foundations ch 5 part 4

What is the implementation phase of the nursing process?

The phase where the established plan of care is put into action.

What is the focus of the implementation phase?

Achieving patient-centered goals.

What activities occur during implementation?

Patient teaching, medication administration, monitoring patient condition, delegating care, and carrying out ordered treatments.

What are nurse-prescribed interventions during implementation?

Independent nursing actions such as turning patients, providing back massages, and monitoring for complications.

What are physician-prescribed interventions during implementation?

Actions ordered by a physician or other healthcare provider that the nurse carries out using clinical judgment.

What is evidence-based practice (EBP)?

The integration of research, clinical expertise, practice-generated data, and patient preferences into patient care.

Why is evidence-based practice important?

It provides rationale and accountability for nursing actions and improves patient outcomes.

What does evidence-based practice integrate?

Research, clinical expertise, patient preferences, and practice-generated data.

What is the evaluation phase?

The phase that determines whether patient goals have been achieved.

What is the first step of evaluation?

Review the patient-centered goals or desired outcomes.

What is the second step of evaluation?

Reassess the patient's response to nursing interventions.

What are the three possible evaluation outcomes?

Goal achieved, goal partially achieved, or goal not achieved.

What is an example of a goal achieved?

The patient successfully demonstrates self-administration of insulin.

What is an example of a goal partially achieved?

A hip ulcer is healing but has not completely healed.

What should be done when a patient problem is resolved?

Remove it from the nursing care plan.

What should be done if goals are only partially achieved or not achieved?

Review and revise the nursing care plan.

What questions should nurses ask during evaluation?

Was the assessment accurate? Was the problem identified correctly? Were goals realistic? Were interventions effective? Did new problems develop? Was enough time allowed?

Why is modifying the care plan important?

It ensures patient care remains appropriate and effective.

Why is effective communication important in healthcare?

It promotes safe, consistent, and quality patient care.

Why is standardized nursing language important?

It ensures all healthcare providers have a common understanding of patient care.

What is managed care?

A healthcare system that controls services, reduces unnecessary costs, and emphasizes prevention and health promotion.

What is case management?

The planning, coordination, and advocacy of cost-effective, quality patient care.

What is the purpose of clinical pathways (care maps)?

To guide multidisciplinary care, improve efficiency, reduce costs, and promote quality outcomes.

Which healthcare professionals may contribute to a clinical pathway?

Nurses, physicians, therapists, pharmacists, dietitians, and social workers.

What is a variance?

A situation in which the patient does not meet the expected outcome on the clinical pathway.

What can cause a variance?

A change in patient condition, ineffective interventions, missed interventions, or new problems.

Why is variance analysis important?

It promotes continuous quality improvement and may lead to revisions of clinical pathways.

What is the overall goal of managed care?

Provide efficient, cost-conscious care with positive patient outcomes.

What is critical thinking?

Thinking with a purpose using logical, fair, and reflective reasoning.

Why is critical thinking essential in nursing?

It supports safe, effective, and individualized patient care.

What does critical thinking help nurses do?

Choose appropriate interventions, solve problems, and make sound clinical decisions.

What knowledge supports critical thinking?

Facts, nursing principles, evidence-based practice, theories, psychology, anatomy, physiology, pharmacology, and experience.

How is critical thinking different from regular thinking?

Critical thinking is purposeful, organized, and goal-directed.

What is an example of critical thinking in nursing?

Rechecking a pulse oximeter reading that does not match the patient's condition.

What is another example of critical thinking?

Assessing an unresponsive diabetic patient by checking ABCs, confirming blood glucose, notifying the provider, and preparing insulin.

How can nurses improve critical thinking?

Anticipate questions, ask experts, ask "why," observe experienced nurses, and reflect on experiences.

What four elements combine to create critical thinking?

Knowledge, observation, experience, and reflection.

What does critical thinking improve?

Safe, effective, and efficient patient care.

How does critical thinking develop?

Through practice and experience.

What is the correct order of the nursing process?

Assessment → Diagnosis → Outcomes Identification → Planning → Implementation → Evaluation.

What is the difference between a medical diagnosis and a nursing diagnosis?

A medical diagnosis identifies a disease, while a nursing diagnosis identifies human responses to health conditions.

What characteristics should patient goals have?

Patient-centered, specific, measurable, realistic, and time-bound.

What are the two categories of nursing interventions?

Nurse-prescribed and physician-prescribed interventions.

How should nursing interventions be written?

Specific, individualized, and evidence-based.

Why are nursing care plans important?

They guide patient care, improve communication, and ensure continuity of care.

What is the key takeaway from this chapter?

Effective nursing combines the systematic nursing process with critical thinking to provide safe, individualized, evidence-based patient care.