2. INTRODUCTION
. Evaluation, the final step of the nursing
process, is crucial to determine whether, after
application of the nursing process, the client’s
condition or well-being improves. The nurse
applies all that is known about a client and the
client’s condition, as well as experience with
previous clients, to evaluate whether nursing
care was effective. The nurse conducts
evaluation measures to determine if expected
outcomes are met, not the nursing
interventions.
3. The expected outcomes are the standards
against which the nurse judges if goals have
been met and thus if care is successful.
Providing health care in a
timely, competent, and cost-effective
manner is complex and challenging. The
evaluation process will determine the
effectiveness of care, make necessary
modifications, and to continuously ensure
favorable client outcomes.
4. DEFINITION
Evaluation is defined as the judgment of the
effectiveness of nursing care to meet client
goals; in this phase nurse compare the client
behavioral responses with predetermined
client goals and outcome criteria.
{CRAVEN 1996}
5. Nursing Diagnosis : Impaired skin integrity related to physical
mobility
Expected Outcomes : The patient will be able to get recovery of pressure
sore.
Planning Rationale Evaluation
Wound healing
•Pressure sore dressing, Cleansing the was observed
area will prevent (tissues were
further infection red, healthy)
•Back care
It will promote blood
circulation
•Change the position
frequently It will put little
pressure on the
sore site
•Encourage the patient to
ambulate
•Take protein rich diet Protein helps
in repair of tissues
6. PURPOSES
1. Determine client’s behavioral response to nursing
interventions.
2. Compare the client’s response with predetermined
outcome criteria.
3. Appraise the extent to which client’s goals were
attained.
7. 4. Assess the collaboration of client and health care team
members.
5. Identify the errors in the plan of care.
6. Monitor the quality of nursing care.
8. ACTIVITIES IN EVALUATION PHASE
Identifying criteria
and standards
Collecting
evaluating data
Interpreting &
summarizing findings
10. • Identifying criteria and standard
Nurses evaluate the nursing care by knowing
what to look for. A client’s goals & expected
outcome give the objective criteria needed a
client’s response to care.
11. • Collecting Evaluative Data
Evaluating a client’s response to nursing
care requires the use of evaluative
measures, which are simply assessment, skill &
techniques, (Eg. Auscultation of lung
sounds, observation of client’s skill
performance, discussion of the client’s
feeling, and inspection of the skin.)
Infact, evaluative measures are the
same as assessment measures, but nurses perform
them at the time of care when they
make, decission about the client’s status and
progress.
12. • Interpreting & Summarizing Findings
Using evidence, nurses make judgement
about a client condition. To develop clinical
judgement, match the result of evaluative measures
with expected outcomes to determine if a client’s
status is improving or not.
1. Examine the goal statement to identify the exact
desired client behavior or response.
2. Assess the client for the presence of that behavior
or response.
13. 3. Compare the established outcome criteria with
the behavior or response.
4. Judge the degree of agreement between
outcome criteria and the behavior or response.
5. If there is no agreement (or only partial
agreement ) between the outcome criteria and
the behavior or response, what is/are the
barriers? Why did they not agree?.
14. •Documenting Findings:
Documentation and reporting are an important
part of evaluation. Written nursing process
notes, assessment flow sheets and information shared
between nurses during changes of shift reports
communicate a client’s progress toward meeting
expected outcomes and goals for the nursing plan of
care.
15. •Care Plan Revision:
Evaluate expected outcomes and
determine if the goals of care have been met
Then decide the need to adjust the plan
of care. If goal met successfully, discontinue
that portion of the care plan.
16. COMPONENTS OF EVALUATION
1. Collecting the data related to the desired
outcomes
2. Comparing the data with outcomes
3. Relating nursing activities to outcomes
4. Drawing conclusion about problem status
5. Continuing, modifying, or terminating the
nursing care plan
17. Collecting the data:
The nurse collects the data so that
conclusion can be drawn about whether goals
have been met. It is usually necessary to collect
both subjective & objective data. Data must be
recorded concisely and accurately to facilitate the
next part of the evaluating process.
18. Comparing the data with outcomes:
If the first part of the evaluation
process has been carried out effectively , it is
relatively simple to determine whether a desired
outcome has been met. Both the nurse and client
play an active role in comparing the client’s
actual responses with the desired outcomes.
19. Relating nursing activities to outcomes
The third aspect of the
evaluating process is determined whether the
nursing activities had any relation to the
outcome.
20. Drawing conclusion about problem status:
The nurse uses the judgement about
goal achievement to determine whether the
care plan was effective in resolving, reducing
or preventing client problems. When goals
have been met the nurse can draw one the
following conclusions about the status of the
client’s problem.
21. •The actual problem stated in the nursing diagnosis
has been resolved , or the potential problem is being
prevented and the risk factors no longer exist. In
these instances , the nurse documents that the goals
have been met and discontinues the care for the
problem.
• The potential problem is being prevented, but the
risk factors still present. In this case , the nurse keeps
the problem on the care plan.
• The actual problem still exists even though some
goals are being met. In this case the nursing
interventions must be continued.
22. Continuing , modifying , or terminating
the nursing care plan:
After drawing conclusion about the
status of the client’s problems , the nurse
modifies the care plan as indicated. Whether
or not goals were met, a number of decision
need to be made about
continuing, modifying or terminating
nursing care for each problem.
23. Before making individual
modification, the nurse must first determine
why the plan as a whole was not completely
effective. This require a review of the entire
plan.
26. EVALUATION SKILL REQUIRED FOR
NURSES
1. Nurse must know the hospital
policies, procedure and protocols of
interventions and recording.
2. Nurse must have up to date knowledge
and information of many subject.
27. 3. Nurse must have intellectual and technical
skill to monitor the effectiveness of nursing
interventions.
4. Nurse must have knowledge and skill of
collecting subjective data and objective
data.
