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Chapter: Medical Surgical Nursing: Critical Thinking,Ethical Decision Making, and the Nursing Process

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Implementation - Using the Nursing Process

The implementation phase of the nursing process involves carrying out the proposed plan of nursing care.

IMPLEMENTATION

 

The implementation phase of the nursing process involves carrying out the proposed plan of nursing care. The nurse assumes re-sponsibility for the implementation. Performance of interventions, however, may be carried out by the patient and the family, other members of the nursing team, or other members of the health care team as appropriate. The nurse coordinates the activities of all those involved in implementation so that the schedule of activities facilitates the patient’s recovery. The plan of nursing care serves as the basis for implementation:

 

·        The immediate, intermediate, and long-term goals are used as a focus for the implementation of the designated nursing interventions.

·        While implementing nursing care, the nurse continually assesses the patient and his or her response to the nursing care.

·        Revisions are made in the plan of care as the patient’s con-dition, problems, and responses change and when reassign-ment of priorities is required

 

Implementation includes direct or indirect execution of the planned interventions. It is focused on resolving the patient’s nurs-ing diagnoses and collaborative problems and achieving expected outcomes, thus meeting the patient’s health needs.

 

Included among nursing interventions are assisting with hy-gienic care; promoting physical and psychological comfort; sup-porting respiratory and elimination functions; facilitating the ingestion of food, fluids, and nutrients; managing the patient’s immediate surroundings; providing health teaching; promoting a therapeutic relationship; and carrying out a variety of thera-peutic nursing activities. Judgment, critical thinking, and good decision-making skills are essential in the selection of appropriate scientifically and ethically based nursing interventions. All nurs-ing interventions are patient-focused and outcome-directed and are implemented with compassion, confidence and a willingness to accept and understand the patient’s responses.

 

Although many nursing actions are independent, others are interdependent, such as carrying out prescribed treatments, ad-ministering medications and therapies, and collaborating with other health care team members to accomplish specific expected outcomes and to monitor and manage potential complications. Such interdependent functioning is just that—interdependent. Requests or orders from other health care team members should not be followed blindly but should be assessed critically and questioned when necessary. The implementation phase of the nursing process ends when the nursing interventions have been completed.

 

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