Categories of Nursing Interventions in Family Nursing Practice - NCM 104

By: Alma A. Alterado RN MAN

 Categories of Nursing Interventions in Family Nursing Practice - NCM 104
By: Alma A. Alterado RN MAN

Introduction:
 To provide quality patient care over a period of time, nurses need a roadmap that guides their
actions and quantifies desired outcomes.
 Nurses are responsible for creating a plan of care based on each patient’s needs and health goals.
 A nursing care plan is a formal process that includes six components: assessment, diagnosis,
expected outcomes, interventions, rationale, and evaluation. ((Helen Ballantyne, “Developing
nursing care plan,” Nursing Standard, Feb. 24,2016: https://pubmed.ncbi.nlm.nih.gov/26907149/)
 Documenting these steps ensures effective communication between doctors, nurses, and other
healthcare professionals over multiple shifts.
 Interventions are a key element of the nursing care plan. This guide explores nursing interventions
and their role in patient care.
What Are Nursing Interventions?
What first comes to mind when you think of a “nursing intervention?” For many, especially newer nurses,
administering medication or evaluating vital signs may come to mind. However, nursing interventions
encompass the holistic nature of the nursing profession. Defining what a nursing intervention is important
to empower nurses to work at their full professional scope.
 The agreed-upon definition of a nursing intervention is “any treatment, based upon clinical
judgment and knowledge, that a nurse performs to enhance patient/client outcomes.” -
Bulechek’s Nursing Interventions Classification (NIC) book, which includes no less than 565
interventions that are mapped to over 13,000 nursing activities.
 Nursing interventions are actions a nurse takes to implement their patient care plan, including any
treatments, procedures, or teaching moments intended to improve the patient’s comfort and
health. ((nursing intervention. (n.d.) Medical Dictionary. (2009).
 According to the Journal of Nursing Education, nursing interventions are:
o Any task that a registered nurse does for a patient,
o Anything a nurse does that may lead or is intended to lead directly to a patient outcome.
 Nurse interventions can involve direct or indirect approach methods-depending on the patient’s
desired outcome and unique situation.
o Direct care refers to interventions that are carried out by having personal contact with
patients.
 Examples of direct care interventions are wound care, repositioning, and
ambulation.
o Indirect care interventions are performed when the nurse provides assistance in a setting
other than with the patient.
 Examples of indirect care interventions are attending care conferences,
documenting, and communicating about patient care with other providers.
 Essentially, nursing interventions are all the actions nurses take to implement care plans with the
overarching goal of improving, maintaining, or restoring a patient’s state. These may include
therapies, procedures, or education opportunities. As long as a measure or activity aids in treating
a patient and aims to increase their health and comfort, it will count as a nursing intervention.
 interventions include basic and complex physiological interventions, behavioral, safety, family,
health system, and community interventions. Clearly nursing interventions are far more complex
and far-reaching than simply carrying out a doctor’s orders.
 Categories of Nursing Interventions in Family Nursing Practice - NCM 104
By: Alma A. Alterado RN MAN

The rationale for the nursing intervention should include answers to the following questions.
 What is the desired outcome?
 Is there a relevant nursing/medical diagnosis that explains the need for this intervention?
 Is the intervention evidence-based?
 Is it feasible to perform this intervention given the care context?
 Is this an intervention that is acceptable to the patient?
 Does the nurse have the skills necessary to perform the intervention?
3 Main Categories of Nursing Intervention:
 Nurses always act as a part of a bigger healthcare team. In the process of caring for a single patient,
there’s an army of nurses, aides, physicians, physical therapists, therapists who all collaborate to
ensure the best patient outcomes.
 With that in mind, an initial categorization for nursing interventions is related to the nurse’s level
of involvement in carrying out the intervention.
1. Independent.
 Nurses perform independent interventions every day while they are working.
 A nurse can perform independent nursing interventions without assistance or input from
others.
 Nursing outcomes only require one certified caregiver to carry out care plans.
 while some independent activities are legally allowed under the scope of a registered
nurse, the individual may need extra training or certification to initiate the intervention
independently.
 An example of independent intervention would be medication adherence, or a nurse
educating a patient on the importance of taking their medication as prescribed.
 Any intervention that the nurse can independently provide without obtaining a
prescription is considered an independent nursing intervention.
 An example of an independent nursing intervention is when the nurses monitor the
patient’s 24-hour intake/output record for trends because of a risk for imbalanced fluid
volume.
 Another example of independent nursing interventions is the therapeutic communication
that a nurse uses to assist patients to cope with a new medical diagnosis.
2. Dependent.
 Dependent nursing interventions require a direct order from a physician and cannot be
performed by a nurse alone (For example, when a physician orders a new prescription
medication for a patient).
 Dependent nursing activities cannot be carried out without another member of the care
team. Usually, this is a legal requirement that does not allow the nurse to perform the task
independently.
 Therefore, to carry out an intervention that includes medication administration, a
prescription is needed, making the intervention dependent.
3. Interdependent.
 These interventions involve multiple members of a healthcare team to perform tasks
smoothly and properly.
 A care team will work together in caring for a patient during an intervention.
 Categories of Nursing Interventions in Family Nursing Practice - NCM 104
By: Alma A. Alterado RN MAN

 An example of an interdependent nursing intervention could include a patient recovering

from ankle surgery who is prescribed pain medication by a physician, administered by a
nurse, and participates in routine physical therapy by a specialist.
 Interdependent or collaborative nursing interventions are performed in a team setting.
There is some crossover between independent and dependent nursing interventions and
collaborative interventions.
 Interdependent nursing interventions are present when interdisciplinary team members
collaborate on a shared care plan for a patient.
 Interdependent nursing interventions may also be carried out in collaboration with other
interdisciplinary team members, such as social workers or physiotherapists.
Nursing Intervention Examples
Independent Nursing Intervention Example
During personal care, the nurse notices redness around the coccyx area. The patient is usually a mobile
person from a nursing care home, but they were recently admitted after a fall and are no longer walking.
They have also had episodes of delirium of an unknown cause and have been experiencing some
incontinence. The nurse recognizes this patient is at risk for further skin breakdown, so they initiate a care
plan that includes scheduled toileting and turns for the patient every two hours. This is communicated in
a written care plan and during reports to their colleagues. This is an independent intervention because no
other health professionals need to be involved in this intervention.
Dependent Nursing Intervention Example
A nurse works in an outpatient heart failure clinic and is on a regularly scheduled phone check-in with a
patient. This patient records their blood pressure measurements daily and alerts you that they’ve been
trending higher than usual for the last few weeks. The nurse suspects that the blood pressure medications
need to be titrated. However, they need the doctor to adjust the prescription. They communicate this
finding to the doctor who prescribes a higher dose of medication for the patient. The nurse then calls the
patient back to review the possible side effects and risks of the medication. This action could not be carried
out without the participation of the physician, making it a dependent intervention.
Interdependent Nursing Intervention Example
There is a quality improvement project underway in an ICU to reduce the incidence of ventilator-associated
pneumonia. One method to reduce ventilator-associated pneumonia is limiting mechanical ventilation to
only when necessary. While discontinuing ventilation requires a physician’s order, ICU-trained nurses can
initiate ventilator weaning to stop mechanical ventilation as soon as possible. Nurses may also work with
other members of the care team, such as a respiratory therapist, to optimize ventilation to reduce the risk
of pneumonia. These interventions are interdependent because the nurse works with other
interprofessional team members for a common goal.

NURSING INTERVENTIONS CLASSIFICATION SYSTEM

 Based on research and input from the nursing profession, NIC categorizes and describes nursing
interventions that are constantly evaluated and updated.
 Nursing Interventions Classification (NIC) system is designed to categorize every possible
intervention a nurse may perform.
 NIC intervention provides a platform for easy communication regarding interventions with other
medical professionals, all while documenting the tests and evaluations they perform on a patient
throughout an intervention.
 Categories of Nursing Interventions in Family Nursing Practice - NCM 104
By: Alma A. Alterado RN MAN

 Keeping this system up to date is constantly evolving through practice, evaluation, and regular
updating to meet the proper standards and requirements.
 This system ensures thorough care, and a therapeutic relationship is provided to every patient.
 Interventions included in NIC are considered evidence-based nursing practices. The nurse is
responsible for using clinical judgment to make decisions about which interventions are best
suited to meet an individualized patient’s needs.
 Nursing Interventions Classification (NIC) is the information system that defines all nursing actions
necessary to provide direct and indirect care to patients.
 NIC helps standardize patient care.
NIC offers the following benefits:
1. Helps document and track tests and medications that patients receive,
2. Makes communication of care across health care settings easier and faster,
3. Measures the effectiveness of nursing interventions,
4. Integrates data across health care systems and settings,
5. Enables the evaluation of nursing competency,
6. Helps measure the productivity of health care establishments,
7. Helps to improve the quality of nursing care, and
8. Provides a detailed curriculum for nursing.
NIC categorizes nursing interventions across seven domains:
1. Community Nursing Intervention
 In many medical facilities, there is a focus on public health initiatives.
 These actions aim to educate larger groups of people: patients, their families, and local
communities, in general, about matters of general health and wellbeing.
 Education programs for diabetes, vaccination campaigns on a larger scale, breast cancer
awareness movements – these are some examples of public health initiatives in which nurses
can take part, subsequently requiring interventions on their part.
 Community nursing interventions are nursing practices that affect communities or many
people at once. These organized public health initiatives seek to educate or encourage a
community or a large group of people to participate in activities that promote a healthy
lifestyle.
 The aim of community nursing interventions is to promote general health and wellness among
masses of people. An example is a health fair set up at a school to teach children and the
public about health and well-being issues.
2. Family Nursing Interventions
 Certain nursing interventions are directed at a patient’s family as much as to the patients
themselves.
 Family nursing interventions are those that address not only the patient, but other family
members as well. They could entail education of family members about caring for the patient;
or, in the case of new mothers, interventions could consist of instruction and assistance with
breastfeeding and other forms of infant care.
 For example, suppose a patient is diagnosed with a transmittable disease. In that case, the
nurse must educate the entire family on ways to reduce the threat of the illness. Or, when a
child is born, the nurse may instruct or assist the mother with breastfeeding her newborn or
offer other forms of infant care to the parents.
 Categories of Nursing Interventions in Family Nursing Practice - NCM 104
By: Alma A. Alterado RN MAN

 Family nursing interventions are nursing programs, procedures or instructions that impact an
entire family.
 These enable family members to care for an ill family member or support one another.
 An example of a family nursing intervention is educating family members on providing care
for patients with chronic conditions.
 Another example is nurses providing support to new parents to help them care for infants,
including teaching them how to bathe, feed and swaddle their baby.
3. Behavioral Nursing Interventions
 If a patient is battling addiction, wants to quit smoking, or needs to learn how to use an
assistive device, the Registered Nurse will have to engage in behavioral nursing interventions.
 These types of actions are aimed at helping the patient learn methods to change a specific
behavior.
 Some more examples include: educating the patient about using a new mobility aid, like a
prosthetic leg, or providing coping mechanisms against stress; suggesting physical coping
mechanisms to substance abuse.
 Offer assistance, including actions, that help a patient change their own behavior.
 Behavioral nursing interventions are tasks that help patients learn methods to change their
behavior. Nurses use behavioral analysis to assess a patient when performing this type of
intervention.
 This may include providing instructions on how to use assistive devices, cope with stress or
handle addiction.
 An example includes providing physical and emotional coping strategies to encourage patients
to quit smoking.
4. Physiological Basic Nursing Interventions
 Physiological basic nursing interventions are simple actions nurses perform to assist patients
with their physical health.
 These procedures range from exercise and offering feeding or bathing assistance to measuring
a patient’s blood pressure or temperature.
 Physiological basic nursing interventions are simple nursing procedures that assist patients
with their physical health and well-being. These interventions are essential for basic patient
well-being, such as assisting them in maintaining hygiene.
 Physiological basic nursing interventions can also include ensuring that patients exercise and
assessing their blood pressure or temperature.
 Triage nurses in the emergency room need to be experts in physiological nursing interventions
because many of these interventions involve assessing a patient and treating physical
ailments.
5. Physiological Complex Nursing Interventions
 This category includes a more complex set of interventions aimed at helping a patient with
their physical health.
 An excellent example of a physiological complex nursing intervention would be providing IV
fluids. This intervention requires a combination of smaller tasks – inserting the needle,
administering medication, and keeping an eye on the patient.
 Categories of Nursing Interventions in Family Nursing Practice - NCM 104
By: Alma A. Alterado RN MAN

 Physiological complex nursing interventions are procedures that usually involve a higher level
of skill and comprise smaller tasks. These interventions are necessary to promote or assist a
patient with maintaining optimum physical health.
6. Safety Nursing Interventions
 Helping patients maintain their safety and preventing further injury is an integral part of a
nurse’s job. That’s where safety nursing interventions come in.
 Safety interventions come in many forms: from educating a patient (or their family) on
postoperative care and teaching them how to use a walker safely after a hip replacement to
giving instructions on how to use the alarm in case they want to move to avoid risk of falls to
showing a disoriented patient back to their room.
 Safety nursing interventions are nursing procedures and tasks that are necessary to assist
patients in maintaining their overall health and well-being.
 These interventions include protecting patients in the hospital or long-term care facility, taking
precautions to prevent injury and educating patients and their families on postoperative care
measures.
 Bed positioning, providing alarms and railings and orienting a patient to their room are all
examples of safety nursing interventions. Training patients and caregivers to call for assistance
is also a safety nursing intervention.
7. Health System Nursing Interventions
 This type of nursing intervention is usually collaborative and includes input from multiple
healthcare team members.
 For example, if the health goal for the patient is to reduce the risk for infections during their
stay, then the subsequent interventions would be the administration of medication (as
prescribed by physician), followed by offering hygiene assistance and changing wound
dressings (by the nurse).
 Health system nursing interventions are often interdependent interventions that promote
patient safety and involve a team of medical professionals.
 This type of nursing intervention involves health care professionals collectively working
together to create a safe atmosphere for all patients.
 An example includes implementing a procedure to reduce infections among patients during
their stay in the hospital. This can include interventions such as administering antibiotics,
bathing the patient and changing wound dressings.

Examples of nursing interventions

Here are some examples of nursing interventions:
1. Fall prevention: Nurses educate patients and encourage the use of footwear with grips, assistive
mobility equipment and bedside alarms to prevent falls or request for help if the patient falls.
2. Pain control: Nurses typically help patients with pain control by administering medication. Pain
management can also include teaching exercises to reduce pain for conditions such as arthritis.
3. Fluid intake: This means helping patients stay hydrated, which is important for their physical
health.
4. Mobility therapy: Nurses may teach patients exercises to increase their mobility. Mobility therapy
also includes moving patients' limbs, especially in cases of paralysis, to prevent muscles from
atrophy.
 Categories of Nursing Interventions in Family Nursing Practice - NCM 104
By: Alma A. Alterado RN MAN

5. Assistive device therapy: Nurses also help patients with the use of assistive devices, such as a
wheelchair or insulin pens. They teach patients how to help themselves at home after a diagnosis.
6. Sleep pattern control: Assisting patients with healthy sleeping habits is important for helping them
recover. Sleep pattern control may involve monitoring or education.
7. Cluster care: This involves communicating patient needs to medical staff, especially between
shifts. Cluster care enables the health care facility to provide patients with proper care throughout
the day.
PURPOSES OF NURSING INTERVENTION:
1. Reaching health goals
 Many nursing interventions help patients reach their wellness and recovery goals. The primary
responsibility of nurses is to aid in formulating treatment plans for a patient to improve their
health or quality of life.
 Examples of nursing interventions that serve this purpose include administering medications,
changing bandages and helping patients stay hydrated. Nurses also help patients reach their
health goals by counseling them and screening to identify underlying diseases or conditions.
2. Educating patients
 Educating patients, families and their caregivers about the patient's condition and treatment plan
is important for a successful recovery. Nurses provide education or instructions on how to support
patients at home, manage their condition and implement their treatment plans after discharge.
 If patients suffer from chronic illness, nurses educate them and their caregivers to identify warning
signs that may require them to seek immediate medical attention.
3. Promoting safety
 Nursing interventions promote patient safety by implementing preventive measures, such as
ensuring the safety of immobile patients by changing their bed positions to prevent injuries.
Nursing interventions that promote patient safety also include monitoring patients' vital signs and
critically observing them to detect changes in their symptoms, behavior or mood.
 Nurses may create patient safety protocols to help health care professionals deal with specific
medical situations, such as how to proceed with care when patients are unconscious. Promoting
patient safety is the ultimate goal of nursing interventions, which also includes reducing disease
incidence rates.
4. Offering support
 Nursing interventions can also offer emotional support and comfort to patients and their families.
For example, nurses can recommend resources for therapy to handle stress. Nurses can also
identify less-than-optimal psychosocial states and advocate for patients. They may conduct
assessments to determine the mental well-being of patients and their families and help them deal
with the conditions they're experiencing.