77 Ill. Adm. Code 250.970
Nursing Care Plans
Section 250
Section 250.970Â Nursing Care
Plans
a)Â Â Â Â Â Â Â Â There shall be evidence that the nursing service provides
safe, efficient, and therapeutically effective nursing care through the
planning of the care of each inpatient, and patient in observation, and the
effective implementation of nursing care plans.
b)Â Â Â Â Â Â Â Â In any case where it is determined that a nursing care plan is
not necessary, that decision shall be documented in the patient's record.
c)Â Â Â Â Â Â Â Â The nursing care plan for each patient shall be coordinated
with their medical management plan and the patient's representative.
d)Â Â Â Â Â Â Â Â Each nursing care plan shall, at minimum, indicate:
1)        The patient’s problems as identified by the nursing staff and
what nursing care is needed;
2)Â Â Â Â Â Â Â Â How it can best be accomplished;
3)Â Â Â Â Â Â Â Â What methods and approaches are believed likely to be most
successful; and
4)Â Â Â Â Â Â Â Â What modifications are necessary to ensure the best results.
e)Â Â Â Â Â Â Â Â Each nursing care plan shall be initiated upon the admission
of the patient to the hospital and shall include a discharge plan.
f)Â Â Â Â Â Â Â Â The nursing care plans shall be available to all nursing
personnel and shall be reviewed and revised as necessary.
g)Â Â Â Â Â Â Â Â Nursing care plans may be considered as a part of and filed
with the patient's record.