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Implementation Process

The document discusses implementation, which is the action phase of the nursing process where nursing care is provided by initiating the care plan. It describes organizing resources like equipment, personnel, and ensuring a safe environment for carrying out the care plan. Implementation requires skills like direct care activities, teaching, counseling, and delegating tasks to other staff. Factors like lack of time can limit a nurse's ability to fully implement the nursing process in practice.

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REVATHI H K
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© © All Rights Reserved
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Download as PPTX, PDF, TXT or read online on Scribd
67 views

Implementation Process

The document discusses implementation, which is the action phase of the nursing process where nursing care is provided by initiating the care plan. It describes organizing resources like equipment, personnel, and ensuring a safe environment for carrying out the care plan. Implementation requires skills like direct care activities, teaching, counseling, and delegating tasks to other staff. Factors like lack of time can limit a nurse's ability to fully implement the nursing process in practice.

Uploaded by

REVATHI H K
Copyright
© © All Rights Reserved
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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 Implementation.

From:
Revathi.H.K.
1st year, M.Sc(N)
The nursing process is a deliberate,
problem-solving approach to meeting the
health care and nursing needs of patients.
It involves assessment, diagnosis, outcome
identification, planning, implementation,
evaluation with subsequent modifications
used as feedback mechanisms that
promote the resolution of nursing diagnosis.
The process as whole is cyclic, the steps
being interrelated, interdependent, and
recurrent.
“ Implementation refers to the action
phase of the nursing process in which
nursing care is provided. It is the actual
initiation of the plan and recording of
nursing actions.”
A standing order is a pre-printed
document containing orders for the
conduct of routine therapies, monitoring
guidelines and/or diagnostic procedure for
specific patients with identified clinical
problems. The orders direct the conduct of
patient care in various clinical settings.
These orders are common in critical care
settings and other specialized practice
settings where patients need can change
rapidly and require immediate attention.
This is also common in community
setting, where nurses face situations that
do not permit immediate contact with a
physician or health care provider.

Before implementing a standard


protocol, guidelines or orders, use sound
judgement in deciding whether an
intervention is correct and appropriate.
Nursing competencies includes core
abilities that are required for fulfilling
one’s role as a nurse. Therefore, it is
important to clearly define nursing
competency to establish a foundation for
nursing education, curriculum. Thus,
nurses must provide comprehensive care
that meets patient’s complex and diverse
needs.
 Safe and quality nursing practice.
 Management of resources and
environment.
 Health education.
 Legal responsibility.
 Ethico-moral responsibility.
 Personal & professional development.
 Quality improvement.
 Research.
 Record management.
 Communication.
 Collaboration and teamwork.
According to Dr. David Sackett ; EBP is

“ The conscientious, explicit and


judicious use of current best evidence in
making decisions about the care of the
individual patient.”
Reassessing the patient.
Patient assessment is a continuous
process that occurs each time when we
interact with a patient. When you gather
new data and identify a new patient need,
modify the care plan. The reassessment
helps to decide if the proposed nursing
care activity is still appropriate for the
patient’s level of wellness.
Reviewing and revising care plan.

After reassessing the patient, review the


care plan and compare assessment data
to validate the nursing diagnosis. The
determine whether the nursing interventions
are the most appropriate.
 Revise data in assessment section to reflect
the patient’s current status.
 Revise nursing diagnosis. Delete diagnosis
that are no longer relevant and add any
new diagnosis.
 Revise specific interventions that
correspond to the new nursing diagnosis
and goals. This revision should reflect the
patient’s present status.
 Determine the method of evaluation to
achieve outcomes.
Organizing resources and care delivery.

A facility resources include equipment and


skilled personnel.
 Equipment- most nursing procedures require
some equipments and supplies. Decide what
supplies are necessary and determine their
availability before you start implementation.
 Personnel- nursing care delivery models vary
among facilities. The model by which nursing is
organized determines how nursing personnel
deliver patient care.
 Environment- a patient’s care environment
needs to be safe and conducive for
implementation of therapies. Patient safety
is your first concern. If the patient has
sensory deficits, physical disability or an
alteration in level of consciousness,
arrange the environment to prevent injury.

 Patient- before you deliver interventions


be sure the patient is as physically and
psychologically comfortable as possible.
Anticipating and preventing
complications.

Risk to patients come with both the


illness and treatment, as a nurse, look for
and recognize the risks, adapt your choice
of intervention to situation, evaluate the
relative benefit of the treatment versus the
risk and take risk prevention measures.
Before beginning care, review the plan to
determine the need for assistance and the
type required.
Implementation Skills.

Nursing practice includes cognitive,


interpersonal and psychomotor (technical)
skills. We need each type of skill to
implement direct and indirect nursing
interventions.
Direct Care.

Nurse provide a wide variety of direct


care measures, those activities that nurses
perform through patient interaction. How a
nurse interacts affects the success of any
direct care activity. Remain sensitive to
patient’s clinical condition, values, and
beliefs, expectations and cultural views. All
direct care measures requires competent,
safe practice. Show a caring approach
when you provide direct care.
Activities of Daily Living.

A patient’s need for assistance with


ADL’s may be temporary, as in the case of
an acute illness or permanent. When
assessment reveals a patient is
experiencing fatigue, a limitation in
mobility, confusion or pain, assistance with
ADL’s is likely needed.
Instrumental activities of daily living
[IADL].
Illness or disability sometimes alters a
patient’s ability to be independent in
society. IADL’s include skill such as
shopping, preparing meals, writing
cheque and taking medications.

Physical care techniques.


Physical care techniques involves the
safe and competent administration of
nursing procedures.
Lifesaving Measures.
These are the techniques that we use
when a patient’s physiological or
psychological state is threatened. The
purpose of life saving measures is to restore
physiological and psychological balance.

Counselling.
Counselling is a direct care method that
helps patients use a problem solving
process to recognize & manage stress and
to facilitate IPR.
Teaching.
Teaching is an important nursing
responsibility. In teaching the focus of change
is intellectual growth or the acquisition of new
knowledge or psychomotor skills.

Controlling for adverse reactions.


An adverse reaction is a harmful or
unintended effect of a medication, diagnostic
test or therapeutic intervention. Adverse
reactions can possibly follow any nursing
intervention. So learn to anticipate them and
know the adverse reactions to expect.
Preventive measures.
Preventive nursing actions promote
health and prevent illness, to avoid the
need for, acute or rehabilitative health
care.

Indirect care.
Indirect care measures are actions that
support the effectiveness of direct care
measures. Many indirect measures are
managerial in nature, such as
documentation & medical order
transcription.
Delegating, Supervising & Evaluating
the work of other staff members.

Depending on the system of health


care delivery, the nurse who develops the
care plan frequently does not perform all
of the nursing interventions. Some activities
you will co-ordinate and delegate to
other members of the health care team.
Remember the RN delegates components
of care but not the nursing process itself.
Despite of their knowledge of the
nursing process, certain factors limited
the ability of nurses to implement it in their
daily practice including lack of time, high
patient volume and high patient
turnover.

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