The document discusses the nursing process and critical thinking in nursing. It defines critical thinking as an active cognitive process used to carefully examine one's own thinking and the thinking of others. The nursing process involves assessment, nursing diagnosis, planning, implementation, and evaluation and is a systematic method of providing individualized care using problem solving and decision making. Developing critical thinking skills is essential for safe nursing practice given the rapid growth of knowledge and need to make complex decisions.
To safeguard the health of patients with thalassaemia, blood should be obtained from carefully selected regular voluntary, non-remunerated donors and should be collected, processed, stored and distributed, by dedicated, quality assured blood transfusion centres.
The document discusses ethics in nursing. It defines ethics as the study of good conduct and character and how it differs from legal issues. It outlines key ethical principles like autonomy, justice, and beneficence. The International Council of Nursing Code of Ethics is also summarized, which establishes the nurse's responsibilities to people in need of care, nursing practices, society, coworkers, and the profession. The code aims to guide ethical nursing behavior and uphold standards of care, confidentiality, and professionalism.
This document discusses critical thinking in nursing. It defines critical thinking as an organized cognitive process used to carefully examine one's own thinking and the thinking of others based on evidence rather than assumptions. Critical thinking is needed for nurses to make accurate clinical decisions, solve problems, plan individualized care, and think creatively. It involves reflection, language skills, and intuition. Critical thinking progresses from basic to complex levels and involves commitment to decisions. Key competencies include using the scientific method, problem solving, decision making, diagnostic reasoning, and clinical decision making. A critical thinking model incorporates knowledge, experience, competencies, attitudes like curiosity and integrity, and standards.
This document outlines a code of ethics and professional conduct for nursing. It discusses the definition and purpose of ethics. It also defines different types of ethics and explains the purpose and principles of a nursing code of ethics. The document then discusses the International Council of Nursing's code and its key elements. It provides examples of a nurse's responsibilities to people, practice, profession, society, and coworkers. It also discusses concepts like autonomy, accountability, assertiveness, and the various roles of a nurse. Finally, it presents some examples of potential research studies related to nursing ethics.
The document provides procedures for inserting a nasogastric tube. Key steps include: assessing the patient's nares and ability to cooperate; determining tube size; explaining the procedure to the patient; lubricating and inserting the tube into the selected nostril, directing it towards the ear on the same side and into the throat; measuring the tube insertion distance using landmarks; and confirming proper placement. The goal is to safely insert the tube into the stomach to the predetermined depth while minimizing patient discomfort.
CODE OF ETHICS: The guiding principle in nursing
code are the direction of conduct , understanding of what is right and wrong while providing care in the hospital and community settings.The ICN code of ethics are the milestone to establish nursing as a profession.
The document discusses inventory control in a healthcare setting. It defines inventory and inventory control, and describes various techniques for inventory classification and control, including ABC analysis, VED analysis, and HML analysis. It also outlines the requisition processes for wards and nursing colleges and the roles and responsibilities of nurses in inventory control. Maintaining careful classification of inventory through ongoing analysis can help control costs and ensure quality patient care.
This document provides information on basic IV certification and administration. It discusses the five rights of medication administration, other checks that should be made, basic IV therapy principles, and potential problems. It also covers equipment used for IV therapy, fluid and electrolyte therapy, medication administration techniques, and complications that may occur like phlebitis, infiltration, or circulatory overload. Procedures for venepuncture, cannulation, and long term venous access devices are also summarized.
To safeguard the health of patients with thalassaemia, blood should be obtained from carefully selected regular voluntary, non-remunerated donors and should be collected, processed, stored and distributed, by dedicated, quality assured blood transfusion centres.
The document discusses ethics in nursing. It defines ethics as the study of good conduct and character and how it differs from legal issues. It outlines key ethical principles like autonomy, justice, and beneficence. The International Council of Nursing Code of Ethics is also summarized, which establishes the nurse's responsibilities to people in need of care, nursing practices, society, coworkers, and the profession. The code aims to guide ethical nursing behavior and uphold standards of care, confidentiality, and professionalism.
This document discusses critical thinking in nursing. It defines critical thinking as an organized cognitive process used to carefully examine one's own thinking and the thinking of others based on evidence rather than assumptions. Critical thinking is needed for nurses to make accurate clinical decisions, solve problems, plan individualized care, and think creatively. It involves reflection, language skills, and intuition. Critical thinking progresses from basic to complex levels and involves commitment to decisions. Key competencies include using the scientific method, problem solving, decision making, diagnostic reasoning, and clinical decision making. A critical thinking model incorporates knowledge, experience, competencies, attitudes like curiosity and integrity, and standards.
This document outlines a code of ethics and professional conduct for nursing. It discusses the definition and purpose of ethics. It also defines different types of ethics and explains the purpose and principles of a nursing code of ethics. The document then discusses the International Council of Nursing's code and its key elements. It provides examples of a nurse's responsibilities to people, practice, profession, society, and coworkers. It also discusses concepts like autonomy, accountability, assertiveness, and the various roles of a nurse. Finally, it presents some examples of potential research studies related to nursing ethics.
The document provides procedures for inserting a nasogastric tube. Key steps include: assessing the patient's nares and ability to cooperate; determining tube size; explaining the procedure to the patient; lubricating and inserting the tube into the selected nostril, directing it towards the ear on the same side and into the throat; measuring the tube insertion distance using landmarks; and confirming proper placement. The goal is to safely insert the tube into the stomach to the predetermined depth while minimizing patient discomfort.
CODE OF ETHICS: The guiding principle in nursing
code are the direction of conduct , understanding of what is right and wrong while providing care in the hospital and community settings.The ICN code of ethics are the milestone to establish nursing as a profession.
The document discusses inventory control in a healthcare setting. It defines inventory and inventory control, and describes various techniques for inventory classification and control, including ABC analysis, VED analysis, and HML analysis. It also outlines the requisition processes for wards and nursing colleges and the roles and responsibilities of nurses in inventory control. Maintaining careful classification of inventory through ongoing analysis can help control costs and ensure quality patient care.
This document provides information on basic IV certification and administration. It discusses the five rights of medication administration, other checks that should be made, basic IV therapy principles, and potential problems. It also covers equipment used for IV therapy, fluid and electrolyte therapy, medication administration techniques, and complications that may occur like phlebitis, infiltration, or circulatory overload. Procedures for venepuncture, cannulation, and long term venous access devices are also summarized.
Critical thinking in nursing involves recognizing issues, analyzing clinical data, evaluating information, and making conclusions. It is a continuous process of open-minded inquiry to determine which assumptions are true and relevant for each unique patient situation. Critical thinking skills for nurses include interpretation, analysis, inference, evaluation, explanation, and self-regulation. There are three levels of critical thinking - basic, complex, and commitment. Critical thinking competencies for nurses encompass general skills like scientific method and problem solving, as well as specific skills like diagnostic reasoning, clinical inference, and clinical decision making. Attitudes that are important for critical thinking include confidence, independent thinking, fairness, responsibility, risk taking, discipline, perseverance, creativity, curiosity, integrity, and
The document discusses the code of ethics for nursing. It begins by defining what a code of ethics is and how it provides standards of behavior for a profession. It then discusses the specific nursing code of ethics, its purposes, and the evolution of the International Council of Nurses' code of ethics. The code has four main elements: nurses and people, nurses and practice, nurses and the profession, and nurses and co-workers. It outlines nurses' responsibilities and basic ethical principles like respect for persons, accountability, and confidentiality that nurses should uphold.
This document contains 26 multiple choice questions about maternal and child health nursing for nurses preparing to take entrance exams. The questions cover topics like assessing a woman in labor, signs to watch for during pregnancy, fetal monitoring, caring for a postpartum patient, and complications that can occur during pregnancy and childbirth.
OPERATION THEATURE MANAGEMENT FOR NURSESshanza aurooj
This document provides an overview of the role and responsibilities of a scrub nurse in the operating room. It discusses welcoming patients, preoperative assessments, scrubbing in using sterile technique, assisting the surgeon by passing instruments and supplies, maintaining sterile fields and patient safety, and concluding procedures. It also provides orientations on common surgical needles, sutures, and instruments that scrub nurses must be familiar with to properly support surgeons during operations.
The principal goal of education is to create men and women . . .who have minds which can be critical, can verify, and not accept everything they are offered.
-Jean Piaget
This document provides an overview of nursing audits, including definitions, types, purposes, processes, and the audit cycle. Some key points:
- A nursing audit is defined as the evaluation of nursing care through retrospective analysis of nursing records to assess quality.
- The main types of audits discussed are internal/external audits, financial/operational audits, department reviews, and integrated/investigative/follow-up audits.
- Purposes include evaluating nursing care quality, verifying records, focusing on care provided and providers, and contributing to research.
- The nursing audit process involves setting criteria, designing audit tools, planning and implementing the tool, recording/analyzing results,
Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health care providers by their approach to patient care, training, and scope of practice.
Professional etiquette is critical for presenting yourself as a polished, confident, and professional nurse.
Here, we discuss about the intake output chart.
The intake output chart is a vital in patient care. By maintaining intake output chart we can monitor the improvement of the patient. So, here we provide about the intake output chart, indications, procedure, precautions, maintaining chart and more.
Please read it attentively and upgrade your professional knowledge and apply it to practice.
Thanks
Urinary catheterization involves inserting a latex, polyurethane, or silicone tube called a catheter into the bladder via the urethra to drain urine. It can be used to inject fluids for treatment or diagnosis. There are two main types: indwelling catheters that remain in place and intermittent catheters that are inserted and removed. The procedure involves preparing equipment, positioning the patient, cleaning the area, lubricating and inserting the catheter, inflating the balloon, and securing drainage. Complications can include infection, injury, and incontinence. Proper technique and aftercare are important to prevent issues.
This document contains no meaningful content to summarize in 3 sentences or less. The document consists of initials, abbreviations and special characters that do not convey any essential information.
The document defines and describes the crash cart, which contains emergency equipment and medications needed to treat cardiac emergencies. It outlines the crash cart's history, contents, and proper arrangement according to hospital policy. The crash cart must be checked regularly by nurses to ensure it is fully stocked and functional. It provides a mobile station containing defibrillators, airway equipment, intravenous drugs, and other supplies to quickly respond to life-threatening situations.
This document provides guidelines for the care of enamelware items like bed pans, urinals, and kidney trays as well as mattresses and pillows. Key points include washing enamelware items immediately after use with soap and warm water, disinfecting them by soaking in Lysol solution, and avoiding boiling them for long periods or cooling them rapidly. Mattresses should be protected from wetting and staining, brushed regularly, and turned daily while being disinfected in sunlight. Pillows also require protection from bodily fluids and covers that are changed twice weekly.
This document discusses various aspects of nursing documentation including definitions, purposes, principles, types, methods, forms of recording data, consequences of inadequate documentation, definitions of reporting, types of reports, importance of records and reports, definitions of electronic documentation, guidelines for electronic documentation, advantages and disadvantages of electronic documentation, and the role of the nurse manager in documentation. It provides a comprehensive overview of documentation in nursing.
The document discusses nasogastric tube insertion and feeding. It defines a nasogastric tube and describes its purposes such as feeding when oral intake is not possible or relieving vomiting. The procedure for NGT insertion is outlined, including measuring tube length, lubricating it, and passing it through the nose into the stomach. Types of feeding like bolus and continuous are covered, as well as preparing feeds, monitoring placement, and managing complications like feeding intolerance.
Nursing ethics provide guidelines for nurses' conduct towards patients, coworkers, and society. A code of ethics outlines nurses' responsibilities and expected behaviors, defining how they should interact with those they serve, work with, and the broader community. Developing and following a code of ethics is important for establishing trust and maintaining high professional standards in nursing.
Nursing service aims to satisfy patient and community nursing needs. Placement involves assigning specific jobs, ranks, and responsibilities to candidates based on job requirements and qualifications. This improves employee outcomes like morale and turnover. Patient care is organized through assignment and delegation of duties among nursing personnel. Factors like patient characteristics and organizational support affect assignment patterns. Various nursing care delivery models distribute direct and indirect patient care functions among different roles.
The document outlines the Code of Ethics for Nurses in India. It discusses several key principles:
1) Nurses must respect the uniqueness of each individual and provide culturally sensitive, dignified care without discrimination.
2) Nurses should respect patients' rights to make informed choices and decisions about their own care.
3) Nurses are obligated to maintain patient privacy and confidentiality while only sharing information judiciously.
4) Nurses must maintain competence through continuing education to ensure quality nursing care for all patients.
Computer technology has significantly impacted the field of nursing. It is used extensively in nursing education for teaching, learning, testing, and managing student records. In nursing practice, computers are used to document and evaluate patient care, assess and monitor patients, and make ethical decisions regarding technologies. Nursing administration utilizes computers for human resources, medical records, quality assurance, facilities management, and budget/finances. Computers are also valuable tools for nursing research, aiding in problem identification, literature searches, data collection and analysis, and disseminating findings.
The document discusses various methods of nursing documentation and recording. It describes the purposes of accurate nursing documentation as communication, legal documentation, nursing audits, education, financial billing, nursing research, and improving the quality of care. The principles of quality documentation include being factual, accurate, complete, current, organized and timely. Common documentation methods discussed are narrative notes, problem-oriented medical records (POMR), source records, charting by exception, and case management plans.
This document discusses nursing assessment, which is defined as a systematic method of planning and providing individualized nursing care. It describes the characteristics of nursing assessment, which include being cyclic, problem-solving oriented, client-centered, and focused on decision making and critical thinking. The document outlines the process of nursing assessment, which involves collecting, organizing, validating, and documenting data from a variety of sources. It discusses different types of assessments and provides details on collecting data through observation, interviewing, and examination. The document also covers organizing, validating, and documenting the assessment data.
The Nursing Process is a framework that helps organize and deliver nursing care through five main steps: assessment, nursing diagnosis, planning, implementation, and evaluation. It provides an orderly and systematic method for planning and providing care, enhances nursing efficiency, and increases care quality. During the assessment step, nurses gather both subjective and objective data on the client's health history, current status, and potential problems through various sources like interviews, examinations, and record reviews. This comprehensive data collection helps identify client needs and priorities to guide the development of the subsequent nursing diagnosis and care plan.
Critical thinking in nursing involves recognizing issues, analyzing clinical data, evaluating information, and making conclusions. It is a continuous process of open-minded inquiry to determine which assumptions are true and relevant for each unique patient situation. Critical thinking skills for nurses include interpretation, analysis, inference, evaluation, explanation, and self-regulation. There are three levels of critical thinking - basic, complex, and commitment. Critical thinking competencies for nurses encompass general skills like scientific method and problem solving, as well as specific skills like diagnostic reasoning, clinical inference, and clinical decision making. Attitudes that are important for critical thinking include confidence, independent thinking, fairness, responsibility, risk taking, discipline, perseverance, creativity, curiosity, integrity, and
The document discusses the code of ethics for nursing. It begins by defining what a code of ethics is and how it provides standards of behavior for a profession. It then discusses the specific nursing code of ethics, its purposes, and the evolution of the International Council of Nurses' code of ethics. The code has four main elements: nurses and people, nurses and practice, nurses and the profession, and nurses and co-workers. It outlines nurses' responsibilities and basic ethical principles like respect for persons, accountability, and confidentiality that nurses should uphold.
This document contains 26 multiple choice questions about maternal and child health nursing for nurses preparing to take entrance exams. The questions cover topics like assessing a woman in labor, signs to watch for during pregnancy, fetal monitoring, caring for a postpartum patient, and complications that can occur during pregnancy and childbirth.
OPERATION THEATURE MANAGEMENT FOR NURSESshanza aurooj
This document provides an overview of the role and responsibilities of a scrub nurse in the operating room. It discusses welcoming patients, preoperative assessments, scrubbing in using sterile technique, assisting the surgeon by passing instruments and supplies, maintaining sterile fields and patient safety, and concluding procedures. It also provides orientations on common surgical needles, sutures, and instruments that scrub nurses must be familiar with to properly support surgeons during operations.
The principal goal of education is to create men and women . . .who have minds which can be critical, can verify, and not accept everything they are offered.
-Jean Piaget
This document provides an overview of nursing audits, including definitions, types, purposes, processes, and the audit cycle. Some key points:
- A nursing audit is defined as the evaluation of nursing care through retrospective analysis of nursing records to assess quality.
- The main types of audits discussed are internal/external audits, financial/operational audits, department reviews, and integrated/investigative/follow-up audits.
- Purposes include evaluating nursing care quality, verifying records, focusing on care provided and providers, and contributing to research.
- The nursing audit process involves setting criteria, designing audit tools, planning and implementing the tool, recording/analyzing results,
Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health care providers by their approach to patient care, training, and scope of practice.
Professional etiquette is critical for presenting yourself as a polished, confident, and professional nurse.
Here, we discuss about the intake output chart.
The intake output chart is a vital in patient care. By maintaining intake output chart we can monitor the improvement of the patient. So, here we provide about the intake output chart, indications, procedure, precautions, maintaining chart and more.
Please read it attentively and upgrade your professional knowledge and apply it to practice.
Thanks
Urinary catheterization involves inserting a latex, polyurethane, or silicone tube called a catheter into the bladder via the urethra to drain urine. It can be used to inject fluids for treatment or diagnosis. There are two main types: indwelling catheters that remain in place and intermittent catheters that are inserted and removed. The procedure involves preparing equipment, positioning the patient, cleaning the area, lubricating and inserting the catheter, inflating the balloon, and securing drainage. Complications can include infection, injury, and incontinence. Proper technique and aftercare are important to prevent issues.
This document contains no meaningful content to summarize in 3 sentences or less. The document consists of initials, abbreviations and special characters that do not convey any essential information.
The document defines and describes the crash cart, which contains emergency equipment and medications needed to treat cardiac emergencies. It outlines the crash cart's history, contents, and proper arrangement according to hospital policy. The crash cart must be checked regularly by nurses to ensure it is fully stocked and functional. It provides a mobile station containing defibrillators, airway equipment, intravenous drugs, and other supplies to quickly respond to life-threatening situations.
This document provides guidelines for the care of enamelware items like bed pans, urinals, and kidney trays as well as mattresses and pillows. Key points include washing enamelware items immediately after use with soap and warm water, disinfecting them by soaking in Lysol solution, and avoiding boiling them for long periods or cooling them rapidly. Mattresses should be protected from wetting and staining, brushed regularly, and turned daily while being disinfected in sunlight. Pillows also require protection from bodily fluids and covers that are changed twice weekly.
This document discusses various aspects of nursing documentation including definitions, purposes, principles, types, methods, forms of recording data, consequences of inadequate documentation, definitions of reporting, types of reports, importance of records and reports, definitions of electronic documentation, guidelines for electronic documentation, advantages and disadvantages of electronic documentation, and the role of the nurse manager in documentation. It provides a comprehensive overview of documentation in nursing.
The document discusses nasogastric tube insertion and feeding. It defines a nasogastric tube and describes its purposes such as feeding when oral intake is not possible or relieving vomiting. The procedure for NGT insertion is outlined, including measuring tube length, lubricating it, and passing it through the nose into the stomach. Types of feeding like bolus and continuous are covered, as well as preparing feeds, monitoring placement, and managing complications like feeding intolerance.
Nursing ethics provide guidelines for nurses' conduct towards patients, coworkers, and society. A code of ethics outlines nurses' responsibilities and expected behaviors, defining how they should interact with those they serve, work with, and the broader community. Developing and following a code of ethics is important for establishing trust and maintaining high professional standards in nursing.
Nursing service aims to satisfy patient and community nursing needs. Placement involves assigning specific jobs, ranks, and responsibilities to candidates based on job requirements and qualifications. This improves employee outcomes like morale and turnover. Patient care is organized through assignment and delegation of duties among nursing personnel. Factors like patient characteristics and organizational support affect assignment patterns. Various nursing care delivery models distribute direct and indirect patient care functions among different roles.
The document outlines the Code of Ethics for Nurses in India. It discusses several key principles:
1) Nurses must respect the uniqueness of each individual and provide culturally sensitive, dignified care without discrimination.
2) Nurses should respect patients' rights to make informed choices and decisions about their own care.
3) Nurses are obligated to maintain patient privacy and confidentiality while only sharing information judiciously.
4) Nurses must maintain competence through continuing education to ensure quality nursing care for all patients.
Computer technology has significantly impacted the field of nursing. It is used extensively in nursing education for teaching, learning, testing, and managing student records. In nursing practice, computers are used to document and evaluate patient care, assess and monitor patients, and make ethical decisions regarding technologies. Nursing administration utilizes computers for human resources, medical records, quality assurance, facilities management, and budget/finances. Computers are also valuable tools for nursing research, aiding in problem identification, literature searches, data collection and analysis, and disseminating findings.
The document discusses various methods of nursing documentation and recording. It describes the purposes of accurate nursing documentation as communication, legal documentation, nursing audits, education, financial billing, nursing research, and improving the quality of care. The principles of quality documentation include being factual, accurate, complete, current, organized and timely. Common documentation methods discussed are narrative notes, problem-oriented medical records (POMR), source records, charting by exception, and case management plans.
This document discusses nursing assessment, which is defined as a systematic method of planning and providing individualized nursing care. It describes the characteristics of nursing assessment, which include being cyclic, problem-solving oriented, client-centered, and focused on decision making and critical thinking. The document outlines the process of nursing assessment, which involves collecting, organizing, validating, and documenting data from a variety of sources. It discusses different types of assessments and provides details on collecting data through observation, interviewing, and examination. The document also covers organizing, validating, and documenting the assessment data.
The Nursing Process is a framework that helps organize and deliver nursing care through five main steps: assessment, nursing diagnosis, planning, implementation, and evaluation. It provides an orderly and systematic method for planning and providing care, enhances nursing efficiency, and increases care quality. During the assessment step, nurses gather both subjective and objective data on the client's health history, current status, and potential problems through various sources like interviews, examinations, and record reviews. This comprehensive data collection helps identify client needs and priorities to guide the development of the subsequent nursing diagnosis and care plan.
The nursing process is a systematic problem-solving approach used by nurses to provide care. It involves five steps: assessment, diagnosis, planning, implementation, and evaluation. Assessment involves continuously collecting and organizing data through various methods like observation, interviews, and physical exams. This data is then validated and documented before moving to the diagnosis step to identify any health problems or needs.
Nursing Process (ADPIE) recopied from the original author of this ppt jeena.aejyJack Frost
The nursing process is a systematic problem-solving approach used by nurses to plan and provide care. It involves five steps: assessment, diagnosis, planning, implementation, and evaluation. Assessment involves continuously collecting subjective and objective data about a patient's health status through various methods like observation, interviews, and physical exams. This data is then organized, validated, and documented before moving to the diagnosis step. The nursing process ensures continuity of care and allows for individualized, collaborative, and outcome-focused care for patients.
The document outlines the nursing process, which includes 5 phases - assessment, nursing diagnosis, planning, implementation, and evaluation.
The assessment phase involves collecting client data through various methods like observation, interview, and examination. In the nursing diagnosis phase, the nurse analyzes the assessment data to identify client problems/needs and prioritize them.
The planning phase involves setting goals to address the problems and selecting nursing interventions. Implementation involves applying the planned care. Finally, in the evaluation phase the nurse determines if the goals were met by collecting additional client data. The nursing process provides a systematic framework to plan and deliver individualized nursing care.
The document outlines the nursing process, which includes 5 phases - assessment, nursing diagnosis, planning, implementation, and evaluation.
The assessment phase involves collecting client data through various methods like observation, interview, and examination. In the nursing diagnosis phase, the nurse analyzes the assessment data to identify client problems/needs and prioritize them.
The planning phase involves setting goals to address the problems and selecting nursing interventions. Implementation involves applying the planned care. Finally, in the evaluation phase the nurse determines if the goals were met by collecting additional client data. The nursing process provides a systematic framework to plan and deliver individualized nursing care.
1. The document discusses critical thinking and the nursing process, which involves collecting patient data, developing nursing diagnoses, planning care, implementing interventions, and evaluating outcomes.
2. Critical thinking requires identifying patient problems, making care decisions, and prioritizing needs based on principles of nursing process and scientific reasoning.
3. The nursing process framework establishes a standard of care that respects patient dignity and autonomy while meeting basic health needs.
Nursing process -presented by Mrs.Chinchu NithinChinchuBalan
The document discusses the nursing process and its components. It defines the nursing process as a systematic method of providing individualized care to clients. The main components of the nursing process discussed are assessment, nursing diagnosis, planning, implementation, and evaluation. Assessment involves collecting, organizing, validating, and documenting client data. Nursing diagnosis involves analyzing the data to identify client health problems or risks. Planning involves prioritizing problems, setting goals, and determining nursing interventions. [END SUMMARY]
Clinical assessment involves collecting information to determine how and why a person is behaving abnormally and how they can be helped. Clinicians use clinical interviews, tests, and observations as assessment tools, which must be standardized, reliable, and valid. The DSM-IV-TR is commonly used for diagnosis and describes diagnostic criteria across five axes. Treatment decisions are based on assessment and diagnosis information, with the goal of empirically supported and evidence-based therapies. Research shows that therapy is generally more effective than no treatment, though some therapies may be more effective than others for specific problems.
Clinical assessment involves collecting information to determine how and why a person is behaving abnormally and how they can be helped. Clinicians use clinical interviews, tests, and observations as assessment tools, which must be standardized, reliable, and valid. The DSM-IV-TR is commonly used for diagnosis and describes diagnostic criteria across five axes. Treatment decisions are informed by assessment and diagnosis, with the goal of empirically supported and evidence-based interventions. Research shows that therapy is generally more effective than no treatment, and that specific therapies can effectively treat particular disorders.
The nursing process includes assessment, diagnosis, planning, implementation, and evaluation. It is a systematic and organized way to provide individualized patient care. The nursing process involves collecting subjective and objective data, formulating nursing diagnoses, identifying goals and outcomes, planning interventions, implementing the care plan, and evaluating the effectiveness of the interventions. It benefits both patients and nurses by ensuring quality care and promoting professional development.
This document outlines the nursing process, which includes assessment, nursing diagnosis, planning, implementation, and evaluation. It is a systematic, critical thinking process used by nurses to provide individualized care. The assessment involves collecting client data through various methods. Nursing diagnosis involves analyzing the data to identify actual or potential health problems. Planning establishes goals and selects interventions. Implementation involves performing the interventions. Evaluation assesses client progress and intervention effectiveness.
The document discusses the nursing process, which is a systematic, critical thinking process that nurses use to provide individualized care. It includes five main steps: assessment, nursing diagnosis, planning, implementation, and evaluation. Assessment involves collecting client data through various methods. Nursing diagnosis involves analyzing the data to identify actual or potential health problems. Planning involves establishing goals and selecting interventions. Implementation is providing the planned care. Evaluation assesses client progress and care plan effectiveness. The nursing process helps nurses apply evidence-based care and problem-solve to promote client health and well-being.
The nursing process is a framework that organizes nursing care through five steps: assessment, nursing diagnosis, planning, implementation, and evaluation. It provides an orderly and systematic method for planning and delivering nursing care centered around the client. The assessment step involves comprehensively gathering both subjective and objective data on the client's health, needs, and situation through various sources like interviews, examinations, and records.
Introduction to Evidence Based Medicine (EBM)Elsayed Salih
This document provides an overview of evidence-based medicine (EBM), including its definition, importance, and process. It defines EBM as the conscientious use of the best available evidence in making decisions about patient care. The key steps in EBM are asking a clear clinical question using the PICO framework, acquiring evidence through a literature search, appraising the evidence for validity and applicability, and applying the evidence to the individual patient. Examples of question types and appropriate study designs are also discussed.
The course deals with concepts, principles and techniques of health assessment, including history taking, physical examination, psychosocial assessment and interpreting laboratory findings to determine nursing diagnoses across the lifespan. The course outline covers the nursing process, data collection, documentation, assessment techniques, vital signs, physical exams and diagnostic procedures. Students will learn to analyze health assessments, utilize the nursing process, demonstrate critical thinking and accurately collect, classify and document subjective and objective data.
The document provides an overview of the nursing process (ADPIE) which is a systematic, critical thinking framework used by nurses to identify health needs and plan, implement, and evaluate care. It consists of 5 phases: assessment, diagnosis, planning, implementation, and evaluation. In assessment, nurses collect comprehensive data on patients' health status to identify needs and problems. They then make nursing diagnoses to determine the nature of the issues. Goals and interventions are developed in the planning phase, and carried out during implementation. Evaluation assesses the effectiveness of the care.
The document discusses the nursing process and how it is used to create nursing care plans and concept maps. It outlines the 5 steps of the nursing process - assessment, diagnosis, planning, implementation, and evaluation. Assessment involves collecting comprehensive patient data. Diagnosis identifies the patient's problems or nursing diagnoses. Planning determines goals and interventions. Implementation puts the plan into action. Evaluation assesses outcomes and the effectiveness of the plan. Concept maps provide an innovative way to organize patient data using diagrams of problems and interventions.
This document discusses evidence-based practice in nursing. It defines evidence-based practice as using systematic research findings to guide clinical decisions. Nurses are encouraged to gather evidence to answer specific questions about problems and interventions. Evidence can come from research, guidelines, experts, and experience. The document outlines how nurses can implement changes based on evidence by planning carefully, understanding the resources and impacts of changes, and measuring outcomes to evaluate the effects of practice changes.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
2. THE NURSING PROCESS: CRITICAL THINKING
Critical thinking in nursing practice:
Definition
“Active, cognitive process used to
carefully examine one’s thinking & the
thinking of others.”
“A discipline specific, reflective reasoning
process that guides a nurse in
generating, implementing & evaluating
approaches for dealing with client care &
professional concerns.”
3. SIGNIFICANCE OF DEVELOPING CRITICAL THINKING
Essential for safe, competent, skillful nursing
practice
Rapid and continuing growth of knowledge
Make complex and important decisions
Draw meaningful information from other
subject areas
Work in rapidly changing, stressful
environments
Recognize important cues, respond quickly,
and adapt interventions
4. TOP 10 REASONS TO IMPROVE THINKING
Things change
Sicker clients
More consumer involvement
Need to move from one setting to another
Need for new learning and workplace skills
Requirement for evidence of benefits, efficiency,
and results
New problems can’t be solved with old ways of
thinking
Thinking skills needed to deal with today’s world
Possible to improve thinking
Difference between success and failure
5. CREATIVITY
Major component of critical thinking
Thinking resulting in development of new ideas &
products.
Ability to develop new & better solutions
Critical Thinking Skills
Critical analysis
Inductive and deductive reasoning
Making valid inferences
Differentiating facts from opinions
Evaluating the credibility of information sources
Clarifying concepts
Recognizing assumptions
6. CRITICAL THINKING ATTITUDES
Independence
Fair-mindedness
Insight
Intellectual humility
Intellectual courage to challenge status quo /
rituals
Integrity
Perseverance
Confidence
Curiosity
7. CRITICAL THINKING AND NURSING
Critical thinking underlies each step of the
nursing, problem-solving, and decision-
making processes
Problem-Solving Process
Clarify the nature of a problem and
suggests possible solutions
Evaluate solutions and choose best one
to implement
Then carefully monitor the situation to
ensure its effectiveness
8. DECISION-MAKING PROCESS
Choosing the best actions to meet a
desired goal
Identify purpose
Set and weigh criteria
Use various priority assessment
frameworks (i.e. – Maslow’s)
Determine what needs to be
preserved/avoided
Seek and examine alternatives
Project, implement, and evaluate
outcome
9. CON’
Commonly used approaches
Trial and Error
Trying a number of approaches until the
solution is found
This can be dangerous – inappropriate
approaches can cause harm to clients
Intuition
Understanding or learning things without
conscious use of reasoning – “I had a
hunch…”
This MUST be coupled with thorough
nursing knowledge and experience –
otherwise, intuition is an inappropriate
basis for nursing decisions
11. CRITICAL THINKING ATTITUDES
Independence
Fair-mindedness
Insight
Intellectual humility
Intellectual courage to challenge status
quo / rituals
Integrity
Perseverance
Confidence
Curiosity
12. Obstacles to Critical Thinking
Overuse of habit mode
Severe anxiety
Working under deadlines
Over commitment to ideological,
religious or political principles
Lack of confidence in one’s
thinking
13. Ways to develop critical thinking skills
Rigorous personal assessment
Reflection
Cultivation of critical thinking abilities
Tolerate dissonance & ambiguity
Seeking situation where good thinking is
practiced (conferences etc)
Awareness of own thinking-while
thinking
Creating environments that support
critical thinking
14. THE NURSING PROCESS: ASSESSING
Nursing Process
Systematic method of planning and providing
individualized care
Characteristics:
Cyclical / dynamic
Client-centered
Focuses on problem solving & decision
making
Interpersonal & collaborative
Universal application
Uses critical thinking
15. Purpose:
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
18. ASS.
Assessment Activities
Collecting data
Organizing data
Validating data
Documenting data
Types of Assessments
Initial
Problem-Focused
Emergency
Time-lapsed
19. TYPES OF DATA
SUBJECTIVE
What the client says (symptoms)
i.e. – “I feel dizzy.”
OBJECTIVE
What you see (signs)
i.e. – vomited 100mL green-tinged fluid.
medical record
diagnostic tests
21. SOURCES OF DATA
Primary Source
Client
This is the best source of data (unless
the client is too ill, young, or confused
to communicate clearly)
If the client is for whatever reason
unwilling to share data, remind her or
him that clients’ privacy is protected by
LAW (so we should all be familiar with
it)
22. Secondary (Indirect) Sources
All other sources of data
Family, or other support persons
Records/reports
Lab results
should be validated, if possible
23. METHODS OF DATA COLLECTION
Interview
Observation
Examination
24. Interviewing
Planned communication or a conversation with
a purpose
Approaches
Directive
Highly structured, elicits specific info
Used when time is limited (emergency)
Non-directive (Rapport-building)
Client controls the purpose, subject matter,
and pacing
Combination approaches usually appropriate
25. Type of interview questions
Closed–ended Question
Restrictive
Yes/no
Factual
effort and info
Open-ended Question
Invite longer answers, more info
Broad topic
“How have you been feeling lately?”
26. CON’
Neutral
Can answer w/o direction /pressure
Open ended
Non-directive
Leading
Directs client’s answer
Closed-ended
Directive
28. Observing
Gathering data using the senses
Used to obtain following types of
data:
Skin color (vision)
Body or breath odors (smell)
Lung or heart sounds (hearing)
Skin temperature (touch)
29. Examining (physical examination)
Systematic data-collection method
Uses observation and inspection,
auscultation, palpation, and percussion
Blood pressure
Pulses
Heart and lungs sounds
Skin temperature and moisture
Muscle strength
30. FRAMEWORKS FOR ORGANIZING DATA
Nursing Models Framework
Gordon’s functional health pattern
framework
Orem’s self-care model
Roy’s adaptation model
31. FRAMEWORKS FOR NURSING ASSESSMENT
Wellness Models
Non-nursing Models
Body systems model
Maslow’s Hierarchy of Needs
Developmental theories
33. THE NURSING PROCESS: DIAGNOSING
Nursing Diagnosis
Diagnosing – a reasoning process
Analyze data
Identify health problems, risks, and strengths
Formulate diagnostic statement
A nursing diagnosis is a client problem that can
be treated primarily by independent nursing
interventions
Implementing a nursing diagnosis provides the basis for
selecting nursing interventions
34. NANDA
North American Nursing Diagnosis Association
(NANDA)
Standardized language
Has evolved & continues to evolve.
Nsg dx
NOC (nursing outcomes)
NIC (nursing interventions)
35. NURSING DIAGNOSIS DEFINITION
“A clinical judgment about
individuals, family, or community
responses to actual or potential
health problems or life processes.”
36. TYPES OF NURSING DIAGNOSES
Actual Diagnosis
Existing
Risk Diagnosis
Potential
Wellness Diagnosis
Readiness for enhancement
Possible Diagnosis
Evidence incomplete/ unclear
Syndrome Diagnosis
Associated with a cluster of other diagnoses
37. COMPONENTS OF NURSING DIAGNOSIS
Problem statement (diagnostic label)
Health problem / response
Etiology (related factors and risk factors)
1 or more probable causes of problem
Defining characteristics
S/s (signs and symptoms) indicating presence
of problem (actual diagnoses)
Factors causing more vulnerability to problem
(risk diagnoses)
NOT THE SAME AS A MEDICAL DIAGNOSIS
38. COLLABORATIVE PROBLEMS
Physiologic complications of disease, tests,
treatments
Pathophysiology-oriented
Nurse and physician diagnose
Physician orders definitive treatment
Independent nursing action for monitoring and
preventing
Dependent nursing actions for treatment
Present when disease/situation present
No classification system
39. CON’
EXAMPLE:
Nursing Diagnosis: Activity Intolerance
related to decreased cardiac output
Medical Diagnosis: Myocardial Infarction
Collaborative Problem: Potential
complication of myocardial infarction:
congestive heart failure
The physiological complication of an MI
Statement of situation/Pathophysiology, and
potential complication
40. STEPS IN DIAGNOSTIC PROCESS
Analyzing Data
Compare data against standards
i.e. – compare the client’s blood levels with
normal ranges
Cluster cues
Finding patterns/relatedness of information
Determining significance
Identify gaps and inconsistencies
Identifying health problems, risks, and
strengths
Formulating diagnostic statements
41. WRITING NURSING DIAGNOSES
Basic Two-Part Statement
Problem (P): statement of the client’s
response
Etiology (E): factors contributing to or
probable causes of the responses
Example: constipation related to
prolonged laxative use
P: constipation
E: prolonged laxative use
42. Basic Three-Part Statement (recommended for
beginners like us!)
Problem (P): statement of the client’s response
Etiology (E): factors contributing to or probable
causes of the responses
Signs and symptoms (S): defining
characteristics manifested by the client
Example: Impaired skin related to immobility
as manifested by Stage I pressure ulcer on the
sacral area
P: Impaired skin
E: immobility
S: Stage I pressure ulcer on the sacral area
43. One-Part Statement
Wellness
Write “readiness for enhanced ___”
Example: Readiness for enhanced Spiritual
Well-Being
Syndrome
A diagnosis related to a cluster of diagnoses
Example: Risk for Disuse Syndrome…which
can be a result of impaired physical mobility,
impaired gas exchange, etc, etc
44. Variations
Unknown etiology
Example: noncompliance
(medication regimen) related to
unknown etiology
Complex factors
Example: chronic low self-esteem
related to complex factors
These factors are too
numerous/complex to state
45. CON’
Possible
“Possible” can describe either the problem or the
etiology
Example: Altered thought processes possibly
related to unfamiliar surroundings
Secondary
Adds a more descriptive second part to the etiology
Example: Impaired Skin Integrity related to
immobility secondary to CVA
Other additions for precision..You can add clarifiers
to make a more precise statement, such as the
location of the problem: Impaired Skin Integrity (Left
scapula)
46. GUIDELINES FOR WRITING A DIAGNOSTIC STATEMENT
State in terms of problem, not need.
Word statement so it’s legally advisable.
Use nonjudgmental statements.
Make sure that both elements of
statement don’t say same thing.
Be sure cause and effect correctly stated.
Word specifically and precisely
Use nursing terminology rather than
medical terminology
47. THE NURSING PROCESS: PLANNING
Planning
Prioritizing problems/diagnoses
Formulating client goals/desired outcomes
Selecting nursing interventions
Writing individualized nursing interventions
Planning is basically the nurse’s
responsibility but input from the client and
support persons is essential if a plan is to be
effective
49. TYPES OF CARE PLANS
Informal
A strategy for action that exists in the nurse’s mind – “My
patient is very tired; I need to reinforce her teaching when
she’s gotten some rest.”
Formal
An organized plan for the client’s care
A major benefit of this is that it provides continuity of care
Standardized
A formal plan for a group of clients with common care needs
(i.e. – MI patients)
Individualized
This is the best type of plan!
Tailored to the specific client – goes beyond the needs addressed by
standardized plans
50. FORMATS FOR NURSING CARE PLANS
Student care plans
Concept maps
Computerized care plans
Multidisciplinary (collaborative) care
plans. Also called critical pathway
52. GUIDELINES FOR WRITING NURSING CARE
PLANS
Date and sign
Use category headings
Use standardized/ approved terminology /
symbols / key words
Be specific
Refer to procedure book or other sources rather
than including steps
Tailor plan to client
Include:
prevention / health maintenance
interventions for ongoing assessment
collaborative and coordination activities
discharge plans and home care
53. THE PLANNING PROCESS: ACTIVITIES
Setting priorities- what’s most important.
Consider:
client’s health values beliefs
Client’s priorities
resources available to the nurse &
client
urgency of the health problem
medical treatment plan
55. GOALS/DESIRED OUTCOMES
What the nurse wants to achieve
Demonstrates problem resolution
Purposes
Direction for planning interventions
Criteria for evaluating progress
Determination of problem resolution
Motivate by providing a sense of achievement
Short / long term
56. Components of Goal/Desired Outcome
Statements
Subject
Verb
Condition or modifier
Criterion of desired performance
“Client will walk the length of the hall
unassisted by 17th/July.”
58. GUIDELINES FOR WRITING GOALS/DESIRED OUTCOMES
Client centered
Must be realistic
Ensure compatibility with the therapies of other
professionals
Derive from only one nursing diagnosis
Use observable, measurable terms
Considered important by client
Mutually agreed upon
59. CON’
The nurse should:
Date & sign the plan
Use category headings
Use approved symbols & key words (instead of writing out
complete sentences)
Be specific
Refer to procedure books or other sources of information
Customize the plan to accommodate the patient’s
needs/wishes
Ensure that it incorporates preventive and health maintenance
aspects (not just health restoration)
Include ongoing assessment plans
Include collaborative and coordination activities (i.e. –
conferring with a specialist)
Include plans for discharge and homecare needs
60. PRACTICE
The client will:
Feel better each day
Broad/subjective
Better: “Decrease in reports of pain; none
within 8 hours”
Understand diabetes mellitus by discharge
Broad/subjective
Better: “Recall 5 symptoms of diabetes
before discharge”
Drink 800cc of fluid between 7am and 7pm
Good!
61. CON’
Report decreased pain
Ok, but no timeframe given…
Improve her relationship with her husband
Broad
Better: “Client and husband communicating
effectively and working together to solve
problems.”
Demonstrate the correct use of crutches on
flat surfaces and stairs by discharge
Good!
62. CON’
PRACTICE GOALS
The patient’s hydration will improve.
It’s ok to be broad with goals, as long as they are
clarified with specific outcomes: “…as evidenced by…”
i.e.: “The patient‘s hydration status will improve as
evidenced by good skin turgor and moist mucous
membranes within 24 hours.”
The patient will verbalize decreased pain
within an hour of pain medication.
Good! Contains subject, verb, conditions, and time.
The patient will ambulate.
Better: “the patient will ambulate [specific distance] by
[specific time]”
63. CON’
The patient will learn about good nutrition.
This goal might not be realistic – also, learning
about “good” nutrition does not ensure
compliance with the best nutritional plan for the
particular patient.
It’d be better to say, for example: “The patient
will discuss the food pyramid and
recommended daily servings before discharge.
"Or: “The patient will identify foods high in salt
from a prepared list before discharge
64. NURSING INTERVENTIONS AND ACTIVITIES
Actions to achieve goals/desired outcomes
eliminate/ reduce etiology of nursing diagnosis
Treatment of signs/symptoms/defining
characteristics
Include:
Observations / assessments
Prevention
Treatments
Health promotion
65. TYPES OF NURSING INTERVENTIONS
Direct care
an intervention performed by the nurse through interaction with
the client
Indirect care
An intervention delegated by the nurse to another provider, or
performed on behalf of the client (but not through direct
interaction) such as interdisciplinary collaboration
Independent interventions
Activities that nurses can initiate themselves
Physical care, ongoing assessments, emotional support/comfort,
teaching, referrals, etc.
Dependent interventions
Physician/HCP orders carried out by the nurse
Collaborative interventions
o Collaboration with health team members – i.e. – coordination
of physical therapy activities
66. CRITERIA FOR CHOOSING APPROPRIATE
INTERVENTIONS
Safe and appropriate for the client’s age, health,
and condition
Achievable with the resources available
Congruent with the client’s values, beliefs, and
culture
Congruent with other therapies
Based on nursing knowledge and experience or
knowledge from relevant sciences
Within established standards of care
67. SAMPLE
GOAL - Reestablish urinary elimination
with complete emptying of bladder within
8 hours of catheter removal.
1. Offer assistance to bathroom q
3hours
2. Offer glass of water every hour.
3. Record I&O q4h.
4. Provide privacy for voiding attempts.
5. Run water for voiding attempts.
68. PRACTICE
Impaired skin integrity related to unknown
etiology as evidenced by a 2cm intact lesion on
left heel.
Goal?
Tissue Integrity; Client’s skin returns to
normal structure and function
Interventions?
Seek dermatology consult to determine
etiology of lesion.
Assess client for elevated body temperature
(fever can indicate infection)
Assess client’s level of discomfort
Identify signs of itching and scratching
69. CON’
Reposition client q2h
Apply a wound barrier to prevent further
injury
Apply appropriate topical medication as
ordered
Maintain sterile dressing technique during
wound care (to reduce risk of infection)
Encourage diet that meets nutritional needs
(to promote healing)
Teach the patient or caregiver signs and
symptoms of infection and when to notify the
nurse/physician
70. THE NURSING PROCESS: IMPLEMENTATION
Implementation
Performance of interventions
Individualized based on assessment data
Activities/ responses examined during
evaluating phase
71. SUCCESSFUL IMPLEMENTATION
Skills needed:
Cognitive skills (intellectual skills)
Problem solving
Decision making
Critical thinking
Creativity
Interpersonal skills
Interaction w/ one another
Technical skills
“hands-on” skills
Tasks, procedures, or psychomotor skills
Require knowledge & manual dexterity
72. FIVE ACTIVITIES OF THE IMPLEMENTING PHASE
Reassessing the client
Determining the nurse’s need for
assistance
Implementing nursing interventions
Supervising delegated care
Documenting nursing activities
73. IMPLEMENTING NURSING INTERVENTIONS:
GUIDELINES
Evidence-based practice
Clearly understand interventions
Adapt activities to the individual client
Implement safe care
Provide teaching, support, and comfort
Be holistic
In other words, treat the patient as a whole – this involves
honoring the client’s expressed treatment preferences
Respect the dignity of the client and enhance
self esteem
Encourage active client participation
74. THE NURSING PROCESS - EVALUATING
Collecting data related to the desired
outcomes
Comparing the data with outcomes
Relating nursing activities to outcomes
Drawing conclusions about problem
status
Continuing, modifying, or terminating the
nursing care plan
75. RELATIONSHIP OF EVALUATING TO OTHER PHASES
Success depends on the effectiveness of
preceding phases
Assessing and nursing diagnosis must
be accurate
Goals/desired outcome must be stated
behaviorally to be useful
Without implementing phase, there
would be nothing to evaluate
Evaluating and assessing phases overlap
76. COMPONENTS OF AN EVALUATION STATEMENT
Conclusion
A statement that the goal/desired
outcome was met, partially met, or not
met
Supporting data
The list of client responses that support
the conclusion
Example:
Goal met: Oral intake 300mL more than
output skin turgor resilient; mucous
membranes moist
77. REVIEWING AND MODIFYING THE CARE PLAN
Critique each phase of the nursing
process
Check whether the interventions were
Carried out
Were unclear or unreasonable
Make necessary modifications
Implement the modified plan
Begin nursing process again
78. CON’
Evaluation
Has the goal(s) been achieved?
Are the interventions working?
If not, why?
How will you modify the Plan?
81. Quality Improvement
Client care
Focus on process
Uses systematic approach to improve quality
of care
Often focus on identifying and correcting a
system’s problems
Also known as:
Continuous quality improvement (CQI)
Total quality management (TQM)
Performance improvement (PI)
Persistent quality improvement (PQI)
82. CON’
Nursing audit
Examination / review of record
Retrospective
Concurrent
Peer Review
Appraisal of quality of care / practice
performed by other equally qualified nurses
Individual
Nursing audits
83. EVALUATION
Has the goal(s) been achieved?
Are the interventions working?
If not, why?
How will you modify the Plan?