This document discusses the planning phase of the nursing process. Planning involves setting priorities, establishing goals, and selecting interventions. It describes initial planning, ongoing planning, and discharge planning. Guidelines are provided for developing different types of nursing care plans such as informal, formal, standardized, and individualized plans. The planning process involves setting priorities, establishing goals and desired outcomes, selecting nursing interventions, and writing nursing orders.

1. NURSING PROCESS -
PLANNING
 PREPARED AND PRESENTED BY
MRS.S.ANUKRISHNAN,
VICE PRINCIPAL CUM HOD OBG NURSING,
P.D.BHARATESH COLLEGE OF NURSING,
HALAGA, BELGAUM.

2. Introduction
 Planning is a deliberative, systematic phase of the
nursing process
 Involves decision making and problem solving.
 Refer to the client’s assessment data and diagnostic
statements for direction in formulating client goals
and designing the nursing interventions required to
prevent reduce or eliminate the client’s health
problems.

3. Types of Planning
 1] Initial planning
 2] Ongoing Planning
 3] Discharge planning

4. 1] Initial planning
 Admission assessment based on the initial care.
 As nurse obtain new information and evaluate the
clients responses to care, they can individualize the
initial care plan further.

5. 2] Ongoing Planning
 Done by all nurses who work with the client.
 Ongoing planning also occurs at the beginning of a
shift as the nurse plans the care.

6. 3] Discharge planning
 Is the process of anticipating and planning for needs
after discharge,
 Is a crucial part of comprehensive health care and
should be addressed in each client’s care plan to be
given that day.

7. Purposes of ongoing planning
1] To determine any changes in client’s health status.
2] To set priorities for the client’s care
3] To decide which problems to focus on during the
shift
4] To Co-ordinate the nurse’s activities so that more
than one problem can be addressed at each client
contact.

8. Developing nursing care plans
 An informal nursing care plan
 A formal nursing care plan
 A Standardized care plan
 An individualized care plan

9. An informal nursing care plan
 Is a strategy for action that exists in the nurses
mind.

10. A formal nursing care plan
 Is a written or computerized guide that organizes
information about the client’s care.
 It provides continuity of care.

11. A Standardized care plan
 Is a formal plan that specifies the nursing care for
groups of clients with common needs. (All clients
with myocardial infarction)

12. An individualized care plan
 Is tailored to meet the unique needs of a specific
client needs that are not addressed by standardized
plan.

13. Guidelines for writing Nursing Care plans
1] Date and sign the plan
2]Use category headings assessment/ nursing diagnoses/
planning /Implementation /Evaluation.
3] Use standardized Medical or English symbols and key
words rather than complete sentences to communicate
your ideas.
Eg. Clean wound with H2O2 b.i.d rather than “clean the
client’s wound morning & evening with Hydrogen
peroxide twice a day.

14. Guidelines for writing Nursing Care plans
4] Be specific. Because Nurses are now working shifts
of different lengths, some working 12 hrs. & some
working 8 hour shifts it is even more to be specific
about expected timing of an intervention. If the order
reads “change incision dressing q shift”
5] Refer to procedure books or other sources of
information rather than including all the steps on a
written plan.

15. Guidelines for writing Nursing Care plans
6] Tailor the plan to the unique characteristics of the
client by ensuring that the client’s choices, such as
preferences about the times of care & the methods
used are included.
7] Ensure that the nursing plan incorporates preventive
and health maintenance aspects as well as
restorative ones.

16. Guidelines for writing Nursing Care plans
8] Ensure that the plan contains interventions for
ongoing assessment of the client (eg. Inspect
incision q8h)
9] Include collaborative and co-ordination activities in
the plan.
10] Include plans for the client’s discharge and home
care needs.

17. The planning process
 Setting priorities
 Establishing client goals/ desired outcomes.
 Selecting nursing interventions
 Writing nursing orders.

18. Assessing
a. Collect data
b. Organize data
c. Validate data
d. Document data
Diagnosing
a. Analyze data
b. Identify health
problems, risks and
strength,
c. Formulating
nursing diagnosis
Planning
a. Setting priorities
b. Establishing client
goals, desired
outcomes
c. Selecting nursing
interventions
d. Writing nursing
orders

19. 1) Setting priorities
 It is the process of establishing a preferential
sequence for addressing nursing diagnoses &
interventions.
 The client & nurse decides which nursing diagnosis
requires attention Primarily, which secondary and so
on.
 Instead of rank ordering diagnoses, nurses can
group then as having high, Medium, or Low priority
requires minimal nursing support.

20.  High: Life threatening problems such as loss of respiratory or
cardiac function
 Medium: Health threatening problems like acute illness,
decreased coping.
 Use Maslow’s hierarchy
 The nurse must consider some factors when assigning priorities,
it includes.
 Client’s health values and beliefs
 Client’s priorities
 Resources available to the nurse & client.
 Urgency of health problem
 Medical treatment plan.

21. 2) Establishing client goals & Desired
outcomes
 After establishing priorities, the nurse & client set
goals for each nursing diagnosis.
 Goal-(Broad) –improved nutritional status,
desired outcome (specific) - Gain ½ kg by 2
weeks.
 Short term goals: - than 6 weeks of period.
 Long term goals: - Goal achieved by 6 weeks &
more

22. 3) Selecting Nursing interventions &
activities
 Nursing interventions & activities are the action not a nurse performs to
achieve client goals.
 Types of nursing interventions
1] Independent Interventions: - activities that are nurses are licensed to
initiate. Eg. Physical care, ongoing assessment, counseling, Emotional
support, environmental Management.
2] Dependent Interventions: - activities carried out under physicians order.
Eg. Medications, diagnostic tests, diet Activity.
3] Collaborative Interventions: - Nurse carries out in collaboration with other
health team members - Such as physiotherapies social workers, dietitians,
physicians, Eg. Crutch walking.

23. 4) Writing Nursing orders
•After choosing appropriate nursing interventions the nurse
write those on care plan on nursing orders.
• Components of Nursing order
Date Action Content Time Sign.
verb area Element
4/4/06 Monitor Vital signs Every q4h
Auscultate Abdomen q6h