Nursing Planning

PRESENTED BY: ROOPIKA CHAUHAN

Introduction:

It is an purposeful activity which involves critical thinking. It is the determination of what is to be done, when is to be done ,where is to be done and who will do and also how to evaluate the result. Planning involves the interaction with client, with family and members of health care team, review the pertinent literature, modifies care and record relevant information.

Definition:

According to Cozier (1975) “Planning is a deliberative systematic phase of the nursing process that involves decision making and problem solving.”

According to Kropt: “Planning is defined as the selecting and carrying out series of action assigned to active stated goals.”

1.Assessing

2.Diagnosis

5.Evaluating

3.Planning•Priortize problem•Formulate goals•Select nursing intervention•Write Nsg intervention

4.Implementing

Purpose of planning

•Give direction to client care activities.•Enhance the continuity of care.•Permit the delegation of specific activities.

Types of planning

•Initial planning

•Ongoing planning •Discharge planning

A) 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 because of trend toward shorter hospital stay.

B)Ongoing Planning:- The ongoing planning is done by all nurses who give care to the client. They carry out daily planning by using ongoing assessment

C)Discharge Planning:-Discharge planning is a crucial part of comprehensive health care and should be addressed in each client’s care plan. It is process of planning about the need of the client which occur after the discharge of client

The Planning Process

“Planning is the where nurses determines how to provide nursing care in an organised, individualized, goal directed way.”

It consist of four phases

•Setting priorities.•Establishing client goal/ desired outcomes.•Selecting the nursing strategies/ intervention.•Writing individualized nursing intervention on care plan.

a)Setting priorities

“Priority setting is the process of establishing a preferential sequence for addressing nursing diagnosis and intervention.”

Priorities are classified as:-

a)High priority

b)Intermediate priority/Medium priority

c)Low priority

Maslow’s hierarchy of need

b)Establishing client goal/Desired outcome

The term goal and desired outcomes are used interchangeably, some references also use the term expected outcome, predicted outcomes outcome criteria and objectives.

What is a goal? “Goal are the statement of expected outcome of nursing intervention.”

Types of goal

Short term goal

Long term goal

Eg. Ineffective airway clearance

related to the effect of sedation.

Eg. Long term goal for a client with an ineffective airway clearance may be to, “Remain free of upper respiratory infection for 6 months.’’

Expected outcomes

e.g.- If the nursing diagnosis is potential impaired skin integrity related to irritating stomal changes or discharge. The expected outcome is the, "Skin around stoma free of redness, excoriation throughout hospitalization.”

Component of goals/Desired outcome

•Subject

•Verb

•Condition or Modifiers

•Criterion of desired

performance

C) Selecting nursing interventions and activities

NURSING INTERVENTION

Collaborative

Intervention

Independent

Intervention

DependentIntervention

Selection of Intervention

a)Characteristics of the nursing diagnosis.b) Expected outcomesc) Research based) Feasibilitye) Acceptability to the clientf) Mutually decided nursing goals

Writing individualized nursing intervention:

Nursing intervention on the care plan are dated when they are written and reviewed regularly at intervals that depend on individuals need.

The format of written intervention is similar to that of outcome: Verb, condition and modifiers plus time element.

E.g.:- Assist client with tub bath at 7:00 daily or Administer analgesic 30 minutes prior to physical therapy.

Nursing care plan in various setting

•In hospital setting•In community health setting•Discharge planning

How to write nursing care plan: Column Ist:-Assessment Column IInd:- Nursing diagnosis according to the priority actual and potential.Column IIIrd:- Expected outcome are written in this according to the Nsg diagnosis.Column IVth:- It include nursing care Intervention which is planned.Column Vth:- The scientific Rationale for a specific intervention is written.Column VIth:- Evaluation.