OCCUPATIONAL NURSING CARE PLAN FORMAT

NAME: _____________________________________
AGE: ______
Nursing Diagnosis
Definition:

ASSESSMENT PLANNING INTERVENTIONS EVALUATION LEVELS OF PREVENTION

Subjective data: Individual: Individual: Individual: Primary:
Short-term goals:

Long-term goals:

Secondary:

Community (Workplace): Short- Community (Workplace): Community (Workplace):

term goals:

Tertiary:
Long-term goals:

Reference:
Name of Student: _________________________________________________ Yr/crs/section: ______________ RLE Group: __________
CI: ______________________________