Ch 17: Imementing Flashcards
What is carried out during implementing
What does implementing help achieve and what are the outcomes
When is there a better outcome
What does the nurse continue to do during implementing and what is then to the care plan
Why are interventions documented
Evidence-based nursing actions that were planned or carried out during implementing
Implementing = achieve valued health outcomes:
- promote health
- prevent disease
- restore health
- facility coping with altered functioning
Better outcomes occur when patient can and is an active participant
Nose continues to collect data and the care plan is modified
Interventions documented for reimbursement
What kind of report is the nursing interventions classification (NIC)

What does each intervention have what is each intervention and what kind of reading is providing
In all nursing interactions what is the nurse concerned with what are we trying to meet for the patient
 The NIC is a report to construct a taxonomy (classification) of nursing interventions
Each intervention has a label, definition, set of activities for the nurse to do in a short list of background readings
Do you know nursing interactions the nurses concerned with the patient response to health and illness any ability to meet basic human needs
How do the nursing outcome classifications ( nOC) come about
Give the 3 goals of The nursing outcome classifications
Nursing outcome classifications (NOC) a come about due to a classification of patient outcomes
3 goals of NOC:
- identify, label, validate classify patient outcomes and indicators
- evaluate validity and usefulness of classification in clinical testing
- define and test measurement procedures for outcomes and indicators
Why do we try to develop a CoMmOn nursing language
Common nursing language (NIC) developed to optimize delivery of safe, high-quality, cost-effective care
In the chart picture what do we do when we implement
- Carry out the plan!!!
- continue data collection and modify plan of care as needed
- Document care
What are ways to engage in clinical reasoning as you are implementing care
Status
EBP
MODIFY
- reassess for changes and status that indicate different interventions
- use EBP interventions and be open to better ways to address problems
- Monitor patients response to be able to modify plan of care
What is Alfaro’s rule to know if our actions are effective
Alfaros rule :
-Assess, reasses, revise, record
Give the components for the checklist for organizing certain clinical responsibilities
- name
- cc/reason
- status
- Basic human needs
- priority/events
- special needs
- Family
- Patient profile and name to be addressed
- Chief complaint and reason for admission
- Current health status
- Routine assistance to meet basic human needs
- Priorities for nursing care and special daily events
- Special teachings, counseling, advocacy needs
- Special family needs
What determines how successful the plan the nurse implement will be
To provide competent and efficient care how much is a nurse stay
A nurse is interpersonal competence GREATLY. determines how successful the plan will be
To remind competent and efficient care nurses should stay professional and communicate with others
What is the best way to implement interventions
What do you need to do right before implementing and why
How should you approach the patient (the whole patient)
-2 ways
What do you modify nursing interventions according to?
D&p
Will
Previous/current
The best way to implement nursing interventions is to do it in a partnership with the family and the patient
Right before you implement RESASSESS to see if the patient still needs the care
Approach the patient holistically and caringly
Modifying nursing interventions according to
- developmental/cycle social background
- patients willingness to participate
- response to previous nursing measures and progress towards goal and outcome
When you’re implementing interventions what do you do them within
Why should you ALWAYS Question the nursing intervention

When implementing interventions do within scope of practice and ethically
 ALWAYS Question interventions to make sure they are the best of all possible alternatives
Define nursing interventions by the NIC
Define direct care define indirect care
What is the invoices at the end of the day for patient to have
Nurse interventions: treatments performed to enhance patient outcomes based on clinical judgment
Direct care: treatment through interaction with patient
Indirect care: performed away from patient on behalf of patient by interdisciplinary members
End of day emphasis:
-Health promotion/maintenance
-disease prevention
Define protocols
Define standing orders
-what do standing orders give patients
How are protocols in standing orders done

Protocols: STRICT written plans detailing nursing activities in specific situations
-routine aspects
Standing orders: orders that let nurse initiate action that typically require physician
-give nurse power
Protocols and standing orders are done independently by nurse
What is the #1 nursing action before interventions (care)
1 nursing action before interventions (care) = REASSESS
What  what do nurses use specialized abilities to do when planning care Determine Promote Assist Resources Anticipate
- Determine new or continuing need for assistance
- promote self-care
- assist patient to achieve valued health outcomes
- organized necessary resources
- anticipate unexpected outcomes/situations
What are a few things to keep in mind when implementing the plan of care
Reassess patient and review care plan
Clarify competency
Organize resources (equipment/environment)
Anticipate unexpected situation
Prevent errors/omissions
Promote self-care, teaching, counseling, advocacy
Assist patients to meet outcomes 
What should each nursing intervention be supported by
What should each nursing intervention be within and consistent to
What do you want to ensure about nursing interventions and the specific patient
If you have a question about an order what do you do
Ensure each nursing intervention is supported by EBP
Each nursing intervention should be within the scope of practice and consistent with policy
Be sure nursing actions are safe for this particular patient and individualized
Question any questionable order
Describe patient variables
Describe nursing variables
Patient variables: influences pt
- developmental stage
- psychosocial background and culture
Nursing variables:
- resources (lacking)
- current standard of care (lacking)
- research findings
- ethical and legal guides to practice (within standard of care)

What type of assessment is an important intervention
-What changes as patient changes
Why do you wanna monitor the patient’s response to planned interventions
How is ongoing risk management used
At risk
Promote
Ongoing assessment collection is an important intervention
-plan of care changes as patient changes
Monitor patients response to plan interventions to determine if effective care plan
 ongoing risk management  identify problems patient is at risk for, ALLOWS INTERVENTION To promote health

What is the # 1 question you want to ask if a patient is noncompliant with care and why do you want to do ? (2 Things)
What are a few considerations when Implementing plan of care
1 question to ask if patient is noncompliant: why is patient not following therapy
- reassess strategy
- Think of changes to get patient participation
Consider: -lack of • Family support •understanding about benefits -Low value attached to outcome (patient does not care) -adverse physical or emotional effects of treatment -cannot afford treatment - limited access to treatment
Define delegation
You do have the right to delegate, but what must you do after delegating
What do you want to consider when delegating and how do you want to communicate (what do you communicate)
Who is responsible for the effects after delegation has been given
Delegation: transfer of responsibility of activity to another person well retaining accountability for outcome
After delegating FOLLOW UP!!
-consider the five rights and -communicate clearly about what, how, any alerts that need to be given to you
The RN is responsible for the effects after delegation
Give the five rights of delegation
- Right task
- what cannot be delegated and what others cannot do - Right circumstance
-  patient MUST be stable
- 🚫 emergency - Right person
- UAP - Right directions and communication
- be clear
- give instructions, clarify information, ensure UAP understands, give criteria for alert - Write supervision and evaluation
- FOLLOW UP

What do you do as a student if you have been Delegated something that you cannot perform safely
What do you never want to do in regards to activities that have been delegated to you
If you cannot carry out delegation:
-tell the nurse giving you the delegation consult your instructor
NEVER try to perform interventions beyond your capacity WITHOUT supervision
