1.2 Care Plan Table

Physical Data:

Subjective

Objective

Psychosocial Data

Spiritual Data

Cultural Data

Developmental Data

Priority Nursing Diagnosis

(3 part diagnosis)

Short Term Outcome (SMART)

Interventions

Scientific Rationale for Intervention

1.

1.

2.

2.

3.

3.

Evaluation Plan:

(How do you know your outcome has been met? At what point will you measure the outcome?