Monday, December 15, 2008


By Sudiryo NPM 220111080041

The term PROSES KEPERAWATAN was first used/mentioned by Lydia Hall, a nursing theorist, in 1955 wherein she introduced 3 STEPs: observation, administration of care and validation.

Since then, Proses Keperawatan continue to evolve:
it used to be a 3-step process,
then a 4-step process (APIE),
then a 5-step (ADPIE),


· is a systematic, organized method of planning, and providing quality and individualized nursing care.

· it is synonymous with the PROBLEM SOLVING APPROACH that directs the nurse and the client to determine the need for nursing care, to plan and implement the care and evaluate the result.

· It is a G O S H approach
(goal-oriented, organized, systematic and humanistic care)
for efficient and effective provision of nursing care.


Goal-oriented – nurse make her objective based on client’s health needs.

Remember: Goals and plan of care should be base according to client’s problems/needs
NOT according to your own problem as the nurse.

Organized/Systematic – the nursing process is composed of 6 sequential
and interrelated steps and these 6 phases follow a logical sequence.

Humanistic care

* plan to care is developed and implemented taking into consideration the unique needs of the individual client.
* plan of care therefore is individualized (no 2 person has the same health needs even with same health condition/illness)
* in providing care, it involves respect of human dignity

Efficient – plan of case is relevant/related to the needs of the client
thereby promoting client satisfaction and progress.

Effective – in planning care, utilized resources wisely (staff, time, money/cost)

Aside from GOSH, other characteristic of Nursing Process

Cyclic and Dynamic in nature – data from each phase provides the input into the next phase so that is becomes a sequence of events (cycle) that are constantly changing (dynamic) base on client’s health status.

Involves skill in Decision-making – nurse makes important decisions related to client care, she choose the best action/steps to meet a desired goal or to solve a problem. She must make decisions whenever several choices or options are available.

Uses Critical Thinking skills – the nurse may encounter new ideas or less-than-routine or non-ordinary situations where decisions must be made using critical thinking.

Purpose of Nursing Process:

1. To identify a client’s health status; his Actual/Present and potential/possible health problems or needs.
2. To establish a plan of care to meet identified needs.
3. To provide nursing interventions to meet those needs.
4. To provide an individualized, holistic, effective and efficient nursing care.

Steps/Phases of the Nursing Process:

1. Assessment
2. Diagnosis
3. Outcome Identification
4. Planning
5. Implementation
6. Evaluation

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