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Chapter 15: Evaluating

Terms in this set (30)

Evaluating:
1. Allows _________
2. Directs ________
3. Measures ___________
4. Identifies ___________
5. Modifies __________
Allows achievement of outcomes
Directs nurse-patient interactions
Measures patient outcome achievement
Identifies factors to achieve outcomes
Modifies the plan of care, if necessary
Actions Based on Patient Response to Plan of Care:
1. Terminate the plan of care when each expected outcome is achieved.

2. Modify the plan of care if there are difficulties achieving the outcomes.

3. Continue the plan of care if more time is needed to achieve the outcomes.
4 types of outcomes
1. Cognitive
2. Psychomotor
3. Affective
4. Physiologic
"Before discharge, parents will demonstrate confidence in holding baby". is what kind of outcome
Psychomotor
"By 2/6/15, parents will report appropriate action to be taken if questions or problems arise after discharge" is what type of outcome
Cognitive
"Before discharge, parents will verbalize decreased anxiety in regard to caring for son." is what type of outcome
Affective
At 1-month postpartal telephone interview 3/14/15 (by parents report) the baby will demonstrate adequate weight gain" is what type of outcome
Physiologic
Increasing a patient's knowledge and is judged by asking patient to repeat information or apply new knowledge
Cognitive outcome
How to judge a psychomotor outcome
Asking the patient to demonstrate a new skill
changes in patient values, beliefs, and attitudes evaluated by observing patient behavior and conversation
Affective Outcome
using physical assessment skill to collect and compare data is used to evaluate
physiologic outcome
5 Parts of Evaluation:
1. Identifying evaluative ___________
2. Collecting data to determine ____________
3. Interpreting and summarizing ______
4. Documenting ______
5. _______, _______, or _______ the plan
1. Identifying evaluative criteria and standards
2. Collecting data to determine if criteria and standards are met
3. Interpreting and summarizing findings
4. Documenting Judgement
5. Terminating, continuing, or modifying the plan
measurable qualities, attributes, or characteristics that specify skills, knowledge, or health status
Criteria
Criteria Describes acceptable levels of performance by_______________
stating expected behaviors of nurse or patient
levels of performance accepted and expected by the nursing staff
Standards
Standards are established by
authority, custom, or consent
after data has been collected and interpreted to determine outcome achievement the nurse makes and documents a judgement summarizing the findings called
the evaluative statement
2 parts of the evaluative statement ✨
1. Decide how well outcome was met (met, partially met, or not met).

2. List patient data or behaviors that support this decision
✨revising the plan of care includes:
1. Delete of modify the _______
2. Make the outcome statement ________
3. Increase the complexity of ____________
4. Adjust ______ in the outcome statement
5. Change ________
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 the outcome statement
5. Change Nursing Interventions
Variables affecting outcome achievement include
Patient ( Gives up and refuses treatment)
Nurse ( Nurse suffering from burnout)
Health Care System ( Inadequate staffing)
IOM's 10 rules to redesign and improve care
1. Care based on continuous healing relationships
2. Customization based on patient needs and values
3. The patient as the source of control
4. Shared knowledge and the free flow of information
5. Evidence-based decision making
6. Safety as a system priority
7. The need for transparency
8. Anticipation of patient's needs
9. Continuous decrease in waste
10. Cooperation among clinicians
4 steps crucial to improving performance
1. Discover a problem
2. Plan a strategy using indicators
3. Implement a change
4. Assess the change and/or plan a new strategy if outcomes are not met
Common Problems Noted During the Evaluation Process: Assessment
inaccurate data, no reflection of changes in patient condition
Common Problems Noted During the Evaluation Process: Diagnosis
Too vague or not up to date
Common Problems Noted During the Evaluation Process: Planning
Only standard knowledge, vague goals, superficial nursing orders
Common Problems Noted During the Evaluation Process: Implementation
Poor prioritization and inadequate documentation
8 methods of improving professional performance✨
Peer review
Quality-assurance programs
Structure evaluations (audit, focus on environment)
Process evaluations (nature and sequence)
Outcome evaluations
Quality improvement
Nursing audit
Concurrent and retrospective evaluations
Determining Adequacy of Evaluation Step
1. Evaluate __________
2. Review _____________
3. Revise ________.
4. Participate in ______________
Evaluate patient achievement of desired outcomes.
Review how the process is used.
Revise the plan of care if necessary.
Participate in quality-assurance programs.
Elements of a healthy work environment include:
1. Skilled ______
2 True _______
3. Effective ________
4. Appropriate _______
5. Meaningful _______
6. Authentic _____________
Skilled communication
True collaboration
Effective decision making
Appropriate staffing
Meaningful recognition
Authentic leadership
7 crucial conversations in health care
1. Broken rules
2. Mistakes
3. Lack of support
4. Incompetence
5. Poor teamwork
6. Disrespect
7. Micromanagement
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