URDANETA CITY

UNIVERSITY COLLEGE OF HEALTH SCIENCES

Owned and operated by the City Government of Urdaneta

NURSING CARE PLAN (NCP)

Name of Student: _________________________________________________ Year Level and Group: ________________________
Affiliating Agency/Area: ___________________________________________ Month/Year of Exposure: ______________________

Assessment Nursing Diagnosis Planning Intervention Rationale Evaluation

(at least 10)

Subjective: Problem, Etiology, Signs Short Term Goal: Independent: Short Term Goal Evaluation
(P.E.S.) format S.M.A.R.T. + Evidence  Assessment

Objective: INFERENCE Long Term Goal:  Therapeutic Long term Goal Evaluation
(at least 5) Scientific Explanation S.M.A.R.T.+ Evidence
(Diagram Form)

 Educative

Dependent:
 Assessment

(075) 600 - 1507

Bright future starts here San Vicente West, Urdaneta City, Pangasinan
ucu.edu.ph | ucu.collegeofhealthsciences@gmail.com
 URDANETA CITY
UNIVERSITY COLLEGE OF HEALTH SCIENCES
Owned and operated by the City Government of Urdaneta

 Therapeutic

 Educative

Interdependent/Collaborative
 Assessment

 Therapeutic

(075) 600 - 1507

Bright future starts here San Vicente West, Urdaneta City, Pangasinan
ucu.edu.ph | ucu.collegeofhealthsciences@gmail.com
 URDANETA CITY
UNIVERSITY COLLEGE OF HEALTH SCIENCES
Owned and operated by the City Government of Urdaneta

 Educative

Checked by: _________________________________ Date: ____________________

Clinical Instructor’s Name and Signature

(075) 600 - 1507

Bright future starts here San Vicente West, Urdaneta City, Pangasinan
ucu.edu.ph | ucu.collegeofhealthsciences@gmail.com