Evaluation

• Evaluation


  Careful, deliberate, appraisal of various aspects of patient care
• Evaluation is the key to excellence in nursing
• Evaluation makes the difference between care practices that are doomed to repeat errors and care practices that are safe, efficient, and constantly improving
• Evaluation phase


  1. Examine assessment

  2. Examine diagnosis

  3. Examine planning

  4. Examine implementation
• Activities in the evaluation phase

  1. Determining outcome achievement

  2. Identifying variables (factors) affecting outcome achievement

  3. Deciding whether to discharge the patient, or continue or change the plan
• Guidelines in determining outcome achievement

  • Assess the patient to determine current health status and readiness to test for outcome achievement
  • List the outcomes set forth in planning
  • Compare what the person is able to do in relation to the outcomes
  • Record your findings on the patient or client record
  • Decide the extent of outcome achievement
• Identifying variables/factors affecting outcome achievement

  1. Assess the patient in-depth

  2. Analyze the patient's chart

  3. Involve the patient, family, and key caregivers

  4. Determine if outcomes and interventions were realistic and appropriate

  5. Determine if interventions were consistently implemented

  6. Determine if new problems or adverse responses were detected early

  7. Determine the person's opinion concerning outcome achievement and the plan of care

  8. Identify factors that impeded progress

  9. Identify factors that enhanced progress

  10. Search the literature for applicable research and practice articles
• Deciding whether to discharge the patient

  1. Continue the plan

  2. Change the plan

  3. Terminate the plan and discharge the patient
• Deciding whether to terminate the plan and discharge the patient


  • The person has achieved outcomes
  • The person has no new problems or risk factors that must be managed
  • The person is able to manage their own care
• Deciding whether to discharge the patient

  1. Determine how health care will be managed at home

  2. Give verbal and written instructions

  3. Ask the person to repeat or show what has been learned

  4. If the person demonstrates knowledge, terminate the plan and discharge according to facility policy
• 3 types of evaluation

  • Outcome evaluation
  • Process evaluation
  • Structure evaluation
• Outcome evaluation


  Studies the results or outcomes
• Process evaluation


  Studies how the care was given
• Structure evaluation


  Studies the setting in which the care takes place
• Evaluative statement


  A decision on how well the outcome was achieved (achieved, partially achieved, not achieved) + the patient data or behavior that support the decision
• Quality improvement is a never-ending process
• Evidence-based practice moves from traditional approaches to approaches supported by the most up-to-date studies
• Improving care and maximizing value

  • Quality of life
  • Functional status
  • Patient satisfaction
  • Compliance measures
  • Impact of educational interventions