If you think you can get away with nursing school without mastering the ADPIE, you’re absolutely wrong. How important is ADPIE? Think of it as the foundation of every nursing intervention.
It’s not a one-time thing, and you do it every day. It is a continuous process even after patient discharge. Breathe it, live by it, and be the best nurse.
In this post, we aim to discuss the ADPIE Nursing process, its importance, and how to conduct it like a pro. Gain confidence and never miss out on a detail ever again. We hope this cheat sheet will guide you throughout your nursing career.
ADPIE: Importance of Individualized Patient Care
So what does the acronym ADPIE mean? Easy!
Assessment, Diagnosis, Planning, Implementation, and Evaluation.
Some use ADOPIE:
Assessment, Diagnosis, Outcome Identification, Planning, Implementation, and Evaluation.
In this case, we will use ADOPIE for a more accurate nursing process.
- Individualized and complete patient care.
- To identify existing and potential problems.
- Develop nursing interventions for proper care.
- Evaluate if goals are met.
- To come up with an individualized nursing intervention.
- The step-by-step process and never miss out on an important detail.
- Time-efficient, so you won’t keep on circling back on the tasks that need to be done.
- Improve the problem-solving and critical thinking skills of nurses.
- Develop accurate decisions for the patient’s treatment.
- Holistic Patient Care: Physical, Mental, Emotional, Spiritual Wellness.
Why is it important to come up with individualized patient care? Can’t you just copy from a patient with a similar case? NO! Consider each patient as a different case. They may be of the same age, height, gender, and diagnosis, but their body is not the same.
What works for one patient might not work for another. They all present different symptoms, have different allergic reactions, or different religious beliefs. How will you know all of these? Step 1 of the ADPIE: Assessment.
Now we proceed with the first step of the nursing process. Assessment is defined in simple terms as data collection. Gather as much information as you can, even if they are not relevant to the pre-existing condition.
Sometimes, an illness ten years ago can affect the treatment of the patient today. A missed detail may lead to a misdiagnosed disease. Worse, the wrong treatment may be prescribed to the patient.
The nurses are the frontliners in gathering these information from the patients. Doctors can get too busy; and they trust in the information the nurse gathered.
- Complete Physical Assessment
- Vital Signs
- Patient’s History
- Objective and Subjective Data
- Definition: What can be seen and touched
- Example: A lump in the breast, discoloration of nails, jaundice, high blood pressure
- Nurse Responsibility: Conduct a head to toe physical assessment
- Definition: Cannot be seen by the eyes; only felt by the patient
- Example: Stomach ache, Headache, nausea, emotions
- Nurse Responsibility: Figure out what the patient feels. Especially if the patient has difficulty in expressing themselves in words.
During critical thinking, a good nurse must ask himself/ herself these questions;
- Are the signs and symptoms pointing to one cause? Or does it have multiple causes?
- What is the other information I need to gather to know the cause?
- Did I forget anything or forgot to do something?
Once the nurse is confident that enough information was gathered during the assessment, proceed to Step 2: Diagnosis.
With the information gathered during the assessment, figure out what is wrong with the patient. List down actual and potential health risks that may arise.
This is everyone’s favorite, and every nurse must master it—the Nursing Diagnosis by the North American Nursing Diagnosis Association (NANDA).
Only choose the nursing diagnosis relevant to your patient’s case. Do not include “Hyperthermia related to infection” to a patient that is afebrile and has no infection.
It is also important to remember that life-threatening risks must take precedence ALWAYS. Do not prioritize “Self Care Deficit” over “Ineffective Airway Clearance.” The patient’s physiological state must be stable before discussing non-life threatening matters.
Once again, this is not a one-time thing. ADPIE is a continuous process and must be performed regularly.
After identifying the problems, prioritizing Outcome Identification and Planning comes next.
3. Outcome Identification
Outcome Identification requires identifying goals using the SMART Framework.
S – Specific
M – Measurable
A – Accurate
R – Realistic
An example of a non-SMART Framework: Relief of Pain.
An example of a SMART Framework: After 8 hours of nursing intervention, the patient will report pain levels are relieved or at least reduced.
This is where the nurse must help the patient reach their goals. The planning phase is what the nurse implements, while the Outcome Identification step defines the goals set for the patient.
A good nurse must be able to answer these questions, to have a systematic planning strategy:
- What is the game plan for achieving the patient’s goals?
- What are the treatment, interventions, procedures that need to be done?
- Are there other members of the medical team who need to be involved?
- Are there any other resources needed? Are they readily available?
- What are the doctor’s orders that I need to do?
- How can the family and support system get involved in the process?
This is where all the actions take place. The nurse and the patient need to follow through the outcome identification and planning results.
Implementation includes all nursing interventions, actual actions, and patient education. In the implementation process, it is crucial to question inappropriate care for the patient.
Like when a doctor transcribed a questionable procedure. It is the responsibility of the nurse to raise the concern with the medical team. This is to ensure that proper care is delivered to the patient.
The nurse needs to evaluate if the patient’s goals have been met or not. It is also in the best judgment of the nurse to see what needs to be changed for future improvements.
This is the reassessment of the nursing care plan. A good nurse will be able to answer these questions:
- What is the patient’s progress?
- Were the short-term and long-term goals met?
- Are there new goals?
The bottom line, to easily remember the ADPIE Nursing process, keep this in mind:
|DIAGNOSIS||Figure out what is happening to the patient|
|PLANNING||Plan on the nursing intervention|
|EVALUATION||Check if the goals are met|
Become a pro in conducting the ADPIE Nursing process. This may seem hard at first, but with proper and constant practice, in no time, you will be a pro.