Nursing PROCESS | Planning | Implementation | Evaluation | NURSING CARE PLAN | NCP | BSN | FON |

Описание: Planning is the third step of the nursing process. It provides direction for nursing interventions.

The process of setting goals and developing a plan of action on the basis of complete assessment and diagnosis of the patient in order to prevent or eliminate the client’s health problems.
Initial Planning:
The nurse who performs the admission/ initial assessment usually develops the initial comprehensive plan of care.
Ongoing Planning:
Ongoing planning is done by all nurses who work with the client. The nurse carries out daily planning for the following purposes to:
determine whether the client’s health status had changed.
set the priorities for the client’s care during the shift.
decide which problems to focus on during the shift.
Discharge Planning:
Is the process of anticipating and planning for needs after discharge. Effective discharge planning involves comprehensive and ongoing assessment.”
Discharge planning should be initiated at the time of admission.
The planning process includes the following activities:
Setting Priorities
Establishing client goals/expected outcome
Selecting nursing interventions
Developing nursing care plans
To put plan into action is implementation.
Intervention is something that is done to prevent, cure, or control a health problem.
Implementation phase involves interventions or nursing actions to achieve expected outcomes and goals planned to provide effective and desired care to the patient.
Intervention could be of three types:
Independent Interventions
Dependent Interventions
Collaborative/Interdependent Interventions
Independent Interventions:
Are those activities that nurses are licensed to initiate on the basis of their knowledge and skills. They include, physical care, ongoing assessment, emotional support, comfort, teaching, counseling, environmental management, and making referrals to other health care professional.
Dependent Interventions:
Are those activities carried out under the physician's order or supervision, or according to specified routine. They include, orders for medications, intravenous therapy, diagnostic tests, treatments, diet, and activity Collaborative/Interdependent Interventions:
Are actions that a nurse carries out in collaboration with other health team members, such as physical therapists, social workers, dieticians, and physicians etc.

E.g. doctor orders diet consultation for the diabetic patient, nurse can inform dietician to carry out consultation and when consultation is successfully carried out nurse assesses patient’s response and include it in her plan of care.
Four main purposes of the recorded care plan are to:
Facilitate communication between care givers.
Direct care and documentation.
To save you and your patient legally.
Provide a written record to be used for evaluation in future.
Evaluation Last step in nursing process
A nurse determines:
the client’s progress toward goal achievement and
the effectiveness of the nursing care planOngoing Evaluation:
Is done immediately after implementing a nursing order, it enables the nurse to make on- the-spot modifications in an intervention. E.g. evaluating client’s responses to steam inhalation during procedure by assessing his pulse on cardiac monitor.
Intermittent Evaluation:
Performed at specified intervals (e.g. once a week), shows the extent of progress toward goal achievement and enables the nurse to correct any deficiencies and modify the care plan as needed.
E.g. a nurse evaluates patient’s level of activity and assistance required after ambulation or exercise for three days.