Study Guide - Chapter 18

Implementing

What is implementing?

Bringing nursing care plan to life // action

Describe Alfaro’s rule? Why is it important?

AREM
Assess before acting
Reassess for change
Evidence based practice
Monitor and modify

It’s important because it provides a framework for the continuous critical thinking required before, during, and after implementation

Why is it important to reassess before implementing?

To detect changes in status that may require a different or modified set of interventions

Name the types of nursing interventions

1 - direct vs indirect care

2 - protocols/standing orders

3 - independent and collaborative

4 - care bundles

Describe direct vs indirect nursing

Direct - face to face interaction w/ patient (ex: wound care, med admin)

Indirect - performed on behalf of pt w/o direct contact (ex: documenting, consulting w/ team)

Describe protocols vs standing orders?

Protocols - pre established guidelines for specific, defined circumstances

Standing orders - physician written, pre approved orders that are allowed to be completed by healthcare professionals under certain conditions

Protocols are more loose while standing orders are more rigid

Describe patient variables vs nurse variables

Patient variables - originate with the individual, not the care system

Nurse variables - available resources, competency, staffing, current standards of care, etc

Identify the common reasons for noncompliance

1 - lack of family support

2 - misunderstanding benefits

3 - low value on outcomes

4 - adverse effects

5 - cost and access barriers

How can we prevent noncompliance?

Explore the root cause of it and then address it/modify your approach.

Always explore with curiosity and compassion - not judgement

What are the 5 rights of delegation?

Right person

Right task

Right circumstance

Right directions + communication

Right supervision + evaluation