Five Stages of The Nursing Process

ADPIE – The Five Stages of The Nursing Process

ADPIE is an acronym that stands for assessment, diagnosis, planning, implementation, and evaluation.

 

 

The ADPIE process helps medical professionals remember the process and order of the steps they need to take to provide proper care for the individuals they are treating. This process is important as it provides a useful and throughout framework for patient care. It also helps medical professionals develop critical thinking and problem-solving skills. By following the ADPIE process, medical professionals can improve their work efficiency and promptly develop more accurate decisions.

Process Overview

The purpose of ADPIE is to help improve an individual’s mental, emotional, and/or physical health through analysis, diagnosis, and treatment. The ADPIE process allows medical professionals to identify potential problems, develop solutions, and monitor the results individually. If the process does not improve the individual’s condition, the process must be re-evaluated, adjusted, and corrected. Here is an explanation detailing each step of the process:

Assessment

Assessment is the first step of the ADPIE process. During the assessment phase, medical professionals will attempt to identify the problem and establish a database. This is accomplished by interviewing the individual and/or family members, observing their behaviour, and performing examinations.

This step focuses heavily on collecting/recording data, validating information, and listing any abnormalities in the data. Assessment data can be collecting in one of two ways, subjective or objective. Subjective data is data that cannot be measured directly.

This can include verbal information such as asking questions, obtaining verbal feedback, interviewing other individuals, and collecting/gathering information on a patient’s health history. Subjective data is frequently referred to as symptomatic as it cannot be measured or observed directly.

Objective data is data that is measurable and can be seen, heard, felt, or smelt. This can include performing an examination to measure a patient’s weight, blood pressure, heart rate, and body temperature. Because objective data is measurable, it is often referred to as signs. It is important to gather as much data as possible during the assessment phase.

While gathering data Identify if the data is accurate, concise, consistent, and clear. Once you have gathered enough accurate data, you can form a conclusion about the patient’s condition. After that, move on to the next phase of the ADPIE process, which is diagnosis.

Diagnosis

The process’s diagnosis phase is where the medical professional develops a theory or hypothesis about the individual’s situation based on the information collected while performing an assessment. Although registered nurses cannot form a professional diagnosis, they can develop critical thinking and communicate their clinical judgments to their team members.

Nurses have a standardized language for communicating their clinical judgments, which comes from NANDA international. With that said, certified nurse practitioners can diagnose medical conditions and act as primary care providers for their patients.

Examples of Medical Language Nurses Use Include:

Activity intolerance

Anxiety

Constipation

Decreased cardiac output

Fluid volume deficit

Hypothermia

Sleep deficit

The diagnostic process allows medical professionals to decide about the individual they are treating. That determination forms an opinion on whether the patient is dealing with a physiological, mental, or emotional condition. And while nurses cannot give a professional diagnosis, they can identify actual or potential medical /health risks. After a diagnosis is performed, risks that can cause complications or harm must be placed in order.

The order must be organized with the highest risk listed as the top priority (life-threatening). Following that, lower risks must be labelled in descending order on the list (non-life-threatening/minor/future well-being). As problems are identified and corrected, new problems/priorities will need to be addressed. Therefore, nurses must perform assessments regularly to ensure the problem is being properly approached. After the problems have been identified and prioritized, the next phase of the process is planning.

Planning

Planning is the process of developing a plan and establishing SMART goals to achieve the desired outcome. For example, reducing a patient’s pain or improving cardiovascular function. SMART goals stand for specific, measurable, attainable, realistic/relevant, and time-restricted. SMART goals provide the individual with a focused set of activities designed to improve their condition. They also provide medical professionals with a plan to measure and evaluate the individual’s improvements.

Goals may be short-term or long-term, singular in nature, and focus on the individual outcome. Upon developing smart goals, the medical professional should determine whether the goals are a good fit for the individual. They must also make sure that the SMART goals are easily attainable.

In addition to creating SMART goals, a care plan and intervention strategies must be developed and communicated to the team. This will help maximize the success of the goals. The care plan involves the steps and strategies needed to achieve the desired goal. Along with the care plan, the development of intervention strategies keeps the individual on track.

The care plan and intervention strategies are communicated to the individual and/or medical team can be performed directly by a medical team member as part of the treatment. After the care plan, interventions, and SMART goals have been established; they must be implemented.

Implementation

The implementation phase is the actionable part of the process. This is where the individual and medical team implement the care plan, SMART goals, and interventions to achieve their goals.

Consequently, this process can be evaluated and measured. The implementation phase may be performed using a combination of direct care and indirect care.

Direct care is care that is given directly to the patient in either a physical or verbal manner. Direct care includes assisting the patient with mobility, performing physical care, range of motion exercises, and assisting with daily living activities.

It may also include coaching, counselling, and providing feedback to the individual. Indirect care involves care that is given while away from the patient. Indirect care may include monitoring/supervising the medical staff, delegating responsibilities, and advocating on behalf of the individuals you care for.

While implementing the care plan, the medical professional needs to use critical judgment and question procedures in the care plan to ensure that they appropriately meet the demands and concerns of the individuals receiving the care. Steps or procedures that appear inappropriate, non-actionable, or questionable should be questioned and re-evaluated with the medical staff. Moreover, it should be communicated with the individual receiving the care plan to ensure it is safe and aligns with the medical teams/individuals’ goals.

Evaluation

The last phase of the process is the evaluation phase. This is where the medical professionals assess and evaluate the success of the planning and implementation processes. This phase ensures that the individual is making progress towards his/her goals and is achieving the desired outcome.

Healthcare professionals must evaluate if the process is working and identify what brings the individual closer to his/her goals. If the process is not working, reassess it and determine whether it needs to be modifying or eliminated. Evaluations should be performed throughout the ADPIE process regularly to assess the plan and adjust when needed. By performing regular evaluations, medical professionals can determine the appropriate course of action, identify potential errors, and ensure that the process works as smoothly as possible (ADPIE – The Five Stages of The Nursing Process – Nurse Theory, 2021).

ADPIE recap

The ADPIE process assists medical professionals in identifying and addressing potential medical concerns. By implementing the process, medical professionals can assess the patient’s condition and ensure they receive adequate care.

The assessment process begins through the collection of subjective and objective data. This data allows medical to develop a diagnosis based on the information that has been collected.

With the diagnosis, nurses can create a plan with interventions and SMART goals for the patient to follow. The process is then implemented into action to achieve the goals of the plan. During and after implementation, the process is evaluated to ensure the individual achieves their goals.

ADPIE is an excellent way to improve the critical thinking process and create, evaluate, and revaluate procedures to be implemented and modified until the desired outcome is achieved.

What Are The Five Stages of The Nursing Process?

The five stages of the nursing process are assessment, diagnosis, planning, implementation, and evaluation. In other words, the five stages of the nursing process are ADPIE, which I explained earlier in this article.

These 5 stages are followed in specific order to ensure proper patient care from the beginning of treatment until the end. Consequently, it allows nurses to utilize a systematic approach to observing, analysing, taking action, and re-evaluating goals, strategies, and outcomes. Overall this helps nurses perform their best and account for potential mistakes and errors throughout patient treatment.

The ADPIE nursing process is an essential component of clinical care. It breaks improves critical thinking and decision making by breaking down processes into simplified and organized steps. Each concurrent step builds upon the previous one throughout the process until a sufficient approach is developed and implemented.

With that said, many nurses lack experience in the application of the ADPIE nursing process. This is partially the result of a shortage of valuable information/resources and busy work schedules making it difficult to implement.

However, new processes are continually developing, allowing current/future nurses to incorporate these processes into their daily work. Without processes such as ADPIE and many others, nurses would have greater difficulty approaching complex patient care scenarios. And although I mention that ADPIE is not well known among many nurses, there are plenty of well-known and implemented processes.

 

Reference:

Nurse Theory. 2021. ADPIE – The Five Stages of The Nursing Process – Nurse Theory. [online] Available at: <https://www.nursetheory.com/adpie/> [Accessed 18 October 2021].