Fundamentals of Nursing: Implementing Nursing Care

Includes key components of the nursing process:
- Assessment
- Diagnosis
- Implementation
- Evaluation
Implementation involves:
- Recognizing cues
- Clinical decision making
- Taking action
- Analyzing outcomes
- Generating solutions
- Prioritizing hypotheses

Types of Nursing Interventions:
- Direct Care Interventions:
- Nurse-initiated actions
- Indirect Care Interventions:
- Health care provider-initiated actions
- Other provider-initiated actions
Examples of Interventions By Initiation:
- Conducting family care plan conferences
- Discharge planning conferences
Domains of Nursing Interventions:
- Helping patients
- Teaching and coaching
- Diagnostic and patient monitoring
- Managing rapidly changing situations
- Administering and monitoring treatments
- Ensuring quality health care practices
- Organizational and work-role competence
Specific Interventions:
- 1:1 instruction and interpersonal skills
- Vital sign monitoring during clinical changes
- Measuring oxygen saturation
- Implementing pressure injury prevention measures
- Following fall prevention protocols
- Reporting and delegating hand-off information
- Blood glucose testing and ADL training
- Monitoring surgical infection rates
- Coaching and counseling patients and families during stressful events
- Interprofessional rounding

Clinical Practice Guidelines and Protocols:
- Foundation of scientific knowledge
- Recommendations for managing patient conditions
Standing Orders:
- Preprinted documents containing medical orders for specific patients with identified clinical problems
Nursing Interventions Classification (NIC):
- Provides standardized communication of nursing care across settings to enable outcome comparison
Standards of Practice:
- Regularly reviewed to emphasize timely patient safety goals

Critical Thinking Components:
- Involves clinical judgment and decision-making
- Allows consideration of intervention complexities, changing priorities, alternatives, and time constraints
Knowledge Base Required:
- Understanding of interventions linked to physiology/pathology
- Awareness of expected effects and techniques of performing interventions
- Knowledge of collaboration with other health care disciplines
- Understanding of interpersonal skills and teaching/learning principles
Attitudes Essential for Implementation:
- Independent thinking
- Responsibility
- Creativity
- Discipline
- Confidence
Standards Influencing Implementation:
- ANA standards and scope of nursing practice
- Clinical practice guidelines and standards
- Agency policies and procedures
- Patient expected outcomes
- Ethical standards

Avoiding Adverse Events:
- Continuous assessment
- Reviewing and revising the current nursing care plan
Preparation for Implementation:
- Effective time management
- Ensuring availability of equipment
- Coordination of personnel
- Creating an optimal environment
- Patient preparation
Anticipating and Preventing Complications:
- Identifying areas where assistance is needed
Skills Required for Implementation:
- Cognitive Skills:
- Decision-making abilities
- Interpersonal Communication Skills:
- Effective communication with patients and team members
- Psychomotor Skills:
- Physical ability to perform interventions

Defined as interventions performed away from patients but for their benefit:
- Communicating nursing interventions
- Delegating, supervising, and evaluating the work of other staff members