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Implementation

Implementing-imp
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The nursing process, known by the acronym ADPIE (assessment, diagnosis, planning, implementation and evaluation), is a five-step systematic approach to patient care using the fundamental principles of critical thinking, individualized patient approaches to treatment, goal-oriented tasks, and evidence-based practice recommendations. Implementation is the fourth step of the nursing process. It involves carrying out the nursing interventions outlined in the plan of care. There are three nursing intervention classifications; direct care, indirect care, and community interventions. When implementing the care plan, it is necessary to act in partnership with the patient and family, and reassess the interventions to ensure they are consistent with the standard of practice and research findings, and are still relevant to the patient. It is also important to be organized before performing the nursing action, and to carefully document every nursing intervention. Nurses should familiarize themselves with the nursing interventions that require professional nurses and which can be safely delegated.
9 KEY FACTS
TYPES OF NURSING INTERVENTIONS
Direct Care Interventions
Direct-route

Direct care interventions involve direct interactions with the patient. They include physiological and psychosocial nursing actions. Some examples are medication administration, health education, emotional support.

Indirect Care Interventions
Indirect-route

Indirect care interventions involve supporting a patient's health with methods developed away from the patient. They include strengthening the patient's care settings and increasing the effectiveness of direct care. Examples would be collaborating patient care with other healthcare team members, documenting care, making referrals, and managing the patient's environment to ensure safety.

A Community (Public Health) Intervention
Community

A community health intervention aims at improving and protecting the health of the population. Examples include health promotion strategies, disease prevention, community supports.

IMPLEMENTING THE CARE PLAN
Partnership with the Patient/Family
Patient and Family

When implementing the care plan, it is essential to include the patient/family. They are your most valuable resource in improving the outcomes of the treatment. They support the nurse in determining new or continuing need for nursing assistance, and any revisions needed in the care plan. Patients are more willing to participate in the care if they have input in the plan.

Performing the Nursing Action
Nurse Performing Nursing Action

Successful implementation of the care plan requires an extraordinary level of planning and efficiency. Some key facts to support the best outcomes include knowing how to perform the nursing action, understanding why the action is being performed and potential adverse responses. The nurse should have all the equipment and supplies ready and should pay special attention to the environment to ensure privacy and safety. And lastly, the nurse should be aware of interventions that can be completed independently or assistance is needed.

Documenting Nursing Care
Documents

All nursing interventions must be thoroughly and accurately charted. Documentation allows for proceeding nurses implementing the care plan to identify modifications made in the nursing interventions, the patient's progress towards the goal/outcome, and to have legal evidence of all nursing efforts to implement the plan.

Delegating Nursing Care
Delegating Tasks

Delegation is the transfer of responsibility of a task to another person while the primary nurse retains accountability for the outcome. It is vital for registered nurses to critically distinguish nursing interventions that require registered nurses and ones that can safely be delegated. Interventions should never be attempted beyond an individual's capacity without supervision.

TEST-TAKING STRATEGY: KEY WORDS
Intervene
Entering-between Patient and Disease-guy

When identifying parts of the nursing process during an exam, certain keywords or phrases can help determine which part of the nursing process they are asking about. In an implementation question, the word “intervene” is one of these keywords.

Priority Action
List of Priorities and Action-clapper

When identifying parts of the nursing process during an exam, certain keywords or phrases can help determine which part of the nursing process they are asking about. In an implementation question, the phrase “priority action” is one of these keywords.

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