Nurse 3010 Foundations Of Professional Practice Chapter 18: Evaluating

Which is a psychomotor client goal?

By 18AUG2015, the client will demonstrate improved motion in the left arm.

A nurse is evaluating a client to determine outcome achievement. The nurse determines that the client's outcome was partially met. When documenting the evaluative statement, the nurse records which other information?

Data that supports the decision that the outcome was only partially met.

The nurse is caring for a postoperative client who reports ineffective pain management with pain rated a 7 on a 0-10 rating scale. Based on the information provided by the client, which step should the nurse take first to modify the care plan?

Evaluate the use of current pain relief measures.

Outcome Evaluation

Focuses on measurable changes in the health status of the patient.

Retrospective Evaluations Include

Post discharge interviews, questionnaires, or documents. But they MUST be POST DISCHARGE.

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

Structure

Quality By Inspection

The nurse observes deficient workers, and removes them in order to prevent client harm.

A new mother is having difficulty breastfeeding a newborn infant. A goal was established stating that the baby would be nursing every 2 to 3 hours by age 1 week. The mother presents to the follow-up center at 1 week and reports having discontinued breastfeeding. The nurse evaluates the original goal as:

completely unmet.

Identifying the kind and amount of nursing services required is a possible solution for:

inadequate staffing.

The focus of a hospital's current quality assurance program is a comparison of the health status of clients on admission and with that at the time of discharge. This form of quality assurance is characteristic of:

outcome evaluation.

The nurse manager is holding a staff meeting and indicates that the unit is looking at a 3% budget cut for the coming year. The nurse manager asks the staff what they see as priorities for the unit, and solicits suggestions from the staff as to what budget areas might be reduced. Which standard for establishing and sustaining healthy work environments does this action represent?

Effective decision making

A nurse finds that a client is not achieving the set outcomes for care and reviews the plan. Which are appropriate actions for the nurse to take while reviewing the plan of care? Select all that apply.

Modify the nursing diagnosis. Make the outcome statement more realistic. Adjust the time limits on the outcome statement. Increase the complexity of the outcome statement.

Which are major premises of a quality-improvement (QI) program? Select all that apply.

QI determines whether nursing standards are being upheld. QI programs may be mandated by some governmental agencies. QI focuses on processes rather than individuals. QI's focus is on ensuring excellence in care.

After incorrectly administering digoxin to a client, a nurse admits the error to the nurse manager and peers to prevent them from making the same mistake. This is an example of which approach to quality assurance?

Quality as opportunity

The Joint Commission is conducting an accreditation visit at the hospital. What is the focus of the evaluation being conducted?

Quality assurance

The nurse manager observes one of the unit nurses failing to wash hands on entering a client room. Hospital protocol is to wash hands before and after entering a client room. This scenario is an example of which approach to quality assurance?

Quality by Inspection.

Which statement regarding quality improvement or quality assurance is correct?

Quality improvement focuses on processes, data, and statistical thinking.

The nursing supervisor is presenting the staff nurses with yearly performance evaluations. What type of evaluation is the supervisor presenting to the staff?

Process

The nurse participates in a quality assurance program and reviews evaluation data for the previous month. The data indicates a nursing plan was developed within 8 hours of admission for 97% of all admissions. The nurse recognizes this as which type of evaluation?

Process evaluation

A client who was admitted to the acute care unit with angina pectoris is no longer having chest pain. Based on this assessment, what does the nurse decide to do with the plan of care for chest pain?

Terminate the plan of care related to the nursing diagnosis of chest pain as the expected outcome has been achieved.

A client has returned to the clinic for a postoperative visit. The nurse reviews the plan of care and may choose to take which actions based on the client's previous responses to the current plan of care? Select all that apply.

Terminate the plan of care if the client has achieved outcomes. Modify the plan of care if the client has encountered difficulty with achieving outcomes. Continue the plan of care if more time could result in achievement of outcomes.

Structure Evaluation

Focuses on the environment in which care is provided. AKA audit.

Process Evaluation

Focuses on the nature, and sequence of activities carried out by nurses such as the timing of nursing care plan creation.

A nurse is participating as a team member involved in the facility's evaluation process. The facility is conducting a retrospective evaluation. Which methods should the nurse expect to use to collect data? Select all that apply.

Post-discharge client questionnaires Chart review Telephone interviews of discharged clients

Which action should the nurse perform in the evaluation phase?

Revise the plan of care.

Which precepts are among the rules suggested by the Institute of Medicine's (IOM) Committee on Quality of Health Care in America to improve health care? Select all that apply.

The client as the source of control Safety as a system priority Anticipation of clients' needs Cooperation among clinicians

A nurse manager attempts to achieve performance improvement in the emergency department of a busy inner-city hospital. Which nursing actions follow Haase and Miller's recommended steps in performance improvement? Select all that apply.

The nurse discovers that there is a problem with the triage system that is in place in the emergency department. The nurse calls a meeting of the emergency department interdisciplinary team to effect change in the triage process. The nurse organizes a task force to implement change in the triage process of a busy emergency department. The nurse meets with the emergency department staff to assess changes made to the triage process.

A large university hospital has commissioned a multidisciplinary group to review client records following discharge to evaluate client outcomes and the character and quality of nursing care that clients receive. Which type of evauation process will take place?

A nursing audit

A nurse is evaluating the plan of care for a client and determines that the achievement of goals is difficult to evaluate. What should the nurse do when evaluating the plan to ensure that the outcomes are achievable? Select all that apply.

Be sure that the criteria for appropriate response are clearly specified. Be certain that the subject is the client or some part of the client. Make sure the client's expected behavior is written in observable, measurable terms. Specify time limits in the plan.

"Measurable qualities, attributes, or characteristics that identify knowledge or health status" defines:

Criteria

Which action should the nurse take during the evaluation phase of the nursing process?

Document reassessment of pain after medication administration.