00:01
So now, we've got to go
into the evaluation phase
after plan of care.
00:05
So now looking back
at those outcomes,
if you look at the oxygenation
was Mrs. Meyer able to maintain her
oxygen saturation greater than 90%.
00:15
Well, with our update she was?
So our goal is met
and we can discontinue
this plan of care, because why?
Well, it was effective.
00:23
Now, if we're talking
about our pain,
if you remember, our outcome here,
our desired outcome was,
will she verbalize
better pain control?
And is she more of where
a winter request pain medication?
Well, if you remember,
her pain was still having
a little bit of issues,
because she wasn't tolerating
her pain medicine.
00:42
So here,
our goal was not met,
and we're going to have
to modify that plan of care.
00:48
So anytime,
you're talking about care planning
is perfectly okay,
that you're going to have
desirable and undesirable
evaluation.
00:56
So what does that mean for us?
We just go back
to our ADPIE,
and we circle back
to the beginning.
01:02
It's very common that we have
to modify our care plan,
because sometimes
our interventions are effective.
01:08
Sometimes they're
partially effective.
01:11
And sometimes they
may not be effective at all,
in regard to meeting
our desired outcomes.
01:16
So therefore, again,
we go back to our ADPIE.
01:19
We modify our care plan,
go back into the circle.
01:23
After evaluation,
we're going to reassess
and then we're going to go through
those ADPIE process steps.
01:30
Now, again,
if that goal was not met,
then again,
it needs to be revised.
01:34
What do we consider here?
Well, were the interventions
implemented as intended?
Did we perform
those interventions correctly?
Now, are there any
barriers for example?
These are all things
we need to consider,
and we need to look at
if those goals were not met,
and we need to
modify our care plan.
01:51
We need to take
a little bit of a look
of why that wasn't effective.
01:55
So with a new consideration
that needs to be,
is there something new
that needs to be integrated
in the plan of care?
Did we miss something the first time
on assessment maybe,
or the planning period?
Well, that's quite possible.
02:07
And then we just go
back to the beginning.
02:10
Now, just know as an update,
Mrs. Meyer was not able
to take her pain medication
because she wasn't
tolerating them.
02:17
Let's say she was nauseated,
she was sick and vomiting,
this is causing her pain score
to be greater than a 5 out of 10.
02:25
So if you recall,
Mrs. Meyer was not able to meet
her pain goal.
02:28
So we have to repeat
the ADPIE process
and modify her plan of care.
02:33
So Mrs. Meyer was not able
to take her pain medication,
because she's not
tolerating it well,
again, because of
nausea and vomiting.
02:40
Causing her pain scale
to be a greater than 5 out of 10,
which was our goal for her
5 or 10, or less.
02:47
So our goal again,
was to lessen that acute pain.
02:51
Now, our outcome
that we created for her
is that we wanted her
to report her pain scale of
five out of 10, or less
by the end of the shift.
03:00
Now, here's where
the thing that happens
when we're talking about
modifying plan of care.
03:04
Sometimes
unexpected events occur
such as
Mrs. Meyer's nausea and vomiting.
03:09
So we have
to adjust, and flex,
and modify
a new plan of care for her
that's going
to meet her need.
03:16
So if you look at the
new interventions here,
it says they use cooling
to supplement her pain control.
03:22
Because right,
we're going to have to do
some other interventions, guys.
Think outside the box,
because taking the pain medications
wasn't working, right?
because of nausea and vomiting.
03:32
Also, we could
offer Mrs. Meyers here
a snack
with her pain medication
that may also help
with the nausea and vomiting
and her ability
to tolerate her medicine.
03:41
And then we're going to create
new outcomes
such as reporting
the pain level is decreased
and her incidence of
nausea and vomiting
will also decrease.
03:49
So, I hope today, guys,
that the application of ADPIE
was help for you
with the patient scenario.
03:54
Thank you for watching.