ANA Nursing Process Competencies
Key Points
- The ANA nursing process supports structured critical thinking and decision-making.
- Six competencies are assessment, diagnosis, expected outcomes, planning, implementation, and evaluation.
- The framework is iterative and requires continuous reassessment and adjustment.
- Family and support-network participation can influence each step.
Pathophysiology
Patient status changes dynamically across disease progression and treatment response. A fixed one-time plan cannot safely account for new risks, partial response, or deterioration. The ANA competency sequence creates a repeatable loop that links data collection to action and outcome interpretation.
Classification
- Assessment: Gather and compare patient cues against expected norms.
- Diagnosis: Group cues into prioritized patient problems.
- Expected outcomes: Define desired patient-specific results.
- Planning: Select activities needed to reach outcomes.
- Implementation: Carry out planned interventions.
- Evaluation: Determine if outcomes are met, partially met, or unmet and revise plan.
Nursing Assessment
NCLEX Focus
Evaluation is not the end; it is the trigger for the next assessment cycle.
- Collect objective and subjective data at baseline and after interventions.
- Prioritize problems by safety risk and progression potential.
- Ensure expected outcomes are measurable and time-bounded.
- Track whether interventions are feasible for patient and support network.
- Reassess quickly when outcomes are partially met or unmet.
Nursing Interventions
- Build care plans with explicit links between diagnosis, intervention, and expected outcomes.
- Engage patients and caregivers in tasks they can safely complete.
- Escalate collaborative needs when independent nursing scope is insufficient.
- Modify interventions when evaluation shows limited effectiveness.
- Continue iterative cycles until goals are achieved or revised.
Loop Failure Risk
Skipping evaluation or failing to revise an ineffective plan increases risk of prolonged instability.
Pharmacology
Medication-related interventions should be evaluated with the same loop: indication, response, adverse effects, adherence barriers, and plan adjustment.
Clinical Judgment Application
Clinical Scenario
A patient with multiple diagnoses shows partial improvement after initial care plan implementation.
Recognize Cues: Some outcomes improving, others stagnant. Analyze Cues: Current plan is only partially effective. Prioritize Hypotheses: Unmet outcomes may require revised interventions. Generate Solutions: Update priorities and intervention set. Take Action: Implement revised plan with clearer metrics. Evaluate Outcomes: Determine whether revised strategy produces full progress.
Related Concepts
- categories-of-nursing-diagnosis - Diagnosis category choice informs planning strategy.
- nursing-diagnosis-vs-medical-diagnosis - Clarifies diagnosis focus used in competency steps.
- evaluation-of-outcomes-in-fluid-electrolyte-and-acid-base-care - Practical example of the evaluation-revision cycle.
Self-Check
- Why must expected outcomes be defined before intervention selection?
- What should happen when a plan is only partially effective?
- How does support-network involvement alter implementation and evaluation?