LEC 5.6: Nursing Process | Evaluating

Evaluating

Planned, ongoing, purposeful activity in which clients and health care professionals determine:

• Client’s progress toward achievement of outcomes

• Effectiveness of NCP

Determines whether nursing interventions should be terminated, continued, or changed

1. Collecting data related to desired outcomes

2. Comparing data with desired outcome

3. Relating nursing activities to outcomes

4. Drawing conclusions about the problem status

5. Continuing, modifying, or terminating the NCP

5 Components of Evaluating

Collecting data related to desired outcome

One of the components of evaluating

To draw conclusions whether goals have been met

Data should be objective and subjective

Data must be recorded concisely and accurately

Comparing data with desired outcome

One of the components of evaluating

Has 3 possible conclusions: The goals was met, partially met, not met

1. The goal was met

2. The goal was partially met

3. The goal was not met

What are the 3 possible conclusions when Comparing data with desired outcomes?

Evaluation Statement

What is the statement written by the nurse?

1. Conclusion

2. Supporting Data

What are the 2 parts of the evaluation statement?

Conclusion

One of the parts of the evaluation statement

Statement whether the goal was met or not

Supporting data

One of the parts of the evaluation statement

List of client responses that support the conclusion

Relating nursing activities to outcomes

One of the components of evaluating

Should never be assumed that the nursing activity was the cause of or the only factor in meeting, partially meeting, or not meeting the goal

Drawing conclusions about the problem status

One of the components of evaluating

When the goals are met can include the three following conclusions:

1. Actual and potential problems have been resolved and risk factors no longer exist → Discontinues the care of the problem

2. The potential problem has been met but risk factors are still present → Problem is kept in the care plan

3. Actual problem still exists even though some goals are being met → Nursing interventions must be continued

When the goals are partially or not met conclusion can either be:

1. Care plan may be needed to be revised

2. Client merely needs more time to achieve the previous established goals

Discontinue care of problem

When a goal has been met and actual and potential problems were resolved, and risk factors no longer exist, what is the conclusion?

Problem is kept in the care plan

When a goal has been met and potential problem has been resolved but risk factors are still present, what is the conclusion?

Nursing interventions must continue

When a goal has been met and actual and potential problems still exist even though some goals are being met, what is the conclusion?

1. Care plan may be needed to be revised

2. Client merely needs more time to achieve the previous established goals

When goals are partially met or not met what are the 2 possible conclusions?

Continuing, modifying, or terminating the NCP

One of the components of evaluating

After drawing conclusions, the nurse modifies the care plan as indicated

Can occur in all phases of ADPIE

Assessment

Continuing, modifying, or terminating the NCP in this phase of ADPIE

If incomplete, reassess client and record new data

Diagnosing

Continuing, modifying, or terminating the NCP in this phase of ADPIE

New diagnostic statements may be required

Check if the identified nursing problem is correct

Planning: Desired Outcome

Continuing, modifying, or terminating the NCP in this phase of ADPIE

If nursing diagnosis is incorrect, goals are also incorrect

Ensure goals are SMART

Check prioritization of nursing problems

Implementing

Continuing, modifying, or terminating the NCP in this phase of ADPIE

Manner of doing this phase should be checked

Check whether interventions are carried out

Evaluation

Continuing, modifying, or terminating the NCP in this phase of ADPIE

Hopefully will meet the goal but if not, return to reassessment, diagnosis, planning, implementing, and evaluation