THE NURSING PROCESS

1
THE NURSING PROCESS

• A systematic problem-solving approach used to
  identify, prevent and treat actual or potential
  health problems and promote wellness.
• A systematic way to plan, implement and evaluate
  care for individuals, families, groups and
  communities.

2
Characteristics of the Nursing Process

• Dynamic
• Client-centered
• Planned
• Interpersonal and collaborative
• Universally applicable
• Can focus on problems or strengths

3
ASSESSMENT

• Collect, organize, validate data
• Obtain information from charts, client, family
• Data gathering (no conclusions)
• Establish information about persons response to
  health concerns and ability to manage

4
DATA COLLECTION

• Observation
• Interview
• Types of questions
• Setting
• Rapport
• Examination

5
DIAGNOSIS

• Sort, cluster, analyze information
• Identify potential problems and strengths
• Write statement of problem or strength
• Risk of infection related to compromised
  nutrition
• Potential for effective breastfeeding related to
  knowledge level and support system
• Prioritize the problems
• Not a medical diagnosis

6
TYPES OF DIAGNOSIS

• Actual diagnosis problem is present
• Risk nursing diagnosis
• Possible diagnosis
• Wellness diagnosis

7
PLANNING

• Establish the goals, interventions and outcomes

8
IMPLEMENTATION

• Carry out the plan
• Assist person to meet goals facilitate coping
• Continue to collect data
• Document care

9
EVALUATION

• Determine if goals were met
• Should care continue
• Modify plan if necessary

10
Benefits of using the nursing process

• Continuity of care
• Prevention of duplication
• Individualized care
• Increased client participation
• Collaboration of care
• Standards of care

11
NANDA North American Nursing Diagnosis
Association

• Identifies nursing functions
• Creates classification system
• Establishes diagnostic labels
• Risk of infection related to compromised
  nutritional state
• Potential complication of seizure disorder
  related to medication compliance

12
Creating nursing diagnosis statements

• State the persons response or diagnostic label
• Identify related factors contributing to or
  causing the problem
• Signs and symptoms

13
Qualities for application of the nursing process

• Intellectual skills
• Critical thinking
• Decision-making
• Interpersonal skills
• Technical skills
• Creativity
• Adaptability