Beyond the Bedside Chapter 18: Implementing
Turn care plans into safe, person-centered action at the bedside.
In this episode
We master how to implement evidence-based interventions using NIC/NOC, QSEN, and Alfaro’s Assess → Reassess → Revise → Record loop—while delegating safely, preventing errors, and documenting like a pro.
You’ll learn
The 9-step implementation workflow you can use on any shift
Direct vs. indirect vs. community interventions (when to use each)
How to apply the Five Rights of Delegation (task, circumstance, person, directions, supervision)
Care bundle must-dos (e.g., central line) and how to stop “work-arounds”
Turning nonadherence into partnership (find the “why,” fix the barriers)
Documentation that protects your patient—and your license
Case studies
James McMahon (ICU): line labeling, compatibility checks, med safety under pressure
Estelle Morrissey (LTC): ethics, loneliness vs. assisted-death requests, pastoral support
Antoinette Browne (Peds): nurse-, provider-, and collaborative interventions; care coordination with family teaching
ED Advocacy (Penuela family): cost barriers, language access, social work + affordable regimens
Tools & frameworks
NIC ↔ NOC mapping to make outcomes measurable
QSEN competencies in action (patient-centered care, teamwork, EBP, QI, safety, informatics)
Box 18-1 checklist before every intervention; Table 18-1 communication behaviors
Dry-erase boards for goals/pain/safety; TJC Speak Up scripting
NCLEX quick-check
Prioritization, “first action” (reassess!), safe delegation to APs, bundle compliance, and what belongs in implementation vs. assessment/diagnosis.
Resources mentioned
AHRQ Patient Safety • IHI Care Bundles • The Joint Commission “Speak Up”
Tags: nursing process, implementation, NIC, NOC, QSEN, delegation, care bundles, patient safety, documentation, NCLEX.
