Fundamentals · chapter 14 · Implementation and Evaluation: Taking Action, Evaluating Outcomes, and Documentation
Types of Interventions
The 14 things this section of the textbook says that you are most likely to be asked about — quoted word for word, not retold. Then 6 practice questions with the reasoning.
Key points
Implementation care categories
During the implementation phase of patient care, different categories of interventions are used to address the patient’s needs effectively.
Direct care purpose
This type of care is a key component of the implementation phase, as it allows nurses to assess patients’ conditions firsthand, respond to their needs, and provide immediate comfort and support.
Therapeutic relationship elements
These interactions are essential for the physical aspects of patient care and building rapport and trust—two essential elements in the therapeutic relationship between a nurse and a patient.
Indirect care coordination
This type of care is crucial for the successful implementation of a patient’s care plan, and it requires organizing, managing, and coordinating healthcare services.
Age-based care adaptation
Both direct and indirect nursing care needs to be adapted according to the age of the patient to ensure it is appropriate and effective.
Intervention type categories
These interventions are categorized as dependent, independent, or interdependent. Each type of intervention plays a distinct role in promoting patient well-being and facilitating recovery.
Interventions and health problems
Healthcare providers design interventions to solve or reduce the risk of health problems.
Prioritization frameworks
Nurses often utilize tools such as the ABC framework (airway, breathing, circulation) and Maslow’s hierarchy of needs to determine the order of their interventions.
Life-threatening priorities
These frameworks remind nurses to address life-threatening problems first, then basic needs next, before proceeding to less critical issues.
Breathing before mobility
For instance, if a patient is experiencing breathing difficulties and has a long-term mobility issue, the nurse should address the breathing problem first, as it poses an immediate risk to the patient’s life.
Patient safety implementation
Ensuring patient safety is a primary concern during the implementation phase and is integral to prioritizing nursing interventions.
Assessing safety threats
Nurses continually assess potential threats to patient safety, such as fall risks, medication errors, or complications from immobility.
Delegation limits
Nurses delegate tasks to manage time effectively and ensure patient care is delivered efficiently. However, not every task can be delegated, and not every staff member can accept a request for delegation.
Scope and delegation
It dictates what nurses are legally permitted to do and informs which tasks can be delegated to other team members.
Terms to know
- Medical interventions
- Medical interventions are treatments and procedures that are performed by healthcare providers, such as administering medications or conducting diagnostic tests.
- Nursing interventions
- Nursing interventions encompass a broad range of actions that are performed by nurses to meet their patients’ physical, emotional, and psychosocial needs.
- direct care
- Interventions that involve personal contact or interaction with patients, whether in person, over the phone, or digitally, are known as direct care.
- indirect care
- Tasks and interventions that are performed away from the patient but are still vital to their overall care are called indirect care.
- Delegation in nursing
- Delegation in nursing is a crucial skill involving the transfer of responsibility for certain tasks while retaining accountability for the outcome.
- nursing scope of practice
- As discussed in Scope of Practice, the nursing scope of practice refers to the defined limits and parameters within which nurses are authorized to work, make decisions, and provide services.
Practice questions
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Every question here, with the answer
A nurse is caring for a patient who has breathing difficulty and a long-term mobility problem. Which intervention should the nurse perform first?
- Begin interventions to improve the patient’s mobility.
- Start discharge planning for home health services.
- Address the patient’s breathing problem.
- Teach the patient long-term strategies for preventing immobility complications.
Answer: Address the patient’s breathing problem.
The nurse should prioritize the breathing problem because it poses an immediate risk to life. Mobility and teaching are important, but they should be addressed after the patient is stabilized.
A nurse is identifying which planned activities are direct care interventions. Select all that apply.
- Documenting the patient’s response to care away from the bedside
- Administering medications to the patient
- Performing a physical assessment at the bedside
- Arranging a referral for follow-up care
- Assisting the patient with daily living activities
Answer: Administering medications to the patient, Performing a physical assessment at the bedside, Assisting the patient with daily living activities
Direct care involves personal contact or interaction with the patient. Documentation and arranging referrals are important but are examples of indirect care because they are performed away from the patient.
A nurse is reviewing several planned interventions. Which action should the nurse identify as a dependent intervention?
- Administering a medication prescribed by the healthcare provider
- Assisting a patient with activities of daily living
- Providing emotional support to a patient who is anxious
- Participating in interdisciplinary rounds to discuss patient progress
Answer: Administering a medication prescribed by the healthcare provider
A dependent intervention is carried out under the order or direction of a healthcare provider, such as administering prescribed medications. Emotional support and assisting with ADLs are independent interventions, while interdisciplinary rounds are interdependent.
A registered nurse is delegating care for stable patients to a certified nursing assistant (CNA). Which tasks are appropriate to delegate to the CNA? Select all that apply.
- Assisting with activities of daily living
- Monitoring routine vital signs
- Collecting specimens
- Performing an initial health assessment
- Creating and implementing a care plan
Answer: Assisting with activities of daily living, Monitoring routine vital signs, Collecting specimens
The section identifies vital signs monitoring, assisting with ADLs, and collecting specimens as tasks that may be delegated to a CNA. Initial health assessments and creating care plans require advanced clinical judgment and should be reserved for RNs.
A patient with limited mobility has no current skin breakdown. Which intervention best matches the focus for this patient problem?
- Treat the patient for an existing pressure ulcer.
- Implement regular repositioning and pressure-relieving devices.
- Collaborate with a dietitian, endocrinologist, and diabetes educator.
- Delay interventions until pressure ulcers become visible.
Answer: Implement regular repositioning and pressure-relieving devices.
Limited mobility places the patient at risk for pressure ulcers, so the focus is prevention before the problem becomes actual. Treating an existing ulcer would apply to an actual problem, and diabetes team management is an example of a collaborative problem.
A nurse is planning care for an older adult patient. Which interventions reflect age-appropriate direct or indirect care for this life stage? Select all that apply.
- Using play therapy to complete assessments
- Addressing mobility issues during direct care
- Coordinating with school officials to support return to school
- Considering home safety assessments and support systems
- Working with multidisciplinary teams to coordinate care
Answer: Addressing mobility issues during direct care, Considering home safety assessments and support systems, Working with multidisciplinary teams to coordinate care
Care for older adults often includes addressing mobility issues and coordinating with multidisciplinary teams. Home safety assessments and support systems are also emphasized for a safe living environment; play therapy and school collaboration are described for pediatric patients.
Where every quote comes from
Section 14.2 Types of Interventions of Fundamentals of Nursing by Christy Bowen, Lindsay Draper, Heather Moore, OpenStax, 2024. Read the whole section free at openstax.org.
The textbook is licensed under CC BY-NC-SA 4.0. This page quotes it word for word and adds the headings, the order and the practice questions; references to the book's figures and stray spaces left by its formatting are removed. The page is shared under the same licence. Nothing here is sold.