Use and effectiveness of psychiatric nursing care plans

Nursing administrators require that bedside nurses should use nursing care plans, which also serve the purposes of auditors, educators and others. They are time consuming, they are not uniformly liked by bedside nurses, and they are not used with equal rigour everywhere. Their efficacy as enhancers of quality of care given has seldom been investigated and never demonstrated. In an attempt to repair this deficiency, the author documented 158 transactions between psychiatric nurses and their patients over a 5-month period. In each instance, the quality of the care given was judged and scored. Subsequently, the author determined whether nursing care plans existed and, by comparing them with the transactions, determined whether or not they had been followed. These nurses did not generally follow the care plans, though usually they thought they had. Transactions done where a nursing care plan existed were not better than those done in the absence of nursing care plans. In transactions following an existing nursing care plan, the quality of care given was judged to be lower than in those where an existing nursing care plan was not followed, a result which was statistically highly significant. These findings are discussed, and the author notes the clear implication of this study that nursing care plans are less than helpful to bedside nursing.