What Makes A Good Nursing Intervention?

A nursing intervention is defined by Bulecheck and McCloskey as “any direct care treatment that a nurse performs on behalf of a client”. It is a specific nursing action that addresses a patient’s need. Nursing interventions are identified in the care plan, but can also be performed by nurses spontaneously in some situations.

Now, do all nurses know what specific intervention he or she should make given a particular situation? Ideally yes, this should be the case. But people are different. Some nurses pick a nursing action just because it “feels” like the right thing to do at that moment. Of course, education and prior experience come into play, so this is not purely gut feeling. In contrast, other nurses act because “they have always done it this way”. Which is perfectly alright if they are aware of the reasoning behind an intervention, or downright scary if done arbitrarily.

So, how do we know if a nursing intervention is a good one or not? Here are some pointers for nurses to consider. A nursing intervention must be:

Prioritized

Higher-level needs must be met first before lower-level needs. A nursing intervention prioritizes airway, breathing, circulation over comfort. For example, the patient who has a minor abdominal wound complains of mild pain but is also increasingly breathless. The nurse recognizes which intervention should be done by reassuring the patient and provides oxygenation first. He or she then provides analgesics as prescribed and performs health teaching to minimize discomfort. Nurses should know the patient’s hierarchy of needs which is the basis of interventions.

Safe

For the stable patient, safety is the priority. Nurses take care of patients, not harm them. That is quite obvious, but in the course of rendering care, nurses can inadvertently harm patients because of carelessness and negligence. A nurse assisting the patient in performing range of motion exercises should be careful not to flex those muscles and joints beyond the point of resistance to avoid injuries. Same goes for a nurse applying a warm compress, utmost care must be followed to avoid burning the patient’s skin.

Consistent with Overall Treatment

Nursing care is just one part of the overall care plan jointly created by the physician and all other members of the health care team. If the physician orders the nurse to measure vital signs every 15 minutes, the nurse can’t decide that he or she will do it every hour instead. Similarly, if a walker is used by the physical therapist in the patient’s rehab, then the nurse should also use this equipment in ambulating the patient. A nursing intervention must be in line with the patient outcomes set by the health team.

Realistic

A nursing intervention should consider the patient’s age, capabilities, disease, coping mechanisms and the team’s resources. For a senior suffering from dementia, a video game may be too much, but a game of sudoku might be more appropriate. An overweight patient hooked to many IV lines needs morning care. In this case, a prudent nurse needs to enlist the help of other nurses to move this patient. The nurse must realize that it is not realistic and also unsafe for him or her and the patient to do the task on his own.

Acceptable to the Patient

No intervention is 100 percent reliable without the cooperation of the patient. For instance, the nurse must explain to the patient that frequent turning, coughing exercises, and ambulation will reduce the risk of complications. It is the nurse’s duty to build rapport, elicit cooperation, and make the patient understand that these activities will help recovery. To be truly attainable, nursing interventions must be acceptable to the patient who is the recipient of care.

Nursing interventions are ways on how the nurse delivers direct care to patients. They are outlined in protocol, best practices, or just become “automatic” for experienced nurses.

A nursing intervention must be prioritized, safe, consistent, realistic and acceptable to the patient. These qualities will ensure that the nurse will perform the most effective nursing intervention.

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