Ch 18: Eval Flashcards
Give the parts of an evaluation statement
MUST HAVE
- Date
- Eval statement (met not met or partially met)
- Patient behavior support decision
What is measured when you are evaluating
What does the nurse identify to achieve outcomes during the evaluation
What is the purpose of evaluation
(What does it allow ?)
-what factors are identified
When you’re evaluating the nursery patient work together to measure how well the patient has achieve the outcome in the care plan
The nurse identifies factors that contribute to the patient’s ability to achieve the outcome
Purpose of evaluation:
- Allow the patient achievement of expected outcomes to direct future nurse patient interactions
- ID FACTOR S THAT CONTRIBUTE TO ACHIEVEMENT
Based on the patient’s responses what can the nurse decide to do to the care plan
What does a successful evaluation help insure for the patient what are a few things it continues
- Terminate care plan when expected outcomes achieved
- Modify care plan if difficulties achieving outcomes
- Continue care plan if more time needed to achieve outcomes
Successful evaluation helps ensure valued patient outcomes are attained
Evaluation continues selection and funding

In the chart picture what are you doing when you’re evaluating
Measuring
Identify contributing
Modify
Measuring how well the patient has achieve desired outcomes

Identify factors contributing to the patient’s successor failure
Modify plan of care if indicated
What is the goal of evaluating
When evaluating what are things that the nurse measure
- outcomes
- target groups
- individual nurse
- degree of influence
The goal of evaluating:
-to provide quality nursing interventions that help patients achieve goals in the nursing care plan
Nurse measure:
-patient Outcome achievements
-how effectively nurses helps target group achieve specific outcomes
-competent of individual nurses
-*** degree to which external factors influence health and wellness
• such as healthcare services, special equipment, procedures, social economic factors
What are five elements of evaluation by critical thinking/clinical reasoning
Identify interchangable collect data to interpretand judgment plan what
- Identify evaluative criteria and standards
-  ensures meeting Requirements - Collecting data to determine whether criteria and standards are met
- Interpreting and summarizing findings
- Documenting your judgment
- Terminating, continuing, modifying plan
Define evaluative criteria
Define evaluative standards
How is the evaluative criteria and standards used
Evaluative criteria:
-Measurable qualities/characteristics that identifies skills, knowledge, Health states
-describe acceptable levels of performance by stating what is expected of nurse or patient
Evaluate two standards:
-level of performance accepted by and expected of nurse and others by institution/organization
Evaluative criteria and standards are used interchangeably
What is the goal for evaluating
The goal is to design and deliver nursing care that evidence supports to PRODUCE EXPECTED OUTCOMES
What are you doing as you’re collecting evaluative data
Id again
id desired
Support
As a collective Evaluative of data:
- identify problem again
- identify desired outcome
- support an outcome achievement with data collected from patient
Give the different types of outcomes and Describe each
Cognitive: increase knowledge (learn)
- verbal
- “list”
Psycho motor: demonstrate new skill
-action 
Effective: relating to values, emotions, attitudes
Physiologic: Physical changes in a patient
-“signs of healing”
What is established along with the outcome to determine whether changes have been achieved
How must the time criteria be
Along with the outcome a timeframe has to be given to determine whether a specific change has been achieved
Time criteria must be specific!!
What is the greatest mistake of evaluation
What leads to a higher successful outcome
Why and what do you do if you have an unsuccessful outcome
Greatest mistake:
-waiting until the day discharged to evaluate the outcome
The earlier you evaluate the higher the chance of a successful outcome
For unsuccessful outcome:
-Detect early and remediate issue for success
To determine if this is a one time incident or a consistent problem what must nurse gather
As a nurse what is vital to consider when interpreting and summarizing findings
When you identify variables what do you want to do if they are positive factors What do you want to do with negative factors
To determine if one time incident or consistent problem nurse must gather more data
As a nurse is vital to consider the factors influence Avenue, treatment when interpreting some reason findings
When identifying variables if(+): reinforce
 If (-): address
What must we do before making judgments of patients achievements
What do we want to avoid
What are we looking at and addressing
Before making judgments on patient achievements we MUST Study and interpret data
- avoid making assumptions
- look at WHOLE PICTURE and address EVERY pt problem
After what steps does a nurse make in document judgments summarizing the findings
What are the parts to an evaluative statement
What are ways to evaluate an outcome
After determining outcome achievement post data, nurse makes and documents judgment summers and findings
Evaluative statement is a 3-parter
- Date
- A decision about how outcome was meant
- Patient data or behaviors that supports decision
Outcomes evaluated by
-meant, partially met, not met


How do you know when you need to modify the care plan
What are a few changes you can make to the care plan
What is done after you identify the contributing factors to the unmet outcome
If patient has little to no progress towards outcome you need to reevaluate in modify the steps
New assessment needed, add a diagnosis or outcomes can be modified or rewritten new orders evaluation more frequently
After defined contributing factors to ultimate outcome
:use evaluate a statement to suggest necessary revisions
What are the types of revisions that may be included (5)
- diagnoses
- realistic
- complexity
- Adjust criteria
- change
- deleting/modifying diagnosis
- making outcome more realistic
- increasing complexity of outcome statement
- adjust time criteria in outcome statement
- Change interventions
What are the Institute of medicine (I OM) 10 rules to redesign and IMPROVE care plans
- Care based on continuous healing relationships
- Customization based on patient needs and values
 - PATIENT AS SOURCE OF CONTROL
 - Share knowledge and free flow of information
 - Evidence-based decision making
6. safety as a system priority

7.NEED FOR TRANSPARENCY
-be truthful about expectations, dos and don’ts
- ANTICIPATION OF PT NEEDS
- Continues decreasing waste
- Cooperation among clinicians
4 steps crucial to improving performance
- Discover problem
- Plan strategy using indicators
- “ what caused problem” - Implement change
- Assist change indoor plant new strategy if out come not meant
What are ways of improving professional performance
Peer review quality assurance programs structured evaluations process evaluations outcome evaluations ***quality improvement nursing audit ***concurrent and retrospective eval‘s
-Peer review: evaluating staff members by another in areas of improvement
***-Quality insurance programs
: special programs to promote excellence in nursing and accountability
- Structure evaluations: audit environment to see lacking or presenting items to give care
- process evaluations: sequence of activities to be carried out
- outcome evaluations: measures/changes in health status of patient
_** Quality improvement: continues systemic action that leads to measure improvement of healthcare services and health status of target population
- nursing audit
- **Concurrent and retrospective eval’s: she went wrong and identify areas of improvement
What is the #1 related factor to continued medical errors and staff turnover
• what must we do
What are a few factors that can cause harm to the patient
#1 factors related to continued medical errors in Septernover: -culture of poor communication and collaboration among healthcare professionals
• we must communicate and support each other PT 1st!
Factors That can cause harm to patient due to communication gap:
- lack of adequate support system
- lack of skill and personal accountability
 What do US regulatory agencies such as state BON, JT require nurses to do
What is the outcome buy these regulatory agencies as an evaluative program
-what does it enable nursing to become
Regulatory agencies require nurses to document that nursing centers are being implemented and maintained
Quality assurance was created by regulatory agencies as a special program to promote excellence in nursing
-enables nursing to become accountable to society fo Providing quality of care
What are models for quality care
- Structured evals
- focused (audit) on environment in which care provided  - Processes evals
- explicit acceptable levels of performance for nursing actions related to patient ADPIE
- sequence - Outcome evals: measurable changes in health status of patient and end result of nursing care
 When is nursing care and patient outcomes evaluate it
Define concurrent evaluations when are they done
Define retrospective evaluations when are they done
Nursing Care patient outcomes evaluated while patient receiving care or after discharge
Concurrent evaluations:
-done by direct observation of nursing care, patient interviews, chart review to see if specified eval criteria met
• may be CURRENT
Retrospective eval‘s:
- can be done post discharge through questionnaires, patient interviews, chart reviews
- what went well, unwell, changes
- ONLY post discharge
