LEC 5.1: Nursing Process | Overview of the Nursing Process

Nursing Process

Systematic, rational method of planning and providing individualized nursing care

“Fundamental blueprint” for how to care for patients

Lydia Hall (1955)

From who and what year did the term “Nursing Process” originate?

Johnson, Orlando, Weidenbach

Who were the first to refer to the “Nursing Process” as a series of phases describing the practice of nursing?

American Nurses Association (ANA) Standards of Nursing Practice (1973)

What were the “Nursing Process” phases included into, thus legitimizing them? What year did this occur?

1. Individual

2. Family

3. Community

4. Group

What are the clients of the Nursing Practice?

Group of women with breast cancer who underwent mastectomy

Example of a group (a type of client of the Nursing Practice)

1. To identify client’s health status and actual or potential health care problems or needs

2. To establish plans to meet the identified needs

3. To deliver specific nursing interventions to meet those needs

What are the 3 Purposes of the Nursing Process?

ADPOIE:

1. Assessment

2. Diagnosis

3. Planning

4. Outcomes Identification

5. Implementation

6. Evaluation

What are the Phases of the Nursing Process according to the American Nurses Association (ANA)?

ADPIE:

1. Assessment

2. Diagnosing

3. Planning

4. Implementation

5. Evaluation

What are the Phases of the Nursing Process according to the National Licensure Examination for Registered Nurses (NCLEX)?

1. Cyclic & Dynamic

2. Client-Centeredness

3. Focus on Problem-Solving & Decision-Making

4. Interpersonal & Collaborative Style

5. Universal Applicability

6. Use of Critical Thinking & Clinical Reasoning

6 Characteristics of the Nursing Process

Cyclic & Dynamic

One of the characteristics of the Nursing Process

Each phase provides input into next phase

For example, ADPIE has a systematic order from assessment in which we observe unusual or significant findings of the client proceeding to diagnosing → planning → implementing → evaluating.

Client-Centeredness

One of the characteristics of the Nursing Process

Plan of care is according to the client’s problem rather than the nursing goal

Focus on Problem-Solving & Decision-Making

One of the characteristics of the Nursing Process

Involves:

1. Problem-Solving, a mental activity in which a problem is identified that represents an unsteady state and requires the nurse to obtain info that clarifies the nature of the problem and suggest possible solutions

2. Decision-Making, in which nurses creatively determine when and how to use data to make decisions and direct towards client’s responses, rather than on physiological systems and disease process

Problem-Solving

A mental activity in which a problem is identified that represents an unsteady state

Requires the nurse to obtain info that clarifies the nature of the problem and suggest possible solutions

Decision-Making

Nurses creatively determine when and how to use data to make decisions

Directed towards client’s responses, rather than on physiological systems and disease process

False (The Nursing Process is directed towards the client’s responses, rather than physiological systems and the disease process.)

True or False: The Nursing Process is directed towards physiological systems and the disease process, rather than the client’s responses.

Medical Diagnosis

Refer to disease process, specific pathophysiologic responses that are fairly uniform

Remain the same as long as the disease process in present

Nursing Diagnosis

Describe the human response (physical, sociocultural, psychological, and spiritual response to an illness)

Change as the client’s response changes

Diabetes Mellitus

Example of a Medical Diagnosis

• Risk for unstable blood glucose

• Risk for infection

• Deficient knowledge

• Imbalanced nutrition: less than body requirements

Example of a Nursing Diagnosis

Interpersonal & Collaborative Style

One of the characteristics of the Nursing Process

Communicate directly to clients

Collaborate with other members of the health care team

Universal Applicability

One of the characteristics of the Nursing Process

Used as a framework for nursing care in all types of health care settings

Use of Critical Thinking & Clinical Reasoning

One of the characteristics of the Nursing Process

Involves:

1. Critical Thinking: process of intentional higher level thinking to define a client’s problem, examining the evidence-based practice in caring for the client, and make choices in the delivery of care

2. Clinical Reasoning: cognitive process that uses thinking strategies to gather and analyze client information, evaluate the relevance of the information and decide on possible nursing actions to improve the client’s psychological and psychosocial outcomes AND requires the integration of critical thinking in the identification of the most appropriate interventions that will improve the client’s condition

Critical Thinking

Process of intentional higher level thinking to…

• define a client’s problem,

• examining the evidence-based practice in caring for the client, and

• make choices in the delivery of care

Clinical Reasoning

Cognitive process that uses thinking strategies to…

• gather and analyze client information,

• evaluate the relevance of the information and

• decide on possible nursing actions to improve the client’s psychological and psychosocial outcomes

Clinical Reasoning

Requires the integration of critical thinking in the identification of the most appropriate interventions that will improve the client’s condition