 Hi, welcome to Nursing School Explained. In this video about the fourth step of the nursing process, which is the implementation phase. So now we have assessed our patient, we have come up with our problem list and prioritized appropriately, and we have established our patient goals. So now we're going to, the goal here is to achieve the patient goals and expected outcomes that we have just identified. Now these will be based on standing orders that you might encounter at the hospital, clinical practice guidelines and protocols established by the American Nursing Association or other guiding agencies, as well as evidence-based practice that I'm sure you've heard about before, where researchers will come together and look at different data from different researchers and come together and gather the evidence to come up with these practice guidelines. Now before we go into the interventions, we are going to review the nursing problems that we have identified, as well as the patient goals and expected outcomes. We're going to identify several actions and interventions that might benefit our patients and choose the best ones that will particularly help our patient to get better. Then we will also have to use our critical thinking to anticipate complications and whatever complications we anticipate, we have to kind of build into these interventions that we'll be taking. Once we have established that, then we can implement individualized interventions, and interventions are always three different categories. They can be independent, dependent, or collaborative. Now independent means that these are interventions that the nurse can take independently from anybody else without any order, for example. Dependent interventions will always depend on the provider or the physician to give us orders. So medications, for example, and collaborative interventions will always be the ones where we collaborate with different disciplines such as physical therapy, speech therapy, occupational therapy, social worker, and so forth. Now let's apply this to the example that we've been discussing this entire time. So we've identified our patient problem was oxygenation. The goal was the patient will maintain an O2 sac greater than 95% during my shift. So now the interventions that I come up with here can be very simple. So again, we focus on independent, dependent, and collaborative interventions. And the first step here again is to assess. And sometimes that can be a little bit confusing to students, because we have already assessed the patient. Well, we need to assess in more detail, because from the first time that we saw the patient and identified the problem, now things might have been a little bit different. And we need to also go in more detail now about this oxygenation problem. So in our example here, we're going to assess respiratory rate, O2sat, lung sounds, capillary refill, their skin color to check for perfusion, and maybe even their hemoglobin and hematocrit to see how that relates to their oxygenation. Now then we can administer oxygen as ordered and titrated appropriately, which would be a dependent nursing intervention, because oxygen is considered a medication, and we always have to have an order for that. And then number three could be something as simple as elevating the head of the bed to facilitate for maximum chest excursion and help the patient achieve the goal of the oxygen saturation greater than 95%. So the interventions here are kind of like the meat of the nursing process, where we really come to doing the things and performing the things that will get the patient better. But again, they have to be individualized, and we have to choose the best ones from a list of possible interventions from the evidence that we have to individualize and then focus on independent first and dependent and collaborative interventions second. Now once we have established our interventions, after we've established a patient problem list as well as goals, then we move on to the fifth and last phase, which is the evaluation phase of the nursing process. So please stay tuned and watch the fifth video in the series where I explain the details and how to evaluate the progress of the nursing care plan. Thanks so much for watching.