60 CHAPTER 13 / Planning
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Identify activities that occur in the planning process.
Concepts for Lecture
1. Activities that occur in the planning phase include prioritizing
problems/diagnoses, formulating goals/desired outcomes, selecting
nursing interventions, and writing nursing interventions.
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Concepts for Lecture
1. Planning begins with the first client contact and continues until the
nurse–client relationship ends, usually when the client is discharged
2. Initial planning is usually performed by the nurse who completes the
3. Ongoing planning is done by all nurses who work with the client.
4. Discharge planning is the process of anticipating and planning for
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Explain how standards of care and predeveloped care plans can be individu-
alized and used in creating a comprehensive nursing care plan.
Concepts for Lecture
1. Most health agencies have a variety of preprinted, standardized plans
2. Standards of care describe nursing actions for clients with similar
medical conditions rather than individuals, and they describe
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• Discuss how poor planning in any of the activi-
ties of planning can affect client care.
•
Provide the students with a list of nursing
diagnoses and ask them to prioritize these.
Ask students to provide the criteria they used
to prioritize the diagnoses.
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Review the care plan forms used in the institu-
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• Show various types of standardized written care
plans used in different clinical settings. Have the
students examine the similarities and differences
among the various care plans.
•
Using the standardized plans in the textbook,
ask the students to give examples of how these
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3. Standardized care plans are preprinted guides for nursing care of a
4. Protocols are preprinted and indicate the actions commonly required
5. Policies and procedures are developed to govern the handling of
6.
Regardless of whether care plans are handwritten, computerized, or
standardized, nursing care must be individualized to fit the unique needs
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Identify essential guidelines for writing nursing care plans.
Concepts for Lecture
1
.
Use the following guidelines when writing nursing care plans:
• Date and sign the plan. The date is essential for evaluation, review,
and future planning. The nurse’s signature indicates
accountability.
• Refer to a procedure book or other sources of information rather
than including all the steps on a written plan.
• Tailor the plan to the unique characteristics of the client by ensur-
ing that the client’s choices, such as preferences about the times of
•
Review the various types of standardized care
differences among the standardized care plans,
problem in the various texts. Ask the students
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• Give the students a list of standardized/approved
medical or English symbols that may be used in
care plans. Discuss why it is important to adhere
to this list.
•
Review the differences between a student care
plan or concept map and the client care plan
used in an institution.
62 CHAPTER 13 / Planning
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Identify factors that the nurse must consider when setting priorities.
Concepts for Lecture
1
.
Priority setting is the process of establishing a preferential sequence
2. Factors that must be considered when setting priorities are the
following:
• The client’s health values and beliefs
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Discuss the Nursing Outcomes Classification, including an explanation of
how to use the outcomes and indicators in care planning.
Concepts for Lecture
1. Standardized or common nursing language is required in all phases
of the nursing process if nursing data are to be included in computer-
ized databases that are analyzed and used in nursing practice. Since
2.
When using the NOC taxonomy to write a desired outcome on a care
plan, the nurse writes the label, the indicators that apply to the particular
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• Provide the students with a list of nursing diag-
noses. Divide the students into groups. Ask each
group to rank the diagnoses as high, medium, or
low priority and to provide the rationale for the
established for their assigned clients. Discuss
prioritizing the diagnoses using Maslow’s hierar-
chy of needs or the prioritizing system used by
the school.
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CHAPTER 13 / Planning 63
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State the purposes of establishing client goals/desired outcomes.
Concepts for Lecture
1. The goals/desired outcomes describe, in terms of observable client
responses, what the nurse hopes to achieve by implementing the
nursing interventions.
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Identify guidelines for writing goals/desired outcomes.
Concepts for Lecture
1. The goal/desired outcome statement usually has the following com-
ponents: subject, verb, condition or modifier, and criterion of desired
performance. (See Table 13–4.) The subject is the client, any part of
2. Guidelines for writing goals/desired outcomes include the following:
• Write goals/desired outcomes in terms of client responses, not
nurse activities.
• Be sure that goals/desired outcomes are realistic for the client’s
capabilities, limitations, and designated time span, if it is
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• Review the terminology used by the school for
goals/desired outcomes.
•
Relate the process of setting personal
goals/desired outcomes to the process used in
establishing client goals/desired outcomes.
have used client goals to assist with care.
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• Hand out a list of goals/desired outcomes state-
ments. Ask the students to identify the subject,
verb, conditions, and criteria for each statement.
•
Provide the students with a list of improperly
stated goals/desired outcomes. Ask the stu-
dents to identify and correct the errors.
64 CHAPTER 13 / Planning
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Describe the process of selecting and choosing nursing interventions.
Concepts for Lecture
1. Nursing interventions and activities are the actions a nurse performs
to achieve client goals/desired outcomes. They should focus on elim-
2. Nursing interventions include both direct and indirect care. Direct
care is an intervention performed through interaction with the client.
Indirect care is an intervention performed away from but on behalf
of the client, such as interdisciplinary collaboration or management
of the care environment. Other types of nursing interventions include
3. The best nursing interventions will meet the following criteria:
• Safe and appropriate for the client’s age, health, and condition
• Achievable with the resources available
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Discuss the Nursing Interventions Classification, including an explanation of
how to use the interventions and activities in care planning.
Concepts for Lecture
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• Provide the students with a list of nursing diag-
noses. Ask the students to develop several inter-
ventions for these diagnoses. Be certain to
include risk diagnoses in the list.
•
Provide a list of interventions. Ask the stu-
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• Discuss how the use of NIC could benefit the
profession of nursing.
•
Debate the pros and cons of using the NIC
system.
•
Invite a representative from nursing administra-
4.
When writing individualized nursing interventions on a care plan, the