Step 3:Analyze nursing diagnoses relationships

1
Step 3Analyze nursing diagnoses relationships

• Draw lines between nursing diagnoses to indicate
  relationships.
• Prepared to verbally explain to your clinical
  faculty why you have made these links if it is
  not obvious.
• Concept mapping is a holistic approach to patient
  care.
• This step focuses on the relationships between
  diagnoses and the labeling of nursing diagnoses .

2
Step 4Identifying goals, outcomes, and
interventions

• Write patient goals and outcomes and then list
  nursing interventions to attain the outcomes for
  each of the numbered diagnoses on your map.
• The nursing interventions should include
  appropriate treatments and medications and
  patient teaching.
• Prepared to verbally explain the goals and
  rationales for nursing interventions with your
  clinical faculty.

3
Step 5Evaluate patients responses

• This step is the written evaluation of the
  patients physical and psychosocial responses.
• It also involves writing your clinical
  impressions and inferences regarding the
  patients progress toward expected outcomes and
  the effectiveness of your interventions to bring
  these outcomes about.

4
Documentation

• Documentation involves correctly identifying
  patient assessment data to record about a
  problem, determining what to record about the
  interventions to correct the problem, and
  describing the patients responses to the
  interventions.
• Concept map care plans as the basis of
  documentation --- detail in chapter 7

5
Medication Administration

• Organizing the drugs to be administered
• Relationship of the drug to the problem
• Interacting effects of the drug related to the
  total clinical picture.
• Example Digitalis -- Decreased cardiac output
• ?what is the relationship between low levels
  of Potassium and digitalis?
• ?assessing the patient carefully for adverse
  reactions to the drug.

6
Nursing Standards of Care

• Standards of the American Nurses Association
• ? general standards of care
• Standards of the Joint Commission on
  Accreditation of Healthcare Organizations (JCAHO)
  
• ? specific policies and procedures
• Standardized nursing care plans
• ? based on typical nursing diagnoses

7
Nursing Standards of Care--cons

• Patient education standards
• ? appropriate for the patients individual
  needs
  and ability
• Insurance agency government care standards
• ? clinical pathway / critical pathway
• Utilization review standards
• ? review charts. Judge the necessity and
  appropriateness of care and efficiency with which
  care is delivered.

8
Managed Care in Hospital Settings

• There is a direct relationship between the care
  standards described above and the management of
  care.
• Hospital-based nurse case managers assigned to
  monitor and coordinate their progress through the
  health-care system.
• To make links for patients to home health
  services, transitional care units, long-term care
  facilities, and other agencies to provide quality
  care.

9
(No Transcript)
10
(No Transcript)