CHAPTER I

THE PROBLEM AND ITS SETTING

Introduction

Nursing is a discipline focused on assisting individuals, families and

communities in attaining, re-attaining and maintaining optimal health and functioning.
Modern definitions of nursing define it as a science and an art that focuses on promoting
quality of life as defined by persons and families, throughout their life experiences from
birth to care at the end of life
The original role of the nurse was primarily to care for the patient as prescribed by
a physician. This evolved into the biomedical model of nursing care which still strongly
influences nursing practice today.
The biomedical model focuses heavily upon pathophysiology and altered
homeostasis but fails to identify individual differences and while it works well for
traditional medical and physical care, it focuses solely on the treatment of disease,
making little account of psychological, socio cultural, or politc economic differences
between individuals. The Biomedical Model essentially views all patients with the same
disease as the same problem regardless of their religion, culture, or ethnicity. This is in
contrast to the social model of healthcare that places emphasis on changes that can be
made in society and in people's own lifestyles to make the population healthier.
Before the start of caring patient the nurse have care plans. Care plans have one
primary purpose that is to provide directions for the nursing staff for a particular client.
For students and nurses inexperienced in caring for a person with a particular condition or
1

after a certain surgical procedure, these directions need to be detailed. For nurses
experienced in caring for people with a particular condition or after a certain surgical
procedure, these directions will be limited to only those specific interventions that are
different for this particular client. It focuses on actions which are designed to solve or
minimize the existing problem. It is a product of a deliberate systematic process. It is
based upon identifiable health and nursing problems. Its focus is holistic.
Care plans are formed using the nursing process. First the nurse collects subjective
data and objective data, then organizes the data into a systematic pattern, such as Marjory
Gordon's functional health patterns. This step helps identify the areas in which the client
needs nursing care. Based on this, the nurse makes a nursing diagnosis.
The full nursing diagnosis includes the relating factors and the evidence that
supports the diagnosis. For example, a nurse may give the following diagnosis to a
patient with pneumonia that has difficulty breathing: Ineffective airway clearance related
to tracheobronchial infection or pneumonia and excess thick secretions as evidenced by
abnormal breath sounds; crackles wheezes; change in rate and depth of respiration; and
effective cough with sputum.
In the USA, the nursing care plan consists of a NANDA nursing diagnosis with
related factors and subjective and objective data that support the diagnosis, nursing
outcome classifications with specified outcomes to be achieved including deadlines, and
nursing intervention classifications with specified interventions. The NANDAInternational is the main organization for defining standard diagnoses in North America
NANDA means North American Nursing Diagnosis Association. Other international
2

associations are AENTDE in Spanish, AFEDI in French language and ACENDIO in

Europe.
These papers want to assess if the nursing care plans at Nueva Ecija Doctors
Hospital follow the standard nursing care plans. The researchers want to know if the
nurses or student nurses have enough knowledge in nursing diagnosis. Is there an
instance that the nursing diagnosis is differ from the doctors diagnosis? What are the
problems arises on nursing care plan to patients? Those are the questions want to clarify
by the researchers. And by end of this research, the researchers goal is to impart more
knowledge to their colleagues and for the future researchers regarding nursing care
plans.
Statement of the Problem

This study sought answers to the following problems:

1.

What is the nursing care plans used by BSN Level IV of NEC and used by

professional nurses at NEDHI?

2. What are the characteristics traits which the student nurses and professional nurses
must possessed in giving nursing care plan?
3. What are the implications of THE STUDY TO Nursing profession?
Scope and Limitation
This study is pertaining to assess the nursing care plans utilized by the nurses and student
nurses at Nueva Ecija Doctors..

The respondents are the nurses of Nueva Ecija Doctors. The Level IV BSN students are
also chosen as respondents because this first semester of school year 2006-2007, is the schedule
of their duties on the said hospital.

This study sought to find the answers if they work well in nursing care plans?
How they assess the patients on diagnosis and what are the problems they encounter
during duties regarding nursing care plans.
This was undertaking in 3 weeks of research.
Significance of the Study

The end result of this research could be assumed would put up significant
possibility for the following groups such as:
To the Nursing Students. This study may provide as guide for doing a study or research
project. Furthermore, to educate them regarding nursing care plans so that they become more
efficient in their task during duties.
To the School. The study is also wished for to give as a additional reference materials
used for the future researchers.
Definition of Terms
The following are the distinct words used so that the people may not be misinform to the
meaning of words in the way they have been used on this study.
Assessment. is the act or process of evaluating of something or procedure;
Nurse. a person who taking care of patients in the hospital or in house of patient.
Nursing Care Plans. is the outlines of the nursing care to be provided to a patient.
________________
*Encyclopedia Britanica, 15th edition (Chicago, London Publishing ,Inc.. 2001)
Oxford-Word Power Dictionary

CHAPTER 2
REVIEW OF RELATED LITERATURE AND STUDIES
This chapter presents the review of related literature and studies that give significance to
the study. The related literature and studies conducted along this line are hereby presented.
Foreign Literature
Nurses and health care consumers agree that nursing care is a key factor in achieving
positive outcomes and enhancing patient satisfaction. Nursing care is instrumental I all phases of
acute care as weak as in the maintenance of general well being like prevention of illness,
rehabilitation and maximization of health or where a return to health as possible, the relief of
pain and discomfort and a peaceful death. To this end the nursing profession has identified a
problem solving process that combines the most relevant element of system theory, using the
scientific method.1
The original concept of nursing process was introduced in the 1950s as a three step
process of assessment, planning and evaluation based on the scientific method of observing,
measuring, gathering data and analyzing the findings. Over time, this process became part of the
conceptual framework of all nursing curricula and is included in the legal definition of nursing in
the nurse practice acts of most states. After years of study, use and refinement, the three step
process was expanded. The five steps are (1) assessment or the systematic collection of data
relating to patients and their problems/needs ;( 2) problem identification or the analysis and
interpretation

of

data;

(3)

planning

or

prioritizing

needs,

identifying

goals

and

choosingsolutions; (4) implementation or putting the plan into action and (5) evaluation or
assessing the effectiveness of the plan and changing the plan as indicated by current needs.
____________
1

Lydia M. Venzon Nursaing Management Towards Qualty Care 2nd Edition C and E Publishng Inc. Q.C Manila .
(2003).

These procedures are the central to nursing actions and the delivery of high quality,
individualized patient care in any setting.
When the patient enters the healthcare system, the nurses uses the steps of the nursing
process to work toward achieving the desired outcomes and goals identified for the patient. The
effectiveness of the plan of care is evaluated by ascertaining whether or not the desired outcomes
and goals have been attained or whether problems remain at the time of discharge. If problems
are unresolved, plans need to be made for further follow up including assessment, additional
problems/need identification, alteration of desired outcomes and goals and or changes of
interventions in the next care settings.
The nursing theory is the term given to the body of knowledge that is used to support
nursing practice. In their professional education nurses will study a range of interconnected
subjects which can be applied to the practice setting. This knowledge may be derived from
experiential learning, from formal sources such as nursing research or from non-nursing sources.
To speak of nursing theory is often difficult. Nursing is many things to many people. Most
universally agreed upon is that nursing is a science involving people, environment and process
fueled by a vision of transcendence in the context of healthcare. It is interesting to note that 90%
of all Nursing theories have been generated in the last 20 years. Many schools encourage
students to formulate theories of Nursing as part of their curriculum. Some might argue that this
multiplicity of theory is detrimental to the practice and undermines common vision. Others
would say that the nature of the young science is sufficiently far reaching to require such tactics
in order to elicit true consensus. It cannot be denied, however, that there is much vanity involved
in the formulation of nursing theory. The pages of "Nursing Science Quarterly", a major

mouthpiece for Nursing Theory, are rife with examples of semantical hair-splitting.2
The Nursing process is often remembered by the acronym ADPIE
"A Delicious PIE" mnemonic is sometimes used to remember this.

Assessment of patient's needs

Diagnosis of human response needs that nursing can assist with

Planning of patient's care

Implementation of care

Evaluation of the success of the implemented care

In many countries, such as the United Kingdom, the diagnosis stage of the process is

omitted. Although nurses in the UK determine a patient's needs or problems, they are not widely
regarded as "diagnoses".
The stage one is an assessment. The nurse should carry out a complete and holistic
nursing assessment of every patient's needs, regardless of the reason for the encounter. Usually,
an assessment framework, based on a nursing model or Waterlow scoring, is used. The purpose
of this stage is to identify the patient's nursing problems. These problems are expressed as
either actual or potential. For example, a patient who has been rendered immobile by a road
traffic accident may be assessed as having the "potential for impaired skin integrity related to
immobility".3
The stage two is the diagnosis. In the U.S., nurses make a nursing diagnosis which is a
standardized statement about the health of a client, individual, family, or community for the
purpose of providing nursing care. Nursing diagnoses express the result of the assessment of the
____________
2 Ibid, page 53- 56
3

Microsoft Encarta Premium Suite 2005).

patient's problems.
Nursing diagnoses are part of a movement in nursing to standardize terminology which
includes standard descriptions of diagnoses, interventions, and outcomes. Those in support of
standardized terminology believe that it will help nursing become more scientific and evidence
based.
The stage three: planning. In agreement with the patient, the nurse addresses each of the
problems identified in the planning phase. For each problem a measurable goal is set. For
example, for the patient discussed above, the goal would be for the patient's skin to remain intact.
The result is a nursing care plan.
The stage four is the implementation. The methods by which the goal will be achieved is
also recorded at this stage. The methods of implementation must be recorded in an explicit and
tangible format in a way that the patient can understand should he/she wish to read it. Clarity is
essential as it will aid communication between those tasked with carrying out patient care.
The stage five is the evaluation.The purpose of this stage is to evaluate progress toward
the goals identified in the previous stages. If progress towards the goal is slow, or if regression
has occurred, the nurse must change the plan of care accordingly. Conversely, if the goal has
been achieved then the care can cease. New problems may be identified at this stage, and thus
the process will start all over again. It is due to this stage that measurable goals must be set failure to set measurable goals will result in poor evaluations.
The entire process is recorded in an agreed format in the patient's care plan in order to
allow all members of the nursing team to perform the agreed care and make additions or changes
where appropriate.

The Nursing diagnoses are part of a movement in nursing to standardize the terminology
involved. This includes standard descriptions of diagnoses, interventions and outcomes. Nurses
who support of standardized terminology believe that it will help nursing become more scientific
and evidence-based. Other nurses feel that nursing diagnoses are an ivory tower mentality and
neither help in care planning nor in differentiating nursing from medicine.4
The NANDA-International system of nursing diagnosis provides for five categories.
1.

Actual diagnosis - a statement about a health problem that the client has and the

benefit from nursing care. An example of an actual nursing diagnosis is: Ineffective
airway clearance related to decreased energy as manifested by an ineffective cough.
2.

Risk diagnosis - a statement about health problems that a client doesn't have yet, but

is at a higher than normal risk of developing in the near future. An example of a risk
diagnosis is: Risk for injury related to altered mobility and disorientation.
3.

Possible diagnosis - a statement about a health problem that the client might have

now, but the nurse doesn't yet have enough information to make an actual diagnosis. An
example of a possible diagnosis is: Possible fluid volume deficit related to frequent
vomiting for three days as manifested by increased pulse rate.
4.

Syndrome diagnosis - used when a cluster of nursing diagnoses are seen together.

An example of a syndrome diagnosis is: Rape-trauma syndrome related to anxiety about

potential health problems as manifested by anger, genitourinary discomfort, and sleep
pattern disturbance.
5.

Wellness diagnosis - describes an aspect of the client that is at a high level of

_________________
4

Microsoft Encarta (2005).

wellness. An example of a wellness diagnosis is: Potential for enhanced organized infant
behavior, related to prematurity and as manifested by response to visual and auditory stimuli.
Local Literature
Nursing care planning is an essential part of nursing practice that provides a written
means of planning patient care and discharge planning based upon nursing diagnosis. Nursing
care plans functions as a means of communicating patient care needs between members of the
nursing team to ensure those needs are met. Written nursing care plans also serve as a means to
document changes in patient's condition, adjustments or additions to nursing diagnosis, as well as
patient responses to nursing or medical treatment. Nursing care plans enable nurses to provide a
holistic approach to patient needs both while hospitalized and after discharge. 5
The educational programs for preparation of nurses today are changing to meet the
changing demands made on the profession. Conditions are progressing so rapidly that changes
may be made in the program during a students own experience in school.
Republic Act 7164 focused on three changes in the effort to improve the peoples health:
1.

From hospital or institutional care, emphasis shifted to community

health delivery;
2.

From emphasis on physical care, efforts are now directed toward

holistic approach to the care of individuals, families and communities

3. From being mere recipients of care, patients, individuals, families and
communities are now active participant in health care efforts.
Professional nursing as an art and science continue to challenge nurse educators and
_____________
5

Lorna M. Daluz Competencies Essential For Nursing Care Skill Guide Part III 1st Ed/. 2003, Educational
Publishing House, Ermita Manila , Philippines

10

practitioners in providing quality nursing care. Despite the constant and unending infusion of
new knowledge and technology, nursing remains to be a nursing profession. The nurse is a doer
with an analytical mind and a compassionate heart.
Related Studies
According to Gabriel (2005),6 Nursing is a profession that requires a lot of
responsibilities, which involves skills, knowledge and attitude with deeper sense of values. In
the health care setting, the knowledge and values of nurses, patients and all of the people
involved interact with each other. If a nurse becomes aware of the values that motivate her
personal and professional behavior, it is easier for her to assist the patient in identifying values
that influence their own attitudes and behaviors. Hence, the extent of influence of Filipino
values in the student nurse or even nurses in general performance of the basic nursing procedures
reflects the quality of care given to the patients not only therapeutically but also in the different
aspect such as moral physical and psychological or even spiritual
Nursing procedures involve a very large core of specialization and this requires
knowledge and skills and also attitudes and values. The nurses that render care to patients are
greatly affected or influenced by these factors.
Significant Findings
1.1 Skills
Rank 1 was Dedicated and effective to work. With weighted mean of 3.7 or interpreted as
always. Rank 2 was 1/7 knowledge of nurses on patient care. With weighted mean of 3.62 or
interpreted as anyways. Rank 3 was skills of using medical 1/7 clinical resources. With
_______________
6

Lorna L. Gabriel Assessment of Senior Nursing Students About Nursing Care Plan and Its Implication to Health
(Unpublished thesis conducted at Nueva Ecija Colleges, )2005, pp 45-48

11

weighted mean of 3.56 or interpreted as always. Rank 4 was feeling of satisfaction of patient in
nursing care given by nurses. With weighted mean of 3.52 or interpreted as always. Rank 5 was
nurses flexibility, component and can accommodate all patients. With weighted mean of 3.48
or interpreted as frequently.
It was tested in hundreds of years in many hospitals worldwide. Many patients were
helped to prevent and cure sickness by the procedure of NCP.
With regards to the perceptions of students and nurses respondents, the important
characteristics of nurses to provide the proper nursing care plan for patients the following
enumerations:Must have critical thinking. The nurses must possess critical thinking so that to
avoid problems on providing care, medicines, intervention to the patients. Most of the time the
malpractice I giving care to patients is because the nurses find themselves on state of unaware
and neglecting. They require cognitive, psychomotor and affective skills to use the tools of a
comprehensive knowledgebase, the nursing process and established standard care. Must be
supportive. The nurse must be supportive to the co-nurses and nursing students. They have
common purpose in the hospital therefore they need to be cooperative to the other members
Must be accommodative to patients. It is important that nurses be accommodative because
they have a responsibility to make the patients well.

Must be competitive. In and out, the

nurse must be competitive so that they function well and apply the best NCP she can to offer to
patients

With the question, what are the problems encountered in nursing care plan? The

following are their responses:The patient did not cooperate with the procedure need to meet
up.

12

Like need to avoid in a certain time which is required to follow. Like avoiding certain
foods and drinks, need to rest, need to loose wait, need to take their medicines in the time
required and others The patient is lack of money to buy the best medicines need to take. The
nurse is lack of critical thinking which engage to medical malpractice. Lack of
communication between patient and nurse assigned.

13

CHAPTER 3
METHODS AND PROCEDURE USED
This chapter presents the research design the selection and description of the respondent,
the locale of the study and the data gathering techniques being employed.
Research Method
The researcher employed the descriptive method in this study. According to Barrientos
Tan1 a descriptive research is a study that describes the nature of the phenomenon under
investigation after a survey of trends, practices and conditions that related to the phenomenon.
This type of research method will answers questions and satisfies the curiosity about a certain
phenomenon it will also describes and elaborates the natures and causes of an existing
phenomenon at the time of study.

The descriptive methods are concerned with existing

conditions. Its meaning and significance and then making adequate interpretations of the data.
The advantages of Descriptive method are concerned to its meaning and significance of making
adequate Interpretations of the study. The present study is concerned with the The Nursing Care
Plan As Requirement to Patient Care: An Assessment
Sources of Data
The data gathered from the responses of the subject were strengthened by recording
books, periodical and published materials the researches made use of the Nueva Ecija Colleges
library. The data gathered from the participants were threatened statistically, tabulated and
computed making use of frequency distribution, percentage, weighted mean and making
compilation.
________________
Crestita B. Tan A Research Guide in Nursing Education 3rd edition (Published by Visual Print enterprises, Pio del
Pilar Makati City 2006) p. 168-190
1

14

Sampling Design
The researchers chose BSN Level IV of Nueva Ecija Colleges and Professional Nurses at
NEDHI as the local of this study to find out their views about nursing care plan.
In selecting the participants the researchers used the purposive or judgment sampling
technique. In this kind of Non-Probability sampling the subject are viewed as typical cases or
experts that provide enough data to answer the researcher questions. Also, the subjects are
handpicked to be included in the sampling frame based on certain qualities for purposes of this
study.
Research Instrumentation
The researchers used the questionnaire to enable to collect relatively significant data.
The population of the study includes the Level IV students of BSN at Nueva Ecija Colleges who
attended the duties at Nueva Ecija Doctors Hospital. In addition, nurses worked at NEDHI are
also respondents.
The table below shows the distribution of respondents in male and female of BSN
students at Nueva Ecija Colleges. The researchers targeted a total of 100 respondents excluded
the clinical instructors of NEC.
Table1.
Participants of the Study
Participants

Target Number of
Respondents
Student nurses
90
Professional nurses
10
Total
100
The respondents were chosen by means of random sampling. Random Sampling is
defined as a method of selecting a sample size from a universe such that each member of the

15

population has an equal chance of being included in the sample and all possible combinations of
size have an equal chance of being selected as sample.
On the other hand the researchers included the selected fourth year BSN students of
NEC and the professional nurses of NEDHI.
Data Gathering Procedure
A requests letter which was signed by the dean of NEC with a copy of the questionnaire
was given to the respondents so as to respond and to clearly identify and understand the study.
The questionnaire employed defined the parameters of the Level IV BSN students
assessment on the Nursing Care Plan their used.
Statistical Treatment of Data
Data gathered were collected and analyzed. To analyze the issues, as assessed by the
Level IV BSN students of NEC and professional nurses of NEDH, the weighted mean was used.
It is refer to the overall average responses of the study.2
The formula uses are
P

the following:

F/n x 100

Percentage

Frequency

Total number of respondents

TWF / n

Where P

WEIGHTED MEAN
WM
Where:

WM

Weighted Mean

TWF

Total Weighted Frequency

Total Number of Respondents.

____________
2

Ibid, p. 185

16

Here are the descriptive equivalents to interpret the responses. The following
quantification is given.3
Table 2.
Rating
Outstanding
Very Satisfactory
Satisfactory
Fair
Poor

The condition is most favorable and highly satisfactory.

The condition is good and very satisfactory
The condition is good and very satisfactory
The condition is satisfactory but lacking in some aspect.
Not accepted.

Table 3.
Numerical Scale Rating
WT. OF RESPONSE

NUMERICAL RATING

EQUIVALENT

4.5-5.00

Outstanding

3.5-4.49

Very Satisfactory

2.5-3.49

Satisfactory

2
1

1.5-2.49
1.0-1.49
.

Fair
Poor

Ranking. This statistical treatment will be utilized to discuss positional advantages.

Ranking is the placement of an item in category of more or less than the same item. It simply
says that one is higher than the other.

_____________
3

Ibid, p 186

17

CHAPTER 4
PRESENTATION, ANALYSIS AND INTERPRETATION OF DATA

This chapter presents analysis and interprets the data obtained from the questionnaires.
The Perception of BSN Students and Nurses on Assessing the Nursing Care Plan:
The Level IV of BSN students in Nueva Ecija Colleges and the professional nurses in
NEDHI were the chose respondents. Their answers on the characteristics of students and
professional nurses who conduct nursing care plan are the following:

Table 1
Characteristics and Attitude of Students
No.
Ite
ms
3

VARIALES

WF

Most of the students comply

with the correct nursing
process.

5
4
3
2
1

39
41
10
10

39%
41%
10%
10%

195
164
30
20

100
39
41
10
10

100%
39%
41%
10%
10%

4.9
195
164
30
20

100
25
50
25
0

4.9
175
200
75

100

100%
25%
50%
35%
0
0
100%

40
40
10
10

40%
40%
10%
10%

4.4
0
200
160
30
20

100

100%

410

Total
5

. They confront situation of

nursing care plan confidently.

The students are punctual.

5
4
3
2
1
5
4
3
2
1

Total
2

They are accommodative to

patients.

Total

5
4
3
2
1

WM

VI

4.9

Outstanding

1.5

4.9

Outstanding

1.5

4.4

Very
Satisfactory

4.1

Very
Satisfactory

18

They work effectively on

getting
information
of
patients.

5
4
3
2
1

Total

45
41
14

45%
41%
14%

225
84
42

100

100%

351

3.5

Very
Satisfactory

The BSN level IV of Nueva Ecjia Colleges possesses the required characteristics of nurses
as follows ranked 1.5 are items ( c) Most of the students comply with the correct nursing
process. And item( d) They confront situation of nursing care plan confidently both have
weighted mean of 4.9 verbally interpreted as outstanding The item ( a) The students are
punctual. has weighted mean of 4.4 interpreted as Very satisfactory, ranked 3; For the rank 4
is item

( b) . They are accommodative to patients has weighted mean of

interpreted as

4.1

Very Satisfactory Item( d ) They work effectively on getting

information of patients has weighted mean of 4.5 verbally interpreted as Very Satisfactory
This means they really obtained the subjective and objective data of patients. they assess
properly the necessary data of patients before any diagnosis and intervention. They are punctual,
accommodative and confront the nursing care confidently.
Table 2
Characteristics and Attitudes on Nurses
No.
Items
4

VARIABLES

WF

They have good heart to

patients/client.

5
4
3
2
1

40
60

40%
60%

200
240

100
30
40
20
10

100%
30%
40%
20%
10%

440
150
160
60
20

100
21

100%
21%

390
105

Total
2

They were accommodative

to patients and student
nurses

5
4
3
2
1

Total
1

They were supportive to the

WM

VI

4.4

Very
Satisfactory

Very
Satisfactory

3.9

19

co-nurses
students.

and

nursing

4
3
2
1

Total
3

They are competitive.

5
4
3
2
1

Total
5

They respect everyone even

poor patients.

Total

5
4
3
2
1

24
40
15
2
100
25
30
20
20
5

24%
40%
15%
2%
100%
25%
30%
20%
20%
5%

100

100%

96
120
30
2
353
125
120
6
0
40
5
350

45
41
14

45%
41%
14%

225
84
42

100

100%

351

3.5

Very
Satisfactory

3.5

Very
Satisfactory

3.5

Very
Satisfactory

Table 2 presents the Characteristics and Attitudes on Nurses , Ranked 1 is item ( d) They
have good heart to patients/client has a weighted mean of 4.4 verbally interpreted as Very
Satisfactory, ranked 2 is item ( b) They were accommodative to patients and student nurses has
a weighted mean of 3.9 interpreted as Very Satisfactory;Items ( a) They were supportive to the
co-nurses and nursing students., ( c) They are competitive. (e) They respect everyone even poor
patients. All has weighted mean of 3.5 verbally interpreted as Very Satisfactory
The findings means that the nurses at Nueva Ecija Doctors are really professional nurses
because according to the result the nurses are competitive, accommodative and they have good
heart even to the less fortunate.

20

Table 3
Nursing Care Plan Process and Characteristics
No.
Items
6
f)dressing

AVARIABLES

WF

some of the issues uncovered in

nursing care plan is workable strategies
in patient care delivery.

5
4
3
2
1

40
60

40%
60%

200
240

10
0
45
45
10

100
%
45%
45%
10

440

10
0
50
25
20
5

100
%
50%
25%
20%
5%

435

10
0
40
40
10
10

100
%
40%
40%
10%
10%

420

10
0
30
40
20
10

100
%
30%
40%
20%
10%

410

40
20
20
15
5
10
0
40
20
20
15
5
10

40%
20%
20%
15%
5%
100
%
40%
20%
20%
15%
5%
100

200
80
60
30
5
375

Total
5

The nursing care plan helps student to

improve their skills on nursing practice.

5
4
3
2
1

Total
7

Care plans provide directions for the

nursing staff for a particular client.

5
4
3
2
1

Total
8

Having competent nurses can improve

the nursing plan care.

5
4
3
2
1

Total

The procedure is focuses on actions

which are designed to solve or
minimize the existing problem

5
4
3
2
1

225
180
30

250
100
60
10

200
160
30
20

150
160
60
20

WM

VI

4.4

Very
Satisfactory

4.3

Very
Satisfactory

4.2

Very
Satisfactory

4.1

Very
Satisfactory

3.9

Very
Satisfactory

Total
3

It is a product of a deliberate systematic

process.

5
4
3
2
1

Total
9

Providing standard descriptions of

diagnoses is can help the care plan in
diagnosis stage.
Total

5
4
3
2
1

200
80
60
30
5
375

3.7

3.7

Very
Satisfactory

6.5

Very
6.5
Satisfactory

21

10

The short and long care plans are

essentially formal records that reflect a
thinking process and provide students
with frequent practice in the nursing
process.

The nursing care plan assessment is

important so that to assess the complete
data of patients and at the same time to
determine
the
diagnosis
and
intervention for his or her case.

5
4
3
2
1

5
4
3
2
1

Total
4

Its focus is holistic.

Total

5
4
3
2
1

0
34
33
23
0
0

%
34
33
23
0
0

10
0
35
30
15
20

100
%
35%
30%
15%
20%

361

10
0
35
30
15
20

100
%
35%
30%
15%
20%

305

10
0

100
%

305

170
132
69
0
0

175
120
45
40

175
120
45
40

3.6

Very
Satisfactory

3.0

Satisfactory

9.5

3.0

Satisfactory

9.5

Table 3 presents the Nursing Care Plan Process and Characteristics Ranked 1 is item f) )
f)dressing some of the issues uncovered in nursing care plan is workable strategies in patient care
delivery. Has a weighted mean of 4.4; ranked 2 is item e) The nursing care plan helps student
to improve their skills on nursing practice has a weighted mean of 4.3 ranked 3 is item b) Care
plans provide directions for the nursing staff for a particular client. as a weighted mean of 4.2 ;
ranked 4 is item h) Having competent nurses can improve the nursing plan care. Has a weighted
mean of 4.1; ranked 5 is item g)The procedure is focuses on actions which are designed to solve
or minimize the existing problem has a weighted mean of 3.9; ranked 6.5 are items c) It is a
product of a deliberate systematic process and i) Providing standard descriptions of diagnoses is
can help the care plan in diagnosis stage. Both has weighted mean of 3.7; ranked 8 is item j)The
short and long care plans are essentially formal records that reflect a thinking process and
provide students with frequent practice in the nursing process has weighted mean of 3.6; all
22

items above are verbally interpreted as Very Saisfactory; ranked 9.5 are items a) The
nursing care plan assessment is important so that to assess the complete data of patients and at
the same time to determine the diagnosis and intervention for his or her case and d) Its focus is
holistic both has weighted mean of 3.0 and interpreted as Satisfactory
The findings of the data gathered presented in chapter 5 could be implied that the
purpose of nursing care plan to student nurses and professional nurses is highly recommended.
Based on the survey, nursing care plan has the best purpose in nursing profession. The
nursing care plan creates the best direction on caring patients. The interpretation on purpose and
characteristics of nursing care plan has outstanding interpretation. This result made clear its
goal either to the student nurses and the professional nurses.

23

CHAPTER 5
SUMMARY, CONCLUSION AND RECOMMENDATIONS

This chapter provides a recap of salient feature of the study the conclusions derived from
the analysis is the previous chapter and the subsequent recommendations. Implications of the
study to nursing profession were also included.
1. Summary
This study entitled The Nursing Care Plan as Requirement to Patient Care: An
Assessment. Through necessity, nurses have found practical ways to incorporate physicians'
orders into practice. The respondents of the study were BSN Level IV of Nueva Ecija Colleges
and Professional Nurses at NEDHI as the local of this study to find out their views about nursing
care plan. In selecting the participants the researchers used the purposive or judgment sampling
technique. In this kind of Non-Probability sampling the subject were viewed as typical cases or
experts that provided enough data to answer the researcher questions.
The descriptive method of research was applied. The data gathered were presented in the
forms of tables, analyzed and interpreted utilizing frequency count, ranking percentage and
weighted means.
In the study, the following specific questions answered:

1.

What is the nursing care plans used by BSN Level IV of NEC and used by

professional nurses at NEDHI?

2. What are the characteristics traits which the student nurses and professional nurses
must possessed in giving nursing care plan?

24

3. What are the implications of nursing care plans in the task of nurse?
Findings of the Study
Based on all the data presented, analyzed and interpreted data , the following findings
were drawn according to their rank:
Characteristics and Attitude of Students
The BSN level IV of Nueva Ecjia Colleges possesses the required characteristics of nurses
as follows ranked 1.5 are items ( c) Most of the students comply with the correct nursing
process. And item( d) They confront situation of nursing care plan confidently both have
weighted mean of 4.9 verbally interpreted as outstanding The item ( a) The students are
punctual. has weighted mean of 4.4 interpreted as Very satisfactory, ranked 3; For the rank 4
is item

( b) . They are accommodative to patients has weighted mean of

interpreted as

4.1

Very Satisfactory Item( d ) They work effectively on getting

information of patients has weighted mean of 4.5 verbally interpreted as Very Satisfactory
Characteristics and Attitudes on Nurses
Ranked 1 is item (d) They have good heart to patients/client has a weighted mean of 4.4
verbally interpreted as Very Satisfactory, ranked 2 is item ( b) They were accommodative to
patients and student nurses has a weighted mean of 3.9 interpreted as Very Satisfactory;Items (
a)

They were supportive to the co-nurses and nursing students., ( c) They are competitive. (e)

They respect everyone even poor patients. All has weighted mean of 3.5 verbally interpreted as
Very Satisfactory
Nursing Care Plan Process and Characteristics
Ranked 1 is item f) ) f)dressing some of the issues uncovered in nursing care plan is
workable strategies in patient care delivery. Has a weighted mean of 4.4; ranked 2 is item e)

25

The nursing care plan helps student to improve their skills on nursing practice has a weighted
mean of 4.3 ranked 3 is item b) Care plans provide directions for the nursing staff for a
particular client. as a weighted mean of 4.2 ; ranked 4 is item h) Having competent nurses can
improve the nursing plan care. Has a weighted mean of 4.1; ranked 5 is item g)The procedure is
focuses on actions which are designed to solve or minimize the existing problem has a weighted
mean of 3.9; ranked 6.5 are items c) It is a product of a deliberate systematic process and i)
Providing standard descriptions of diagnoses is can help the care plan in diagnosis stage. Both
has weighted mean of 3.7; ranked 8 is item j)The short and long care plans are essentially formal
records that reflect a thinking process and provide students with frequent practice in the nursing
process has weighted mean of 3.6; all items above

are verbally interpreted as Very

Saisfactory; ranked 9.5 are items a) The nursing care plan assessment is important so that to
assess the complete data of patients and at the same time to determine the diagnosis and
intervention for his or her case and d) Its focus is holistic both has weighted mean of 3.0 and
interpreted as Satisfactory
Conclusions
1. The nurse must acquire and develop the necessary competence in knowledge skills
and attitude to effectively render appropriate nursing service through varied learning situation.
2. Commitment to continual learning and active participation in the development and
growth of the profession are commendable obligation.
3. Finally, there are some good benefits derived by the patient from the nurse rendering
the proper care for clients. Establishing right interpersonal relationship, shorten hospitalization
confinement and discomfort may also relieved.

26

Recommendations
Based on the collected data and the conclusion formed, the following are the
recommendations:
1.

In nursing care plan, the student nurses is suggested not to hesitate to ask questions

from the colleagues or the clinical instructors if he/she do not know in the procedure.
2.

Before the care plan for specific patients is ended, examining problems of

implementation may be helpful. The pitfalls of the past must be avoided if future care planning
methods are to be successful.
3.

It is important that the student nurses to be elaborated in nursing care plan contents

so that to understand well what he or she does which she will benefit for future career.
4.

In nursing care plan, it is important to fill up all necessary data like the subjective

and objective data so that to avoid mistakes.

5.

The nurses must be possessed analytical mind and more so, a compassionate heart in

dealing with patients and doing nursing care plan.

27

IMPLICATION TO NURSING PROFESSION

As nursing students and later as graduates, we must possess these values and have them
implemented on our struggle in our chosen career.
We must have faith and should be based on honest and sincere respect which recognizes
our human dignity. Respect for ourselves helps us to acknowledge in developing our rights and
responsibilities, in developing our talents and abilities and in driving personal as well as
professional happiness and satisfaction. Together to give our outmost and endeavor best to
patient needs our attention.
Finally, this study would serve as guide to all nursing practitioner, nursing educators,
whose purpose is to help the hospitalized patients physically, emotionally, mentally and maybe
spiritually. Through this study staff nurses would be able to carry on their good performance and
strive hard to maintain the pure image of nursing profession.

28

BIBLIOGRAPHY
Books
Daluz ,Lorna M. Competencies Essential For Nursing Care Skill Guide Part III 1 st
Ed/. 2003, Educational Publishing House, Ermita Manila , Philippines
Tan ,Crestita B. A Research Guide in Nursing Education 3rd edition (Published by
Visual Print Enterprises, Pio del Pilar Makati City 2006) p. 168-190
Venzon, Lydia M., Nursing Management Towards Quality Care Second Edition.
2003., C and E Publishing Inc., Quezon City Manila
Competencies Essential For Nursing Care Skill Guide Part III 1st Ed/. 2003,
Educational Publishing House, Ermita Manila , Philippines
Swansburge, Keith, Nursing Management:An Assessment,1993
Unpublished Thesis

Nueva Ecija

Gabriel Lorna L. Assessment of Senior Nursing Students About Nursing Care

Plan and Its Implication toHealth (Unpublished thesis conducted at
Colleges, )2005, pp 45-48
Internet
Microsoft Encarta Premium Suite 2005
Atkinson, HaleNursing Characteristics, New Jersey , 1986
Butts, Mark Fundamentals of Nursing, Washington , 2005
http://en.wikipedia.org/wiki/Nursing_theory
http://en.wikipedia.org/wiki/Category:Nursing_diagnoses
http://www.fadavis.com/townsend4e/additionalnursingcareplans.htm
http://www.nursing.com

29

SAMPLE LETTER TO DEAN

NUEVA ECIJA COLLEGES
College of Nursing
Cabanatuan City

October 21, 2006

Dra. Aurora R. Carbonell

Dean, College of Nursing
Nueva Ecija Colleges
Cabanatuan City
Dear Madam:
Greetings in the Name of the Lord!
We the Level IV BSN students of Nueva Ecija Colleges, would like to request your good
office to please grant us the permission to conduct the study in Nueva Ecija Doctors Hospital
The research study entitled, The Nursing Care Plan as a Requirement to Patient Care:
An Assessment. This is for us to fulfill the requirement in research subject. Any favorable
action regarding this request will be highly appreciated.
Thank you very much and God bless!
Respectfully yours,
Juliet M. Arzanan
May Ann S. Castillo
Jayson F. Novelles
Andrea S. Idang
Approved:
DR. AURORA C. CARBONELL
Dean, College of Nursing
Nueva Ecija Colleges

30

SAMPLE LETTER TO RESPONDENTS

(Student Nurses)
NUEVA ECIJA COLLEGES
College of Nursing
Cabanatuan City
February 5, 2007

Dear Fellow Students:

Good Day!
The Researchers are senior students of Bachelor of Science in Nursing. They are
currently working on a thesis titled, The Nursing Care Plan as requirement to Patient Care:
An Assessment, in partial fulfillment of the requirement in the subject, Nursing Research.
To complete the study, this survey questionnaire has been developed to generate the
necessary data and seeking your kind and generous participation by giving your honest responses
to the questions posed therein. Rest assures that all the responses provided shall be treated with
utmost confidentially.
Thank you for your support and cooperation. God bless.
Sincerely yours,
Juliet M. Arzanan
May Ann S. Castillo
Jayson F. Novelles
Andrea S. Idang
Noted:
DR. AURORA C. CARBONELL
Dean, College of Nursing
Nueva Ecija College

31

SAMPLE LETTER TO THE PARTICIPANTS

(Professional Nurses)
Nueva Ecija Colleges
College of Nursing
Cabanatuan City
Dear Sir/Madam,
Greetings in the Name of the Lord!
We are Senior Nursing Students of Nueva Ecija Colleges and at present are conducting a
thesis research entitled, The Nursing Care Plan as Requirement to Patient Care: An
Assessment, in partial fulfillment of the requirements in the subject, Nursing Research.
To complete the study, this survey questionnaire has been developed to generate the
necessary data and seeking your kind and generous participation by giving your honest responses
to the questions posed therein. Rest assures that all the responses provided shall be treated with
utmost confidentiality.
Thank you for your kind support and cooperation it is hoped that this request merits your
favorable action.
Sincerely yours,
Juliet M. Arzanan
May Ann S. Castillo
Jayson F. Novelles
Andrea R. Samaniego-Idang
Noted:
DR. AURORA C. CARBONELL
Dean, College of Nursing
Nueva Ecija College

32

SAMPLE QUESTIONNAIRE

Name(Optional)_______________________________
Instructions: Please rate the following using the range below to assess and determine
the nursing care plan of Level IV nursing students of NEC and the nurses at NEDH.
Place a check mark on the space provided at columns of rating. Your suggestions can be
write on the space below.
NUMERICAL RATING
5
4
3
2
1

EQUIVALENT
Outstanding
Very Satisfactory
Satisfactory
Fair
Poor

ITEMS
Characteristics and Attitude of Students
1. The students are punctual.
2. They are accommodative to patients.
3. Most of the students comply with the correct nursing
process.
4. They work effectively on getting information of patients.
5. They confront situation of nursing care plan confidently.

Characteristics and Attitudes on Nurses

1. They were supportive to the co-nurses and nursing students.
2. They were accommodative to patients and student nurses
3. They are competitive.
4. They have good heart to patients/client.
6. They respect everyone even poor patients.
Nursing Care Plan Process and Characteristics
1. The nursing care plan assessment is important so that to assess
the complete data of patients and at the same time to determine the
diagnosis and intervention for his or her case.
2. Care plans provide directions for the nursing staff for a
33

NUMERICAL RATING

EQUIVALENT

particular client.
3. It is a product of a deliberate systematic process.
4. Its focus is holistic.
5. It is based upon identifiable health and nursing problems.
6. Addressing some of the issues uncovered in nursing care plan is
workable strategies in patient care delivery.
7. The procedure is focuses on actions which are designed to solve
or minimize the existing problem
8. Having competent nurses can improve the nursing plan care.
9. Providing standard descriptions of diagnoses is can help the
care plan in diagnosis stage.
10. The short and long care plans are essentially formal records
that reflect a thinking process and provide students with frequent
practice in the nursing process.

34

Curriculum Vitae
PERSONAL BACKGROUND:
Name

Juliet M. Arzanan

Nickname

Juliet

Address

Sto. Rosario Young, Zaragosa Nueva Ecija

Age

26 years/old

Birthdate

September 12, 1985

Place of Birth

Sta. Cruz Zaragoza, Nueva Ecija

Civil Status

Single

Name of Parents

Maxima M. Arzanan
Danilo S. Arzanan

EDUCATIONAL ATTAINMENT:
TERTIARY:

Bachelor of Science in Nursing

Nueva Ecija Colleges
Cabanatuan City
April, 2007

SECONDARY:

Vincentian Catholic Academy

March, 2002

ELEMENTARY:

Zaragoza Central School

March, 1999

35

Curriculum Vitae
PERSONAL BACKGROUND:
Name

May Ann S. Castillo

Nickname

May

Address

#302 Encarnacion Subd. San Jose City, Nueva Ecija

Age

25 years/old

Birthdate

May 16, 1986

Place of Birth

San Jose City, Nueva Ecija

Civil Status

Single

Name of Parents

Annabelle S. Castillo
Meliton C. Castillo

EDUCATIONAL ATTAINMENT:
TERTIARY:

Bachelor of Science in Nursing

Nueva Ecija Colleges
Cabanatuan City
April, 2007

SECONDARY:

Saint Joseph High School Department

March, 2003

ELEMENTARY:

The United Methodist Church Learning Center

March, 1999

36

Curriculum Vitae
PERSONAL BACKGROUND:
Name

Jayson F. Novelles

Nickname

Jayson

Address

Alua San Isidro, Nueva Ecija

Age

25 years/old

Birthdate

March 23, 1986

Place of Birth

Pob. San Isidro, Nueva Ecija

Civil Status

Single

Name of Parents

Nenita F. Novelles
Ricardo Q. Novelles

EDUCATIONAL ATTAINMENT:
TERTIARY:

Bachelor of Science in Nursing

Nueva Ecija Colleges
Cabanatuan City
April, 2007

SECONDARY:

General de Jesus Colleges

March, 2003

ELEMENTARY:

San Isidro Central School

March, 1999

37

Curriculum Vitae
PERSONAL BACKGROUND:
Name

Andrea Samaniego-Idang

Nickname

Andrea

Address

#172 Brgy. Sta. Rosa, Nueva Ecija

Age

25 years/old

Birthdate

June 27, 1986

Place of Birth

Sta. Rosa, Nueva Ecija

Civil Status

Married

Name of Parents

Delia R. Samaniego
Roberto D. Samaniego

EDUCATIONAL ATTAINMENT:

TERTIARY:

Bachelor of Science in Nursing

Nueva Ecija Colleges
Cabanatuan City
April, 2007

SECONDARY:

Saint Rose of Lima Catholic School

March, 2003

ELEMENTARY:

Dr. Antonio Oliveros Memorial School

March, 1999

38