CHN Formulating, Implementing, and Evaluating Plan of Care.pdf

Lesson about formulating and implementing plan of care.

1. Formulating the
Plan of Care
Presented by: Leo Franco B. Baldoza
BSN 2-A

2. Planning involves:
Priority Setting
Establishing goals and objectives
Determining appropriate
interventions

3. A. Priority Setting
Determining the sequence in dealing with identified
family needs and problems. This is necessary
because the nurse cannot possibly deal with all
identified family needs and concerns all at once.

4. Factors the nurse need to consider in
priority setting:
Family Safety
Family Perception
Practicality
Projected Effects

5. Family Safety
A life-threatening situation is given top priority.

6. Family Perception
Next to life-threatening emergencies, priority is
given to the need that the family recognizes as most
urgent and/or important.

7. Practicality
Together with the family, the nurse looks into
existing sources and constraints.

8. Projected Effects
The immediate resolution of a family concern gives
the family a sense of accomplishment and confidence
in themselves and the nurse.

9. B. Establishing goals
and objectives
GOAL- is a desired observable family response to
planned
interventions in response to a mutually identified family
need. It is the end that the nurse and the family aim to
achieve.

10. Specific: The objectives clearly articulates who is
expected to do what, i.e., the family or a target family
member will manifest a particular behavior.
Measurable: Observable, measurable and whenever
possible, quantifiable indications of the family’s
achievement as a result of their effects toward a goal
provide a concrete basis for monitoring and
evaluation.
OBJECTIVES- define the desired step-by-step family
responses as they work toward a goal. They are used to
measure family achievement for monitoring and
evaluation. Workable, well stated objectives should be:

11. Attainable: The objective has to be realistic and in
conformity with available resources, existing
constraints, and family traits, such as style and
functioning.
Relevant: The objective is appropriate for the family
need of problem that is intended to be minimized,
alleviated, or resolved.
Time-Bound: Having a specified target time or date
helps the family and the nurse in focusing their
intention and efforts toward the attainment of the
objective.

12. C. Determining appropriate
interventions
Interventions may range from the simple or
immediate, such as offering information about
external, health resources available to the family,
to the complicated or prolonged.

13. Three Types of Nursing Interventions
Supplemental Interventions- are actions that the nurse
performs on behalf of the family when it is unable to do
things for itself.
Facilitative Interventions- refers to actions that remove
barriers to appropriate health action.
Developmental Interventions- aim to improve the capacity
of the family to provide for it’s own health needs.

14. The plan should be based on:
The Principle of Mutuality- the family is given the
opportunity to decide for itself how they can best
deal with a health situation, just as the nurse takes
into consideration his or her own resources, time- as
well as the resources and policies f the health
agency (Maurer and Smith, 2009).
1.

15. A related principle is consideration of family values
and health care beliefs, which are the basis for family
health behavior.
2. The Principle of Personalization- requires that the
nursing care plan fits the unique situation of a family:
it’s needs, style, strengths, and patterns of functioning.

16. Implementing the
Plan of Care

17. Implementation is the step when the family and/or
the nurse execute the plan of action. The pattern of
implementation is determined by the mutually
agreed upon goals and objectives and the selected
courses of action. The nurse should be conscious of
possible barriers to implementing planned strategies.

18. Family-related Barriers: include apathy and
indecision. Seeing apathy may be a manifestation
of the family’s feeling of hopelessness and
powerlessness. Indecision may result in the family
allowing events to just happen.

19. Nurse-related Barriers: arises from the nurse’s
behavior, such as imposing ideas, negative
labeling, overlooking family strengths and
neglecting cultural and gender implications of
family interventions.

20. Evaluation

21. Evaluation is determining the value of nursing care
that has been given to a family. The product of this
step is used for further decision making: to terminate,
continue, or modify the intervention(s). There are two
ways of conducting an evaluation: formative or
summative.

22. Formative Evaluation- judgement made about
effectiveness of nursing interventions as they are
implemented. Results of this evaluation guide the
nurse and the family in updating plans as
necessary.

23. Summative Evaluation- determining the end
results of family nursing care and usually involves
measuring outcomes or the degree to which goals
have been achieved.

24. Aspects of Evaluation
Effectiveness- is determination of whether goals
and objectives were attained. It answers the
question, “Did we produce the expected results”
or “ Did we attain our objectives?”
Appropriateness- refers to the suitability of the
goals/objectives and interventions to the
identified family health needs. It answers the
question, “Are our goals/objectives and
interventions correct in relation to the family
health needs we intend to address?”

25. Adequacy- the degree of sufficiency of
goals/objectives and interventions in attaining the
desired change in the family. It answers the
question, “Were our interventions enough to
bring about the desired change in the family?”
Efficiency- the relationship of resources used to
attain the desired outcomes. It answers the
question, “Are the outcomes of family nursing
care worth the nurse’s time, effort, and other
resources?”

26. Thank You!!!