2 Foundational Nursing Concepts
Explore nursing’s foundational concepts, approaches to coordinated and person-focused care, prevention, health promotion, and the steps nurses use to plan and evaluate care.
Nursing’s foundational concepts
Nursing supports health and healing, prevents illness and injury, and helps people manage health needs across the lifespan. Its focus includes individuals and families, as well as communities and populations.
The organizes nursing knowledge and practice around four interconnected concepts:
Person: The individual, family, group, or community receiving care, understood within their own values, relationships, and circumstances.
Health: A changing state of well-being and illness, not simply the presence or absence of disease.
Environment: The physical, social, cultural, economic, and organizational conditions that affect health.
Nursing: The knowledge, judgment, and actions nurses use to support health and respond to people’s needs.
These concepts interact. For example, a person’s ability to manage a chronic condition may depend not only on symptoms and treatment, but also on housing, family support, access to services, and the care environment.
Models of care and coordination
A model of care provides an organized way to understand or deliver care. Models differ in emphasis, but effective nursing care responds to the person’s needs and preferences and is coordinated across the people and services involved.
treats the person as an active partner: the nurse asks what matters to the person, respects their choices, and adapts care to their needs, abilities, and circumstances. broadens what the nurse considers by addressing physical, psychological, social, cultural, and spiritual dimensions together. The approaches overlap: guides how decisions are shared, while broadens the dimensions of care considered.
Interprofessional teamwork and care coordination involve nurses, patients, families, and other professionals sharing relevant information and organizing activities to support continuity, especially when care moves between settings. For example, planning a safe discharge may involve the patient, nurse, prescriber, pharmacist, and community services.
and prevention
enables people to increase control over and improve their health. It involves more than giving advice: nurses can support people’s skills and choices, identify barriers to health, and work with families, communities, and other sectors to improve conditions that affect well-being.
The Ottawa Charter highlights several kinds of action for :
Building healthy public policy.
Creating supportive environments.
Strengthening community action.
Developing personal skills.
Reorienting health services toward .
Prevention is commonly described at three levels, which help nurses match activities to a person’s or population’s needs:
aims to prevent a condition before it starts. Examples include immunization and supporting smoking cessation.
seeks early detection and timely action. An example is screening for high blood pressure.
limits complications and supports function after a condition is established. An example is rehabilitation after a stroke.
The
The is a systematic, evidence-informed, iterative framework for organizing nursing care. Its six interrelated steps are assessment, diagnosis or problem identification, outcomes identification, planning, implementation, and evaluation. Nurses may revisit earlier steps as a person’s condition or response changes.
Assessment: Gather and analyze relevant information, including the person’s reported concerns, observed findings, history, strengths, preferences, and circumstances.
Diagnosis or problem identification: Use clinical judgment to identify the person’s responses, needs, or risks that nursing care can address. This differs from a medical diagnosis, which identifies a disease or condition.
Outcomes identification: Set clear, measurable goals with the person. Outcomes describe the changes or results the care aims to achieve.
Planning: Select and prioritize evidence-informed nursing actions, including coordination with the person and care team.
Implementation: Carry out the planned actions, communicate relevant information, and document care.
Evaluation: Compare the person’s response with the expected outcomes. Continue, adjust, or revise the plan as needed.
Applying the steps to a recovery goal
A person recovering from surgery says pain makes walking difficult. The nurse assesses pain, mobility, and the person’s goals; identifies pain and reduced mobility as nursing concerns; and agrees on a goal such as walking safely to the corridor. The nurse plans appropriate pain-relief and mobility support, implements the plan, and evaluates whether pain and walking ability improve. If the goal is not met, the nurse reassesses and revises the plan.