Nursing Care Plan Based on Nursing Students’ Clinical Experience

posted Apr 4, 2018, 8:39 PM by BND Admin

Nursing Care Plan Based on Nursing Students’ Clinical Experience

Patalagsa, Joel Gonzales, RN, PhD

University of St. La Salle

Bacolod City, Philippines

 

Background

Clinical training is an important component in nursing education. Changes in population characteristics and health needs necessitate updating and enhancing frameworks in training nursing students. Using nursing care plan in training nursing students in assessing client’s condition or needs, formulating clinical judgment by identifying the appropriate nursing diagnosis, planning outcomes, implementing interventions, and evaluating patient’s condition based on the care plan remained an important clinical training tool.

 

Aims:

1.      Assessed nursing students understanding of the nursing process

2.      Analyzed nursing care plans formulated by nursing students

3.      Assessed difficulties in formulating nursing care plan

4.      Introduced educational enhancements to improve students’ written nursing care plan

5.      Evaluated nursing students’ application of educational enhancements

 

Methods

Descriptive analysis was used in this study

Data collection

Data analysis

One-on-one interview

Thematic analysis

Pre-intervention Nursing Care Plan

Content analysis

One-on-one interview

Thematic analysis

Post-intervention Nursing Care Plan

Content analysis

Focus group discussion

Thematic analysis

 

RESULTS

Objective 1: Students’ understanding of nursing process

·         Students were able to explain the components of nursing process based on their understanding appropriately

·         Students identified nursing process as guide in formulating plan of care for their patients

 

Objective 2: Pre-test nursing care plan content analysis

·         Content mismatches and inconsistencies were observed between

·         assessment findings and nursing diagnosis

·         assessment findings and plan

·         assessment findings and nursing interventions

Objective 3: Difficulties encountered in formulating nursing care plan

·         Matching assessment findings with nursing diagnosis

·         Matching assessment findings with care plan outcomes criteria

·         Matching assessment findings with nursing interventions

·         Most of nursing interventions identified did not match assessment findings

 

Objective 4:

 Intervention 1

·         Review of nursing process

·         Aligning subjective and objective assessment findings

·         Providing measurable description of signs and symptoms (quantitative or qualitative)

·         Appropriately identifying excesses or deficits in signs and symptoms or needs

·         Aligning care outcomes criteria with assessment findings

·         Identifying interventions that will help improve signs/symptoms or needs

 

Intervention 2

·         Introduction of modified wellness-illness continuum



 

Intervention 3

·         Introduction of integrated intervention matrix

 

RESULTS

Objective 5a: Application of educational interventions (nursing care plan content analysis)

·         Subjective and objective assessment findings were aligned using the modified wellness-illness model as guide

·         Nursing diagnosis matched with assessment findings

·         Planned outcomes were appropriately stated and aligned with assessment findings

·         Interventions were appropriate, relevant, and complete using the integrated intervention matrix as model

 

Objective 5b: Application of educational interventions as new knowledge (FGD)

·         Expressed satisfaction with the application of new knowledge

·         Demonstrated confidence in nurse-patient interaction especially when gathering information (history taking)

·         Expressed appreciation of the importance of assessment

·         New knowledge provided practical guide in formulating appropriate and workable patient-centered nursing care plan

 

Conclusion

·         The educational interventions apparently contributed in improving how nursing students approached assessment of their patients and the way they formulated their nursing care plans.

 

Recommendations

·         Clinical instructors need to consistently guide nursing students with the application and use of nursing process when writing their care plans

·         Clinical instructors need to conduct pre- and post-clinical training feedback sessions

·         Faculty lecturers and clinical instructors need to align theory with practice

 

Key words: Nursing care plan, wellness-illness continuum, assessment, intervention

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