Chapter 18 Evaluating

A nurse evaluates nursing care and outcomes for a current patient by using direct observation of nursing care, patient interviews, and chart review to determine whether the specified evaluative criteria are met. This practice is known as:

a concurrent evaluation

A nurse has developed a plan of care for the nursing diagnosis Risk for Loneliness for a recently widowed man. When evaluating the plan, the man tells the nurse new information about his active social life. What would the nurse do next?

Delete the nursing diagnosis.

A nurse working in a hospital setting discovers problems with the delivery of nursing care on the pediatric unit. Which of the following suggestions from the Institute of Medicines Committee on Quality of Health Care in America (Kohn, Corrigan, & Donaldson, 2000) could help redesign and improve care? Select all that apply.

Base care on continuous healing relationships. Share knowledge and allow for free flow of information Practice evidence-based decision making Emphasize safety as a system property.

A nurse is evaluating an established plan of care. After identifying the evaluative criteria and standards (expected patient outcomes), what must the nurse do next?

Collect data about patient responses.

A nurse is interested in improving patient care on the unit through performance improvement. What is the first step in this process?

Discover the problem.

A nurse is counseling a novice nurse who gives 150% effort at all times and is becoming frustrated with a healthcare system that provides substandard care to patients. Which of the following advice would be appropriate in this situation? Select all that apply.

Encourage the new nurse to leave her problems at work behind, instead of rehashing them at home. After establishing a reputation for delivering quality nursing care, have her seek creative solutions for nursing problems. Tell her to view nursing care concerns as challenges rather than overwhelming obstacles and seek help for solutions. Tell the nurse that if administration is not supportive, moving to another practice setting might be more appropriate.

Which of the following are major premises of a quality-improvement program? Select all that apply.

It focuses on processes rather than individuals. It has no end points. It focuses on data and statistical thinking.

Nurses evaluate many aspects of the healthcare delivery system. Which of the following is always the primary concern when performing the evaluating step of the nursing process?

the patient

A nurse forgets to raise the railings of the bed of a patient who is confused after taking pain medications. The patient attempts to get out of bed, and suffers a minor fall. The nurse asks a colleague who witnessed the fall not to mention it to anyone because the patient only had minor bruises. What would be the appropriate action of the colleague?

The colleague should inform the nurse that a full report of the incident needs to be made.

Which of the following best summarizes the evaluating step of the nursing process?

The nurse and patient measure achievement of planned outcomes of care.

Patient lost 2 of the 5 pound/month goal. How should the nurse alter the plan of care in response to this new data?

The nurse should modify the time criteria.

Why are quality-assurance programs important in nursing?

They enable nursing to be accountable for the quality of care.

What is the purpose of evaluation in the nursing process?

to direct future nursing interventions

Which of the following is a descriptor that helps to define the term criteria?

acceptable level of performance

A nurse is teaching a patient how to administer insulin, with the expected outcome that the patient will be able to self-administer the insulin injection. How would this outcome be evaluated?

asking the patient to demonstrate self-injection of insulin

Which of the following would not be part of the nurses decision about care after evaluating the patients responses to the plan of care?

begin the plan of care

A nurse is evaluating the outcomes of a plan of care to teach an obese patient about the calorie content of foods. What type of outcome is this?

cognitive

What cognitive processes must the nurse use to measure patient achievement of outcomes during evaluation?

critical thinking

A plan of care for a patient with a low potassium level includes providing information about the effect of medications and dietary intake of foods high in potassium. How would a nurse measure achievement of an outcome for this plan?

laboratory data

The nursing staff on a hospital unit are using peer review to improve professional performance. Who performs the review?

nurses

A nurse in a community health center has been having regular meetings with a woman who wants to stop smoking. Which of the following outcome decision options would the nurse document if the woman has not smoked for 3 months?

outcome met

What is evaluated when conducting a nursing audit?

patient records

A hospital is evaluating its policies and procedures. What type of evaluation is the hospital conducting?

structure