nursing process planning
TRANSCRIPT
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