Module 7 - Think like a Nurse - Caputi Method Step 2 continued & Step 3

What is Step 3 of the Caputi Method?

Determining Actions to Take (planning).

What is the purpose of Step 3?

Determine what to consider when planning interventions.

What are the 3 competencies of Step 3?

Selecting interventions; managing potential complications; setting priorities.

What is selecting interventions?

Deciding what action needs to be taken based on the patient care needs and considering whether the intervention is appropriate.

What may be part of selecting an appropriate intervention?

Setting acceptable parameters.

What are the 5 things nursing must consider when selecting interventions?

Legal, ethical and professional guidelines; policies and procedures; roles of people you work with; work environment and resources; individual patient factors.

What type of thinking is used when selecting interventions?

Situation-based thinking and patient-centered thinking.

What is the goal of selecting interventions?

Address the individual patient's care needs.

What interventions could be selected for constipation?

Increase fluids if not contraindicated; assist with ambulation; provide dietary fiber education; offer a warm beverage; administer a prescribed stool softener or laxative.

What is managing potential complications?

Thinking ahead to prevent potential complications and knowing what to do if a potential complication occurs.

What is required to manage potential complications?

Clinical forethought.

Why is managing potential complications essential?

For patient safety.

What is the goal when managing potential complications?

Prevent complications and manage them if they occur to avoid adverse reactions.

What complication can antibiotics cause in a patient with pneumonia?

Diarrhea and dehydration.

How can a nurse manage potential diarrhea from antibiotics?

Monitor stool frequency and consistency; encourage oral fluids; assess for abdominal pain or tenderness; educate the patient to report loose stools or worsening abdominal discomfort.

What is setting priorities?

Deciding what patient issues or concerns are most important and need to be addressed first.

When can priorities be set?

With a group of patients or with an individual patient.

What is the ABCD prioritization model?

A = Absolutely do now; B = urgent and should be done within 1 hour; C = can wait a few hours; D = delegate to support staff.

What does A mean (ABCD model)

Interventions that must be done now because they are the most important.

What does B mean (ABCD model)

Urgent interventions that should be done within 1 hour but can wait until task A is completed.

What does C mean (ABCD model)

Interventions that can wait a few hours but still must be completed.

What does D mean (ABCD model)

Interventions that can be delegated to support staff.

What should be considered when prioritizing a group of patients?

Patient stability; risk for injury; pain or need for pain medication; and time-sensitive medications such as heart medications or insulin.

Why is the COPD patient the highest priority?

Airway and breathing are always a priority.

How did the nurse prioritize the pneumonia patient?

Airway/breathing first; fever management second; nutrition third.

What interventions can address falls risk?

Use fall prevention strategies such as room signage, bed alarms, frequent checks, and educating her to use the call bell when unsteady.

What interventions can address pain?

Administer pain medication as prescribed and review its effectiveness.

What should the nurse do about dizziness?

Explore possible causes such as postural hypertension or blood pressure medications.

What interventions can address risk for skin breakdown?

Encourage position changes every 2 hours and assess pressure points every shift.

How should the nurse manage the potential complication of a fall?

Assist the patient, follow facility fall protocol, assess and monitor for injuries, and notify the physician.

What should the nurse do if pain worsens or does not improve?

Reassess pain, explore causes, and readjust the medication regimen in collaboration with the HCP.

What should the nurse do if pt. develops a wound?

Notify the physician, document, and initiate wound care and orders.

What is the goal of an appropriate plan of care?

Provide safe patient care and improve patient outcomes.

What should an appropriate plan of care address?

An occurring problem and a potential problem.

What are the goals of an appropriate plan of care?

Improve the patient situation and prevent the situation from worsening.

How does Step 3 fit into the Caputi Clinical Judgment Framework?

Step 1 gathers information; Step 2 makes meaning of the information; Step 3 determines actions to take; Step 4 takes action.