The nursing process comprises of the assessment, diagnosis, planning, implementation and evaluation steps. Registered nurses follow this process to deliver holistic, quality care to patients.
The first step in the nursing process is assessment. In this step, the nurse uses a systematic way to collect and analyze information about the patient. The information can be either physiological, socio-cultural, economic, spiritual or psychological.
Diagnosis is the second step. It involves analyzing information from the assessment and identifying problems that need nursing intervention. This step also addresses problems resulting from the patient's condition such as anxiety, poor nutrition and family conflicts.
In the planning or outcome step, the nurse sets measurable and achievable goals for the patient. These goals may include maintaining proper nutrition, attending counseling sessions, resolving conflicts, and exercising. The nurse writes these goals in the patient's care plan so that other health professionals can have access.
The fourth step involves implementation of the nursing interventions according to the set goals. It includes prioritizing of the nursing actions to ensure continuity of care for the patient during hospitalization and in preparation for discharge.
Evaluation is the last step in the nursing process. The nurse evaluates the patient's status and the effectiveness of the nursing care, and modifies them accordingly.