Fundamentals: Chapter 19, Implementing
Nursing Care Study Guide 2022
Implementation - The fourth step of the nursing process,(formally begins after the
... [Show More]
nurse develops a plan of care) the nurse initiates the interventions that are most
likely to achieve the goals and expected outcomes needed to support or improve the
client's health status.
Nursing intervention - Is any treatment, based on clinical judgment and knowledge,
that a nurse performs to enhance client outcomes.
Ideally the interventions a nurse uses are evidenced based, providing the most
current, up-to-date, and effective approaches for managing patient problems.
Interventions include direct and indirect care aimed at individuals, families, and/or
the community.
Direct care (interventions) - Are treatments performed through interactions with
patient's.
Ex: Medication administration, insertion of an intravenous (IV) infusion, or counseling
during a time of grief.
Indirect care (interventions) - Are treatments performed away from the patient but on
behalf of the patient or group of patient's.
Ex: Actions for managing patient's environment (e.g. safety and infection control),
documentation, and interdisciplinary collaboration.
Critical Thinking in Implementation - Critical thinking is necessary to consider the
complexity of interventions, including the number of alternatives approaches and the
amount of time available to act.
Before implementing a planned intervention, use critical thinking to confirm whether
the intervention is correct and still appropriate for the patient's clinical situation.
Identify the factors that should be considered when making decisions about
implementation - a. Review the set of all possible interventions for the patient's
problem
b. Review all of the possible consequences associated with each possible nursing
action
c. Determine the probability of all possible consequences
d. Make a judgment of the value of that consequence to the patient
Standard nursing interventions - Many patients have common health care problems;
thus standardized interventions for these health problems make it quicker and easier
for nurses to intervene.
->Nurse/Physician initiated standardized interventions- Clinical guidelines or
protocols, Preprinted (standing) orders, and Nursing Interventions Classification
(NIC) interventions.
->Professional level- The American Nurses Association (ANA) defines standards of
professional nursing practice, which include standards for the implementation step of
the nursing process.
Clinical practice guideline - Or protocol is a document that guides decisions and
interventions for specific health care problems or conditions.
(or protocol) Is a systematically developed set of statements that helps nurses,
physicians, and other health care providers make decisions about appropriate health
care for specific clinical situations.
Standing orders - Is a preprinted document containing orders for the conduct of
routine therapies, monitoring guidelines, and/or diagnostic procedures for patients
with identified clinical problems.
Nursing Interventions Classification (NIC) interventions - Offer a level of
standardization to enhance communication of nursing care across settings and to
compare outcomes
What are the five preparatory activites for implementation of safe and effective
nursing care. - 1. Reassessing the patient
2. Reviewing & Revising the existing nurse care plan
3. Organizing resources and care delivery
4. Anticipating and preventing complications
5. Implementation nursing interventions
1. "Reassessing the patient" - Reassessing the patient is a continuous process that
occurs each time you interact with a patient; you collect new data, identify a new
patient need, and modify the care plan
2. " Reviewing & Revising the existing nurse care plan" - If the patient's status has
changed and the nursing diagnosis and related nursing interventions are no longer
appropriate, modify the nursing care plan
3. "Organizing resources and care delivery" - Organizing resources and care
delivery involves organization of equipment, skilled personnel, and the environment.
This makes timely, efficient, skilled patient care possible.
4. "Anticipating and preventing complications" - Risks to patients come from both
the illness and the treatments
5. "Implementation skills" - Implementation skills includes cognitive (application of
critical thinking in the nursing process), interpersonal (trusting relationship, level of
caring and communication) and psychomotor skills (integration of cognitive and
motor activities). CONTINUES.... [Show Less]