Taylor - Fundamentals Of Nursing - Adn 1 Exam #3 Chapter 16 -Evaluating

Front 1

In the fifth step of the nursing process, evaluating,the nurse and patient together measure:

Back 1

how well the patient has achieved the outcomes specified in the plan of care. When evaluating patient outcome achievement, the nurse identifies factors that contribute to the patient’s ability to achieve expected outcomes and, when necessary, modifies the plan of care

Front 2

The purpose of evaluation is to allow the patient’s achievement of expected outcomes to direct future nurse–patient interactions. Based on the patient’s responses to the plan of care, the nurse decides to:

Back 2

•Terminate the plan of care when each expected outcome is achieved
•Modify the plan of care if there are difficulties achieving the outcomes
•Continue the plan of care if more time is needed to achieve the outcomes

Front 3

When evaluation points to the need to modify nursing care, the nurse reviews:

Back 3

each preceding step of the nursing process (assessing, diagnosing, planning, and implementing).

Front 4

Successful evaluation ensures:

Back 4

that valued patient out-comes are attained.
It also enhances the public’s image of nursing and helps ensure nursing’s survival by promoting continued selection and funding of nursing services in the competitive healthcare market.

Front 5

The five classic elements of evaluation are:

Back 5

(1) identifying evaluative criteria and standards (what you are looking for when you evaluate, e.g., expected patient outcomes),
(2) collecting data to determine whether these criteria and standards are met,
(3) interpreting and summarizing findings,
(4) documenting your judgment, and
(5) terminating,continuing, or modifying the plan.

Front 6

In the nursing process, evaluative criteria are:

Back 6

the patient outcomes developed during the planning step.

Front 7

Criteria are:

Back 7

measurable qualities
attributes, or
characteristics
that specify skills,
knowledge,or
health states.
They describe acceptable levels of performance by stating the expected behaviors of the nurse or the patient.

Front 8

Standards are:

Back 8

(aka clinical practice guidelines),the levels of performance accepted and expected by the nursing staff or other health team members.

Front 9

evidence-based practice

Back 9

its goal is to design and deliver nursing care that evidence supports as likely to produce the expected patient outcomes

Front 10

The nurse collects evaluative data to:

Back 10

determine whether or not the patient has met the desired outcomes.
The data collected in the evaluation step are used to determine whether the identified health problems have been or are being resolved through outcome achievement.

Front 11

The type of patient data collected to support the evaluation of outcome achievement is determined by the nature of the out-come. The four types of outcomes are:

Back 11

cognitive,
psychomotor,
physiological,
affective.

Front 12

Cognitive outcomes involve:

Back 12

increases in patient knowledge. These outcomes may be evaluated simply by asking patients to repeat information or, at a higher level of performance, by asking patients to apply the new knowledge to their everyday situations.

Front 13

Psychomotor outcomes describe:

Back 13

the patient’s achievement of new skills; they are evaluated by asking the patient to demonstrate the new skill.

Front 14

Affective outcomes pertain to:

Back 14

changes in patient values,beliefs, and attitudes and are more complex to evaluate.
Observation of patient behavior and conversation can determine whether affective outcomes have been achieved.

Front 15

physiologic outcomes are:

Back 15

physical changes in the patient. To evaluate achievement of this type of outcome, the nurse uses physical assessment skills to collect relevant data and compares these with previous patient data.

Front 16

outcomes are developed in observable and measurable terms, . Examples of three types of time criteria follow::

Back 16

•By 7/8/12, the patient will walk the length of the hallway with support of a walker.
•Beginning 7/8/12, the patient will demonstrate a weight loss of 3 lb per month until target weight (135 lb) is achieved (6/8/12, weight: 151 lb).

Front 17

performance improvement.The following four steps are crucial in improving performance:

Back 17

•Discover a problem
.•Plan a strategy using indicators.
•Implement a change.
•Assess the change;
if the outcome is not met, plan a new strategy.

Front 18

Peer review is:

Back 18

The evaluation of one staff member by another staff member on the same level in the hierarchy of the organization, is an important mechanism nurses can use to improve their professional performance.

Front 19

quality-assurance programs.

Back 19

Specially designed programs that promote excellence in nursing. Quality-assurance programs enable nursing to be accountable to society for the quality of nursing care.

Front 20

A structure evaluation or audit focuses on:

Back 20

the environment in which care is provided. Standards describe physical facilities and equipment; organizational characteristics, policies,and procedures; fiscal resources; and personnel resources.

Front 21

Outcome evaluation focuses on:

Back 21

measurable changes in the health status of the patient or the end results of nursing care.

Front 22

process evaluation focuses on:

Back 22

the nature and sequence of activities carried out by nurses implementing the nursing process.
Criteria make explicit acceptable levels of performance for nursing actions related to patient assessment,
diagnosis,
planning,
implementation, and
evaluation

Front 23

quality improvement is:

Back 23

internally driven,
focuses on patient care rather than organizational structure,
focuses on processes rather than individuals, and
has no end points.
Its outcome is improving quality rather than assuring quality.

Front 24

The major premises of quality improvement are as follows :

Back 24

•Focus on organizational mission
•Continuous improvement
•Customer orientation
•Leadership commitment
•Empowerment
•Collaboration/crossing boundaries
•Focus on process
•Focus on data and statistical thinking

Front 25

A nursing audit is:

Back 25

a method of evaluating nursing care that involves reviewing patient records to assess the outcomes o fnursing care or the process by which these outcomes were achieved. Successful nursing audits depend on careful nursing documentation.

Front 26

Concurrent evaluation is conducted by:

Back 26

using direct observation of nursing care, patient interviews, and chart review to determine whether the specified evaluative criteria are met.

Front 27

Retrospective evaluation may use:

Back 27

post-discharge
questionnaires,
patient interviews (by telephone or face to face),or
chart review (nursing audit)
to collect data.
The type of retrospective audit most familiar to nurses working in hospitals is the Joint Commission retrospective chart review.