Elements Of The Nursing Process – ADPIE

What Is ADPIE? 

ADPIE is an acronym used to describe the five different phases of the nursing process. These five phases are Assessment, Diagnosis, Planning, Implementation/Intervention, and Evaluation. These five phases provide the framework of nursing care with goal and patient oriented care. 

Standardized Process​ Of ADPIE

ADPIE has turned into a standardized process​ that was created with the intent to improve a patient's condition and health through proper analysis and treatment. This process has allowed health professionals to discover current and potential medical issues, create patient-oriented care plans, and closely analyze the results. 

The process is repeated or adjusted if the patient shows no signs of improvement over a designated period of time. Adjustments will be made using ADPIE to identify the issue and help the patient. 

Assessment 

This phase of ADPIE is the nursing assessment. This is the first part in trying to identify the problem with the patient. This is a holistic assessment of the patient. The nurse gathers as much information as possible. 

This examination from the nurse will attempt to analyze the physiological, psychological, and emotional status. The nurse records all of this information in the patient's medical records. This is so any other nurse or medical staff can see the information and carry on with treatment. 

The nurse will interview the patient and the family, analyze patient and family medical history, and observe patient behavior.

The examination consists of objective and subjective data as well. Subjective data is data that cannot be quantified. Meaning there is no universal metric it can be measured on.

The gatherer or reader of the information has to choose how interpret the data. This can lead to medical staff having different opinions on a piece of data because it can be interpreted differently by different people. 

Subjective data includes verbal or written interviews, verbal feedback, and patient and family health history. These things cannot be observed directly and have no formal metric of which they can be measured on.

Objective data is the complete opposite of subjective data. Objective information can be measured directly. This type of data can be observed, heard, seen, or smelt. There is no dispute over what the data means.

Data like body weight, heart rate, and eye sight are objective data. They are easily quantifiable and there is little dispute over what the metric means.  

During the assessment phase, the nurse gathers as much subjective and objective data as possible. Once the data is gathered and interpreted to determine a conclusion about the patient's health, you can move on to the next phase.  

​Diagnosis 

​This is the professional and clinical judgement of the patient's current or potential health problem. This is based on data gathered during the nursing assessment.

When the nurse can clearly interlink symptoms, characteristics, related factors; her judgement about the patient's condition will be validated.

However, different nurses and medical staff can still have different opinions. Remember that a medical diagnoses identifies a disorder within the patient.

A nursing diagnoses identifies other health problems that arise from the disorder (that was originally diagnosed by the doctor). 

Nurses use standardized diagnoses when communicating their clinical judgments about their patients. An example of a nursing diagnoses is activity intolerance.

This is an issue that results because of a serious illness or chronic condition (like cancer or congestive heart failure).    

Other Nursing Diagnoses Include:
   - Sleep Deficiency
   - Constipation
   - Chronic Pain
   - Anxiety
   - Hypothermia
   - Relocation Syndrome
   - Risk For Shock

There are four different types of nursing diagnoses. They are the following:
   - Actual Diagnosis - This is professional and medical judgment about human experience/      and responses to health conditions and life processes that exist in the patient. Like                  Sleep Deprivation.

   - Risk Diagnosis -  Details human response to health processes that may develop and        
      make the patient more vulnerable. Like "at risk for shock or hypertension".

   - Health Promotion Diagnosis - A professional determination about the patient's desire         and motivation to get better and work through the hardships of recovery.

   - Syndrome Diagnosis - A medical and clinical judgement about a series of nursing                      diagnoses that happen together or over a very small period of time. Therefore, they are      addressed together using care plans, treatments, and interventions. 

​Planning

​This is also known as the outcome phase in the nursing and medical community. This is the phase where a nursing care plan built. The nurse and the patient come to an agreement on the diagnoses and begin treatment. The nurse creates a treatment and action plan for the patient. The assessment, diagnoses, and goals are all written in the nurse care plan.

The nurse and patient are on a set of short and long term goals that have the sole purpose of improving the patients condition. The development of the plan is based on the goals summarized by another medical process. The nursing community uses the acronym called SMART to address this plan.

SMART stands for specific, measurable, attainable, realistic and time restricted goals. This gives the patient a specific set of goals and actions meant to improve their mental, emotional, and physical state over a certain span of time. 

Intervention activities are created and communicated to the medical staff and the patient. These strategies are meant to keep the patient on course for a full recovery. They are meant to address any factors that hurt the patient's path to recovery and full health. They are always performed by medical staff. 

To this section up, the planning phase of ADPIE is all about setting realistic goals, planning out patient specific treatment to be given by the medical staff, setting up activities for the patient to do that are related to recovery, and intervention procedures to address risk ensure the patient stays on the road to recovery.  

Implementation 

This is the phase of the nursing process where the nurse actually implements the care plan on the patient. The medical staff performs the interventions and treatment necessary to meet the goals and outcomes for the patient. 

The nurses may choose to give care directly to the patient. They do this by physically providing treatment. Or they can choose to indirectly provide the care. This could consist of supervising or monitoring the patient and/or activities for the patient to do on their own.  

Parts of the care plan that do not make sense for the patient or prove to be ineffective in improving his/her condition will be reevaluated. These parts of the care plan will be adjusted to continue to help patient improve his/her condition. 

​Evaluation 

​This is the final phase of ADPIE and nursing process. Although this is the final phase, this might be the most important aspect of the process. Here is why. The nurse evaluates the goals and outcomes of the treatment and interventions that have been given to the patient. 

If the recovery process is slower than expected or if the patient has regressed then the nurse must adjust the care plan.

If new issues are discovered then nursing process starts all over again. However, if the goals are achieved successfully then treatment for the patient is no longer needed. 

It is important that the nurse perform patient evaluations regularly throughout this process. This allows for the medical staff to make changes as they go.

More importantly, the medical staff does not waste valuable time and effort on useless treatment. They will be able to make the changes necessary to ensure patient recovery.  

Conclusion

​Remember that ADPIE is an acronym for the most important phases of the nursing process.

ADPIE stands for Assessment, Diagnoses, Planning, Implementation, and Evaluation.

This means to collect data, draw a clinical judgement about the patient's condition, using SMART goals to map a plan to recovery, implement that plan for the patient, and evaluate the results to see if they are meeting the planned outcome.

This is a systemic process and scientific method that is meant to discover current and potential problems for the patient. 

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