Planning Phase and Establishing Priorities (Nursing)

by Samantha Rhea, MSN, RN

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    00:01 Welcome to the planning phase of the ADPIE process.

    00:04 If you guys remember when we're talking about ADPIE, we're talking about also known as our nursing process.

    00:12 So we're talking about the nursing process.

    00:14 Don't forget that we have the P part of the pie, which is the planning phase.

    00:19 Now before this, of course, we've assessed our patient, we formed a nursing diagnosis.

    00:24 Now, that we have a priority problem, we can create a plan.

    00:28 So we're creating that plan.

    00:30 We're going to establish priorities for our patient.

    00:33 We're also going to create goals that way we have these to evaluate from.

    00:38 And don't forget, in this phase interventions from the nurse are key, because these are going to help us reach these goals.

    00:44 Now, with the planning phase, we also create what we call expected outcomes for the patient.

    00:50 Now, we're hoping our interventions are going to improve our patient condition.

    00:54 And then we can look at these expected outcomes, and see did we meet these or not? Now, when we talk about our planning phase, it's important, of course, to establish priorities.

    01:04 We have a lot of priority issues, but we need to establish a sequence for our nursing interventions.

    01:11 So, we've got to think, hey, which ones do we need to do first? Which needs are the most emergent and need to be addressed? So of course, highly emergent issues are something that we of course, have to treat promptly, because this can be a safety issue.

    01:26 It could result in an oxygenation, maybe a circulation issue.

    01:31 And of course, don't forget your airway.

    01:33 If you remember, back to your basics of nursing as those ABCs, airway, breathing, circulation.

    01:39 So there's anything that can impair this, of course, this is number one, we've got to treat this first.

    01:46 Now, if we have a highly emergent situation, or a priority, of course, these will go first.

    01:51 But they're also very important intermediate priorities we need to consider.

    01:57 Now, of course, these aren't necessarily, non-emergent.

    02:00 Maybe they're not life sustaining, but they do need prompt attention.

    02:04 A great example of that is going to be pain, right? Because this can affect our patient in a number of ways.

    02:10 So this necessarily isn't going to affect the patient's airway or oxygenation, for example, but it is something that has to do with the patient's mobility, their ability to be compliant with treatment.

    02:23 So pain is a great intermediate issue to think about, and right after our highly emergent things that we need to address.

    02:31 And also don't of course, forget about nutrition.

    02:34 This is going to help sustain and to support our needs of our patient.

    02:39 And then if we've addressed those, we have our lower priority issues.

    02:43 These are health needs that maybe we need address in the long-term, or be working towards for the future.

    02:49 This could be anything to do with education, for example, about maybe the patient's disease process, maybe physical therapy, rehabilitation, or any sort of health maintenance and prevention for our patients.

    03:04 Once again, establishing priorities we've assessed, we formed our nursing diagnosis, and prioritized our patient needs.

    03:11 Now with that diagnosis, we always have to take a look and reevaluate is this still priority for our patient.

    03:19 And when we're talking about our priorities, we need to consider the ethical considerations, also the interventions and strategies in creating priorities, And also our patient, making sure that they're included in regard to their plan of care.

    03:34 So now, let's take a look at prioritization in our practice.

    03:37 Now, if you take a look at this slide set is really, there's a lot of information, right? What I really, want you to focus on if you see all of that in the middle, those bullet points in the screen, this really is our ADPIE process.

    03:51 This is our assess, our diagnosis, planning, implementation, and our evaluation phase.

    03:58 And again, as a nurse, we typically do this organically throughout this shift to address a patient need.

    04:04 But just look at all of these factors on the outside of this middle circle here, this middle square, these are all things that can affect our ability to prioritize care for a patient.

    About the Lecture

    The lecture Planning Phase and Establishing Priorities (Nursing) by Samantha Rhea, MSN, RN is from the course Nursing Process – Assessment, Diagnosis, Planning, Interventions, and Evaluation.

    Included Quiz Questions

    1. Ineffective airway clearance related to increased sputum production as evidenced by cyanosis to client’s lips
    2. Imbalanced nutrition: less than body requirements, related to frequent nausea, as evidenced by the client losing fifteen lbs in two months
    3. Risk for inadequate pain control related to recent abdominal surgery
    4. Self-care deficit, bathing, related to decreased mobility following fall, as evidenced by the client being unable to wash themselves
    1. Ethical considerations
    2. Reevaluation of the nursing diagnoses
    3. Interventions and strategies
    4. Client priorities
    5. Nurse priorities

    Author of lecture Planning Phase and Establishing Priorities (Nursing)

     Samantha Rhea, MSN, RN

    Samantha Rhea, MSN, RN

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