OVERVIEW

1. OVERVIEW Introduction to Problem Solving and the Nursing Process: 5 Steps Discussion of Assessment: Defining Characteristics and Contributing Factors Physiological Integrity Growth and Development Care Environment Psychosocial Integrity Writing Expected Outcomes Nursing Interventions Evaluation

2. PROBLEM SOLVING: CRITICAL THINKING • Fun Exercise: What are the ways that you used to solve the word problems? • Discussion of Problem-Solving Strategies: The 5 Star Solution Wheel: Do it Yourself Influence Others Assign Someone Do Nothing Combine Knowledge Types of Critical Thinking • Discuss Scenarios 1, 2, 4, 5

3. What is critical thinking? • Check page 222 of Craven • NLN – logical, content-driven, reflective, reasoning process that guides the nurse in generating, implementing, and evaluating effective approaches to client care and professional concerns

4. Factors affecting critical thiniking • Anxiety • Attitude • Level of preparation • Learning style • Intellectual development

5. NURSING PROCESS: CRITICAL THINKING • Definition of Nursing Process: 5 Steps (Figure 5-1, Lipe and Beasley) • “specialized form of systematic inquiry or problem solving process used in drawing conclusions about the patient’s problems and the corresponding nursing actions to resolve problems”

6. Figure 5-2 Priority Setting (Lipe and Beasley) Urgent physiologic needs Circulation, Respiration Immediate physiologic needs Food/fluid, Elimination, Neurosensory Important physiologic needs Activity/Rest, Hygiene, Sexuality

7. Box 5-3 Sample Care Plan (Lipe and Beasley) • Scenario 1 and 2 • What is the purpose of care plans?

8. CARE PLANS CCPASSESSMENT: BEHAVIORS/DEFINING CHARACTERISTICS • Behaviors tell a story about the Nursing Diagnosis • Behaviors include both subjective and objective data Subjective: client statements Objective: observation, lab data, vital signs

9. CARE PLANS CCP:ASSESSMENT: CONTRIBUTING FACTORS • Physiological Integrity Common Health Problems; Pathophysiology NEED RATIONALE • Growth and Development Norms for each body system RATIONALE NOT NEEDED

10. CARE PLANS CCP:CONTRIBUTING FACTORS • Care Environment Situation (hospitalization),Previous Patterns, Medical/nursing treatments, Medications NEED RATIONALE • Psychosocial Stressors, Coping Mechanisms, Support Systems NEED RATIONALE

11. CARE PLANS CCP:EXPTECTED OUTCOMES • Measurable • Outcomes are about the client; “The client will walk in the hall for 20 minutes this morning with the assistance of the nurse”. • Answers: who (the client), what, where, for how long

12. CARE PLANS CCP: NURSING INTERVENTIONS • Derived from significant contributing factors • Address one or more of the following categories: Physiological Integrity Psychosocial Integrity Safe, Effective Care Environment Health Promotion/Health Maintenance • Interventions are about what the nurse does: “The nurse will…. NEED RATIONALE

13. EVALUATION • Evaluate the expected outcome: Was the outcome met? • Modify the outcome based on your evaluation • Not all outcomes are met.

14. NURSING PROCESS:CARE PLANS AT CCP FOR N101 AND N132 • Case Study: Video: Time to Care • Development of a Care Plan for Health Promotion: Respiratory Function: Hilda • Use of CCP Template for Care Plan Development