Importance of Nursing Diagnosis
Patient in a holistic perspective, which facilitates the decision of specific nursing interventions. The use of nursing diagnoses can lead to greater quality and patient safety and may increase nurses’ awareness of nursing and strengthen their professional role.
After identifying nursing diagnoses, the next step is prioritization according to the specific needs of the patient. Prioritization is the process that identifies the most significant nursing problems, as well as the most important interventions, in the nursing care plan.
Abraham Maslow’s theory on the hierarchy of needs posits that humans are motivated by the intrinsic need for self-actualization. Nurses can apply Maslow’s theory to their practice of patient care. Each person’s needs must be met individually in order for them to feel satisfied, cared for and cooperative.
After establishing nursing Diagnosis the nursing process is initiated which functions as a systematic guide to client-centered care with 5 sequential steps. These are assessment, diagnosis, planning, implementation, and evaluation. Assessment is the first step and involves critical thinking skills and data collection; subjective and objective.
A nursing diagnosis helps nurses to see the patient in a holistic perspective, which facilitates the decision of specific nursing interventions. The use of nursing diagnoses can lead to greater quality and patient safety and may increase nurses’ awareness of nursing and strengthen their professional role.
Application of Nursing Care Plan
Nursing Care plans make it possible for interventions to be recorded and their effectiveness assessed. Nursing care plans provide continuity of care, safety, quality care and compliance. A nursing care plan promotes documentation and is used for reimbursement purposes such as Medicare and Medicaid.
Orem’s Self-Care Framework focuses on the actions taken by people who are considered legitimate patients to meet their own and their dependent others’ therapeutic self-care demands, as well as on actions taken by nurses to effectively use nursing systems that will assist people who have limitations in their abilities.
The Universal Self-Care Requisites that are needed for health are:
Air.
Water.
Food.
Elimination.
Activity and Rest.
Solitude and Social
Interaction.
Hazard Prevention.
Promotion of Normality.
A nursing care plan contains all of the relevant information about a patient’s diagnoses, the goals of treatment, the specific nursing orders (including what observations are needed and what actions must be performed), and a plan for evaluation.
Nursing care plans are an important part of providing quality patient care. They help to define the nurses’ role in the patient’s treatment, provide consistency of care and allow the nursing team to customize its interventions for each patient.
Nursing Interventions & Therapeutics
A Nursing intervention is defined as “any treatment, based upon clinical judgment and knowledge, that a nurse performs to enhance patient/client outcomes.
There are different types of nursing interventions: independent, dependent and interdependent. After a nurse uses education and experience to select an intervention, an evaluation must be performed to determine whether or not the intervention was a success.
In the nursing field, Dorothea Orem was one such influential thinker. The theory helps nurses determine what aspects of patient care they should focus on in a given situation, and it stresses the importance to patients themselves of maintaining autonomy over their self-care processes.
There are 8 main areas of self-care which are incorporated by nursing for patients care according to Dorthe Orem’s SCDT whose are : physical, psychological, emotional, social, professional, environmental, spiritual, and financial. Movement of the body, health, nutrition, sleep and resting needs.
Collaborative nursing interventions are actions that the nurse carries out in collaboration with other health team members, such as physicians, social workers, respiratory therapists, physical therapists, and occupational therapists.
There are five components to the nurse-client relationship: trust, respect, professional intimacy, empathy and power. Regardless of the context, length of interaction and whether a nurse is the primary or secondary care provider, these components are always present. Professional intimacy.
The five key components of the therapeutic nurse-client relationship are professional intimacy, power, empathy, respect and trust.
Health system nursing interventions are actions nurses take as part of a healthcare team to provide a safe medical facility for all patients, such as following procedures to reduce the risk of infection for patients during hospital stays.
Identified therapeutic instruments used by nurses in therapeutic interventions were: therapeutic letters, bathing and comforting care, humour, music, presence, mindfulness (cognitive therapy), therapeutic touch, information management and emotional management.
Using Health Information Technology to Improve Medication Safety
Maintain an active medication allergy list.
Maintain an active medication list.
Use computerized physician order entry for medication orders.
Generate and transmit electronic prescriptions for noncontrolled substances.
Medication safety refers to the safe use of medicines to achieve therapeutic outcomes and improve people’s quality of life, while minimising risks and responding to errors.
The “rights” of medication administration include right patient, right drug, right time, right route, and right dose. These rights are critical for nurses.