Developing the

Nursing Care Plan

Juvelyn T. Navarro, RN

The Family Care Plan

Definition
this is the blueprint of the care that the nurse designs to
systemically minimize or liminate the identified health and
family nursing problems through explicitly formulated
outcomes of care (goals and objectives) and deliberately
chosen set of interventions, resources and evaluation criteria,
standards, methods and tools.
Characteristics, which are Based on the Concept of Planning as
a Process:
1.The nursing care plan focuses on actions, which are designed to solve or
minimize existing problem.
The cores of the plan are the approaches, strategies, activities, methods
and materials, which the nurse hopes, will improve the problem.

2. The nursing care plan is a product of the liberate systematic process.

3. The nursing care plan as with all other plans relate to the future.
It utilizes events in the past and what is happening in the present to
determine patterns. It also projects the future scenario if the situation
is not corrected.
Characteristics, which are Based on the Concept of Planning as
a Process:

4. The nursing care plan is based upon identified health and nursing problems.

5. The nursing care plan is a means to an end, not an end in itself.

The goal in planning is to deliver the most appropriate care to the
client by eliminating barriers to the family health development.

6. The nursing care plan is a continuous process not a one shot deal.
The results of evaluation of the plan’s effectiveness trigger another
cycle of the planning process until the health and nursing problems
are eliminated.
Desirable Qualities of a Nursing Care Plan
1. It should be based on clear, explicit definition of
the problem(s).
2. A good plan is realistic.
3. The nursing care plan is prepared jointly with the
family.
4. The nursing care plan is most useful in written
form.
The Importance of Planning Care
1. They individualize care to clients.
2. The nursing care plan helps in setting priorities by providing
information about the client as well as the nature of his problem.
3. The nursing care plan promotes systematic communication among
those involve in the health care effort.
4. Continuity of care is facilitated through the use of nursing care plans.
Gaps and duplications in the services provided are minimized, if
not totally eliminated.
5. Nursing care plans facilitate the coordination of care by making
known to other members of the health team what the nurse is doing.
Steps in Developing
Care Plan

The prioritized conditions of the problem

Goals and objectives of the nursing care

The plan of interventions

The plan for evaluating care

Schematic

presentation of
Nursing Care Plan
Prioritizing Health Problems
Modifiability of the condition
Nature of the condition
or problem
or problem
refers to the probability of
categorized into wellness success in enhancing the
state/potential, health wellness state improving the
threat, health deficit of condition minimizing,
foreseeable crisis. alleviating or totally eradicating
the problem through
intervention.
Prioritizing Health Problems
Preventive potential Salience

refers to the nature and refers to the family’s

magnitude of future perception and
problem that can be evaluation of the
minimized or totally condition or problem in
prevented if
terms of seriousness and
interventions are done
urgency of attention
on the condition or
problem under needed or family
consideration. readiness.
Formulation of Goals and Objectives
GOAL - is a general statement of condition or
state to be brought about by specific courses of
action.

OBJECTIVE - refers to a more specific

statement of the desired results or outcomes of
care. They specify the criteria by which the
degree of effectiveness of care to be measured.
Barriers to Joint Goal Setting Between the
Nurse and the Family:
1. Failure on the part of the family to perceive the
existence of the problem.
2. The family may realize the existence of the health
condition or problem but is too busy at the moment.
3. Sometimes the family perceives the existence of the
problem but does not see it as serious enough to
warrant attention.
Barriers to Joint Goal Setting Between the
Nurse and the Family:
4. The family may perceive the presence of the problem and the
need to take action. It may however refuse to face and do something
about the situation.
Reasons to this kind of behavior:
a. Fear of consequences of taking actions.
b. Respect for tradition.
c. Failure to perceive the benefits of action.
d. Failure to relate the proposed action to the family’s goals.
Barriers to Joint Goal Setting Between the
Nurse and the Family:

5. A big barrier to collaborative goal setting between the nurse

and the family is the working relationship.
Goals, like objectives, are best stated in terms of
client outcomes, whether at the individual, family
or community levels. It tells where the family is
going.

Objectives, refer to more specific statements of the

desired results or outcomes of care. These are the
is the milestones to reach the destination.
Example: GOAL
1. After nursing intervention, the malnourished preschool members of
the family will increase their weights by at least one pound per
month.

Example: Objectives
1. After nursing intervention, the family will be able to:
a. Feed the mentally retarded child according to prescribed
quantity and quality of food.
b. Teach the mentally retarded child simple skills related to the
activities of daily living.
c. Apply measures taught to prevent infection in the mentally
retarded member.
Nursing goal: The family will manage malaria as a disease and threat.

SHORT TERM/IMMEDIATE OBJECTIVE

The sick member/s will take the drugs accurately as to dose, frequency,
duration and drug combination. All members will use self-protection
measures at night till early morning when biting time of malaria vector is
expected.

MEDIUM-TERM/INTERMEDIATE OBJECTIVE
All members will have medical check-up and laboratory confirmation
(blood smear) to diagnose malaria.

LONG-TERM OBJECTIVE
All members will carry out mosquito vector control measures
Developing the Intervention Plan

Examples of methods of nurse-family contact:

Home Visit
Clinic or Office Conference
Telephone Conference
Written Communication
School Visit or Conference
Industrial or Job Site Visit
Developing the Intervention Plan

The resources which include:

Materials
supplies, equipment, teaching aids/kits, visual
materials, handouts, charts
Human
other health team members, development
workers, community leaders
Guides to select the appropriate nursing interventions:
1. Analyze with the Family the Current Situation and
Determine Choices and Possibilities based on a Lived
Experience of Meanings and Concerns
2. Develop/Enhance Family's Competencies as Thinker, Doer and
Feeler
3. Focus on Interventions to Help Perform the Health Tasks
4. Catalyze Behavior Change through Motivation and
Support
Guides to select the appropriate nursing interventions:

1. Analyze with the Family the Current Situation and

Determine Choices and Possibilities based on a Lived
Experience of Meanings and Concerns
During this phase, the nurse experiences with the family a
lived meaningful world of mutual, dynamic interchange
of meanings, concerns, perceptions, biases, emotions and
skills.
Guides to select the appropriate nursing interventions:
2. Develop/Enhance Family's Competencies as Thinker, Doer
and Feeler
To determine the appropriateness of nursing
intervention, the nurse is given a choice of possibilities
that helps her and the family gain a clearer
understanding of the self as a thinker, a doer and a
feeler. The choice contributes to a process of self-
understanding of the family as a system and of each
individual member.
Guides to select the appropriate nursing interventions:
3. Focus on Interventions to Help Perform the Health Tasks

A. Help the family recognize the problem.

Increasing the family’s knowledge on the nature, magnitude and cause of the
problem.
Helping the family see the implications of the situation or the consequences
of the condition.
Relating the health needs to the goals of the family.
Encouraging positive or wholesome emotional attitude toward the problem
by affirming the family’s capabilities/qualities/resources and providing
information on available actions.
3. Focus on Interventions to Help Perform the Health
Tasks

B. Guide the family on how to decide on appropriate health

actions to take.
Identifying or exploring with the family courses of action
available and the resources needed for each.
Discussing the consequences of action available.
Analyzing with the family of the consequences of inaction.
3. Focus on Interventions to Help Perform the Health
Tasks

C. Develop the family’s ability and commitment to provide

nursing care to each member.
Contracting-is a creative intervention that can maximize the
opportunities to develop the ability and commitment of the
family to provide nursing care to its members.
3. Focus on Interventions to Help Perform the Health
Tasks

D. Enhance the capability of the family to provide home

environment conducive to health maintenance and personal
development.
The family can be taught specific competencies to ensure such
home environment through environmental manipulation or
management to minimize or eliminate health threats or risks or to
install facilities of nursing care.
3. Focus on Interventions to Help Perform the Health
Tasks

E. Facilitate the family’s capability to utilize community

resources for health care.
Involves maximum use of available resources through the
coordination, collaboration and teamwork provided by
effective referral system.
Guides to select the appropriate nursing interventions:

4. Catalyze Behavior Change Through Motivation and

Support
To bring about self-directed change, people must
learn to learn from their experiences.
Criteria for Selecting the Type of Nurse
Family Contact
1.Effectivity

2. Efficiency

3.Appropriateness
Criteria for Selecting the Type of Nurse Family Contact
Home Visit - is expensive in terms of time, effort, and logistics for
the nurse, it is an effective and appropriate type of family-nurse
contact if the objectives and outcomes of care require accurate
appraisal of family relationships, home and environment, and family
competencies.

Clinic/Office conference - less expensive for the nurse and provides

the opportunity to use equipment that cannot be taken to the home.
Criteria for Selecting the Type of Nurse Family Contact

Telephone Conference - may be effective, efficient and

appropriate if the objectives and outcomes of care require
immediate access to data, given problems on distance or travel
time.

Written Commuication - less time-consuming option for the

nurse in instances when there are a large number of families
needing follow-up on top of problems of distance and travel time.
Criteria for Selecting the Type of Nurse Family Contact
School Visit or Conference- It is done to work with family and
school authorities on how to appraise the degree of vulnerability
of and worked out interventions to help children and adolescence
on specific health risks, hazards or adjustment problems.

Industrial or Job Site Visit - It is done when the nurse and family
need to make an accurate assessment of health risks or hazards
and work with employer or supervisor on what can be done to
improve on provisions for health and safety of workers.
Developing the Evaluation Plan

Specifies how the nurse will determine changes in health

status, condition, or situtaion and achievement of the
outcomes of care (goals and objectives). The plan includes
criteria/indicators, evaluation methods/tools and sources of
evaluation data.