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Lesson 10 Planning

The document discusses planning in nursing, which involves setting priorities, goals, and expected outcomes to address patient problems. It covers establishing priorities, writing goals and outcomes, implementing the plan of care through various nursing interventions, and the skills needed to successfully implement the plan.

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Naomi Rebong
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0% found this document useful (0 votes)
20 views4 pages

Lesson 10 Planning

The document discusses planning in nursing, which involves setting priorities, goals, and expected outcomes to address patient problems. It covers establishing priorities, writing goals and outcomes, implementing the plan of care through various nursing interventions, and the skills needed to successfully implement the plan.

Uploaded by

Naomi Rebong
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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PLANNING  Priority setting- is the ordering of

nursing diagnoses or patient problems


 Planning is a deliberative, systematic
to establish a preferential order for
phase of the nursing process that
nursing interventions.
involves decision making and problem
solving.  Methods of Prioritizing- classify
patients’ priorities as high,
 In planning, the nurse refers to the
intermediate, or low importance.
client’s assessment data and diagnostic
statements for direction in formulating  Prioritize nursing diagnoses first by
client goals and designing the nursing considering patients’ immediate needs
interventions required to prevent, based on ABC (Airway, Breathing,
reduce, or eliminate the client’s health Circulation)
problems.
 The highest priority can also be
Types of Planning determined by using Maslow’s hierarchy
of needs.
 Initial Planning- the nurse who
performs the admission assessment  Intermediate priority nursing diagnoses
usually develops the initial are nonemergent and not life
comprehensive plan of care. threatening.

 Ongoing Planning- as nurses obtain new  Low priority nursing diagnoses are not
information and evaluate the client’s always directly related to specific illness
responses to care, they can individualize or prognosis but affect a patient’s future
the initial care plan further. well-being.

 Purpose of ongoing planning  Goal- is a broad statement that


describes a desired change in a patient’s
1. To determine whether the client’s status
condition, perceptions, or behavior.
has changed
 A goal is realistic and based on patient
2. To set priorities for the client’s care
needs, preferences, and resources.
during shift
 It predicts resolution of a problem,
3. To decide which problems to focus on
evidence of progress toward problem
during the shift
resolution, progress toward improve
4. To coordinate the nurse’s activities so health status, or continued
that more than one problem can be maintenance of good health or function
addressed at each client contact (Carpenito, 2017)

 Discharge Planning- the process of  Short-term goal- is an objective


anticipating and planning for needs behavior or response that you expect
after discharge, is a crucial part of a the patient to achieve in a short time,
comprehensive health care plan and usually less than a week. In an acute
should be addressed in each client’s care setting-term goals may be set for
care plan. just a few hours.

Establishing Priorities
 Long-term goal- in an objective or 3. Enable the client and nurse to
response that you expect the patient to determine when the problem has been
achieve, usually over several days, resolved
weeks, or months.
4. Help motivate the client and nurse by
Writing Goals and Expected Outcome providing a sense of achievement.

 Goals and expected outcomes direct IMPLEMENTING


your nursing care.
 Implementation- begins after you
 Use SMART develop a patient’s plan of care.

 Specific  It involves the performance of nursing


and collaborative interventions
 Measurable
necessary to achieve the goals and
 Attainable expected outcomes needed to support
or improve a patient’s health
 Realistic
 Nursing Intervention- is any treatment
 Timed based on clinical judgment and
Establishing Client Goals/ Desired Outcomes knowledge that a nurse performs to
enhance patient outcomes (Butcher et
› On the care plan, the goals/desired al, 2018)
outcomes describe, in terms of
observable client responses, what the  Nursing intervention include direct and
nurse hopes to achieve by indirect care measures, which are either
implementing the nursing interventions. nurse-initiated, physician initiated, or
other provider-initiated.

 Direct care interventions are treatment


nurses provide through interactions
with patients or a group of patients.

 Indirect care interventions are


treatments performed away from a
patient but on behalf of the patient or
group of patients (e.g., managing a
patient’s environment, safety and
Purpose of Goals/Desired Outcomes
infection control), documentation, and
1. Provide direction for planning nursing interprofessional collaboration.
intervention.
Implementing Skills
2. Serve as criteria for evaluating client
› To implement the care plan successfully,
progress
nurses need cognitive, interpersonal,
and technical skills.
› Cognitive skills (intellectual skills) › Independent interventions are those
include problem solving, decision activities that nurses are licensed to
making, critical thinking, clinical initiate on the basis of their knowledge
reasoning, and creativity. They are and skills.
crucial to safe, intelligent nursing care.
› They include physical care, ongoing
› Interpersonal skills are all of the assessment, emotional support and
activities, verbal and non-verbal, people comfort, teaching, counseling,
use when interacting directly with one environmental management, and
another. The effectiveness of a nursing making referrals to other health care
action often depends largely on the professionals.
nurse’s ability to communicate.
Interpersonal skills are necessary for all › Dependent interventions are carried
nursing activities: caring, comforting, out under the orders or supervision of a
advocating, referring, counseling, and licensed physician or other health care
supporting are just a few. provider authorized to write orders to
nurses.
› Technical skills are purposeful “hands-
on” skills such as manipulating › Collaborative interventions are actions
equipment, giving injections, the nurse carries out in collaboration
bandaging, moving, lifting, and with other health team members, such
repositioning client. These skills are also as physical therapists, social workers,
called tasks, procedures, or dieticians, and primary care providers.
psychomotor skills. The term Criteria for Choosing Nursing Interventions
psychomotor refers to physical actions
that are controlled by mind, not by › The plan must be:
reflexes.
– Safe and appropriate for
Process of Implementing individuals age, health, and
condition
› Reassessing the client
– Achievable with resources
› Determining the nurse’s need for available
assistance
– Congruent with the client’s
› Implementing the nursing interventions values, beliefs, and culture
› Supervising the delegated care – Based on nursing knowledge
› Documenting nursing activities and experience or knowledge
from relevant sciences (i.e.,
Types of Nursing Intervention based on rationale)

› Nursing interventions are identified and – Within established standards of


written during the planning step of the care as determined by state
nursing process; however, they are laws, professional organizations,
actually performed in implementing accrediting organizations , and
step. the policies of the institution.
Relationship of Nursing Interventions to › Evaluation is the sixth standard of the
Problem Status ANA Standards of Practice states that
“The registered nurse evaluates
› Depending on the client problem, the
progress towards attainment of
nurse writes interventions for
outcomes”
observation, prevention, treatment, and
health promotion. Quality Assurance

– Observations › QA program is an ongoing, systematic


process designed to evaluate and
– Prevention interventions promote excellence in the health care
– Treatments’ provided to clients.

– Enhancement or promotion › QA refers to evaluation of the level of


interventions care provided in a health care agency,
but it may be limited to the evaluation
of the performance of one nurse or
more broadly involve the evaluation of
the quality of the care in an agency, or
even in a country.

QA requires evaluation of three components of


care:

1. Structure evaluation focuses on the


setting in which care is given

2. Process evaluation focuses on how the


care was given.
EVALUATING 3. Outcome evaluation focuses on
demonstrable changes in the client’s
› To evaluate is to judge or to appraise.
health status as a result of nursing care.
› Evaluating is a planned, ongoing,
purposeful activity in which clients and
health care professionals determine

› a) the client’s progress toward


achievement of goals/ outcomes

› b)the effectiveness of the nursing care


plan

› Evaluating is an important aspect of the


nursing process because conclusions
drawn from the evaluation determine
whether the nursing intervention is
terminated, continued, or changed.

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