Nursing Care Plan: Priorities & Goals

• Planning involves the midwife and patient setting priorities, goals, and choosing interventions.
• The plan guides the midwife's actions and interventions.

Purpose of a Care Plan

• To tailor care to the individual.
• To prioritize needs.
• To improve communication among healthcare staff.
• To aid in continuous care, discharge planning, and setting goals.
• To ensure care is coordinated.
• To assess the care given.
• To foster professional growth.

Stages of Planning

• Setting Priorities: Establishes the order for addressing nursing diagnoses and interventions, with life-threatening functions as top priority.
• Establishing Client Goals/Desired Outcomes: Midwife and client set goals describing observable client responses hoped to be achieved through interventions.
• Nursing Outcomes Classification: Describes client outcomes from nursing interventions, made specific through client-specific indicators.

Desired Goals/Outcomes

• Direct the planning of nursing interventions.
• Provide criteria for assessing client progress.
• Help determine when a problem has resolved.
• Motivate client and midwife through a sense of progress.
• Nursing diagnoses inform the goals, derived from the unhealthy response in the diagnostic label.

Goal Statement Components

• Subject: Typically the client, but can be a specific attribute (e.g., pulse, urinary output).
• Verb: Specifies the client's action, needing observable behaviors like administering, showing, or walking.
• Condition/Modifiers: Details the circumstances of the behavior, explaining what, where, when, or how.
• Criterion: Defines the standard for evaluating performance, with the level at which the client will perform the action.

Types of Goals

• Short-term Goals: Outcomes achieved in days or a week.
• Long-term Goals: Outcomes achieved in weeks or months, especially for chronic conditions.

Guidelines

• S: Specific
• M: Measurable
• A: Attainable
• R: Realistic
• T: Time-bound

Setting Priorities

• Address life-threatening issues first, focusing on breathing, heartbeat, and blood pressure.
• Medium priority concerns include problems that may delay development or cause destructive changes.
• Low priority includes issues from normal development or needing minimal support.
• Consider safety issues, patient-identified issues, midwife-identified priorities, and resource availability.

Intervention/Implementation

• Intervention: Putting the care plan into action.
• Midwives use knowledge to select interventions that are safe, legal, and align with medical orders.

Implementation

• Direct Interventions involve direct interaction with the client, like performing a tepid sponge bath for fever.
• Indirect Interventions are actions taken away from the client but on their behalf, such as maintaining nursery temperature for newborns.

Functions of Midwife

• Independent Actions: Midwives carry these out without orders, assuming responsibility (e.g., performing TSB).
• Dependent Actions: Midwives perform these following a superior's orders (e.g., following a doctor’s order).
• Interdependent Actions: Midwives conduct these collaboratively with other healthcare team members (e.g., collecting urine specimens for the lab).

Preventive Measures

• Aims to halt or lessen the chances of sickness, harm, or problems before they arise.
• Emphasize boosting health, halting illnesses, and protecting patients from injury.
• Includes routine check-ups, vaccinations, practicing good hygiene, and educating about healthy lifestyle choices.

Health Care Strategies

• Preventive: Focuses on averting illness or its complications.
• Promotive: Aims to elevate health, including activities for enhanced well-being, disease prevention, and health promotion.
• Curative: Employs treatments like pharmacotherapy and alternative medicine to eradicate disease and alleviate symptoms.
• Rehabilitative: Assists in recovering from serious injury, illness, or surgery, focusing on regaining strength and skills.

Infection Control

• Aims to halt the spread of infections in healthcare, safeguarding patients and workers from microorganisms like bacteria, viruses, and fungi.
• Includes correct hand washing, PPE use, surface disinfection, patient isolation, and safe medical equipment use.
• Lowers the risk of healthcare-associated infections (HAIs), securing a safe setting for all.

Purpose

• To protect patients from acquiring infections.
• To protect healthcare workers from becoming infected.

Terms

• Infection: Pathogens invade tissue, leading to changes or symptoms.
• Colonization: Microorganisms present and growing without tissue invasion or damage.
• Handwashing: A highly effective infection control measure to prevent microorganism spread.

Chain

• Infectious Agent: Microorganisms that cause infection, including normal flora.
• Reservoir: Places where microorganisms live and multiply, such as in humans, animals, or insects.