Nursing

Care
Plan
Template
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Nursing Care Plan Template

Care Plan Instructions
1. Write an appropriate Nursing Diagnosis, including a “related to” statement
a. Include subjective data
b. Include objective data
2. List at least 2 SMART goals for the patient
(https://www.nursechoice.com/blog/profiles-and-features/nursing-smart-goals-how-to-
set-smart-goals-for-nursing)
3. List 3-4 interventions with rationale
4. Note if interventions were implemented
5. Evaluate the outcome of each intervention

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Nursing Patient Intervention: Implementation Evaluation

Diagnosis Goals Rationale (Yes or No) Outcome

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 Version 5.0.0

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