Nursing Care Plans

Nursing care plans are used by professional care providers for hospital stays, nursing home care, where skilled nursing is needed, and for home care services. If you will be the home care provider, you can help construct a plan using criteria developed by the North American Nursing Diagnosis Association (NANDA).

Knowing what a plan entails will help you decide if any of the services can be handled by family or if they must be contracted out to a licensed professional or other provider.

For example, there is a plan for “Impaired Home Maintenance Management,” i.e., your parent is not keeping up with personal hygiene, household chores, nutrition, etc., even though he believes he is still independent.

Assess the Problem

Each plan starts with a comprehensive assessment. The information will come from:

1. the observations of family and friends (referred to as “signs” of a problem or disorder);
2. complaints or statements from the “patient” (called “symptoms”);
3. the patient’s medical and social history;
4. the observations and testing by one or more professionals.

In constructing a nursing care plan for a member of your family, you may have information from family members, a visiting nurse who had cared for the patient after an injury, a social worker at the assisted living center where the patient lives, and the opinions and observations of the patient’s primary care physician and neurologist.

Set Attainable Goals

From the assessment a list is made of any medical diagnoses and the daily challenges confronting the patient, family or relationship problems, and existing strengths and supports. If you are conducting this process yourself without input from health professionals, this is a good time to consult with the patient’s primary care provider, who can help you interpret the information you have gathered and provide direction for next steps.

With your “challenges and strengths” list in hand, ask whether each problem area can improve. If so, then set a reasonable time to work on improvement, and assess whether improvement has been made at the end of this time period. It is important that this improvement be:

A Case Example

In one family, the patient had diminished use of one arm from nerve damage suffered in a fall. Many daily activities were affected, such as balance, eating, cooking, personal hygiene, and dressing. The initial plan including neurological testing, physical therapy and daily activity support provided mostly by a family member but occasionally by a nurse aid.

Since nerves heal very slowly, the first goals were to keep the injured arm’s muscles from “freezing up” during this slow process, and to help the patient in her daily activities. The interventions (therapy and home help) were measured by the therapist and the home help providers, and the expected outcome was evaluated each week to see if it was still reasonably attainable. This process helped everyone stay motivated toward a specific goal, and gave objective ways to measure how it was working.

If the challenge or problem presented is not going to improve, then your care plan can focus on preventing it from becoming worse. Again, specific, measurable and attainable goals are set.

Unfortunately for patient in our example, the nerve damage did not heal and so the goals shifted to maintaining lifestyle supports. The family care giver, realizing that he could not maintain his previous high level of care permanently, arranged for more nursing aid assistance. Our patient began using a cane and bath modifications were planned to accommodate the disability.

Sample nursing care plans will give you an idea how a simple plan may look. Printable plans are available for you to use.

Free nursing care plans for many conditions are available online. For these, a template is supplied with check boxes to guide you in completing a plan.

Nursing care plans are useful organizational and brainstorming tools. They are not a substitute for professional advice and judgment. Please consult a physician or other professional where the health or safety of a loved one is concerned.

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