Sample Care Plan Template Page 50

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Evaluation of outcome(s):
1. The outcome was met the nurse turned the patient q2hrs during the nursing shift and the patient did not develop any new areas of
skin breakdown during the shift.
2. The outcome was met the nurse elevated the necessity of the 2-point soft restraints on the UE q2hrs. The restraints were deemed
necessary because of patient’s sedation agitation and pulling of lines. Nurse documented on restraints q2hrs on whether or not
affecting circulation or causing skin breakdown. No new issues related to skin were noted due to the restraints.
3. The outcome was met the nurse performed the daily cares qshift and cleaned up moisture PRN and there was no new areas of skin
breakdown during the shift.
Reference for rationales:
Ackley, B. J., & Ladwig, G. B. (2011). Nursing diagnosis handbook: An evidence-based guide to planning care (9th ed.). St. Louis,
MO: Mosby Elsevier.
Magnan, M.A., & Maklebust, J. (2009). The nursing process and pressure ulcer prevention: making the connection. Advanced Skin
Wound Care 22(2):83-91. Retrieved on February 23, 2013, from
844646.
National Pressure Ulcer Advisory Panel (NPUAP). (2009). The new international guideline consensus on implementation, 11th
Annual Biennial Conference. Washington, DC: NPUAP. Retrieved on February 23, 2013, from
F:\group\MEPN\MEPN Level III\NURS610B\2013NURS 610B\610BCarePlan
12/17/2012
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