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• Nursing process

  – Action oriented

  – Client centered

  – Outcome directed
• Implementing

  • Doing and documenting the activities that are the specific nursing actions needed to carry out interventions
• First three phases (assessing, diagnosing, planning) provide basis for nursing actions performed.
• • Cognitive (intellectual) skills

  – Problem solving

  – Decision making

  – Critical thinking

  – Creativity
• Interpersonal skills

  – Verbal and nonverbal

  – Effectiveness depends largely on ability to communicate.

  – Therapeutic communication necessary for caring, comforting, advocating, referring, counseling, and supporting

  – Includes conveying knowledge, attitudes, feelings, interest

  – Appreciation of the client's cultural values and lifestyle
• Technical skills

  – Purposeful "hands-on" skills

  – Often called tasks, procedures, or psychomotor skills
• Psychomotor

  ▪ Physical actions that are controlled by the mind, not by reflexes
• Evaluating

  • Judgment and appraisal

  • Planned, ongoing, purposeful activity

  • Determines client's progress, effectiveness of care plan

  • Continuous process

  • Demonstrates nursing responsibility and accountability for their actions
• Collecting Data – Some may require interpretation.
• Persistent quality improvement (PQI)
• Performance improvement (PI)
• Total quality management (TQM)
• Continuous quality improvement (CQI)
• Quality Improvement – Often focuses on identifying and correcting a system's problems
• National Database of Nursing Quality Indicators (NDNQI)
• – National Quality Forum (NQF)
• Serious reportable events (SRE) also known as "never events"
• Nursing Audit – Examination or review of records
• Retrospective audit – Evaluation of a client's record after discharge from an agency
• Concurrent audit – Evaluation of a client's healthcare while client still receiving care from the agency