Chapter 15 Implementing

1. Chapter 15Implementing

2. Advantages of Nursing Interventions Classifications • Standardizing nomenclature • Expanding nursing knowledge • Developing information systems • Teaching decision making • Ensuring appropriate reimbursement • Allocating nursing resources • Communicating nursing to non-nurses • Linking nursing content

3. Aims of NOC Research • Identify, label, validate, and classify nursing-sensitive patient outcomes and indicators • Evaluate the validity and usefulness of the classification in clinical field testing • Define and test measurement procedures for the outcomes and indicators

4. Outcomes for “Caregiver Home Readiness” • Willing to assume caregiving role • Knowledge about caregiver role • Demonstration of positive regard for care recipient • Participation in home care decision • Confidence in ability to manage care at home • Knowledge of where to obtain needed equipment

5. Types of Nursing Interventions • Independent nursing actions • Nurse-initiated interventions • Protocols • Standing orders • Collaborative nursing actions • Physician-initiated interventions • Collaborative interventions

6. Implementing

7. Implementing the Care Plan • Organize resources • Anticipate unexpected outcomes/situations • Promote self-care: teaching, counseling, advocacy • Assist patients to meet health outcomes

8. Checklist for Organizing Student Clinical Responsibilities • Patient profile and name by which patient is addressed • Patient’s chief complaint and reason for admission • Patient’s current health status • Routine assistance to meet basic human needs • Priorities for nursing care and special daily events • Special teaching, counseling, or advocacy needs • Special family needs

9. Variables Influencing Outcome Achievement • Patient variables • Developmental stage • Psychosocial background • Nurse variables • Resources • Current standards of care • Research findings • Ethical and legal guides to practice

10. Common Reasons for Noncompliance • Lack of family support • Lack of understanding about the benefits • Low value attached to outcomes • Adverse physical or emotional effects of treatment • Inability to afford treatment

11. Question Which one of the following is an example of a nurse variable influencing patient outcomes? A. A patient in a nursing home refuses to take his medications. B. A low-income family is unable to afford formula for their newborn infant. C. An alcoholic patient is unwilling to participate in AA meetings. D. A rape victim does not receive counseling at the ER because a counselor is not available.

12. Answer Answer: D. A rape victim does not receive counseling at the ER because a counselor is not available. Rationale: Nurse variables that influence the plan of care include resources (Answer D), current standards of care, research findings, and ethical and legal guides to practice. The remaining answer options are patient variables, which include the patient’s changing ability and willingness to participate in the plan of care and personal responses to the nursing interventions implemented.

13. Question Tell whether the following statement is true or false. One of the advantages of using Nursing Intervention Classifications in nursing practice is to ensure appropriate reimbursement for nursing services. A. True B. False

14. Answer Answer: A. True One of the advantages of using Nursing Intervention Classifications in nursing practice is to ensure appropriate reimbursement for nursing services.

15. Question Which one of the following nursing interventions is an indirect care intervention? A. A nurse explains available birth control measures to a young couple. B. A nurse meets with the collaborative care team to plan nursing measures for a patient. C. A nurse prays with a patient prior to surgery. D. A nurse administers pain medication to a patient with end-stage renal cancer.

16. Answer Answer: B. A nurse meets with the collaborative care team to plan nursing measures for a patient. Rationale: An indirect care intervention is treatment performed away from the patient but on behalf of a patient or group of patients, such as the example in answer B: consulting with the collaborative care team. The remaining answer options are direct care interventions or treatment performed through interaction with the patient.

17. Question Tell whether the following statement is true or false. A nurse who follows the protocol for taking vital signs following surgery is performing a physician-initiated intervention. A. True B. False

18. Answer Answer: B. False A nurse who follows the protocol for taking vital signs following surgery is performing a nurse-initiated intervention.

19. Question Tell whether the following statement is true or false. When a patient fails to cooperate with the plan of care despite the nurse’s best efforts, it is time to reassign the patient to another caretaker. A. True B. False

20. Answer Answer: B. False When a patient fails to cooperate with the plan of care despite the nurse’s best efforts, it is time to reassess the strategy.