UNIVERSITY OF SOUTH ALABAMA

COLLEGE OF NURSING Student Name: _________________

ADULT HEALTH NURSING
NURSING PLAN OF CARE Date: _________________

ASSESSEMENTS NURSING DIAGNOSIS NURSING INTERVENTIONS EVIDENCE SUPPORTING IMPLEMENTATION EVALUATION

(Subjective/Objective Data NANDA diagnosis? Related Administering, demonstrating and PRACTICE (Rationale) Explain how interventions State outcome achievement in
pertinent to this nursing factors noted? Evidence if an performing treatments, & teachings (Cite source: Author & Page #) were met or explain why behavioral terms. Note: Continue ,
diagnosis) “actual” problem? pertinent to diagnosis) List full reference separately. they were not. Change (specify), Discontinue POC

Subjective: Ongoing Assessments: Evaluate achievement of patients

goals and objectives:

Objective:
OUTCOME STATEMENTS
Measurable? Realistic? Time Evaluate the effectiveness of each
Prioritized Interventions: intervention:
element noted? Pertinent to
diagnosis?

Identify indicated changes to the

POC: (May write on the back of
this page)

List a minimum of two references to indicate interventions are derived from and supported by evidence-based practice. References are to be documented in APA format.