Assignment: Nursing Process Performance N 545

Assignment: Nursing Process Performance N 545

DQ2 How could you use the Nursing Process to address a staff member’s performance shortcomings?

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Nursing Process Performance?

The acuity of patient care in the hospital setting has grown significantly over the last 10 years. For the nurse who works on an acute medical-surgical unit, it can be challenging to address the demands of post-operative assessment and care, as well as common medical challenges such as advanced age, obesity, and co-morbid disease.

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The 79-year-old female who has just had a hip fracture repair is not just “a hip” patient, but may also be an individual with diabetes, osteoporosis, hypertension, alcohol use disorder, asthma, obstructive sleep apnea, or early-stage dementia. This article outlines how the nursing process must be embedded in patient care to ensure optimal outcomes for acute and complex patients.

Nursing students are introduced to the nursing process during academic preparation. The nursing process is a stepped approach to assess and care for patients. It is a tool for both students and nurses to help ensure a consistent and strategic approach to patient care. The steps of the nursing process include assessment, nursing diagnosis, planning, intervention, and evaluation. These five steps are used cyclically and repeatedly during patient care. The sequence must be followed from start to finish to ensure that the needs of the patient are addressed (Morris, 2006).

Step 1—Assessment

In the first step of the nursing process, the nurse gathers key information in completing a comprehensive patient assessment. This can be viewed as the most important step of the nursing process, as it determines the direction of care by judging how the patient is responding to and compensating for a surgical event, anesthesia, and increased physiologic demands. Some of the components of a post-operative assessment include obtaining vital signs, pain score, assessing breath sounds, fluid intake and output, level of consciousness, the surgical site, and more (see List 1 below).