Planning care: priorities, measurable goals and interventions
- Fundamental
Planning means deciding which problem comes first, what result you want and what the team will do to get there.
What it is
Planning is the third phase of the nursing process. First the diagnoses are ranked, using Maslow's hierarchy and the ABCs (airway, breathing and circulation): acute, uncompensated problems before chronic ones, and actual problems generally before risks, unless the risk is high. Then each problem gets a patient-centred expected outcome that is specific, measurable, attainable, relevant and time-bound (SMART). Finally, evidence-based interventions are chosen: independent, dependent or collaborative with the team. The plan is written down, shared with the patient and family, and revised when the situation changes.
Key points
- Maslow's hierarchy helps rank needs: physiological and safety needs first.
- The goal's time frame is set by the nurse, the team and, when possible, the patient.
- The plan is modified whenever ongoing assessment shows a change in the patient.
- Institutions use standardised care plans, which the nurse adapts to each patient.
Components
- A prioritised nursing diagnosis.
- An expected outcome with a measurable criterion and a time frame.
- Concrete interventions: what, when, how often and who.
- The reason for each intervention: which related factor it targets.
- Space for evaluation and the review date.
What it is for
- It points the whole team toward the same results.
- It keeps care continuous between shifts.
- It makes it possible to evaluate later whether care worked.
Types of nursing intervention
| Type | Who initiates it | Examples |
|---|---|---|
| Independent | The nurse, without a prescription | Repositioning, watching intake and output trends, therapeutic communication to cope with a new diagnosis |
| Dependent | A prescription | Giving a prescribed medication on schedule |
| Collaborative | Several disciplines of the team | Consulting the respiratory therapist about oxygen therapy; working with physiotherapy, occupational therapy or social work |
In nursing practice
- A badly written goal: «improve mobility». Better: «the patient walks to the bathroom with one person's help by day 3».
- If the patient's goal is not realistic, a smaller, achievable goal is agreed with them.
- Discharge needs are planned with the patient, the family and the team, for example with social work.
Common mistakes
- Goals that cannot be measured or have no time frame.
- Goals written as nurse tasks instead of patient outcomes.
- Dealing first with a chronic problem and leaving an acute, uncompensated one for later.
- Leaving the patient and family out of goal setting.
- Not updating the plan when the patient's condition changes.
Test yourself
Think of the answer, then tap the question to see it.
What does it mean for a goal to be SMART?
It is specific, measurable, attainable, relevant and has a defined time frame.
Which comes first, an actual problem or a risk?
In general, the actual problem, unless the risk is high; airway, breathing and circulation are weighed first.
What type of intervention is giving a prescribed medication?
Dependent: the nurse does it on a medical order, while assessing and monitoring with their own judgment.
Who should take part in setting the goals?
The patient and, when feasible, the family, with the nurse and the team; this makes the goals more realistic and motivating.
Connections
Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.
Sources: Nursing Fundamentals (Open RN), 4.4 Diagnosis (Open RN, Chippewa Valley Technical College (LibreTexts), 2022); Nursing Fundamentals (Open RN), 4.5 Outcome Identification (Open RN, Chippewa Valley Technical College (LibreTexts), 2022); Nursing Fundamentals (Open RN), 4.6 Planning (Open RN, Chippewa Valley Technical College (LibreTexts), 2022).
Spotted a mistake?We are always improving for the community. Tell us what is wrong and our team will review it.Report a mistake
Representative model, for educational purposes only.