Ward Class

An Online Resource Site For Student Nurses

Welcome

Ward Class is an online resource for student nurses. Created with the aim of helping student nurses cope with the demands of nursing school and clinicals, it offers free downloads, notes, sample NCPs, sample drug studies, study aids, news and updates, and practical tips to its users.

Site Announcement

The December 2012 PRC Nursing Board Exam Result is already available here at Ward Class and at Pinoy R.N.




The Nursing Process: An Overview


Definition
  • a systematic, rational method of planning and providing nursing care
  • a process that seeks to identify a client's healthcare status, actual or potential health problems, to establish plans to meet the client's identified needs, and to deliver specific nursing interventions to address those needs
Characteristics of the Nursing Process
  • cyclical and dynamic--> components follow a logical sequence but more than once component may be involved at one time; responds to the changing health status of the client so there is no absolute beginning or end
  • open and flexible--> meets the unique needs of the client, family, group, or community
  • client-centered--> the plan of care is organized according to the client’s health problems rather than nursing goals
  • interpersonal and collaborative--> to ensure delivery of quality nursing care, the nurse shares concerns and problems regarding the client’s health status; rapport is developed and an open communication is established between the client and the nurse to carry out the nursing process effectively
  • planned
  • goal directed
  • allows client and nurse to devise ways to solve identified health problems--> decision-making is involved in every step of the nursing process and nurses are not bound by standard responses; nurses can use their skills and knowledge to assist the client attend to health-related goals
  • emphasizes feedback--> determines if there is a need to revise the nursing care plan
  • universally applicable--> it can be used with clients at any age and at any point in the wellness-illness continuum and can be used in a variety of settings.
  • utilizes problem-solving techniques and the systems theory--> decision-making is involved in every component of the nursing process
Components of the Nursing Process

Components

Purpose

Activities

ASSESSING

-Collecting, organizing, validating, and recording data

To establish a database of client’s response to health condition and the ability to manage healthcare needs

-obtain health history

-conduct physical assessment

-review records

-review lit.

-consult support persons/significant others

-consult health professionals

-update data

-organize data

-communicate/document data

DIAGNOSING

-Analyzing and synthesizing data

To identify strengths and health problems to be addressed by collaborative and independent nursing interventions

To develop a list of nursing diagnoses and collaborative problems

-interpret and analyze data (compare against standards, cluster data, identify gaps and inconsistencies)

-determine client’s strengths, risks, and problems

-formulate nursing diagnoses and

collaborative problem statements

PLANNING

-Determining how to prevent, resolve, reduce identified health problems; how to support client’s strengths and how to effectively implement nursing interventions

To develop an individualized care plan (based on your client needs) that specifies goals and related nursing interventions

-collaborate with client regarding

priorities and goals

-write goals/outcome criteria

-select nursing interventions

-consult other members of the healthcare team

-write nursing orders and care plan

-communicate care plan to relevant members of the healthcare team

IMPLEMENTING

-Carrying out planned nursing interventions

To assist the client meet desired goals/outcomes

-Reassess client to update database

-Determine need for assistance

-Perform interventions

-Document care and clients responses; give verbal reports as needed

EVALUATING

-Measuring the degree to which outcomes have been achieved and identifying factors that influenced goal achievement

To determine whether to continue, modify, or terminate plan of care

-collaborate with client and collect data related to outcomes

-determine whether goals have been met

-relate nursing interventions to client outcomes

-make decisions about problem status

-review and modify care plan as indicated



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