Implementation n evaluation

• Action phase in which the nurse performs the nursing interventions.

  implementing
• According to NIC, it consists of doing and documenting the activities that are specific nursing actions needed to carry out the interventions.

  implementing
• implementing helps the nurse --- the client at every contact.

  reassess
• Provides the actual nursing activities and client responses that are examined in the final phase, the ---.

  evaluating phase
• To implement, the care plan successfully, a nurse needs the following skills:

  cognitive skills

  interpersonal skills

  technical skills
• Also known as intellectual skills.

  include problem solving, decision making critical thinking, clinical reasoning, and creativity


  cognitive skills
• Activities (both verbal and nonverbal) people use when interacting directly with one another.

  interpersonal skills
• interpersonal skills' effectiveness depends on the nurse's --- with others.

  ability to communicate
• include conveying knowledge, attitudes, feelings, interest, and appreciation of the client's cultural values, and lifestyles

  interpersonal skills
• Purposeful "hands on" skills. Also called tasks, procedures, or psychomotor skills.

  technical skills
• Require knowledge and manual dexterity (fine work or skills in performing technical nursing skills)

  technical skills
• process of implementing

  Reassessing the client

  Determining the nurse's need for assistance

  Implementing nursing interventions

  Supervising delegated care

  Documenting nursing activities
• Nurse may require assistance in the following situations.

  Inability to do activity safely or efficiently (alone)

  Assistance would reduce stress on the client.

  Lack of knowledge or skills to implement a particular nursing activity.
• E.g., You are taking care of a 100 pound - client and need to transfer him. Can you carry him alone or need assistance?

  Determining the nurse's

  needs for assistance
• Reassess to make sure the intervention is needed.

  Reassessing the client
• Base nursing intervention on

  scientific knowledge, nursing research, and professional standards of care when these exist (scientific back up).


  Implementing the nursing

  interventions
• Clearly understand the interventions to be implemented and question any that are not understood.

  Adapt activities individual to the client.

  Implementing the nursing

  interventions
• guidelines for implementing the nursing

  intervention

  Implement safe care.

  Provide teaching, support,

  and comfort.

  Be holistic (e.g., Cover

  private parts of patient when

  they are transferred).

  Respect the dignity of the client and enhance the

  client's self - esteem.

  Encourage clients to participate actively in implementing the nursing

  interventions.
• The nurse should ensure that the activities have been implemented.

  The nurse should validate and respond to any adverse findings or client responses.

  Includes modifying the NCP.

  supervising the delegated care
• Completes the implementing phase by recording the interventions and client responses in the nursing progress notes (if done already, use past tense).

  Recorded data must be up to date, accurate and available to other nurses and other health care professionals.


  Documenting the nursing

  activities
• A planned, ongoing, purposeful activity in which clients and healthcare professional determine:


  Client's progress toward achievement of outcomes (is there a progress or downgrade).

  Effectiveness of the NCP.
• Determines whether the nursing interventions should be terminated, continued, or change.

  evaluating
• 5 components of evaluating

  - collecting data

  - comparing data with desired outcomes

  - relating nursing activities to outcomes

  - drawing conclusions about the problem status

  - continuing, modifying or termination the NCP
• To draw conclusions whether goals have been met.

  Data should be objective and subjective.

  Data must be recorded concisely and accurately.

  collecting data
• 3 possible conclusions when comparing data with desired outcomes

  The goal was met.

  The goal was partially met.

  The goal was not met at all.
• a statement that consists of two parts: a conclusion and supporting data; written by the nurse

  Evaluation Statement
• Statement whether

  the goal was met or

  not.

  conclusion part of evaluation statement
• List of client responses that support the conclusion.

  supporting data of evaluation statement
• It should never be assumed that the nursing activity was the cause of or the only factor in meeting, partially meeting, or not meeting the goal.

  Relating nursing activities to

  outcomes
• When the goals are met, conclusions can include: (1)

  The actual problem has been

  resolved, potential problem is resolved, and risk factors no longer exist. (discontinues the care of problem)
• When the goals are met, conclusions can include: (2)

  The potential problem has been met but risk factors are still present.

  (The problem is kept in the care plan.)
• When the goals are met, conclusions can include: (3)

  Actual problem still exist even though, some goals are being met.

  (Nursing interventions must be continued.)
• When goals are partially met or not met, the conclusion can either be:

  Care plan may be needed to be

  revised.

  Care plan does not need revision

  because the client merely needs more time to achieve the previously established goals.
• After drawing conclusions, the nurse modifies the care plan, as indicated if goals are partially met or not met at all

  we need to reassess patient (Continuing, modifying or

  termination the NCP)
• If incomplete, reassess client and record new data.

  Assessing
• New diagnostic statements may be required.

  Check of the identified nursing is also correct.

  ▪ If incorrect, revise the nursing diagnosis.

  Diagnosing
• If nursing diagnosis is incorrect, goals are also incorrect. T or F

  T
• Goals should be?

  SMART: specific, measurable, attainable, relevant, time-bound
• Manner of implementation should be checked (how it is performed).

  Check whether are they are carried out.

  After making the necessary modifications, the modified plan should be implemented.

  implementing
• After implementation, go back to assessment if needed. T or F

  T