Chapter 15: Evaluating Vocabulary

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UNIT III: Person-Centered Care and the Nursing Process Chapter 15: Evaluating
Alexandra Bozan
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Alexandra Bozan
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evaluating the nurse/patient together measure how well the patient has achieved the outcomes specified in the plan of care
five classic elements of evaluation 1. identifying evaluative criteria/standards 2. collecting data to determine whether these criteria/standards are met 3. interpreting/summarizing findings 4. documenting your judgement 5. terminating, continuing or modifying the plan
evaluative criteria are the patient outcomes developed during the planning step
the most common mistake when evaluating is waiting until the day the patient is to be discharged b4 evaluating outcome achievement. At that point, it's too late to revise the plan of care.
evaluative statement 2-part evaluative statement includes a decision about how well the outcome was met, along w/patient data or behaviors that support this decision. Outcomes may have been met, partially met or not met
After identifying the factors contributing to the outcomes not being achieved, revisions in the plan of care include 1. delete or modify the nursing diagnosis 2. make the outcome statement more realistic 3. increase the complexity of the outcome statement 4. adjust time criteria in outcome statement 5. change the nursing intervention
Four steps crucial in improving performance 1. discover the problem 2. plan a strategy using indicators 3. implement a change 4. assess the change, if the outcome is not met, plan a new strategy
2 different approaches to ensuring quality 1. Quality by inspection 2. Quality by opportunity
quality by inspection focuses on finding deficient workers and removing them
quality as opportunity focuses on finding opportunities for improvement/fosters an environment that thrives on teamwork, with people sharing the skills and lessons they have learned. mistakes are viewed not as being caused by a lack of motivation or lack of effort but rather a result of a problem in the system
ANA model quality assurance program 1. identify values 2. identify structure, process, outcome standards and criteria 3. measure the degree of attainment of criteria/standards 4. make interpretations about strengths/weaknesses based on such measurements 5. identify possible courses of action 6. choose a course of action 7. take action
ANA model directs attention to 3 essential components of quality care structure, process and outcome
structure evaluation focuses on the environment in which care is provided: physical facilities/equipment, organizational characteristics, policies/procedures
process evaluation focus is the nature/sequence of activities carried out by nurse implementing the nursing process
outcome evaluation focuses on measurable changes in the health status of the patient or the end results or nursing care
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