The nursing process (ADPIE)

Reviewed November 2, 2026 by our editorial team

What is the nursing process?

The nursing process applies the scientific method to patient care. Instead of acting out of habit, the nurse collects data, identifies the problems nursing can address, decides what to achieve, acts, and checks whether it worked. It gives the team a common language, documents every decision and puts the patient, not the disease, at the center.

The nursing process is not a form you fill out once. It is cyclical: evaluation leads to a new assessment, and the plan is adjusted as the patient changes.

The 5 steps of the nursing process (ADPIE)

1. Assessment

   You collect patient data in an organized way: health history interview, physical exam, vital signs, scales and test results. You separate objective data (what you measure or observe) from subjective data (what the person tells you) and organize them, for example by NANDA-I domains or by functional health patterns.

   Example: RR 28 breaths/min, SpO2 90% on room air, weak cough with thick secretions, temperature 38.6 °C (101.5 °F). Patient states, "I get tired when I talk."

2. Diagnosis

   You analyze and cluster the data and choose the NANDA-I label that best explains them. You write it in PES format (problem, etiology, signs and symptoms) or, for a risk diagnosis, with its risk factors. Then you prioritize: anything that threatens the airway, breathing or circulation comes first.

   Example: Ineffective airway clearance related to thick secretions and fatigue as evidenced by a weak cough that does not clear secretions, rhonchi and SpO2 of 90%.

3. Planning

   You define what you want to achieve (goals or NOC outcomes) in measurable, time-bound terms, and you choose the interventions (NIC) with their rationales. This is when you write the nursing care plan.

   Example: Goal: patient clears secretions with an effective cough and maintains SpO2 ≥ 94% within 24 hours. Interventions: Fowler's position, teaching effective coughing, hydration, nebulizer treatments as ordered.

4. Implementation

   You carry out the interventions, on your own or with the team, and document what you did and how the patient responded. You keep assessing during implementation: if something changes, you adjust the plan.

   Example: Patient placed in Fowler's position, taught a three-step cough, nebulizer treatment given at 10:00, and 20 mL of yellowish sputum documented.

5. Evaluation

   You compare the patient's status with the goal. If it was met, you resolve or continue the diagnosis; if not, you review what went wrong: the data, the diagnosis, the goal or the interventions.

   Example: At 24 hours the patient coughs effectively, rhonchi have decreased and SpO2 is 95%. Goal met; the diagnosis is continued until the secretions resolve.

Characteristics of the nursing process

• Systematic: it follows an order of steps that build on each other.
• Dynamic and cyclical: it is revisited every time the patient's condition changes.
• Patient-centered: it addresses the person's responses, not just the disease.
• Goal-oriented: every action aims at a measurable outcome.
• Flexible: it works in the hospital, in the community, with families and with groups.
• Evidence-based: every intervention has a rationale.

Types of nursing assessment

• Initial (comprehensive): on admission or at first contact. It is complete and serves as the baseline for comparison.
• Focused: centers on a specific problem, such as pain or breathing, and is repeated to track how it evolves.
• Emergency: fast, aimed at airway, breathing and circulation when there is a threat to life.
• Time-lapsed (follow-up): done some time later to look for changes, for example at an outpatient visit.

Data are organized with a framework: the 13 NANDA-I domains, functional health patterns or basic human needs, depending on what your program or facility uses. What matters is not leaving any area unassessed.

What a nursing process assignment includes

Every nursing program has its own template, but almost all include these parts:

1. Cover page and patient identification (with no information that could identify the patient).
2. Case summary: reason for admission, history and treatment.
3. Assessment organized by domains or patterns, with objective and subjective data.
4. Diagnostic reasoning: how you clustered the data and why you chose each diagnosis.
5. Prioritized nursing diagnoses written in PES format.
6. Care plan in table format: goal or NOC outcome, interventions or NIC, rationale and evaluation. You can build it with the care plan generator.
7. Final evaluation and conclusions.
8. References, including the NANDA-I edition you used.

Nursing process, NANDA-I, NIC and NOC: how they fit together

Complete nursing process example

More complete examples, with assessment and evaluation, in the case study of each guide: ineffective airway clearance, acute pain, risk for infection. And by condition: pneumonia, diabetes, stroke.

Common mistakes in the nursing process

• Copying diagnoses from a standardized plan when the assessment does not support them.
• Using the medical diagnosis as the etiology: "related to pneumonia."
• Goals with no time frame or number: "improve breathing."
• Interventions with no rationale or that do not address the diagnosis.
• Skipping evaluation, or not stating whether the diagnosis is resolved, continued or revised.

Frequently asked questions

Text and examples: written by our editorial team. Reviewed November 2, 2026.