Nursing Process - Planning: Prepared and Presented by

NURSING PROCESS -
PLANNING
 PREPARED AND PRESENTED BY
MRS.S.ANUKRISHNAN,
VICE PRINCIPAL CUM HOD OBG NURSING,
P.D.BHARATESH COLLEGE OF NURSING,
HALAGA, BELGAUM.
Introduction
 Planning is a deliberative, systematic phase of the nursing
process
 Involves decision making and problem solving.
 Refer to the client’s assessment data and diagnostic
statements for direction in formulating client goals and
designing the nursing interventions required to prevent
reduce or eliminate the client’s health problems.
Types of Planning
 1] Initial planning
 2] Ongoing Planning
 3] Discharge planning

1] Initial planning
 admission assessment based on the initial care.
 As nurse obtain new information and evaluate the clients
responses to care, they can individualize the initial care
plan further.
2] Ongoing Planning
 done by all nurses who work with the client.
 Ongoing planning also occurs at the beginning of a shift
as the nurse plans the care.
3] Discharge planning
 Is the process of anticipating and planning for needs after
discharge,
 is a crucial part of comprehensive health care and should
be addressed in each client’s care plan to be given that
day.
Purposes of ongoing planning
1] To determine any changes in client’s health status.
2] To set priorities for the client’s care
3] To decide which problems to focus on during the shift
4] To Co-ordinate the nurse’s activities so that more than

one problem can be addressed at each client contact.
Developing nursing care plans
 An informal nursing care plan
 A formal nursing care plan
 A Standardized care plan
 An individualized care plan
An informal nursing care plan
 is a strategy for action that exists in the nurses mind.
A formal nursing care plan
 is a written or computerized guide that organizes
information about the client’s care.
 It provides continuity of care.
A Standardized care plan
 is a formal plan that specifies the nursing care for groups
of clients with common needs. (all clients with
Myocardial Infarction)
An individualized care plan
 is tailored to meet the unique needs of a specific client
needs that are not addressed by standardized plan.
Guidelines for writing Nursing Care plans
1] Date and sign the plan
2] Use category headings assessment/ nursing diagnoses/

planning /Implementation /Evaluation.
3] Use standardized Medical or English symbols and key words

rather than complete sentences to communicate your ideas.
Eg. Clean wound with H2O2 b.i.d rather than “clean the client’s
wound morning & evening with Hydrogen peroxide twice a
day.
4] Be specific. because Nurses are now working shifts of
different lengths, some working 12 hrs. & some working 8
hour shifts it is even more to be specific about expected
timing of an intervention. If the order reads “change
incision dressing q shift”
5] Refer to procedure books or other sources of information

rather than including all the steps on a written plan.
6] Tailor the plan to the unique characteristics of the client
by ensuring that the client’s choices, such as preferences
about the times of care & the methods used are included.
7] Ensure that the nursing plan incorporates preventive and

health maintenance aspects as well as restorative ones.
8] Ensure that the plan contains interventions for ongoing
assessment of the client (eg. Inspect incision q8h)
9] Include collaborative and co-ordination activities in the

plan.
10] Include plans for the client’s discharge and home care
needs.
The planning process
 Setting priorities
 Establishing client goals/ desired outcomes.
 Selecting nursing interventions
 Writing nursing orders.
Assessing
a. Collect data
b. Organize data
c. Validate data
d. Document data
Diagnosing
a. Analyze data
b. Identify health
problems, risks and
strength,
c. Formulating
nursing diagnosis
Planning
a. Setting priorities
b. Establishing client
goals, desired
outcomes
c. Selecting nursing
interventions
d. Writing nursing
orders
1) Setting priorities
 It is the process of establishing a preferential sequence for

addressing nursing diagnoses & interventions.
 The client & nurse decides which nursing diagnosis
requires attention Primarily, which secondary and so on.
 Instead of rank ordering diagnoses, nurses can group then
as having high, Medium, or Low priority requires minimal
nursing support.
 Eg.
 High: Life threatening problems such as loss of respiratory or cardiac function
 Medium: Health threatening problems like acute illness, decreased coping.
 Use Maslow’s hierarchy
 The nurse must consider some factors when assigning priorities, it includes.
 Client’s health values and beliefs
 Client’s priorities
 Resources available to the nurse & client.
 Urgency of health problem
 Medical treatment plan.
2) Establishing client goals & Desired
outcomes
 After establishing priorities, the nurse & client set goals
for each nursing diagnosis.
 Goal-(Broad) –improved nutritional status, desired
outcome (specific) - Gain ½ kg by 2 weeks.
 Short term goals: - than 6 weeks of period.
 Long term goals: - Goal achieved by 6 weeks & more
3) Selecting Nursing interventions &
activities
 Nursing interventions & activities are the action not a nurse performs to achieve client
goals.
 Types of nursing interventions
1] Independent Interventions: - activities that are nurses are licensed to initiate. Eg.
Physical care, ongoing assessment, counseling, Emotional support, environmental
Management.
2] Dependent Interventions: - activities carried out under physicians order. Eg.
Medications, diagnostic tests, diet Activity.
3] Collaborative Interventions: - Nurse carries out in collaboration with other health team
members - Such as physiotherapies social workers, dietitians, physicians, Eg. Crutch
walking.
4) Writing Nursing orders
•After choosing appropriate nursing interventions the nurse write

those on care plan on nursing orders.
• Components of Nursing order
Date Action verb Content area Time Element Sign.
4/4/06 Monitor Vital signs Every hours

q4h
Auscultate Abdomen q6h

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NURSING PROCESS -

VICE PRINCIPAL CUM HOD OBG NURSING,

P.D.BHARATESH COLLEGE OF NURSING,

1] To determine any changes in client’s health status.

2] To set priorities for the client’s care

3] To decide which problems to focus on during the shift

4] To Co-ordinate the nurse’s activities so that more than

2] Use category headings assessment/ nursing diagnoses/

3] Use standardized Medical or English symbols and key words

5] Refer to procedure books or other sources of information

7] Ensure that the nursing plan incorporates preventive and

9] Include collaborative and co-ordination activities in the

 It is the process of establishing a preferential sequence for

 Types of nursing interventions

Physical care, ongoing assessment, counseling, Emotional support, environmental

2] Dependent Interventions: - activities carried out under physicians order. Eg.

Medications, diagnostic tests, diet Activity.

members - Such as physiotherapies social workers, dietitians, physicians, Eg. Crutch

•After choosing appropriate nursing interventions the nurse write

4/4/06 Monitor Vital signs Every hours

Auscultate Abdomen q6h

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