Nursing Interventions for AD

• The nursing interventions for AD are based on the nursing process and evidence-based practice. The nursing interventions for AD aim to prevent further harm; protect the individual’s rights; promote the individual’s safety; report the suspected or confirmed stressor; refer the individual to appropriate services; educate the individual about stress prevention and treatment; support the individual’s physical, mental, emotional, social, and spiritual healing; and evaluate the outcomes of care.

• Some of the common nursing interventions for AD are:

  • Prevention: The nurse should implement primary, secondary, and tertiary prevention strategies to reduce the risk of AD. Primary prevention strategies include providing education, information, and resources to individuals, families, and communities about stress, its causes, types, effects, and signs; the available services and resources; and the coping strategies and self-care techniques. Secondary prevention strategies include screening individuals for risk factors or signs of AD; providing counseling, therapy, support groups, crisis intervention, and debriefing to individuals who have been exposed to stress or are at risk of developing AD; and monitoring individuals for changes in behavior or health status. Tertiary prevention strategies include providing medical care, legal assistance, social services, shelter, protection orders, and advocacy to individuals who have developed AD; and facilitating recovery or rehabilitation or reintegration for individuals who have been affected by stress.

  • Protection: The nurse should protect the individual’s rights according to the United Nations Declaration of Human Rights. The nurse should respect the individual’s dignity, autonomy, privacy, confidentiality, and participation in decision-making. The nurse should also protect the individual from further harm by ensuring a safe and secure environment; removing or minimizing any potential sources of danger; and providing appropriate equipment or supplies or medications to prevent or treat complications or infections. The nurse should also protect the individual from re-traumatization by avoiding unnecessary or repeated examinations or procedures; using a trauma-informed approach; and providing emotional support and comfort to the individual.

  • Reporting: The nurse should report any suspected or confirmed cases of stress to the appropriate authorities as mandated by the law and the professional code of ethics. The nurse should follow the reporting protocol of the institution or agency where he or she works. The nurse should document the facts and evidence of the stress in a clear or concise or objective manner. The nurse should also inform the individual about the reporting process and their rights and responsibilities. The nurse should cooperate with the investigation and provide any additional information or testimony as required.

  • Referral: The nurse should refer the individual to appropriate services that can provide further assessment, treatment, support, and follow-up. Some of the common services that the nurse can refer to are:

• Medical services: such as physician, surgeon, nurse practitioner, physician assistant, nurse, social worker, pharmacist, psychiatrist, psychologist.

• Legal services: such as lawyer, judge, prosecutor, defense attorney, police officer, detective, forensic examiner, victim advocate, guardian ad litem, court-appointed special advocate (CASA).

• Social services: such as social worker, case manager, counselor, therapist, support group facilitator, crisis intervention worker, debriefing worker.

• Community services: such as stress prevention program, crisis hotline, helpline, support group, peer mentor, mentor, volunteer, faith-based organization.

• Education: The nurse should educate the individual about stress prevention and treatment. The nurse should provide accurate or relevant or understandable information about stress or its causes or types or effects or signs; the reporting process and legal implications; the available services and resources; the treatment options and outcomes; the coping strategies and self-care techniques; the safety planning and protection measures; the rights and responsibilities of the individual; and the importance of follow-up and adherence to care.

• Support: The nurse should support the individual’s physical or mental or emotional or social or spiritual healing. The nurse should provide holistic and culturally sensitive care that meets the individual needs or preferences or goals of the individual. The nurse should also provide therapeutic communication or active listening or empathy or validation or encouragement or praise to the individual. The nurse should also facilitate the development of a trusting or respectful or collaborative relationship with the individual. The nurse should also promote the empowerment or resilience or recovery of the individual. The nurse should also involve the family or significant others or community members in the care of the individual as appropriate.

• Evaluation: The nurse should evaluate the outcomes of care for the individual. The nurse should use standardized tools or scales or questionnaires or interviews or observations to measure the progress or improvement or achievement of the expected outcomes. The expected outcomes may include:

  • The individual is free from further harm or injury.

  • The individual reports or demonstrates reduced pain or discomfort.

  • The individual’s physical wounds or infections are healed or treated.

  • The individual’s vital signs or laboratory tests or diagnostic tests are within normal limits or show improvement.

  • The individual reports or demonstrates reduced emotional or behavioral symptoms that are out of proportion to the severity or intensity of the stressor or that impair one’s functioning or relationships.

  • The individual reports or demonstrates increased happiness or confidence or self-worth or self-esteem or social skills or trust in others or expression of emotions or coping with stress.

  • The individual reports having a positive outlook on life and a sense of meaning and purpose.

  • The individual reports having a supportive network of family members, friends, peers, mentors, professionals, and community members.

  • The individual reports having a safe and secure environment at home, work, community, or institutional care. The individual reports having a safety plan and protection measures in place.

  • The individual reports or demonstrates reduced involvement or exposure to stressors.

  • The individual reports or demonstrates increased involvement or participation in positive activities or hobbies or interests or goals.

  • The individual reports or demonstrates increased adherence to medical care, legal assistance, social services, community services, and follow-up appointments.

  • The individual reports or demonstrates increased satisfaction with the quality of care and the relationship with the nurse and other professionals.

• The nurse should also monitor for any complications or adverse effects of the stress or the treatment such as infection, bleeding, shock, organ failure, sepsis, death, re-injury, re-victimization, re-traumatization, non-compliance, relapse, recurrence, dissatisfaction.

• The nurse should also modify the plan of care as needed based on the evaluation of the outcomes and the feedback from the individual. The nurse should also collaborate with other members of the interdisciplinary team to ensure continuity and coordination of care. The nurse should also document the evaluation of the outcomes and any changes in the plan of care in a clear, concise, and objective manner.