Nursing Planing

The next step in the nursing process is planning activities to promote healthy client responses or prevent, correct or reduce unhealthy client responses.Planning and setting expected outcomes begins by determining the priority of human response (Fig. 3.7).

Phases of Planning

The assessment of priorities to nursing diagnosis
The specification of short-term, intermediate and long- term goals of nursing action
The identification of specific nursing interventions appropriate for attaining the goals
The documentation of the nursing diagnosis, goals nursing interventions and expected outcomes in the nursing care plan.

Setting Priorities

The assignment of priorities to the nursing diagnosis should be a joint effort by the nurse and the patient or his family members.
Consideration must be given to the urgency of the problems. The most critical receiving the highest priorities.
The use of this hierarchy requires that high priorities be given to physical needs.

Establishing Goals for Nursing Action

After the priorities of the nursing diagnoses have been establish, the short-term goals and the nursing actions appropriate for attainment of the goals are identified (Fig. 3.8)
The patient and his family should be included in the establishment of the short-term intermediate and long- term goals of the nursing actions
Short-term goals are those that are of immediate concer and that can be reached in a short period of time
The critical time periods provide a time for determining the effectiveness of the nursing interventions and the existence of a need for additional or altered nursing care.

Team Planning

Ideally the accomplishment of all aspects of the planning phase of the nursing process is a group effort
The nurse collaborates with other members of the nursing team, with the patient and his family and with appropriate resource persons from the health care agency and community agencies.
It is also important to remember that the patient is part of a family. The family members have need that arises from the patient’s illness
Another aspect of care planning takes into the account the fact that the patient comes from the community. Community agencies have an interest in the patient and are involved in planning.

Formulating the Nursing Care Plan

The nursing care plan serves to communicate the following information to all members of the nursing team:

Nursing diagnosis and their priorities The goals of the nursing interventions
The nursing interventions which are expressed in the form of nursing orders
The outcomes criteria, which identify the expected behavioral outcomes for the patient
The critical time period within which each outcome must be met.

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Ethical Issues in Nursing