ࡱ> a (bjbj[[ 49bE\9bE\l&&vvv8|>"f**@@@"""""""$$&jA"v&"&&A"&&@@?V"&j&8@v@"&"^ @Puv"l"0","'"' "'v  WA"A""&&&&"'> : YesNoN/ASection I: Nursing DiagnosisA. Is the nursing diagnosis a nursing diagnosis-approved nursing diagnosis?B. Is there an appropriate statement based on the type of NURSING DIAGNOSIS: Is there a two part statement for a Readiness NURSING DIAGNOSIS? Is there a two part statement for a Risk/Potential NURSING DIAGNOSIS? Is there a three part statement for an Actual NURSING DIAGNOSIS?C. Is there an appropriate secondary statement for underlying medical issues/diagnoses? D. Does the etiology cause/contribute to the patient problem? Or, if it is an at risk for nursing diagnosis have sufficient and appropriate risk factors been identified?E. Is the etiology something a nurse can treat/fix? (NOT a medical diagnosis) F. Is there sufficient evidence (subjective and/or objective data) to support the nursing diagnosis? G. Is the evidence consistent with defining characteristics for this nursing diagnosis?H. Are the subjective and/or objective data labeled correctly?I. Is the evidence consistent with the patients Physical & Health Assessment findings? J. Is this the highest priority problem for the patient? Section II: Clinical ReasoningA. Does the clinical reasoning provide rationale for choosing the stated nursing diagnosis?B. Are principles of scientific analysis (hypothesis, cause and effect, etc.) evident in the explanation?C. Has relevant data from the patients assessment, relevant pathophysiology (at the cellular level), and/or relevant psychosocial principles been included in the reasoning?D. Does the Clinical Reasoning accurately depict the chosen nursing diagnosis?E. Is there an explanation of how the etiology (R/T) contributed to or caused the stated nursing diagnosis? Or, if it is an at risk for nursing diagnosis is there an explanation of how the risk factors increase the risk for developing the problem?Section III: OUTCOMES A. Are the outcomes patient focused? B. Are the outcomes related to the NURSING DIAGNOSIS? C. Do the outcomes address all the subjective and objective data?D. Do the outcomes include a time frame?E. Are the outcomes correctly labeled ST or LT? (ST - during dates of care with patient; LT after dates of care) F. Are the outcomes realistic, measurable, and attainable?Section IV: INTERVENTIONS A. Are the interventions nursing actions? B. Are the interventions written clearly? (what, when, how often, how long, where) C. Are the interventions individualized for the patient? D. Are there sufficient interventions to address the patients problems? E. Do the interventions help to meet the stated outcomes? F. Has patient teaching been included?G. Has discharge planning been included? H. Are the interventions complex enough for the current educational level of the student?Section V: RATIONALES A. Is there a scientific rationale provided for each intervention? B. Does the rationale specifically explain how the intervention is therapeutic? C. Has the source been credited for the rationales? Section VI: EVALUATION A. Is there an evaluation of each outcome? B. Does the evaluation include an accurate date? (Reflecting the last time the student cared for pt.)C. Does the evaluation state whether each outcome is met, partially met, or unmet? D. Are there sufficient criteria/indicators to support whether the goal is met or not? E. If the goal is partially met or unmet, does the evaluation indicate: a revised outcome; additional interventions; or continuation of current plan of care? (CPOC)Section VII: COMPLETENESS A. Is the nursing care plan complete? (No missing data/or empty spaces)? B. Is the nursing care plan legible?C. Does the nursing care plan have accurate spelling and proper grammar? ϸ Community College Health Sciences Division - NRSG Nursing Care Plan Evaluation/Guideline      FILENAME \p \* MERGEFORMAT K:\Forms\Nursing Forms\Care Plan Evaluation 2016.doc Name:__________________________________ Date:______________________ CP # ________ Score: ____________________NA =_________ Faculty: __________________________________ Course: _________________________________   *+/2ALM^gy{   % X i k t      X \ h l m ĵĵĵĵsshTHCJOJQJaJhEXh0= CJOJQJaJhQCJOJQJaJhEXhcCJOJQJaJhTfCJOJQJaJhEXh}9&CJOJQJaJhEXhtRCJOJQJaJhTf5CJOJQJaJhhcCJOJQJaJhq-hc5CJOJQJaJ,   .kd$$Ifl\C^*,% t 6P-0644 lap(yt$-&P#$/Ifgds +,-./{mkd$$Ifl**  t 6P- 0644 lap yt$-&P#$/Ifgds{|}~>....$-&P#$/Ifgdskd$$Ifl\C^*,% t 6P-0644 lap(yt l .kdr$$Ifl\C^*,% t 6P-0644 lap(yt$-&P#$/Ifgds  $-&P#$/Ifgdw W$-&P#$/Ifgds     >...$-&P#$/IfgdskdP$$Ifl\C^*,% t 6P-0644 lap(ytm    # & X ' ( , / S ] ˼˼ڀp˼ڞ˼˼ahEXhC)CJOJQJaJhA^9B*CJOJQJaJphhEXhi<CJOJQJaJhEXhO CJOJQJaJhEXh}9&CJOJQJaJhEXhtRCJOJQJaJhhcCJOJQJaJhEXhcCJOJQJaJhTfCJOJQJaJhQCJOJQJaJhTf6CJOJQJaJ  .$-&P#$/Ifgdskd.$$Ifl\C^*,% t 6P-0644 lap(yt$-&P#$/IfgdQ  $-&P#$/IfgdQ$-&P#$/Ifgds ! " # >...$-&P#$/Ifgdskd $$Ifl\C^*,% t 6P-0644 lap(yt# .$-&P#$/Ifgdskd$$Ifl\C^*,% t 6P-0644 lap(yt$-&P#$/IfgdQ .kd$$Ifl\C^*,% t 6P-0644 lap(yt$-&P#$/Ifgds ( ) * .kd$$Ifl\C^*,% t 6P-0644 lap(yt$-&P#$/Ifgds* + , $-&P#$/IfgdQ$-&P#$/Ifgds B C D E ĵxk[ĵOCOh!CJOJQJaJh)\CJOJQJaJhq-hc5CJOJQJaJh)\5CJOJQJaJhq-htR5CJOJQJaJhEXh%ACJOJQJaJhEXhCJOJQJaJhEXh}9&CJOJQJaJhEXhtRCJOJQJaJhhcCJOJQJaJhEXhcCJOJQJaJhEXh2CJOJQJaJhEXhAtuCJOJQJaJ >....$-&P#$/Ifgdskd$$Ifl\C^*,% t 6P-0644 lap(yt <,$-&P#$/IfgdQkdb $$IflF\C^*,% t 6P-0644 lap(ytXtY D }mmm]$-&P#$/Ifgd)\$-&#$/sD $$Ifl**  t 6P- 0644 lap ytD E F G H <,,,$-&P#$/Ifgdskd $$Ifl\C^*,% t 6P-0644 lap(yt!E H O p "#,cdehiku񺫜}n_P_AhXchcCJOJQJaJhXch1HCJOJQJaJhXch)\CJOJQJaJhXchtRCJOJQJaJhhcCJOJQJaJhXch}c5CJOJQJaJhXchXcCJOJQJaJhXch}cCJOJQJaJh}cCJOJQJaJhEXhfJCJOJQJaJhfJhfJ5CJOJQJaJhfJCJOJQJaJhhfJCJOJQJaJH ,$-&P#$/Ifgdskd $$Ifl\C^*,% t 6P-0644 lap(yt!$-&P#$/Ifgd)\ d$-&P#$/Ifgd)\$-&P#$/Ifgdsdefgh<,,,$-&P#$/Ifgdskd $$Ifl\C^*,% t 6P-0644 lap(yt!h,$-&P#$/Ifgdskd $$Ifl\C^*,% t 6P-0644 lap(yt)\$-&P#$/IfgdQ$-&P#$/IfgdQ$-&P#$/Ifgds &zӵvgXI:IghEXhlCJOJQJaJhEXhcCJOJQJaJhEXhtRCJOJQJaJhh CJOJQJaJhq-h+5CJOJQJaJhq-hc5CJOJQJaJhq-htR5CJOJQJaJhXchcCJOJQJaJhXchfJCJOJQJaJhXch)\CJOJQJaJhXchCJOJQJaJhXchXcCJOJQJaJhhcCJOJQJaJ>.$-&P#$/Ifgd9kdt$$Ifl\C^*,% t 6P-0644 lap(yt}mmm]$-&P#$/Ifgd6HD$-&#$/s`$$Ifl**  t 6P- 0644 lap yt>...$-&P#$/Ifgdskd$$Ifl\C^*,% t 6P-0644 lap(yt/01237:wxy}"%?L\]^kDzym]hq-htR5CJOJQJaJhXcCJOJQJaJhEXhgCJOJQJaJhEXhCPCJOJQJaJh6HDCJOJQJaJhhcCJOJQJaJ(hw Wh6B*CJOJQJaJphhEXh[KCJOJQJaJhTfCJOJQJaJhEXhcCJOJQJaJhEXhtRCJOJQJaJ345.$-&P#$/Ifgdskd$$Ifl\C^*,% t 6P-0644 lap(yt$-&P#$/Ifgd6HD567y$-&P#$/Ifgd6HD$-&P#$/Ifgdsyz{|}>....$-&P#$/Ifgdskd$$Ifl\C^*,% t 6P-0644 lap(yt>...$-&P#$/Ifgdskd$$Ifl\C^*,% t 6P-0644 lap(yt .$-&P#$/Ifgdskd$$Ifl\C^*,% t 6P-0644 lap(yt$-&P#$/Ifgd6HD !"]$-&P#$/Ifgd6HD$-&P#$/Ifgds]^z>.$-&P#$/Ifgd6HDkd^$$Ifl\C^*,% t 6P-0644 lap(ytkxyz|}~=>?CFввввp[вLhEXhC)CJOJQJaJ(hEXh\~f6B*CJOJQJaJph(hEXh I6B*CJOJQJaJphhEXh%ACJOJQJaJhEXh+CJOJQJaJhEXhcCJOJQJaJhEXhtRCJOJQJaJhhcCJOJQJaJhhcCJOJQJaJhq-h6HD5CJOJQJaJhq-hc5CJOJQJaJz{|}~}mmm]$-&P#$/Ifgdd>$-&#$/s<$$Ifl**  t 6P- 0644 lap yt>...$-&P#$/Ifgdskd$$Ifl\C^*,% t 6P-0644 lap(yt.$-&P#$/Ifgdskd$$Ifl\C^*,% t 6P-0644 lap(yt$-&P#$/Ifgd?$-&P#$/Ifgd6HD$-&P#$/Ifgds?@ABC>...$-&P#$/Ifgdskd$$Ifl\C^*,% t 6P-0644 lap(ytC.$-&P#$/Ifgdskd~$$Ifl\C^*,% t 6P-0644 lap(yt$-&P#$/Ifgd6HD$-&P#$/Ifgd6HD$-&P#$/Ifgds%&'+ǸǩpaQAhq-hc5CJOJQJaJhq-htR5CJOJQJaJhEXhCJOJQJaJhEXh%ACJOJQJaJhCJOJQJaJhEXhCPCJOJQJaJhEXhC)CJOJQJaJhEXhtRCJOJQJaJhhCPCJOJQJaJhhcCJOJQJaJhEXhcCJOJQJaJhCJOJQJaJhEXh+CJOJQJaJ>...$-&P#$/Ifgdskd\$$Ifl\C^*,% t 6P-0644 lap(yt.$-&P#$/Ifgdskd:$$Ifl\C^*,% t 6P-0644 lap(yt$-&P#$/Ifgd6HD'().kd$$Ifl\C^*,% t 6P-0644 lap(yt$-&P#$/Ifgds)*+.kd$$Ifl\C^*,% t 6P-0644 lap(yt$-&P#$/Ifgds 9:;<=ADtuvwvg[LhEXhO CJOJQJaJhCJOJQJaJhEXhiCJOJQJaJhEXhC)CJOJQJaJhEXhCPCJOJQJaJhEXh\~fCJOJQJaJhEXhSCJOJQJaJhEXhtRCJOJQJaJhhSCJOJQJaJhhcCJOJQJaJhq-hc5CJOJQJaJhq-hD5CJOJQJaJm]]]M$-&P#$/Ifgd\~f$-&#$/s$$Ifl**  t 6P- 0644 lap yt$-&P#$/IfgdQ<,,,$-&P#$/Ifgdskd|$$Ifl\C^*,% t 6P-0644 lap(ytQ=>?.$-&P#$/Ifgdskd^$$Ifl\C^*,% t 6P-0644 lap(yt$-&P#$/IfgdQ?@Av$-&P#$/Ifgd6HD$-&P#$/Ifgdsvw>.$-&#$/Q<$$Ifl\C^*,% t 6P-0644 lap(ytw'*+/2SXvwxl\MhEXhC)CJOJQJaJhEXhS5CJOJQJaJhDCJOJQJaJhEXhCPCJOJQJaJh'G{CJOJQJaJhEXhvCJOJQJaJhEXhSCJOJQJaJhEXhtRCJOJQJaJhhSCJOJQJaJhq-hEX5CJOJQJaJhq-hS5CJOJQJaJhq-htR5CJOJQJaJ}mmm]$-&P#$/Ifgd$-&#$/s( $$Ifl**  t 6P- 0644 lap yt+>....$-&P#$/Ifgdskd $$Ifl\C^*,% t 6P-0644 lap(yt+,-./<,,,$-&P#$/Ifgdskd!$$Ifl\C^*,% t 6P-0644 lap(yti/.$-&P#$/Ifgdskd"$$Ifl\C^*,% t 6P-0644 lap(yt$-&P#$/Ifgd6HD$-&P#$/Ifgd"$-&P#$/Ifgds+/2CDEFGMegjklrⵦ◦◈|p|paUhq-CJOJQJaJhEXhiCJOJQJaJhCJOJQJaJhcCJOJQJaJhEXhCJOJQJaJhEXhCPCJOJQJaJhEXhtRCJOJQJaJhhSCJOJQJaJhEXhvCJOJQJaJhEXhgCJOJQJaJhEXhSCJOJQJaJhEXh"CJOJQJaJ,>....$-&P#$/Ifgdskdn#$$Ifl\C^*,% t 6P-0644 lap(yt,Gl.kdL$$$Ifl\C^*,% t 6P-0644 lap(yt$-&P#$/Ifgds    23457:еЩsgXLhDCJOJQJaJhhQCJOJQJaJhQCJOJQJaJhEXhEXCJOJQJaJhEXhSCJOJQJaJhCJOJQJaJhQCJOJQJaJhTHCJOJQJaJhTHhTHCJOJQJaJhSCJOJQJaJhhSCJOJQJaJhq-hv5CJOJQJaJhq-hS5CJOJQJaJ }mmm]$-&P#$/IfgdTH$-&#$/s*%$$Ifl**  t 6P- 0644 lap yteX    <,,,$-&P#$/Ifgdskd%$$Ifl\C^*,% t 6P-0644 lap(ytEX34567.kd&$$Ifl\C^*,% t 6P-0644 lap(yt$-&P#$/Ifgds7.&$a$gdu7kd'$$Ifl\C^*,% t 6P-0644 lap(yt$-&P#$/Ifgd6HD̽yqmqmqmqmieieieXOXh h CJjh h CJUh]h hDjhDUh)\h] CJOJQJaJ hCPCJ\ h] CJ\h)\CJOJQJaJh'aCJOJQJaJhCPhCJOJQJaJhCPhCPCJOJQJaJ*jhQCJOJQJUaJmHnHuhhQCJOJQJaJhEXhQCJOJQJaJIJKLMNOwdhgdC)  H$0*gd*CJOJQJaJ(h'ah^FF5B*CJOJQJaJph(h'ahx5B*CJOJQJaJph+h'ahs5>*B*CJOJQJaJph(h'ahs5B*CJOJQJaJph+h'ahw W5>*B*CJOJQJaJph21h:pS/ =!"#@$% $$If!vh#v#v#v#v,%:V l t 6P-065555,%/ p(yt$$If!vh#v*:V l  t 6P- 065*p yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v#v#v#v,%:V lF t 6P-065555,%p(ytXtY$$If!vh#v*:V l  t 6P- 065*p yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt!$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt!$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt!$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt)\$$If!vh#v#v#v#v,%:V l t 6P-065555,%/ p(yt$$If!vh#v*:V l  t 6P- 065*p yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v*:V l  t 6P- 065*p yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v*:V l  t 6P- 065*p yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(ytQ$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%/ p(yt$$If!vh#v*:V l  t 6P- 065*p yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yti$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v*:V l  t 6P- 065*p yteX$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(ytEX$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yt$$If!vh#v#v#v#v,%:V l t 6P-065555,%p(yts02 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@_HmH nH sH tH @`@ NormalCJ_HaJmH sH tH DA D Default Paragraph FontRi@R  Table Normal4 l4a (k (No List jj  Table Grid7:V0HH  Balloon TextCJOJQJ^JaJ4@4 cHeader  H$6/!6 c Header CharCJaJ4 @24 c0Footer  H$6/A6 c0 Footer CharCJaJPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭VvnB`2ǃ,!"E3p#9GQd; H xuv 0F[,F᚜K sO'3w #vfSVbsؠyX p5veuw 1z@ l,i!b I jZ2|9L$Z15xl.(zm${d:\@'23œln$^-@^i?D&|#td!6lġB"&63yy@t!HjpU*yeXry3~{s:FXI O5Y[Y!}S˪.7bd|n]671. tn/w/+[t6}PsںsL. J;̊iN $AI)t2 Lmx:(}\-i*xQCJuWl'QyI@ھ m2DBAR4 w¢naQ`ԲɁ W=0#xBdT/.3-F>bYL%׭˓KK 6HhfPQ=h)GBms]_Ԡ'CZѨys v@c])h7Jهic?FS.NP$ e&\Ӏ+I "'%QÕ@c![paAV.9Hd<ӮHVX*%A{Yr Aբ pxSL9":3U5U NC(p%u@;[d`4)]t#9M4W=P5*f̰lk<_X-C wT%Ժ}B% Y,] A̠&oʰŨ; \lc`|,bUvPK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!R%theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK] (( giknm E kw( !'+3;@FLOTVX {    # * D H dh5y ]z?C)?v+/, 7w( "#$%&()*,-./012456789:<=>?ABCDEGHIJKMNPQRSUW/dn8@(  \  # #" `? B S  ?(f+$tX))=*urn:schemas-microsoft-com:office:smarttags PlaceType NO&)r~NOSU{}&)333ceehi? L ^ ^ IJNOSvwz$&)ceehi? L ^ ^ HNOSvz$)eQ%X_^`o(. ^`hH. pL^p`LhH. @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PL^P`LhH.eQ%         tsQ&K0= O N` `v ,%A.PS}c1HXcv}9&>)+&+ -2e 71~7A^9i<d>6!PD9c"lDEX4:ssz'] .ga;q-]N6Y,}xfC)i=cCP u7B[si@ (@UnknownG.Cx Times New Roman5Symbol3. *Cx Arial7.@Calibri5. .[`)TahomaA$BCambria Math"1hHGHG;A_ _ !@24 3QHP ?2!xx Yes AdministratorMichelle Montpas Oh+'0|   , 8 D P\dltYesAdministratorNormalMichelle Montpas2Microsoft Office Word@F#@ufI@u@u_ ՜.+,0 hp  ϸ Community College Yes Title  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXY[\]^_`abcdefghijklmnpqrstuvwxyz{|}~Root Entry FPUuData Zp(1Tableo2'WordDocument 4SummaryInformation(DocumentSummaryInformation8MsoDataStoreuPuWCVLBIPL==2uPuItem  PropertiesUCompObj r   F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q