Ch 19: Implementing Nursing Care (potter)

Ch 19: Implementing Nursing Care (potter)

1. 4th step of nursing process (after plan of care)

2. Nursing Intervention

   • Any treatment based on clinical judgment & knowledge that a nurse performs to enhance patient outcomes
     • Indirect care
       • performed away from pt (ex: safety & infection control)
         • ADL's, IADLs, physical care techniques, lifesaving measures, counseling, teaching, controlling adverse reactions, preventative measures
     • Direct care
       • performed through interactions w/ pt (ex: administering meds)
         • communicating nursing interventions (electronic, written, or oral);delegating supervising, & evaluating the work of other staff members

3. Standard Nursing interventions

   • Clinical Practice guidelines & protocols
     • systematically developed set of statements that help health professionals make decisons about appropriate health care for specific clinical situations
       • nurse individualizes how to apply interventions for each unique pt
     • evidence based research provides the basis for sound clinical practice guidelines & associated recommendations that improves quality of care
   • Standing order
     • Preprinted document containing orders for routine therapies, monitoring guidelines, and/or diagnostic procedures for specific pts w/ identified clinical problems
   • Nursing Interventions Classification Interventions
     • a level of standardization to enhance communication of nursing care across settings & outcomes
   • Standards of practice
     • The ANA standard of practice
       • competencies for establishing professional & caring relationships, using evidence based interventions & technologies, ethical holistic care across life span to diverse groups &
         • implement timely plan follwoing pt safety goals
   • QSEN

4. Critical thinking

   • making approprate interpretations or conclusions about the interventions used to address a pt's human response to health conditons or life processes

5. Implementation Process

   • Reassess pt
     • Review & revise the existing nursing care plan
       • Preparing for implementaion
         • time management
         • equipment
         • personnel
         • environment
         • patient

6. Anticipating & preventing complications

   • identify areas of assistance
     • continual growth in healthcare tech. you may lack skills to perform procedure
       • when asked to administer new med, operate a new piece of equipment or administer a procedure which you are unfamiliar follow these steps:
         • 1) seek info about procedure from science lit for evidence based info, review manuals & procedure book of ageny, or consult w/ experts
         • 2) collect all equipment necessary for procedure
         • 3) have another nurse or health professional who has completed the procedure correctly/safely provide assistance & guidance
   • always stay alert for risks posed by patients illness or treatment
     • assessment reveals the level of patients current risk
       • the evidence/scientific rationales for how interventions prevent or minimize complications help you select most appropriate prevetative measures

7. Implementation skills

   • Cognitive skills
     • use good judgement & sound clinical decision making when preforming any intervention
   • Interpersonal skills
     • communication is essential for effective nursing action
       • develop trusting relationship, express level of caring, and communicate clearly w/ pts & families
   • Psychomotor skills
     • require integration of cognitive & motor skills
       • EX: understanding Anat & pharm (cogntive) & use good coordination & precision to administer injection correctly (motor)

8. Achieving pt goals

   • patient adherence (pts & families invest time in carrying out required treatments)