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The Nursing Process: Planning, Implementation, and Evaluation Study Guide

This guide explains the critical stages of the nursing process: outcome identification and planning, implementation of care, and evaluation of patient progress. It covers how nurses establish priorities using frameworks like Maslow's Hierarchy and ABCs, categorize patient outcomes (cognitive, psychomotor, affective, physiologic), and implement various types of interventions. The guide also details the evaluation phase, including assessing patient response, modifying care plans, and monitoring fo

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Healthcare Delivery Systems and Nursing Roles

Targeted Health Care-Associated Infections and Precautions

This content covers targeted health care-associated infections, personal protective equipment, standard precautions, and transmission-based precautions including airborne, droplet, and contact routes.

  • Catheter-associated urinary tract infection (CAUTI)
  • Surgical site infection (SSI)
  • Central-line–associated bloodstream infection (CLABSI)
  • Ventilator-Assisted Pneumonia (VAP)
  • Clostridioides difficile (C. diff) infections (CDIs)
  • Multidrug-Resistant Organisms (MDROs)
  • Personal Protective Equipment
  • Standard Precautions
  • Transmission-Based Precautions
  • Contact precautions
  • Airborne precautions
  • Droplet precautions

Health Care Delivery System Settings

This document outlines various health care settings including hospitals, primary care centers, ambulatory care centers, home health care, extended care services, specialized care centers, and services for the seriously ill and dying.

  • Hospitals
  • Primary care centers
  • Ambulatory care centers
  • Home health care
  • Extended care services
  • Specialized care centers
  • Respite care
  • Hospice
  • Palliative care

Roles of Nurses in Healthcare Settings

Nurses serve as direct care providers, managers, educators, and researchers in hospitals and primary care centers.

  • Role of Nurses in Hospitals
  • Role of Nurse in Primary Care Centers
  • Advanced practice registered nurses (APRNs)
  • Health maintenance
  • Health promotion

Collaborative Care Health Care Team

Collaborative care involves the health care team including physician, nurse, therapist, dietitian, pharmacist, and chaplain.

  • Physician
  • Physician assistant
  • APRN
  • Nurse
  • Assistive personnel
  • Physical therapist
  • Occupational therapist
  • Speech therapist
  • Respiratory therapist
  • Dietitian
  • Pharmacist
  • Chaplain
  • Spiritual care provider

Magnet Recognition Program Components

The American Nurses Credentialing Center established the Magnet Recognition Program to recognize health care organizations that achieve excellence in nursing practice.

  • Magnet Recognition Program
  • transformational leadership
  • structural empowerment
  • exemplary professional practice
  • new knowledge, innovation and improvements
  • empirical quality results

Clinical Judgment and the Nursing Process

Clinical Judgment and the Nursing Process

This content explores clinical judgment, clinical reasoning, and the nursing process including assessment and diagnosis/problem identification.

  • Critical thinking
  • Clinical reasoning
  • Clinical judgment
  • Situational awareness
  • Clinical Judgment Measurement Model (CJMM)
  • Nursing process
  • Mental model
  • Assessment
  • Diagnosing/Problem identification
  • Planning
  • Evaluation
  • Concept map
  • Initial assessment
  • Focused assessment
  • Triage
  • Objective data
  • Subjective data
  • Nursing history
  • Patient interview phases
  • Problem-focused diagnosis

Outcome Identification, Implementation, and Evaluation

The nursing process involves establishing priorities, selecting nursing interventions, implementing the plan of care, and evaluating patient achievement of expected outcomes.

  • Outcome Identification and Planning
  • Establishing Priorities
  • Maslow’s hierarchy of human needs
  • Cognitive, Psychomotor, Affective, and Physiologic Outcomes
  • Nurse-initiated, Physician-initiated, and Collaborative Interventions
  • Direct and Indirect Care Interventions
  • Implementing the Plan of Care
  • Evaluating Patient Response
  • Ameliorable, Adverse, Environmental, and Preventable Adverse Events

Fundamentals of Health Assessment and Nursing Care

Asepsis and Infection Control

This material covers components of the infection cycle, common portals of entry and exit, means of transmission, and infection types.

  • Infectious agent
  • Normal body flora
  • Reservoir
  • Portal of exit
  • Portal of entry
  • Respiratory tract
  • Gastrointestinal tract
  • Direct contact
  • Indirect contact
  • Vector
  • Exogenous infection
  • Endogenous infection
  • Community-acquired infection

Surgical Asepsis and Disinfection Principles

Demonstrate effective hand hygiene, identify signs of infection, and apply surgical asepsis and disinfection techniques to prevent or break the chain of infection.

  • Hand hygiene
  • Infection control
  • Asepsis
  • Surgical asepsis
  • Medical asepsis
  • Sterile technique
  • Sterile field
  • Disinfection
  • Cleaning
  • Sterilization

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