Nursing care plan format

format of nursing care plan guides the assessment

1. NURSING CARE PLAN
Demographic data:-
Name:-
Age:-
Gender:-
I.P. D No.:-
Ward:-
Address:-
Education:-
Occupation:-
Marital status :-
Religion:-
Date of admission:-
Name of the surgery:-
Type of anesthesia:-
Allergic to:-
Date of discharge:-
Socio economic status:-
Personal history:-
Family history :-
Past medical history and surgical history:-
Present medical history:-
Present surgical history:-
Investigation:-
S.No. Date Name of investigation Patient’s value Normal value Remarks

2. Medication:-
S.No. Name Dose/frequency/route Action Nurse’s
responsibility















Nursing care plan :-
Assessment Nursing
diagnosis
Goal Planning Rationale Implementation Evaluation
Subjective data


Objective data







Health education:-
S.No. Date Topic

3. Nurse’s record :-
Date Recording Signature