nursing process planning

PREPARED AND PRESENTED BY

MRS.S.ANUKRISHNAN,

VICE PRINCIPAL CUM HOD OBG NURSING,

P.D.BHARATESH COLLEGE OF NURSING,

HALAGA, BELGAUM.

NURSING PROCESS - PLANNING

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.

Types of Planning

1] Initial planning

2] Ongoing Planning

3] Discharge planning 

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.

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.

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.

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.

Developing nursing care plans

An informal nursing care plan

A formal nursing care plan

A Standardized care plan

An individualized care plan

An informal nursing care plan

is a strategy for action that exists in the

nurses mind.

A formal nursing care plan

is a written or computerized guide that

organizes information about the client’s care.

It provides continuity of care.

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)

An individualized care plan

is tailored to meet the unique needs of a

specific client needs that are not addressed by

standardized plan.

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.

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.

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.

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.

The planning process

Setting priorities

Establishing client goals/ desired outcomes.

Selecting nursing interventions

Writing nursing orders.

Assessing a. Collect datab. Organize datac. Validate datad. Document data

Diagnosinga. Analyze datab. Identify health

problems, risks and strength,

c. Formulating nursing diagnosis

Planninga. Setting prioritiesb. Establishing client

goals, desired outcomes

c. Selecting nursing interventions

d. Writing nursing orders

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.

Eg.

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.

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

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.

4) Writing Nursing orders

Date Action verb Content area Time Element Sign.

4/4/06 Monitor Vital signs Every hours

q4h

Auscultate Abdomen q6h

•After choosing appropriate nursing interventions

the nurse write those on care plan on nursing

orders.

• Components of Nursing order