BAKERSFIELD COLLEGE
LICENSED VOCATIONAL NURSING PROGRAM
1ST SEMESTER FUNDAMENTALS
CRITICAL THINKING IN NURSING PRACTICE
CHAPTER 18 - Nursing Process: PLANNING NURSING CARE
INTRODUCTION
Once the nursing assessment has been completed and nursing diagnoses are formulated, the nurse must be able to determine client goals related to each nursing diagnoses. Determine priorities among nursing diagnoses, select appropriate nursing interventions to deal with each diagnosis, and develop projected outcomes in order to evaluate the nursing care to be given. In other words, the nurse must plan the care for each client based upon that individual’s nursing diagnoses.
OBJECTIVES
Upon completion of this unit, the student will be able to:
A. 1. List the purposes of the nursing care plan.
2. Discuss the differences between care plans used in the hospital and community health settings.
3. Describe the difference between short-term and long-term goals.
4. Define scientific rationale.
5. Identify correct nursing interventions developed during the planning component.
6. Discuss the differences between dependent, independent, and interdependent intervention.
ASSIGNMENT
A. Read Chapter 18 - Potter & Perry – Critical Thinking Exercise # 1, #3 and Review Questions
B. Study Guide for Chapter 18
Chapter 18 Planning Nursing Care
Establishing Priorities
Helps nurses to anticipate and sequence nursing interventions
Classification of priorities:
Ø High
Ø Intermediate
Ø Low
Time Factor in Setting Priorities
The planning of nursing care occurs in three phases:
Ø Initial
Ø Ongoing
Ø Discharge planning
Critical Thinking in Establishing Goals and Expected Outcomes
Goal
Ø A broad statement that describes the desired change in a client’s condition or behavior
Ø An aim, intent, or end
Expected outcome
Ø Measurable criteria to evaluate goal achievement
Goals of Care
Client-centered goal
Ø A specific and measurable behavior or response
Short-term goal
Ø An objective behavior or response expected within hours to a week
Long-term goal
Ø An objective behavior or response expected within days, weeks, or months
Expected Outcomes
A specific, measurable change in a client’s status
Provide focus or direction
Determine when a specific, client-centered goal has been met
Guidelines for Writing Goals
Types of Interventions
Nurse initiated
Ø Independent
Physician initiated
Ø Dependent
Collaborative
Ø Interdependent
Selection of Interventions
Six factors to include
Ø Characteristics of nursing diagnosis
Ø Goals and expected outcomes
Ø Evidence base for interventions
Ø Feasibility of the intervention
Ø Acceptability to the client
Ø Nurse’s competency
Planning Nursing Care
Nursing care plan
Student care plan
Institutional care plan
Concept map
Consulting Other Health Care Professionals
Consultation is a process in which you seek the expertise of a specialist to identify ways to handle problems in client management or the planning and implementation of therapies.