Ch 18: Eval Flashcards

1
Q

Give the parts of an evaluation statement

MUST HAVE

A
  • Date
  • Eval statement (met not met or partially met)
  • Patient behavior support decision
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2
Q

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

A

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
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3
Q

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

A
  1. Terminate care plan when expected outcomes achieved
  2. Modify care plan if difficulties achieving outcomes
  3. Continue care plan if more time needed to achieve outcomes

Successful evaluation helps ensure valued patient outcomes are attained
Evaluation continues selection and funding

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4
Q

In the chart picture what are you doing when you’re evaluating

Measuring
Identify contributing
Modify

A

Measuring how well the patient has achieve desired outcomes

Identify factors contributing to the patient’s successor failure

Modify plan of care if indicated

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5
Q

What is the goal of evaluating

When evaluating what are things that the nurse measure

  • outcomes
  • target groups
  • individual nurse
  • degree of influence
A

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

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6
Q

What are five elements of evaluation by critical thinking/clinical reasoning

Identify interchangable 
 collect data
to interpretand 
judgment 
 plan what
A
  1. Identify evaluative criteria and standards
    -  ensures meeting Requirements
  2. Collecting data to determine whether criteria and standards are met
  3. Interpreting and summarizing findings
  4. Documenting your judgment
  5. Terminating, continuing, modifying plan
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7
Q

Define evaluative criteria

Define evaluative standards

How is the evaluative criteria and standards used

A

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

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8
Q

What is the goal for evaluating

A

The goal is to design and deliver nursing care that evidence supports to PRODUCE EXPECTED OUTCOMES

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9
Q

What are you doing as you’re collecting evaluative data
Id again
id desired
Support

A

As a collective Evaluative of data:

  • identify problem again
  • identify desired outcome
  • support an outcome achievement with data collected from patient
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10
Q

Give the different types of outcomes and Describe each

A

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”

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11
Q

What is established along with the outcome to determine whether changes have been achieved

How must the time criteria be

A

Along with the outcome a timeframe has to be given to determine whether a specific change has been achieved

Time criteria must be specific!!

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12
Q

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

A

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

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13
Q

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

A

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

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14
Q

What must we do before making judgments of patients achievements

What do we want to avoid

What are we looking at and addressing

A

Before making judgments on patient achievements we MUST Study and interpret data

  • avoid making assumptions
  • look at WHOLE PICTURE and address EVERY pt problem
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15
Q

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

A

After determining outcome achievement post data, nurse makes and documents judgment summers and findings

Evaluative statement is a 3-parter

  1. Date
  2. A decision about how outcome was meant
  3. Patient data or behaviors that supports decision

Outcomes evaluated by
-meant, partially met, not met



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16
Q

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

A

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

17
Q

What are the types of revisions that may be included (5)

  • diagnoses
  • realistic
  • complexity
  • Adjust criteria
  • change
A
  • deleting/modifying diagnosis
  • making outcome more realistic
  • increasing complexity of outcome statement
  • adjust time criteria in outcome statement
  • Change interventions
18
Q

What are the Institute of medicine (I OM) 10 rules to redesign and IMPROVE care plans

A
  1. Care based on continuous healing relationships
  2. Customization based on patient needs and values
  3. PATIENT AS SOURCE OF CONTROL
  4. Share knowledge and free flow of information
  5. Evidence-based decision making

6. safety as a system priority

7.NEED FOR TRANSPARENCY
-be truthful about expectations, dos and don’ts

  1. ANTICIPATION OF PT NEEDS
  2. Continues decreasing waste
  3. Cooperation among clinicians
19
Q

4 steps crucial to improving performance

A
  1. Discover problem
  2. Plan strategy using indicators
    - “ what caused problem”
  3. Implement change
  4. Assist change indoor plant new strategy if out come not meant
20
Q

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
A

-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
21
Q

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

A
#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
22
Q

 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

A

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

23
Q

What are models for quality care

A
  1. Structured evals
    - focused (audit) on environment in which care provided 
  2. Processes evals
    - explicit acceptable levels of performance for nursing actions related to patient ADPIE
    - sequence
  3. Outcome evals: measurable changes in health status of patient and end result of nursing care
24
Q

 When is nursing care and patient outcomes evaluate it

Define concurrent evaluations when are they done

Define retrospective evaluations when are they done

A

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