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

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

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

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

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”

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

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

CARE PLANS CCP ASSESSMENT: 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

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

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

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

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

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

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