chapter 18

Terminate the care plan

-when each expected outcome is achieved.

Which action should the nurse take when a patient has achieved each expected outcome in the care plan? A. Terminate the care plan. B. Modify the care plan. C. Continue the care plan.

Answer: A. Terminate the plan of careRationale:The plan of care is terminated when thepatient has achieved all of its goals.The plan of care is modified when there aredifficulties achieving outcomes.The plan of care is continued if more time isneeded to achieve the outcomes.

Tell whether the following statement is true or false. An outcome evaluation focuses on measurable changes in the health status of the patient or the end result of nursing care. A. True B. False

Answer: A. TrueAn outcome evaluation focuses onmeasurable changes in the health status ofthe patient or the end result of nursing care

The purpose of evaluation is to allow the patient's achievement of expected outcomes to direct future nurse-patient interactions. A. True B. False

Answer: A. TrueThe purpose of evaluation is to allow thepatient's achievement of expected outcomesto direct future nurse-patient interactions

Which example is a psychomotor outcome? A. A patient learns how to control his weight using the Choose MyPlate food guide. B. A patient is able to test for glucose levels and inject insulin as needed. C. A patient values his health enough to decide to quit smoking. D. A patient is able to ambulate the hallway following knee surgery

Answer: B. A patient is able to test for glucose levels and inject insulin as needed.Rationale:Psychomotor outcomes involve the patient's achievement of a new skill, such as controlling diabetes.Cognitive outcomes involve an increase in patient knowledge (Answer A).Affective outcomes pertain to changes in patient values (Answer C).Physiologic outcomes target physical changes in the patient (Answer D).

Tell whether the following statement is true or false. Asking a patient to plan an exercise program to lower blood pressure based on information provided to the patient in an A/V presentation is an excellent method to evaluate a physiologic outcome. A. True B. False

Answer: B. False Asking a patient to plan an exercise program to lower blood pressure based on information provided to him in an A/V presentation is an excellent method to evaluate a cognitive outcome

Tell whether the following statement is true or false.Asking a patient to plan an exercise program to lower blood pressure based on information provided to him in an A/V presentation is an excellent method to evaluate a physiologic outcome.A. TrueB. False

Answer: B. FalseAsking a patient to plan an exercise program to lower blood pressure based on information provided to him in an A/V presentation is an excellent method to evaluate a cognitive outcome

HCAHPS=

Consumer Assessment of Healthcare Providers and Systems

time criteria

In addition to knowing what type of data to collect to determine outcome achievement, the nurse needs to know when to collect the data. When the patient outcomes were developed, a time frame was established for determining whether the specified changes have been achieved. At the designated time, the nurse, in collaboration with the patient, the family, and other members of the nursing team, evaluates the patient's attainment of the outcome. If outcomes are developed in observable and measurable terms, the task of collecting data for evaluation is clear-cut. Examples of three types of time criteria follow:

Evaluating Step

Nurse and patient together measure how well the patient has achieved the outcomes specified in the care plan. THEN the care plan is: TERMINATED MODIFIED CONTINUED

Quality-assurance programs

are special programs that promote excellence in nursing

Standards

are the levels of performance accepted by and expected of nursing staff or other health team members. They are established by authority, custom, or consent

Affective:

changes in patient values, beliefs, and attitudes

process evaluation

evaluation focusing on the nature and sequence of activities carried out by nurses implementing the nursing process

outcome evaluation

evaluation that focuses on measurable changes in the health status of the patient or the end results of nursing care

A structure evaluation or audit .

focuses on the environment in which care is provided

Continue the care plan-

if more time is needed to achieve the outcomes.

Modify the care plan-

if there are difficulties achieving the outcomes.

Cognitive:

increase in patient knowledge

criteria

measurable qualities, attributes, or characteristics that specify skills, knowledge, or health status

Psychomotor

patient's achievement of new skills

Physiologic:

physical changes in the patient