evaluation

• Evaluation


  Assessing the client's response to nursing interventions, comparing the response to predetermined standards or outcome criteria
• Four possible judgments of evaluation

  • The goal was completely met
  • The goal was partially met
  • The goal was completely unmet
  • New problems or nursing diagnoses have developed
• Evaluation as a standard component of care: ANA Standards

  • Standard VI: Evaluation

  The nurse evaluates the client's progress toward attainment of outcomes
• Requirements for evaluation

  • Be performed as a systemic process
  • Occur on an ongoing basis
  • Lead to revision of the plan of care when needed
  • Involve the client, significant others, and other members of the health care team
  • Be documented
• Purposes of evaluation

  • To determine the client's progress or lack of progress toward achievement of expected outcomes
  • To determine the effectiveness of nursing care in helping clients achieve the expected outcomes
  • To determine the overall quality of care provided
  • To promote nursing accountability
• Techniques for effective evaluation

  • Accurate use of communication and observation skills

  Sensitivity to clients' willingness or hesitation to discuss their responses to nursing actions

  Use of therapeutic communication techniques to collect all necessary data

  Sensitivity to changes in the client's physiological condition, emotional status, and behavior
• Sources of data for evaluation

  • Nurse
  • Client
  • Family
  • Other health care providers
• Methods of evaluation

  1. Establishing standards

  2. Collecting data

  3. Determining goal achievement

  4. Relating nursing actions to client status

  5. Judging the value of nursing interventions

  6. Reassessing the client's status

  7. Modifying the plan of care
• Elements in evaluating the quality of care

  • Organizational evaluation

  Structure evaluation

  Process evaluation

  Outcome evaluation
• Structure evaluation


  Determination of the health care agency's ability to provide the services offered to its client population, focusing on assessing the systems by which nursing care is delivered
• Process evaluation


  Measurement of nursing actions by examination of each phase of the nursing process, to determine whether nursing care was adequate, appropriate, effective, and efficient
• Outcome evaluation


  Process of comparing the client's current status with the expected outcomes, examining all direct care activities that affect the client's health status
• Variables assessed during outcome evaluation

  • Modifications of symptoms
  • Signs
  • Knowledge
  • Attitudes
  • Satisfaction
  • Skill
  • Compliance with treatment regimen

  Client's self-care ability