Chapter 15 Flashcards
Evaluating Step
- Allows achievement of outcomes
- Directs nurse–patient interactions
- Measures patient outcome achievement
- Identifies factors to achieve outcomes
- Modifies the plan of care, if necessary
purpose of evaluation
to allow the patient’s achievement of expected outcomes to direct future nurse–patient interactions.
Actions Based on Patient Response to Plan of Care
- Terminate the plan of care when each expected outcome is achieved.
- Modify the plan of care if there are difficulties achieving the outcomes.
- Continue the plan of care if more time is needed to achieve the outcomes.
When is the plan of care terminated?
when the patient has achieved all of its goals
When is the plan of care modified?
when there are difficulties achieving outcomes
When is the plan of care continued?
if more time is needed to achieve the outcomes
Psychomotor outcomes involve:
the patient’s achievement of a new skill
ex.A patient is able to test for glucose levels and inject insulin as needed.
Cognitive outcomes involve:
an increase in patient knowledge
ex.A patient learns how to control his weight using the MyPyramid food guide
Affective outcomes pertain to:
changes in patient values
ex.A patient values his health enough to decide to quit smoking.
Physiologic outcomes target:
physical changes in the patient
ex.A patient is able to ambulate the hallway following knee surgery.
Evaluating Cognitive Outcomes
asking patient to repeat information or apply new knowledge
Evaluating Psychomotor Outcomes
asking patient to demonstrate new skill
Evaluating Affective Outcomes
observing patient behavior and conversation
Evaluating Physiologic Outcomes
using physical assessment skill to collect and compare data
Five Classic Elements of Evaluation
- Identifying evaluative criteria and standards
- Collecting data to determine if criteria and standards are met
- Interpreting and summarizing findings
- Documenting judgment
- Terminating, continuing, or modifying the plan
Criteria
- measurable qualities, attributes, or characteristics that specify skills, knowledge, or health status
- Describe acceptable levels of performance by stating expected behaviors of nurse or patient
Standards
- levels of performance accepted and expected by the nursing staff
- Established by authority, custom, or consent
Four Steps Crucial to Improving Performance
- Discover a problem.
- Plan a strategy using indicators.
- Implement a change.
- Assess the change and/or plan a new strategy if outcomes are not met
outcome evaluation
focuses on measurable changes in the health status of the patient or the end result of nursing care
Seven Crucial Conversations in Health Care
- Broken rules
- Mistakes
- Lack of support
- Incompetence
- Poor teamwork
- Disrespect
- Micromanagement
