Government College of Nursing Rajnandgaon Chhattisgarh .

2. INTRODUCTION
 Nurses provide patient centered care using an
organizing framework called the nursing
process. The nursing process is a problem
solving approach to the identification and
treatment of patient problem that is the
foundation of nursing practice. It is
framework provide a structure for the
delivery of nursing care and the knowledge
judgment and actions that nurses use to
achieve best patient outcome. Once started
the nursing process is not only continues but
also cyclic in nature.

3. DEFINITION
“ According toYura &Walsh”
 Nursing process as a set of actions to assist
the client in maintaining optimal wellness.
 “ According to ANA”
 The nursing process is used to identify,
diagnose and treat human response to health
and illness.

4. Purposes of the nursing process
 To provide a systematic methodology for nursing
practice.
 To identify the healthcare needs, determine
priorities, establish goals and expected outcomes of
care .
 Give direction, guidance and meaning to nursing
care .
 Promotes creativity and flexibility in nursing
practice.
 Facilitate documentation of data, diagnosis, plan.
 It emphasizes on health promotion, maintenance,
restoration or on enhancing a peaceful death
depending on clients situation.
 Evaluate the efficiency and effectiveness of care.

5. CHARACTERISTICS OF NURSING
PROCESS
• Data from each phase provide input to the next
phase.
 The nursing process is client centered. it organizes
plan of care according to client problem.
 Decision making is involved in every phase of
nursing process.
 Nursing process is interpersonal and
collaborative.
 Nursing must use critical thinking skills to
carryout nursing process.
 It is an adaptation of problem –solving and system
theory.

7. ASSESSMENT
 Assessment is the deliberate and
systematic collection of data to
determine a clients current and past
health status
 It define as “ nursing assessment is the
systematic process of gathering ,
verifying , and communicating data
about a client. This phase of the
nursing process consists of the
collection of data and its subsequent
analysis as a basic for nursing

8. Purpose of assessment
1) To establish a data about the clients
perceived needs.
2) To get data that reveal related
experiences.
3) The assessment must be relevant to the
particular health problem

9. TYPES OF DATA
 SUBJECTIVE DATA:- these are clients
perceptions about a health problems. What the
patient says expresses perceives verbalization
or feels written as per patients words to
prevent error misinterpretation and to promote
accuracy and data is otherwise known as
symptoms,
eg. I cannot breath , I can not walk , I feel
pain, I feel like vomiting , patient expresses in
his/her own words.

10. OBJECTIVE DATA
 These are observation made by the data
collected . It is measurable data in
quantitative and qualitative terms are all
the sing confirms or measures the
subjective expression or the symptoms
of the clients. For eg.
patients look dehydrated skin turn
or poor pulses feeble 50 beat/min
confronting the subjective data objective
data.

11. SOURCES OF DATA
 client- best source of subjective data
clients who are oriented and can answer can
provide most accurate data.
 family & significant others- they are
interviewed for primary information when
the client is an infant, client is critically –ill
,mentally handicapped.
 health team member- they give
information about how the client react to
health care professionals to procedure,
investigation ,response to visitors.

12. Con…
 medical record- this provides data about the
clients medical history, test and treatment.
 others records- educational ,military,
employment record give information about
clients past health status.
 literature review- review of medical ,nursing,
pharmacological literature help to complete
assessment.
 nurses experience- post experience and
relevant knowledge help the nurse to assess
correctly and wisely.

13. Nursing Diagnosis
 Diagnosis is the science and art of
identifying problem. Nursing diagnosis
is the second step of nursing process. It
is a term used to classify health problem
within the domain of nursing.

14. Types of nursing diagnosis
 1) Actual nursing diagnosis- The describes human
response to health condition/ life process that exit in
an individual , family or community.
 2) Risk nursing diagnosis- This describes human
responses to health conditions.
 3) Wellness nursing diagnosis- This describes
human response to level of wellness in an
individuals.
 4) possible nursing diagnosis- This is one in
which evidence about the health problem is not clear.
 5) Syndrome diagnosis- This is a diagnosis
associated with a cluster of other diagnosis.

15. goal
A client-centered goal is specific
and measurable behavior or
response that reflects a clients
highest possible level of wellness
and independence in function.

16. Two types of goals
 Short-term goals: It is an
objectives that is expected to be
achieved within a short times
frame.
 Long- term goals: An objective
that is expected to be achieved
over a longer time frame.

17. Planning
Planning is one of the important
steps of nursing process. It is very
essential component in order to
make short term or long term goals
and interventions in caring patient
needs based on priority.

18. DEFINITION
 Planning is the third step in nursing
process in logical systematic
organized decision making process of
designing an orderly , detailed
program of action to accomplish
specific goals and objective.
Marriner has given an equation of
planinig , that is :-
planning = setting priorities + goals +
intervention .

19. Purpose of planning
 to determine how to satisfy client
needs.
To prescribe the specific action
necessary to meet them.
Server to guide the activities of all
health workers who are involved in the
patient care .

20. Types of planning
 Initial planning :- The nurse who performs the
admission assessment usually develops the
initial comprehensive plan of care. Planning
should be initiated as soon as possible after the
initial assessment especially because of the
trend toward hospital stays.
 Ongoing planning:- ongoing planning is done
by all nurses who work with the client more to
obtain new information and evaluate the clients
response to care; they can individualize the
initial care plan even more.

21. Con…
 Discharge planning:- discharge
planning is a process of anticipating
and planning for needs after discharge
as it has become a crucial part of
comprehensive healthcare and should
be addressed in each client’s care plan.

22. Steps of planning
1. Set priorities.
2. Research the problems
3. Analyze the patient and the total
situation
4. Establish the nursing prognoses
5. Develop goals & expected patient
outcome
6. Set deadlines
7. Formulate a plan of action
8. Validating the plan of care
9. Ongoing data collection

23. Implementation
According to yura & walsh’’
“ implementation is the initiation
and completion of actions to
accomplish the defined goals of
the optimal wellness for the
client.”

24. Implementation process
 Reassessing the client
 Reviewing and revising the existing
nursing care plan
 Organizing resources and care delivery
 anticipating and preventing
complications
 5 Communicating nursing
interventions

25.  Reassessing the client : Assessment is a continuous process
that occurs each time the nurse interacts with the client.
 Reviewing and revising the existing nursing care plan : After
reassessing a client , the nurse receive the care plans revises the
priorities of nursing diagnosis and modifies the exiting care plan
according to the present needs.
 Organizing resources and care delivery –
 a) Equipment - Most nursing procedures require some equipment
and supplies.
 b) Personal - A primary nurse is accountable for the nursing care
of a client received during her length of stay.
 Environment – The surrounding in which nursing activities occur
should be safe and conducing to the implementation therapy
 Client –Make the client physiologically and psychologically
comfortable before doing any procedure
 ANTICIPATING AND PREVENTING COMPLICATIONS:- Risk to the
client arise both from illness and treatment. Identify areas of
assistances.
 Implementation skills :- Nursing practice includes cognitive ,
interpersonal and psychomotor skills.
 Communicating nursing interventions :- Nursing intervension
are written or communicated orally . Written interventions are part
of plan and permanent medical record.

26. Steps in implementation
 Assess the patient need & problems.
 The objectives to be stored in terms of
behavior and specific skills.
 Consider the situation and the environment .
 Establish common clients.
 Globalization/ common other health
professional.
 Consider the likes and dislike of the client.

27. Evaluation
 According to Janer w Kenney
evaluation is a planned systematic
process of collecting, organizing,
analyzing & comparing the client’s
health status with the desired expected
outcome and judging the degree of
client achievement of the outcome.

28. Purpose of evaluation
Is to determine the clients progress in the
designated expected outcomes.
Is to judge the effectiveness of the nursing
process components in assisting the client to
achieve the expected outcomes.
Used to determine the overall quality of care
given to a group of client through quality
improvement and total management
programs.

29. Principles of evaluation
 Evaluation should be a continuous
process.
 Should determine to what extent the
objectives of care being met.
 Method of evaluation should be selected
on the basis of behavior to be measured.
 Adequacy of expertise should be in terms
of acquiring skill and quality of life.

30. Process of evaluation
Identifying the outcome criteria that will
be used to measure achievement of the
goals.
Gathering data related to the identified
criteria.
Comparing the data collected with the
identified criteria and judging whether
goals have been attained .
Relating nursing actions to the
outcomes.
Reexamining the clients care plan.

31. Nursing care plan

32. Thank you