Exam 3: Chapter 16: Outcome Identifcaiton and Planning Flashcards
Goal of Outcome Identification and Planning Step
Establish Priorities
Identify and Write Expected Patient Outcomes
Select Evidence-Based Nursing Interventions
Communicate the Plan of Care
What is Initial Planning?
Performed by the nurse with the admission nursing history and physical assessment. Comprehensive plan addresses each problem listed in the prioritized nursing diagnoses and identifies appropriate patient goals and the related nursing care.
What is Ongoing Planning?
Carried out by any nurse who interacts with the patient. Chief purpose is to keep the plan up to date
What is Discharge Planning?
Best carried out by the nurse who has worked most closely with the patient and family, possibly in conjunction with a nurse or social worker with a broad knowledge of existing community resources.
Five Maslows Hierarchy Human Needs?
Physiologic Need sā> Safety Needs ā> Love and Belonging Needs -> Self-Esteem Needs -> Self-Actualization Needs
Four Types of Outcomes?
Cognitive
Psychomotor
Affective
Physiologic
What is a Cognitive Outcome?
Increase in patients knowledge or intellectual behaviors
What is a Psychomotor Outcome?
Patients achievement of new skills
What is aAffective Outcome?
Changes in patients values, beliefs, and attitudes
What is Physiologic Outcomes?
Physical changes in the patient
A Formal Plan of Care Allows the Nurse To
Individualize care that miaximizes outcome achievement
Set Priorites
Facilitate communication among nursing personnel
Promote continuity of high-quality; cost-effective care
Outcome Identification, Planning, and Clinical Reasoning
Be familar with standards and agency policies for setting priorities, identifying, and recording expected patient outcomes
Remember that the goal of patient centered care is ot keep the patient and patients interests and preferences central in every aspect.
Three elements on comprehensive planning?
Initial
Ongoing
Discharge
Prioritizing Nursing Diagnoses
High Priority: Greatest Threat to patient well being
Medium Priority: Nonthreatening Disease
Low Priority: Diagnoses not specifically related to current health problem
Clinical Reasoning and Establishing Priorities
What problems need immediate attention adn which ones can wait?
Which problems are your responsibility and which do you need to refer to someone else?
Which problems can be dealt with by using standard plans
Long Term Outcomes
Long-Term outcomes require longer period to be achieed and may be used as discharge goals
Short-Term Outcomes
May be accomplished in a specified period of time
What are the categories of outcomes?
Cognitive, Psychomotor, Affective
What are the parts of a measurable outcome?
Subject (Pt), Verb (What are they doing), Condition(Condition to achieve outcome), Performance Criteria (How measurable will they perform), Target Time (Time Specific)
Measurable outcome example
Pt (1) O2 (2) stats will be > 92% (3) within 30 minutes of ordered treatment (5)
How to remember all parts of measureable outcome?
SMART
Specific, Measurable, Attainable, Realistic, Time-Bound
Common Errors in Writing Patient Outcomes
Expressing patient outcome as nursing intervention
Using verbs that are not observable or measurable
Including more than one patient behavior or manifestation in short-term outcomes
Writing vague outcomes
Types of Nursing Interventions
Nurse-Initiated
Physician-Initiated
Collaborative
What is a nursing intervention?
Any treatment based upon clinical judgement and knowledge that a nurse performs to enhance patient/client outcomes
What is a Nurse-Initiated Intervention
An autonomous action based on scientific rationale that a nurse executed to benefit the patient in a predictable way related to the nursing diagnosis and projected outcomes
What is a Physician-Initiated Intervention?
When an interveention is initiated by a physician in response to a medical diagnosis but is carried out by a nurse in response to a doctors order
What is a Collaborative Nursing Intervention?
Nurses that carry out treatments initiated by other providers such as pharmacists, respiratory therapists, or physician assistants
What is a nursing care plan?
The written guide that directs the efforts of the nursing team working with the patient to meete his or her health goals. Specifies nursing diagnosis, outcomes, and associated nursing interventions
Types of institutional Plans of Care
Computerized Plans of Care Concept Map Plans of Care Change of Shift Reports Multidisciplinary Plans of Care Student Plans of Care
What is a Concept Map Care Plan?
Diagram of patient problems and interventions.
Five Steps in the Nursing Process?
Assessing -> Diagnosing -> Outcome Identification and PLanning -> Implementing -> Evaluating
Steps in Concept Mapping?
- Develop a basic skeleton diagram
- Analyze and Categorize Data
- Analyze Nursing Diagnoses Relationships
- Identify goals, outcomes, and interventions
- Evaluate patients responses