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1

whats involved in planning nursing care

- setting priorities based on pt. diagnosis and collaborative problems
- identifying pt. centered goals and expected outcomes
- prescribing nursing interventions appropriate for each diagnosis

2

priority setting

- ordering of nursing diagnosis or pt. problems to establish a preferential order for nursing interventions
- problem-focused diagnoses and problems take priority over wellness, possible risk, and health promotion problems
- helps anticipate and sequence nursing interventions when a pt. has multiple nursing diagnoses and collaborative problems
- establish priorities in relation to their ongoing clinical importance

3

methods for prioritizing: high

- nursing diagnosis that, if untreated, results in harm to a pt. or other
- maslow's hierarchy of needs

4

methods for prioritizing: intermediate

nonemergent and not life-threatening

5

methods for prioritizing: low

not always directly related to a specific illness or prognosis but affect a pt. future well-being

6

the goal of critical thinking

- a broad statement that describes the desired change in a pt. condition, perceptions, or behaviors
- short term
- long term
- standards of care or clinical guidelines established for minimal safe practice

7

pt. collaboration is needed to

- better priortize goals of care
- develop a realistic and relevant plan of care

8

interprofessional team collaboration is increasing as a result of

- more complex needs assocated with chronic diseases
- increasing complexity of skills required to diliver care
- knowledge required to provide comprehensive care to pt.
- increasing specialization within health professions

9

nursing outcomes

- nursing- sensitive pt. outcome
- nursing outcomes classification

10

expected outcomes

speicfic
measurable
attainable
realistic
times

11

critical thinkign in planning nursing care

select interventions designed to help pt. the present level of health described in the goal and measured by the expected outcomes

12

types of interventions

- nurse initiated
- healthcare provider- initiated
- other provider-initiated

13

selection of interventions factors to consider

- desired pt. outcvomes
- characteristics of the nursing diagnosis
- research base knowledge for the intervention
- feasibility for doing the intervention
- acceptability to the pt.
- your own competency

14

what did the iowa intervention project develop

nursing interventions that provide a level of standardization to enhance communication of nursing care across health care settings and to compare outcomes

includes 3 levels: domains, classes, and interventions for ease of use

linked with NANDA international nursing diagnosis

15

systems for planning nursing care

health care agency care plans
- nursing care plans
- interprofessional care plans

- student care plans
- care plans for the community- based settings

16

hand-off reporting

transferring essential information from one nurse to the next during transitions in care
- clarify and confirm important details
- pt progress
- transfer of info
- focus reports on the nursing care, treatments, pt. goals and expected outcomes documented in your care plans

17

critical pathways

many hospitals are using critical pathways and enhanced recovery after surgery (ERAS) protocols to:
- reduce variations in clinical practice
- standardized evidence- based care
- reduce pt. length of stay
- improve pt. outcomes
- must individualize pt. care

18

consulting with health care professionals

- consult with members of the health care team when you face problems in providing nursing or collaborative care or in delivering dependent interventions
- when to consult
- how to consult
- successful planning equals pt. participation