Step 3Step 3 ：： Analyze nursing diagnoses relAnalyze nursing diagnoses relationshipsationships

Draw lines between nursing diagnoses to indicate Draw lines between nursing diagnoses to indicate relationships.relationships.

Prepared to verbally explain to your clinical faculty Prepared to verbally explain to your clinical faculty why you have made these links if it is not obvious.why you have made these links if it is not obvious.

Concept mapping is a holistic approach to patient Concept mapping is a holistic approach to patient care.care.

This step focuses on the relationships between This step focuses on the relationships between diagnoses and the labeling of nursing diagnoses .diagnoses and the labeling of nursing diagnoses .

Step 4Step 4 ：： Identifying goals, outcomes, anIdentifying goals, outcomes, and interventionsd interventions

Write patient goals and outcomes and then list Write patient goals and outcomes and then list nursing interventions to attain the outcomes for nursing interventions to attain the outcomes for each of the numbered diagnoses on your map.each of the numbered diagnoses on your map.

The nursing interventions should include The nursing interventions should include appropriate treatments and medications and appropriate treatments and medications and patient teaching.patient teaching.

Prepared to verbally explain the goals and Prepared to verbally explain the goals and rationales for nursing interventions with your rationales for nursing interventions with your clinical faculty. clinical faculty.

Step 5Step 5 ：： Evaluate patient’s responsesEvaluate patient’s responses

This step is the written evaluation of the This step is the written evaluation of the patient’s physical and psychosocial patient’s physical and psychosocial responses.responses.

It also involves writing your clinical It also involves writing your clinical impressions and inferences regarding the impressions and inferences regarding the patient’s progress toward expected patient’s progress toward expected outcomes and the effectiveness of your outcomes and the effectiveness of your interventions to bring these outcomes about.interventions to bring these outcomes about.

DocumentationDocumentation

Documentation involves correctly identifying Documentation involves correctly identifying patient assessment data to record about a patient assessment data to record about a problem, determining what to record about problem, determining what to record about the interventions to correct the problem, and the interventions to correct the problem, and describing the patient’s responses to the describing the patient’s responses to the interventions.interventions.

Concept map care plans as the basis of Concept map care plans as the basis of documentation --- detail in chapter 7documentation --- detail in chapter 7

Medication AdministrationMedication Administration

Organizing the drugs to be administered Organizing the drugs to be administered Relationship of the drug to the problemRelationship of the drug to the problem Interacting effects of the drug related to the toInteracting effects of the drug related to the to

tal clinical picture.tal clinical picture. ExampleExample: Digitalis -- Decreased cardiac output: Digitalis -- Decreased cardiac output

。。 what is the relationship between low levels what is the relationship between low levels of Potassium and digitalis? of Potassium and digitalis?

。。 assessing the patient carefully for adverse reassessing the patient carefully for adverse reactions to the drug.actions to the drug.

Nursing Standards of CareNursing Standards of Care

Standards of the American Nurses AssociationStandards of the American Nurses Association

general standards of care general standards of care Standards of the Joint Commission on Standards of the Joint Commission on

Accreditation of Healthcare Organizations Accreditation of Healthcare Organizations (JCAHO) (JCAHO)

specific policies and proceduresspecific policies and procedures Standardized nursing care plansStandardized nursing care plans

based on typical nursing diagnoses based on typical nursing diagnoses

Nursing Standards of Care--Nursing Standards of Care--con’scon’s

Patient education standardsPatient education standards

appropriate for the patient’s individual needs appropriate for the patient’s individual needs and abilityand ability

Insurance agency & government care standards Insurance agency & government care standards

clinical pathway / critical pathwayclinical pathway / critical pathway Utilization review standardsUtilization review standards

review charts. Judge the necessity and review charts. Judge the necessity and appropriateness of care and efficiency with appropriateness of care and efficiency with which care is delivered. which care is delivered.

Managed Care in Hospital SettingsManaged Care in Hospital Settings

There is a direct relationship between the There is a direct relationship between the care standards described above and the care standards described above and the management of care.management of care.

Hospital-based nurse case managers Hospital-based nurse case managers assigned to monitor and coordinate their assigned to monitor and coordinate their progress through the health-care system.progress through the health-care system.

To make links for patients to home health To make links for patients to home health services, transitional care units, long-term services, transitional care units, long-term care facilities, and other agencies to care facilities, and other agencies to provide quality care.provide quality care.