Lecture for nursing student

1. Jasmin Akter
Lecturer
Prime College of Nursing, Dhaka
Nursing Process

2. Definition
Nursing process is a scientific process which is
a foundation, the essential tool, and the
enduring skill that has characterized nursing
from the beginning of the profession. It is a
plan of care for the patient which may look
different from institution to institution but
provides both systematic and effective course
of intervention to patient.

3. Significance of Nursing process
• Provides individualized care
• Client is an active participant
• Promotes continuity of care
• Provides more effective communication among
nurses and healthcare professionals
• Develops a clear and efficient plan of care
• Provides personal
• Professional growth as you evaluate effectiveness
of interventions

4. Characteristics of Nursing process
1. Cyclic and Dynamic: – it is an ongoing continuous
process throughout the stages of illness and treatment
and ends with the cease of the illness.
2. Goal directed and Client oriented: The nursing
process is intended to treat the patient and is in the
best interest of the patient.
3. Interpersonal and Collaborative: This goes to
explain the amount of interaction that might be
necessary between nurses, patients of similar illnesses
and the medical team. It might involve group therapy
and / or family counseling.

5. 4. Universally applicable: This process is
universally standard and no matter what the
institution it may be, the process remains the
same. It is like a common nursing language with
common nursing terminology followed
universally.
5. Scientific and Systematic: Every symptom or
sign is a result of a scientific fact which leads to
scientific methods of treatment and follow-ups.

6. Steps of Nursing
Process
IMPLEMENTATION
PLANNING AND
OUTCOME IDENTIFICATION
NURSING DIAGNOSIS
ASSESSMENT
EVALUATION

7. 1. Assessment
Definition: It is also called as data collection.
Assessment is both the most basic and the
most complex nursing skill which is at the
same time both the initial step in the nursing
process and an ongoing component in every
other step in the process.

8. Assessment is composed of -
Observation of patient
Interview of patient, family and support
systems
Examination of the patient
Review of medical records.

9. Purposes of Assessment
To establish a database
To identify health‐promotingbehaviors
To identify actual and/or potential healthproblems.

10. Types of nursing assessments
Comprehensive
Ongoing
Focused

11. Steps in Nursing Assessment
STEPS1.Collecting
data
2.Validating
data
3.Organizing
data
4.Interpreting
data
5.Documenting
data

12. 2. Diagnosis
A nursing diagnosis is a clinical judgment
about the patient’s response to actual or
potential health conditions or needs.
It is the process of-
 Data analysis
 Problem identification
 Formulation of nursing diagnosis.

13. Types of Nursing diagnosis
There are three types of nursing diagnosis with
example:
Actual nursing diagnosis: Impaired skin integrity
r/t physical immobilization as manifested by
disruption of the skin surface over the elbows
and coccyx.
Risk nursing diagnosis : Risk for impaired skin
integrity r/t physical immobilization in total body
cast, diaphoresis.
Possible nursing diagnosis: Possible nutritional
deficit.

14. Components in Nursing Diagnosis
(PES Format)
● Problem statement or diagnostic
label
● Etiology
● Defining characteristics
Problem
statemen
t
Etiology Defining
characteristics
Deficient
fluid
volume
Diarrhea Dry skin ,dryness of
the mouth.

15. Advantages of nursing diagnosis
● Communication
● Identification of AppropriateGoals
● Quality improvement
● Standard for NursingPractice
● Acuity Information
● Assist in Dischargeplanning
● Common language

16. Comparison between nursing &
Medical diagnosis
Nursing Diagnosis
• Within the scope of nursing
practice
• Identify responses to health
and illness
• Can change from day to day
• Example: Ineffective
Breathing Pattern
Medical Diagnosis
• Within the scope of
medical practice
• Focuses on curing
pathology
• Stays the same as long as
the disease is present
• Example: Chronic
Obstructive Pulmonary
Disease

17. 3. Planning
Once a patient and nurse agree on the
diagnoses, a plan of action can be developed.
If multiple diagnoses need to be addressed,
the head nurse will prioritize each assessment
and devote attention to severe symptoms and
high risk factors.

18. Ongoing
Plannin
g
Initial
Planning
Discharg
e
Planning
Phases of Planning

19. PLANNING PROCESS
1‐Setting priorities.
2‐Establishing client goals/desired outcomes.
3‐Selecting nursing strategies.
4‐Writing nursing orders.

20. Intermediate Low
High
Classification of priorites

21. Implementation
This fourth step of the nursing process involves the
execution of the nursing care planderived during the
Planning phase.
Direct care Indirect care
INTERVENTION

22. Implementation skills
1.Cognitive Skills
2.Interpersonal Skills
3. Psychomotor skills

23. Implementation process
1.Reassessing theclient
2.Reviewing and revising the existing nursing careplan
3.Organizing resources and caredelivery
4.Anticipating and preventingcomplications
5.Implementing nursinginterventions.

24. Evaluation
Evaluation is defined as the judgment ofthe
effectiveness of nursing care to meet client goals; in this
phase nurse compare the client behavioral responseswith
predetermined client goals and outcomecriteria.
{CRAVEN 1996}

25. Purposes
1.Determine client’s behavioral response.
2.Compare the client’s response with outcome
criteria.
3.Appraise the extent to which client’s goals.
4.Assess the collaboration of client and health
team 5.Identify the errors in the plan ofcare.
6.Monitor the quality of nursingcare.

26. Methods of Evaluation of nursing care
Evaluating
nursing
care
Reflection
Reflect on own
experiences
both sociallywith
other friends..
Nursing handover
Hand over information
about the nursing care
of clients tonurses
Reviewing the
plan
Evaluates the
care given
against the set
goals.
Patient
satisfaction
Appreciation thatis
sometimes offered
by clients

27. Example for Evaluation
At the end of 8hours ,patient painhas
reduced as evidenced by pain score 2/10 andimproved
activity