Evaluation

Notes

Introduction
  • Evaluation, the final step of the nursing process, is crucial to determine whether, after application of the nursing process, the client’s condition or well-being improves. The nurse applies all that is known about a client and the client’s condition, as well as experience with previous clients, to evaluate whether nursing care was effective. The nurse conducts evaluation measures to determine if expected outcomes are met, not the nursing interventions.
  • The expected outcomes are the standards against which the nurse judges if goals have been met and thus if care is successful.Providing health care in a timely, competent, and cost-effective manner is complex and challenging. The evaluation process will determine the effectiveness of care, make necessary modifications, and to continuously ensure favorable client outcomes.
Definition
  • Is assessment the client’s response to nursing interventions and then comparing that response to predetermined standards or outcome criteria.

Evaluation is defined as the judgment of the effectiveness of nursing care to meet client goals; in this phase nurse compare the client behavioral responses with predetermined client goals and outcome criteria. –CRAVEN 1996

Sample Case Study

Nursing Diagnosis : Impaired skin integrity related to physical mobility

Expected Outcomes : The patient will be able to get recovery of pressure sore.

Planning:

  • Pressure sore dressing
    • Rationale: Cleansing the area will prevent further infection
  • Back care
    • Rationale: It will promote blood circulation
  • Change the position frequently
    • Rationale: It will put little pressure on the sore site
  • Encourage the patient to ambulate
    • Rationale: It will put little pressure on the sore site
  • Take protein rich diet
    • Rationale: Protein helps in repair of tissues

Evaluation : Wound healing was observed (tissues were red, healthy)

Purposes
  1. Determine client’s behavioral response to nursing interventions.
  2. Compare the client’s response with predetermined outcome criteria.
  3. Appraise the extent to which client’s goals were attained.
  4. Assess the collaboration of client and health care team members.
  5. Identify the errors in the plan of care.
  6. Monitor the quality of nursing care.

Components of Evaluation
  1. Collecting the data related to the desired outcomes
  2. Comparing the data with outcomes
  3. Relating nursing activities to outcomes
  4. Drawing conclusion about problem status
  5. Continuing, modifying, or terminating the nursing care plan
Collecting the data
  • The nurse collects the data so that conclusion can be drawn about whether goals have been met. It is usually necessary to collect both subjective & objective data. Data must be recorded concisely and accurately to facilitate the next part of the evaluating process.
Comparing the data with outcomes
  •  If the first part of the evaluation process has been carried out effectively , it is relatively simple to determine whether a desired outcome has been met. Both the nurse and client play an active role in comparing the client’s actual responses with the desired outcomes.
Relating nursing activities to outcomes
  • The third aspect of the evaluating process is determined whether the nursing activities had any relation to the outcome.
Drawing conclusion about problem status
  • The nurse uses the judgement about goal achievement to determine whether the care plan was effective in resolving, reducing or preventing client problems. When goals have been met the nurse can draw one the following conclusions about the status of the client’s problem.
    • The actual problem stated in the nursing diagnosis has been resolved , or the potential problem is being prevented and the risk factors no longer exist. In these instances , the nurse documents that the goals have been met and discontinues the care for the problem.
    • The potential problem is being prevented, but the risk factors still present. In this case , the nurse keeps the problem on the care plan.
    • The actual problem still exists even though some goals are being met. In this case the nursing interventions must be continued.
Continuing , modifying , or terminating the nursing care plan

After drawing conclusion about the status of the client’s problems , the nurse modifies the care plan as indicated. Whether or not goals were met, a number of decision need to be made about continuing, modifying or terminating nursing care for each problem.

Before making individual modification, the nurse must first determine why the plan as a whole was not completely effective. This require a review of the entire plan.

Factors Affecting Goal Attainment
  1. Family Members
  2. Health Team Members
  3. Nurse
Evaluation Skill Required for Nurses
  1. Nurse must know the hospital policies, procedure and protocols of interventions and recording.
  2. Nurse must have up to date knowledge and information of many subject.
  3. Nurse must have intellectual and technical skill to monitor the effectiveness of nursing interventions.
  4. Nurse must have knowledge and skill of collecting subjective data and objective data.

 

Exam

Welcome to your Evaluation Practice Exam! This exam is carefully curated to help you consolidate your knowledge and gain deeper understanding on the topic.

 

Exam Details

  • Number of Questions: 10 items
  • Mode: Practice Mode

Exam Instructions

  1. Practice Mode: This mode aims to facilitate effective learning and review.
  2. Instant Feedback: After each question, the correct answer along with an explanation will be revealed. This is to help you understand the reasoning behind the correct answer, helping to reinforce your learning.
  3. Time Limit: There is no time limit for this exam. Take your time to understand each question and the corresponding choices.

Tips For Success

  • Read each question carefully. Take your time and don't rush.
  • Understand the rationale behind each answer. This will not only help you during this exam, but also assist in reinforcing your learning.
  • Don't be discouraged by incorrect answers. Use them as an opportunity to learn and improve.
  • Take breaks if you need them. It's not a race, and your understanding is what's most important.
  • Keep a positive attitude and believe in your ability to succeed.

Remember, this exam is not just a test of your knowledge, but also an opportunity to enhance your understanding and skills. Enjoy the learning journey!

 

Click 'Start Exam' when you're ready to begin. Best of luck!

💡 Hint

Focus on the goal that directly pertains to a standard measure of care, particularly concerning routine monitoring and prevention.

1 / 10

1. Nurse Bailey is formulating goals for her patients, ensuring each is aligned with clinical standards of practice. Which of the following goals is best based on such standards?

💡 Hint

Think about the foundational step a nurse must take to ensure that the care adjustments are accurately aligned with the client's current health status.

2 / 10

2. Nurse Cooper is adapting the care plan for a client whose health status has undergone considerable changes over the past few days. What is the most appropriate initial action for her to ensure the care plan meets the client's current needs?

💡 Hint

Focus on reinforcing positive progress while planning further steps.

3 / 10

3. Nurse Carter is working with a client who has almost reached their goal of reducing smoking to half a pack per day but hasn't fully met it yet. To help the client achieve their target, what should Nurse Carter consider as the most effective nursing intervention?

💡 Hint

Consider which option directly relates to assessing the impact of all nursing actions on the patient's health outcomes.

4 / 10

4. The core objective of the nursing evaluation process is to:

💡 Hint

Focus on the assessment that directly relates to monitoring a key parameter affected by digoxin.

5 / 10

5. Nurse Harris has set a goal for her patient who is receiving digoxin therapy: "The patient will independently perform necessary assessments before taking their medication." Which capability should Nurse Harris evaluate to determine if the patient has met this outcome criterion?

💡 Hint

Consider the outcome that directly relates to a nurse's intervention and has a measurable impact on patient safety and care quality.

6 / 10

6. Nurse Alvarez is reviewing outcomes to determine which best represents a nurse-sensitive client outcome. Which of the following should she identify?

💡 Hint

Consider which method directly assesses the improvement in skin redness specified in the outcome.

7 / 10

7. Nurse Mitchell has established a specific outcome for a patient with a skin impairment: "Erythema will decrease within three days." To evaluate the effectiveness of the interventions, what should Nurse Mitchell focus on?

💡 Hint

Consider which evaluation directly relates to the outcome of clearing secretions from the airways.

8 / 10

8. Nurse Baker is monitoring a patient diagnosed with impaired gas exchange due to excessive secretions. The goal is for the patient's airways to be clear. To determine if this outcome has been achieved, Nurse Baker should focus her evaluation on:

💡 Hint

Focus on the statement that shows the client consistently applying their understanding over a period of time.

9 / 10

9. Nurse Thompson has identified a nursing diagnosis of knowledge deficit regarding the need to monitor blood glucose levels daily. Which statement best demonstrates the client’s understanding of this necessity?

💡 Hint

Consider which statement directly relates to observing and reporting on the specific goal of walking without respiratory issues.

10 / 10

10. Nurse Thompson is reviewing her patient's progress in physical therapy after a recent lung surgery. She needs to provide an objective evaluation of the patient's ability to walk without experiencing shortness of breath, indicating goal attainment. Which statement should she include in her report?