Nursing Process: Planning Interventions

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Nursing Interventions

Purpose: Achieve Client Outcomes

Also called: nursing actions, measures, strategies and activities

Based on clinical judgement and nursing knowledge = learned in clinical settings

Reflect direct and indirect care

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Independent Interventions

One that RNs can prescribe, perform or delegate based on their knowledge and skills

Does not require a provider's orders

Knowing how,when and why to perform an activity = autonomous (independent)

Done in response to a nursing diagnosis

Dependent Interventions

Prescribed by a physician or APRN

Carried out by the bedside nurse

Usually: diagnostic tests, medications, treatments, IV therapy, diet and activity

Must carry out the prescription, assess the need for it, explain it to the patient and evaluate it

Interdependent Intervention

One that is carried out in collaboration with other health-team members

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Choosing Nursing Interventions

Use:

Professional standards

ANA Nurse Practices

Theories

Theory = a set of interrelated concepts that describes or explains something

Influences your perspective:

What you consider to be a problem, how you define a problem, and what you choose to do about it

Nursing Research

Use evidence-based knowledge to guide practice decisions

Incorporates evidence when changing nursing practice

Evidence-based guidelines

Blending clinical judgement and expertise with the best available research evidence and patient characteristics and preferences

Identifies the most effective and cost-efficient treatments for a particular disease

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Problem Status + Nursing Interventions

Observation/Assessment Interventions and Prevention Interventions used for:

Actual Nursing Diagnosis

To relieve symptoms and resolve etiologies

Potential Nursing Diagnosis

Possible Nursing Diagnosis

Collaborative Problems

Implement nursing and medical orders for relieving or eliminating the underlying condition for which complications may develop

Wellness diagnoses - to keep them on a good track

Support a client's health promotion efforts and achieve a higher level of wellness

Treatment Interventions used for:

Actual nursing diagnoses

Collaborative Problems

Health Promotion Interventions used for:

Wellness diagnoses

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Process Used for Generating and Selecting Interventions

Review the nursing diagnosis.

Review the desired client outcomes.

Identify several interventions/actions.

Choose the best interventions for this client.

Individualize the standardized interventions

Patient MUST be involved

Generating Interventions from Problem and Etiology

Strongest Evidence: Meta-analysis of randomized clinical traits - a lot of data and evidence

Weakest Evidence: Expert Opinion - what you learn from your clinical instructor

Standardized Language for Interventions

Nursing Interventions Classification (NIC)

Consists of a label, a definition, and a list of specific activities

NIC interventions are linked to NANDA-I diagnoses and NOC outcome labels.

NIC includes interventions applicable to all settings.

Clinical Care Classification (CCC)

The OMAHA System

NIC, CCC, and OMAHA include interventions to address health promotion and cultural and spiritual needs.

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Writing Nursing Orders

Instructions that describe how and when nursing interventions are to be implemented

Reflecting Critically About Nursing Orders

Is the set of order complete?

Is each order technically complete?

Are the orders clear, specific and precise?

Is the order individualized for this particular client?

Include patient likes and dislikes.

Are the orders concise?

Keep the orders as brief as possible without sacrificing

clarity and specificity.

Which orders have priority?

Decide which orders must be implemented immediately, which ones must be done on this shift, and which ones must be done today. You may use Maslow’s hierarchy, problem urgency, future consequences,and patient preference to establish your priorities.

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