (37 to 42 weeks
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Francesca Gottschalk - How can education support child empowerment.pptxEduSkills OECD
Francesca Gottschalk from the OECD’s Centre for Educational Research and Innovation presents at the Ask an Expert Webinar: How can education support child empowerment?
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
2. Introduction
The Nursing Process enables the nurse to
organize and deliver nursing care.
For the successful application of Nursing
Process, the nurse integrates elements of critical
thinking to make judgments and take actions
based on reason.
The nursing process is used to identify, diagnose
and treat human responses to health and illness.
It is a dynamic continuous process as the clients
need change.
3. The use of Nursing Process promotes
individualized nursing care
and assists the nurse in responding to
client needs in a timely and reasonable
manner to improve or maintain the client’s
level of health.
The term Nursing process originated in
1955 by Hall and Johnson (1959),
Orlando (1961) & Wiedenbach (1963)
were the first user with a series of phases
4. Definition
It is a systematic, rational method of
planning and providing nursing care. Its
goal is to identify a client’s health care
status and actual or potential health
problems, to establish plans to meet the
identified needs, and to deliver specific
nursing interventions to address those
needs.
5. Definition
The nursing process is cyclical, that is, its
components follow a logical sequence, but
more than one component may be involved
at one time. At the end of the first cycle,
care may be terminated if goals are
achieved, or cycle may continue with
reassessment or plan of care may be
modified.
6. Purposes
1] Identify a client’s health status & actual
or potential health problems or Needs.
2] To establish plans to meet the identified
needs
3] Deliver specific nursing interventions to
meet those needs.
8. Characteristics of the Nursing
Process
1] Cyclic & dynamic in nature
2] Client centered
3] Focus on problem solving & Decision making
4] Interpersonal & Collaborative style
5] Universal applicability
6] Use of critical thinking.
7] Data from each phase provide input into the next
phase.
8] Decision making involved in every phase of nursing
9. Assessing
It is the systematic and continuous collection,
organization, validation, and documentation of
data (information).
It is continuous process carried out during all
phases of the nursing process.
For Eg. In evaluation phase assessment is
done to determine the outcomes of the nursing
strategies and to evaluate goal achievement.
All phases of nursing process depend on the
accurate and complete collection of data.
10. Types of assessment
There are 4 different types of
assessment:-
1] Initial assessment
2] Problem focused assessment
3] Emergency assessment
4] Time lapsed reassessment
11. Type Time performed Purpose Example
Initial Performed To establish a Nursing
assessment within complete admission
specified time database for assessment
after problem
admission to a identification,
health care reference, and
agency. future
comparison
12. Type Time performed Purpose Example
Problem- Ongoing To determine Hourly
assessment of
focused process the status of a client’s fluid
assessment integrated with specific intake and
urinary output
nursing care problem in an ICU
identified in
Assessment of
an earlier client’s ability
assessment to perform self
care while
assisting a
client to bathe.
13. Type Time performed Purpose Example
Emergency During any To identify life- Rapid
assessment of
assessment physiologic or threatening a person’s
psychologic problems airway,
breathing
crisis of the status, and
client circulation
during a
cardiac arrest
Assessment of
suicidal
tendencies or
potential for
violence.
14. Type Time performed Purpose Example
Time-lapsed Several To compare the Reassessment
of a client’s
reassessment months after client’s current functional
initial status to health patterns
in a home care
assessment baseline data or outpatient
previously setting or, in a
hospital, at
obtained. shift change.
15. Assessment varies according to
◦ purpose,
◦ timing,
◦ time available &
◦ client status.
Nursing assessments focus on a client response to
a health problem.
A Nursing assessment include the clients perceived
needs, health problems, related experience , health
practices, values and life styles.
Data should be relevant to a particular health
problem.
17. Description of the assessment
phase Description
Phase Purpose Activities
Assessment Collecting, Establish a database
To establish Obtain a nursing health
history
Organizing, database about the Conduct a physical
assessment
Validating & client’s response Review client records
Review Nursing
Documentin to health concerns literature
Consult support
g client data. or illness and the persons
ability to manage Consult health
professionals update
health care needs. data as needed organize
data validate data
communicate /
document data.
18. Collecting Data
Is the process of gathering information
about a client’s health status.
It must be both systematic & continuous
To prevent the omission of significant
data &
reflect a client’s changing health status.
19. A data base is all the information about
a client; it includes
◦ Nursing health history,
◦ Physical assessment,
◦ The history & physical examination,
◦ Results of laboratory & diagnostic tests,
◦ And material contributed by other health
personnel.
To collect data clearly both the client &
nurse must actively participate.
20. • Client data includes past history as well
as current problems.
Eg of Past history Eg of Current
◦ History of allergic Problems
to penicillin ◦ pain, nausea, sleep
◦ Past surgical patterns & religious
procedures practices.
◦ Folk healing
practices
◦ Chronic disease
21. Types of data
Subjective Data Objective data
also referred to as also referred to as signs or
symptoms or covert data overt data,
can be verified described by are detectable by an observer
only the person who or
affected. can be measured or tested
Eg. Itching, pain, feelings of against an accepted standard.
worry. They can be seen, heard felt
It includes the client’s or smelled and
sensations, feelings values, they are obtained by
beliefs, attitudes and observation or physical
perception of personal examination
health status and life
for Eg. Discoloration of skin,
22. During Physical Examination, the nurse
obtains objective data to validate subjective
data.
Information supplied by family members,
significant others or health professionals
are considered subjective if it is not based
on fact.
A complete data base of both subjective &
objective data provides a base line for
23. Eg. Of subjective & objective
data.
Sl. Subjective Data Objective Data
No.
1 I have fever Body tem – 1000F
Tachycardia – 100 bt/mt
Dull & tired
Dried lips
2 I feel sick to my stomach Vomited 100ml of green tinged fluid
Abdomen firm
Slightly distended
Active bowel sounds in all 4 quadrants
3 I am short of breath RR – 28br/mt
Tachypnoea
Lung sound diminished in ® lower lobe.
24. Sources of Data
Sources of data are primary or secondary.
The client is the primary source of data.
Secondary or indirect sources are Family
members or other support persons, other health
professionals, records & reports laboratory and
diagnostic analyses, and relevant literature.
all sources other than the client are considered
secondary sources.
25. Client
The best source of data
unless the client is to ill, young or
confused to communicate clearly.
The client can provide subjective data
that no one else can offer.
26. Support people
Family members, friends and care givers who know
the client well often can supplement or verify
information provided by the client.
◦ They might convey information about the client’s
response to illness
◦ the stresses client was experiencing before the
illness,
◦ family attitudes on illness and health,
◦ and the clients home environment.
Support people data are very important in case of a
client who is very young unconscious or confused.
27. Client Records
It includes information documented by various health
care professionals.
Client records also contain data regarding the client’s
occupation, religion, and marital status.
By reviewing the records the nurse can avoid asking
questions for which answers have already been
supplied.
Medical records (Medical history, physical
examination, operative report, progress notes &
consultations by Physicians.)
Records of therapies – Social workers, nutritionists,
29. Data Collection Methods
The primary methods of data collection
are
◦ Observing – Occurs whenever the nursing is
in contact with the client or support persons.
◦ Interviewing – is used while taking the
nursing health History
◦ Examining – Major method used in the
physical health assessment.
30. In reality, the nurse uses all three
methods simultaneously when
assessing clients.
for Eg. During the client interview the
nurse observes, listens, asks
questions, and mentally retains
information to explore in the physical
examination.
31. Observing
is to gather data by using the senses.
Observation is a conscious, deliberate
skill that is developed through effort &
with an organized approach.
Eg. Using the senses to observe client
data.
32. ◦ Vision :- overall appearance (body size ,
general weight, signs of distress or posture
& grooming) discomfort, facial & body
gestures, skin colour & lesions
◦ Smell: - Body or Breath odors.
◦ Hearing: - lung, heart sounds, bowel
sounds, ability to communicate, language
spoken.
◦ Touch :- Skin temperature, moisture,
muscle strength (Hand grip)
33. Two aspects of Observation
1] Noticing the data
2] Selecting, organizing & interpreting the
data
Eg : - A nurse who observes that a client’s
face is flushed must relate that observation
to body temperature, activity, environmental
temperature, and blood pressure.
Errors can occur in selecting, organizing &
interpreting data.
34. Nursing observations must be organized so that nothing
significant is missed.
Most nurses develop a particular sequence for observing
events, usually focusing on the client first.
For Eg. A nurse walks into a client’s room and observes, in
the following order.
1]Clinical signs of client distress (Eg. pallor or flushing, labored
breathing, and behavior indicating pain or emotional distress)
2] Threats to clients safety, real or anticipated (Eg. a lowered side rail)
3]The presence and functioning of associated equipment (Eg.
Equipment & oxygen)
4] The immediate environment, including the people in it.
35. Interviewing
An interview is a planned communication
or a conversation with a purpose
for Eg. to get or give information, identify
problems of mutual concern, evaluate
change, teach
Eg. for an Interview is nursing Health
history.
There are 2 approaches in interview
36. Direct Indirect or nondirective
Highly structured & elicits Rapport- building interview
specific informations (understanding between two
or more people)
Nurse establishes purpose of Nurse allows the client to
interview and controls the control the purpose, subject
interview matter and pacing
Clients who responds may
have limited opportunity to
ask question or Discuss
concerns
37. Types of interview
questions
There are 4 types of interview questions
Closed question
Open ended question
Neutral questions
Leading question
38. Closed question Open ended Neutral Leading
question questions question
Used in direct Associated with Is a question the Used in directive
interview, nondirective client can answer interview &
Are restrictive interview with out direction or
Thus directs client
pressure from the
Invite clients to nurse. answer.
Generally requires
yes of No or short discover & explore,
factual answers elaborate, clarify or Eg.
illustrate their Used in non
Often begin with thoughts or feelings. directive that
You’re stressed
question.
when, where, who, It specifies only the about surgery
what, do, did or broad topic to be Eg. tomorrow, aren’t
does, or is, are, was. discussed & invites How do you feel you?
longer that one or about that?
Eg. two words. You’ll take medicine
Are you having pain won’t you?
now? An open ended Why do you think
What medication did question begins with you had the
what or how? operation?
you take?
Eg. What brought
you to hospital?
39. Planning the interview and
setting
Before beginning an interview, the nurse
reviews available information.
Eg. Operative report, information about
the current illness.
Each interview is influenced by time,
place, seating arrangement or distance,
and language.
40. Time: -
Nurse need to plan for an interview with hospitalized
clients physically comfortable,
free of pain, when interruptions by friends, family, and
other health professionals are minimal.
The client should be made to feel comfortable &
unhurried.
Place: - Well lighted, well ventilated, moderate
sized room, free of nurse, movements, interruptions
encourages the communication.
Seating arrangements: -
Distance:-
41. Stages of an interview
Opening or introduction 2 steps
1] establish rapport
2] orientation
Body or development – closing
42. Examining
Physical examination or physical
assessment is a systematic data
collection method that uses observation
to detect health problems.
To conduct examination the nurse uses
techniques of 1) Inspection 2)
auscultation, 3) palpation, 4)
percussion.
43. Inspection: - Process of checking that
things are in the correct condition.
Auscultation: - Examining the internal
organs by listening to the sounds that they
give out
Palpation: - Examination of organ by
touches or pressure of the hand over the
part.
Percussion: - Tapping with the fingers or
44. The physical examination is carried
our systematically.
It may be organized according to
the examiner’s preference,
Head to toe approach
System wise approach
45. Validating Data
The information gathered during
assessment phase must be complete,
factual, and accurate because the
nursing diagnoses and interventions
are based on this information.
Validation is double checking or
verifying the data is accurate and
46. Validating data helps nurse in following
tasks.
1] Ensure that assessment information is
complete.
2] Ensure that objective data & related
subjective data agree.
3] Obtain additional information that may
have been overlooked.
4] Differentiate between cues &
47. Cues - subjective and objective data that
can be directly observed by the nurse.
(What client can say, what the nurse can
see, hear, feel, smell or measure)
Inferences - Nurses interpretation or
conclusions made based on the cues
(Eg. cues nurse observes incision is red, hot
& swollen. nurse makes the inference that
the incision is infected
48. Documenting data
To complete the assessment phase, the nurse records
client data.
record in a factual manner
It includes all data collected about client status.
Eg. Data in factual manner Wrong manner
Slice of toast – I Appetite is good”
Egg - I “normal appetite”
Juice - 250ml.
Coffee- 240ml.
- Record subjective data in client’s own words (more
accuracy)