STEPS OF

NURSING
PROCESS
PLANNING
Planning
“Planning is a deliberative ,systematic
phase of the nursing process that involves
decision making and problem solving”
• Formulating client goals and designing
the nursing interventions required to
prevent
,reduce or eliminate the client’s health
problems
Nursing interventions

“ Any treatment , bared upon clinical

judgment and knowledge ,that a nurse
performs to enhance patient or
outcomes” client
• Product of planning phase is a clients
care plan
Types of planning
• Initial planning
• Ongoing planning
• Discharge planning
 The planning process
1. Setting priorities
2. Establishing client goals /desired outcome
3. Selecting nursing interventions
4. Writing individualized interventions on
care plan
 1. Setting priorities
– Priority setting is the process of
establishing a preferential sequence for
addressing nursing diagnosis and interventions
– High priority
– Medium priority
– Low priority
• Nurses use frequently use Maslow’s
hierarchy of needs when setting
priorities
 Setting priorities

• Factors effecting priorities

– Client health values and beliefs

– Client’s priorities

– Resources available to the nurse and client

– Urgency of health problem

– Medical treatment plan

 2. Establishing client goals /desired
outcome
• Goals or desired outcomes
– Nurses hope to achieve by implementing the nursing
interventions

• Expected outcome
• Predicted outcome
• Outcome criterion
• Objective
• Goals are broad statement of client status
• Desired outcomes as more specific, observable
criteria used to evaluate whether the goals have
been met
Goal (broad): improved nutritional
Desired outcomes (specific): gain 5lb by April
status
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 2. Establishing client goals /desired
outcome
• Purposes of desired goals and outcomes
– Provide direction for planning nursing
interventions
– Serve as a criteria for evaluating
client progress
– Enable the client and nurses to determine when the
problem has been resolved
– Help to motivate the client and nurse by providing
a sense of achievement
2. Establishing client goals /desired
outcome

Short Long
term goal term goal
2. Establishing client goals /desired
outcome
Components of goal
•Subject : a noun ,is the client ,any part of client or
some attribute to client
•Verb: the verbs specifies an action the client is to
perform Eg: show, walk and drink
•Condition or modifiers :are added to the verb to
explain the circumstances under which the
behavior is to be performed. Eg: walks wit the help
of cane
•Criterion of desired performance :the criterion
indicates the standard by which performance is
evaluated Eg: walks one block per day
 2. Establishing client goals /desired
outcome
Subject Verb Conditions/ Criterion For
Modifiers Desired
Performance

Client Drinks 2500ml of fluid Daily(time)

Client Administers Correct insulin Using aseptic

dose technique (quality
standard)

Client Performs Leg ROM Every 8

exercises as hours(time)
taught
 Guidelines for writing goals and
outcomes
• Client centered
• Singular goal and outcome
• Observable
• Measurable
• Realistic
• Time limited
• Mutual factors
• Compatible
• Make sure client considers the goals important
and value
 3. Selecting nursing interventions
Nursing interventions are the actions
that a nurse performs to achieve the
client goals
• Nurse chooses interventions to treat the
signs and symptoms
Eg: pain, anxiety
• Interventions for risk nursing diagnoses
should focus on measures to reduce the
client risk factors
Types of nursing interventions

Nursing
interventions

Independent Collaborative

interventions interventions

Dependent
interventions
 Types of nursing interventions
• Independent interventions: are those
activities that nurses are licensed to initiate
on the basis of their knowledge and skills
– Physical care
– Teaching
– Counseling
– Emotional support
– Ongoing assessment
– Making referrals other health care
professionals
 Types of nursing interventions
• Dependent interventions :Are activities
carried out under the physician orders or
supervision or according to specific routine
– Medications
– Treatments
– Intravenous therapy
– Diagnostic tests
– Diet and activity
 Types of nursing interventions
• Collaborative interventions : are actions
the nurse carries out in collaboration with
other health team members such as physical
therapists, social workers, dietitians
and physicians.
 Criteria for choosing nursing
interventions
• Safe, appropriate for individuals age and health
condition
• Achievable with the resources available
• Congruent with the client’s values ,beliefs and
culture
• Congruent with other therapies
• Based on nursing knowledge and experience
• Written established standards of care as
determined by state laws , professional
association and policies of the institution
 4. Writing individualized nursing
interventions
• After choosing appropriate interventions
the nurse write them on the care plan
• The format of written interventions
– Verb
– Conditions and modifiers
– Plus time element
• The action verb starts the intervention
and must be precise
 Observation

Relationship of
Health nursing
Prevention
promotion interventions to interventions
interventions problem status

Treatment
s
 Nursing intervention classification
(NIC) taxonomy
• NIC taxonomy was first published in
1992 and been updated every 4yrs after
then…..
• Consist of three levels
– Level 1 –Domains
– Level 2 – Classes
– Level 3 – Interventions
• All NIC interventions are linked to NANDA
nursing diagnostic label
Nursing intervention classification
(NIC) taxonomy
 The nurses chooses the activities
appropriate for the client and individualizes them to fit the
supplies equipment
, and other resources available in the agency

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