Chapter 18
Which example is a psychomotor outcome? A. A patient learns how to control his weight using the MyPyramid 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.
2Answer: 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).
Evaluating Step
Allows achievement of outcomes Directs nurse-patient interactions Measures patient outcome achievement Identifies factors to achieve outcomes Modifies the plan of care, if necessary
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. True Rationale: An outcome evaluation focuses on measurable changes in the health status of the patient or the end result of nursing care.
Tell whether the following statement is true or false.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. True Rationale: The purpose of evaluation is to allow the patient's achievement of expected outcomes to direct future nurse-patient interactions.
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 Rationale: Asking a patient to plan an exercise program to lower blood pressure based on information provided in an A/V presentation is an excellent method to evaluate a cognitive outcome.
Seven Crucial Conversations in Health Care
Broken rules Mistakes Lack of support Incompetence Poor teamwork Disrespect Micromanagement
Ways to Evaluate Outcomes
Cognitive: asking patient to repeat information or apply new knowledge Psychomotor: asking patient to demonstrate new skill Affective: observing patient behavior and conversation Physiologic: using physical assessment skill to collect and compare data
Four Steps Crucial to Improving Performance
Discover a problem Plan a strategy using indicators Implement a change Assess
Five Classic Elements of Evaluation Identifying
Identifying evaluative criteria and standards Collecting data to determine if criteria and standards are met Interpreting and summarizing findings Documenting judgment Terminating, continuing, or modifying the plan
Variables Affecting Outcome Achievement
Patient Example: a patient gives up and refuses treatment Nurse Example: a nurse is suffering from burnout Health care system Example: inadequate staffing
Elements of Healthy Work Environments
Skilled communication True collaboration Effective decision making Appropriate staffing Meaningful recognition Authentic leadership
Actions Based on Patient Response to Plan of Care
Terminate plan of care when/if each expected outcome is achieved Modify plan of care if there are difficulties achieving the outcomes Continue with same plan of care if more time is needed to achieve the outcomes
Affective Outcome
changes in patient values, beliefs, and attitudes
Cognitive Outcome
increase in patient knowledge
Psychomotor Outcome
patient's achievement of new skills
Physiologic Outcome
physical changes in the patient
