THE

NURSING
PROCESS
Cecille Sinampaga Manelyn Buendicho Marianne Lirio Mary Grace Sacro
 HISTORY OF THE NURSING
PROCESS
o The term ‘Nursing Process’ was first used/mentioned by Lydia Hall,
a nursing theorist, in 1955 wherein she introduced 3 STEPs:
Observation, Administration of care and Validation.
o In 1967, Yura and Walsh added assessment to the three steps and
described a four phase process (APIE).
o In the mid-1970s an addition of diagnostic phase resulted into a five
step process (ADPIE).
o The use of nursing process in clinical practice was started in 1973
by the American Nurses Association (ANA) in Standards of Nursing
Practice.
o After 1980 the nursing process was added to the General Nursing
Curriculum in India.
o In 1991, revisions were made to the standards to incorporate
outcome identification in the planning phase. now a 6-step process
(ADOPIE) Assessment, Diagnosis, Outcome Identification and
Planning, Implementation, and Evaluation.
 HISTORY OF THE NURSING
PROCESS

ORIGIN

o The nursing process is a systematic approach used by nurses to provide

patient-centered care. It is a critical thinking framework that helps nurses
assess, diagnose, plan, implement, and evaluate the care they provide to
patients. The origin of the nursing process can be traced back to the work of
nursing theorist and educator, Ida Jean Orlando.
o In the 1950s, Ida Jean Orlando developed her theory of nursing, which
emphasized the importance of the nurse-patient relationship and the role of
the nurse in helping patients meet their immediate needs. Her work laid the
foundation for what would later become the nursing process.
o However, it's important to note that while Ida Jean Orlando's work
significantly influenced the development of the nursing process, the
concept of a systematic approach to nursing care can be traced
even further back in history. Florence Nightingale, often considered
the founder of modern nursing, emphasized the importance of
observation, assessment, and planning in providing nursing care
during the Crimean War in the 19th century. Her writings and
practices laid the groundwork for evidence-based nursing and the
organized approach to patient care that later evolved into the
nursing process.
o Over time, nursing educators and theorists further refined and
developed the nursing process into the widely accepted framework
used in nursing practice today. The nursing process has become an
integral part of nursing education and is a fundamental aspect of
delivering quality patient care across various healthcare settings.
 CONTRIBUTOR IN THE HISTORY
OF NURSING PROCESS

The history of the nursing process dates back to the early 20th
century, although its development and formalization continued over the
years. Here's an overview of the key milestones in the history of the
nursing process:

1. Early Concepts of Systematic Nursing Care: The roots of the

nursing process can be traced back to the work of Florence Nightingale
in the 19th century. During the Crimean War (1853-1856), Nightingale
and her team of nurses provided care to wounded soldiers. She
emphasized the importance of systematic data collection, assessment,
and planning, recognizing the significance of environmental factors in
patient outcomes.
 CONTRIBUTOR IN THE HISTORY
OF NURSING PROCESS

2. Hildegard E. Peplau (1952): As mentioned earlier, Dr. Hildegard E.

Peplau, a psychiatric nurse and theorist, published her book
"Interpersonal Relations in Nursing" in 1952. In this work, she
introduced the concept of the nurse-patient relationship as a
therapeutic tool, emphasizing communication and interpersonal
interactions in nursing care. Her ideas laid the foundation for the
development of the nursing process.

3. Virginia Henderson (1955): In her work, "The Nature of Nursing,"

Virginia Henderson, another influential nursing theorist, identified the
components of nursing care based on human needs. She proposed
that the nurse's role was to assist patients in meeting their basic
physiological, psychological, and social needs, which aligns with the
core principles of the nursing process.
 CONTRIBUTOR IN THE HISTORY
OF NURSING PROCESS
4. Ida Jean Orlando (1961): Ida Jean Orlando, a nurse and theorist, developed
her theory of nursing process in her book "The Dynamic Nurse-Patient
Relationship." Her theory emphasized the importance of the nurse's response
to the patient's immediate needs and introduced a systematic process of
nursing, including assessment, diagnosis, planning, intervention, and
evaluation.
5. 1970s - 1980s: During this period, the nursing process gained broader
recognition and adoption as nursing education programs incorporated it into
their curricula. The process became a standard framework for nursing practice,
encouraging nurses to approach patient care systematically and holistically.
6. 1982 ANA Publication: In 1982, the American Nurses Association (ANA)
published the "Standards of Nursing Practice," which included the nursing
process as a key component of professional nursing practice. This publication
further solidified the nursing process as a vital approach to patient care.
 CONTRIBUTOR IN THE HISTORY
OF NURSING PROCESS

7. 1990s - Present: The nursing process continues to evolve with

advancements in nursing research, technology, and evidence-based
practice. Today, it remains an integral part of nursing education and
practice, guiding nurses in delivering individualized, patient-centered
care.
It's important to note that various nursing theorists and educators
have contributed to the development and refinement of the nursing
process over time. The process has been adapted to suit different
healthcare settings and patient populations, but its core principles of
assessment, diagnosis, planning, intervention, and evaluation remain
consistent in modern nursing practice.
Benefits of knowing the history
- knowing the history of the nursing process in the modern era enriches
nursing practice, education, and research. It empowers nurses to
deliver high-quality care, promotes a patient-centered approach, and
reinforces the profession's core values and principles. Ultimately,
understanding the historical context of the nursing process strengthens
the nursing profession as a whole and positively impacts patient
outcomes.
NURSING PROCESS

A process is a series of steps that follow a logical

sequence. The term nursing process is widely
accepted to designate a series of steps that the nurse
takes in planning and giving nursing care. It provides a
logical framework on which the nursing care is based.

It is defined as a systematic problem-solving approach

for giving  comprehensive nursing care.

It can also be defined as an orderly, systematic way of

identifying the client’s problems, making plans to solve
them, initiating  the plans or assigning others to
implement it and evaluating the extent to which the
plan was effective in resolving the problems identified.
 WHAT IS THE PURPOSE OF THE
NURSING PROCESS?

The following are the purposes of the nursing process:

• To identify the client’s health status and actual or potential health care
problems or needs (through assessment).
• To establish plans to meet the identified needs.
• To deliver specific nursing interventions to meet those needs.
• To apply the best available caregiving evidence and promote human
functions and responses to health and illness (ANA, 2010).
• To protect nurses against legal problems related to nursing care when the
standards of the nursing process are followed correctly.
• To help the nurse perform in a systematically organized way their practice.
• To establish a database about the client’s health status, health concerns,
response to illness, and the ability to manage health care needs.
 CHARACTERISTICS OF
THE NURSING PROCESS

The following are the unique characteristics of the nursing process: 

• Patient-centered
• Interpersonal
• Collaborative
• Dynamic and cyclical
• Requires critical thinking
COMPONENTS
OF THE
NURSING
PROCESS
- the first step and involves critical thinking skills
and data collection; subjective and objective
- involves collection of information or details about
the client obtained from different sources, e.g.,
through interview, physical examination using
different methods and clinical examination.
- encompasses Maslow's Hierarchy of Needs and
helps to prioritize and plan care based on patient-
centered outcomes
- basic physiological needs/goals must be met
before higher needs/goals can be achieved such as
self-esteem and self-actualization
- physiological and safety needs provide the basis
for the implementation of nursing care and nursing
interventions.
- development of strategies to alleviate client’s
problem identified in nursing diagnosis through a
series of steps
- nursing care plans are essential in this phase of
goal setting
- enhances communication, documentation,
reimbursement, and continuity of care across the
healthcare continuum
- the step which involves action or doing and the
actual carrying out of nursing interventions outlined
in the plan of care
- this phase requires nursing interventions such as
applying a cardiac monitor or oxygen, direct or
indirect care, medication administration, standard
treatment protocols and EDP standards
- assessment of strategies planned to alleviate the
clients’ suffering or otherwise re-plan and revise
the care
- vital to a positive patient outcome
- they must reassess or evaluate to ensure the
desired outcome has been met
RELATIONSHIP OF THE
THEORIES TO THE
NURSING PROCESS
Theory provides a rationale for
collecting reliable and valid
data about the health status of
clients, which are essential for
effective decision making and
implementation.
It enhances autonomy (independence
and self-governance) of nursing by
defining its own independent functions.
 It provides the foundations of nursing
practice, helps to generate further
knowledge, and indicates in which direction
nursing should develop in the future. Theory
is important because it helps us to decide
what we know and what we need to know.
 Theory helps build a common nursing
terminology to use in communicating with
other health professionals. Ideas are
developed and words defined.
 It helps to distinguish what should form the
basis of practice by explicitly describing
nursing. The benefits of having a defined body
of theory in nursing include better patient care,
enhanced professional status for nurses,
improved communication between nurses, and
guidance for research and education
 As medicine tries to make a move towards
adopting a more multidisciplinary approach
to health care, nursing continues to strive to
establish a unique body of knowledge.
 On the other hand, the nursing process validates
and tests nursing theories in real-life clinical
situations. The process of assessment, diagnosis,
planning, implementation, and evaluation allows
nurses to observe the effectiveness of nursing
interventions based on theoretical concepts. It
helps identify gaps in theories, areas of
improvement, and areas where further research is
needed.
Theoretical Basis of Nursing Process:
• System theoryIn nursing, systems theory means that the safety and
health of patients is the result of how a healthcare system is structured.
• Problem-solving  The systematic identification of a problem 2)
Determination of goals rprocess1)elated to the problem 3) Identification
of possible solutions to achieve these goals 4) Implementation of selected
solutions 5) Evaluation of goal achievement.
• Decision making processClinical decision-making in nursing is an
active approach to assessing a patient's condition and basing care decisions
on the evidence. It's a collaborative approach, with a team of health care
providers weighing in and determining the best course of action.
• Information processing theoryThe information processing
theory describes how individuals record, store, and retrieve information in
their brains. This affects the motivation and the behavior of a person (Hann
et al., 2007). Consequently, the actions and behavior of individuals influence
society as a whole.
• Diagnostic reasoning processa dynamic thinking process that
leads to the identification of a hypothesis that best explains the clinical
evidence
In summary, nursing theories
provide the foundation for
nursing practice, while the
nursing process serves as a
practical application and
validation of those theories in
patient care. Together, they
form a dynamic relationship
that enhances the quality of
nursing care and contributes
to the advancement of the
nursing profession.