Chapter 14: Assessment, planning, implementation and evaluation (APIE): The process of nursing 205

1. When performing a patient assessment, several skills are required. What skills might these might include?

Answer: observe, measure, listen, question, examine, analyse, interpret

2. Why might you prefer to use an open, rather than a closed question when interviewing a patient?

Answer: Open questions allow the patient to elaborate and provide their own accounts.

3. When observing a patient, what things might you notice?

Answer: facial expression and emotional state, skin colour and integrity, behaviour or any other non-verbal sign

4. Why is it useful to adopt a process of APIE?

Answer: It facilitates patient-centred systematic delivery of patient care.

5. Why is planning important in the nursing process?

Answer: A plan allows an order for actions to be devised to help resolve a need.

6. What is the implementation part of the nursing process?

Answer: It is when the care prescribed to achieve the goal is put into action.

7. Why do you need to evaluate your care?

Answer: It is the assessment of the response to the care implemented, to ascertain if the goal is achieved and need resolved.

8. Why is a need orientated approach to care helpful to nursing?

Answer: It allows examination of a person to identify needs they might have, affording interventions to be provided to resolve the need identified.

9. What senses might you use when assessing a patient?

Answer: Speech, sight, smell, hear, touch

10. When might you use a secondary source of information rather than a direct source?

Answer: When the patient is unable to provide the necessary information, such as when they are unconscious or lack capacity.

11. Why should you not assume when a patient cries it is always because they are unhappy?

Answer: People have individual responses to different situations; one person may cry in responses to pain, being happy or relief, for example.

12. What can you do if the evaluation reveals the goal has not been achieved?

Answer: reassess as to why

13. Why is it important to work with the patient in the process of APIE?

Answer: It is crucial for person-centred care and fundamental to maintaining the patient’s best interests.

14. What might be the possible causes of a goal not being achieved?

Answer: The goal was unrealistic, the intervention ineffective or the need has changed.

15. Explain the cyclic nature of the APIE approach.

Answer: Assessment leads to planning, which leads to implementation and evaluation, which, if the gaol is not achieved, evaluation leads to reassessment, resetting goals, implementation and evaluation.