Help P.I.E. Charting Cellulitis

Daytonite, BSN, RN · May 18, 2008

P.I.E. charting, or the pie system, as i know it is where P stands for the problem, I for interventions and E for evaluation. the P (problem) is data obtained from your assessment of the patient and often is a nursing diagnosis that has been identified. The I (interventions) are the actual nursing actions that you have taken for that particular problem. The E (evaluation) is the patient's response.

Here is a sample of p.i.e. charting from page 678 of Portable RN: The all-in-one nursing reference, Third edition...

P #1: nausea related to anesthetic.

I p#1: pt. given compazine 1 mg iv at 2300.

E p#1: vomited 100 ml clear fluid at 2255. pt. now states no nausea after given compazine

P #2: risk for infection related to incision sites.

I p#2: drainage from jackson-pratt drain measured. site monitored for redness, drainage and swelling. temperature monitored.

E p#2: incision site in front of left ear extending down and around the ear and into neck--approximately 6 " in length--without dressing. no swelling or bleeding, bluish discoloration below left ear noted, sutures intact. jp drain in left neck below ear with 20 ml of bloody drainage. drain remains secured in place with suture.

P #3: delayed surgical recovery

I p#3: at 2245 assisted patient getting back in bed and using bedpan after attempting to get up. explained to pt how to dangle legs and get oob slowly. assisted with and taught about coughing and deep-breathing exercises, turning, and use of antiembolism stockings. assessed breath sounds.

E p#3: pt. reported feeling dizzy after first attempt to get oob. pt. did coughing and deep-breathing exercises effectively and lungs sound clear bilaterally.

P p#4: acute pain related to surgical incision.

I p#4: assessed pain as 7 on scale of 0 to 10. gave pt. morphine 2 mg iv at 2335.

E p#4: prior to med. administration pt. reported pain as 7/10. now pt reports pain as 1/10.

Of course, before you can do this kind of charting on a patient, it is presumed that you have assessed and determined your patients nursing diagnoses and the nursing interventions needed, i.e. written a care plan for her.

TangoLima · May 19, 2008

PIE charting is actually my favorite type of charting. It makes you really focused and on track.

The example by the previous poster is excellent. But, you can adjust it to fit your needs. What I learned from another nurse is to give each PIE a short label, like "Pain", "Airway", or " Urinary". Then, for the "P" write your assessment data like "Pt. c/o pain 6/10, pt seen grimacing, etc." Use your "I" for what you have done or plan to do throughout the day. You may not always be able to evaluate your interventions right away. So, later in the day, you can use your label, and then write in your evaluation. So, your charting might look like:

Nsg: Pain

P: Pt c/o pain 6/10, Pt seen grimacing and holding breath

I: Administer pain meds as ordered, Reposition for comfort, Decrease stimuli in room, will re-assess pain in 30 mins

*****(Other documentation)*******

*****(Blah, Blah, Blah)***********

Nsg: Pain

E: Pt rates pain 0/10

For cellulitis, you would want to watch for pain, infection control, and possibly decreased mobility.

Hope that helps.

Daytonite, BSN, RN · May 19, 2008

I believe that the op's assignment may tie in to a care plan that was supposed to be written, but I couldn't determine that from her post. That makes sense to me. When I've seen pie charting used in work situations, there was always a master problem list that was used to base the pie charting on. It stands to reason that for a student assignment a care plan or at least the first two steps of the nursing process would replace that master problem list. It did not escape me that pie is also part of the acronym, adpie, which represents the steps of the nursing process, a problem solving method, and that a care plan is a written document of our decisions on how we are planning to solve a patient's nursing problems.