chapter 20.txt

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chapter 20.txt
2015-05-31 00:05:08

Chapter 20 Evaluation of nursing care
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  1. What is the importance of evaluation, the final step of the nursing process?
    Evaluation is crucial to determine whether after application of the nursing process the client's condition or well-being improves. You conduct evaluative measure to determine if you met expected outcomes, not if nursing interventions were completed.
  2. How does the nurse apply critical thinking to the ongoing process of evaluation?
    • Critical thinking directs you to analyze the findings from evaluation. During evaluation you make clinical decisions and continually redirect nursing care.
    • This sequence of critically evaluating and revising therapies continues until you and the client successfully and appropriately resolve the problems, as define by nursing diagnoses.
  3. How would you apply the following components of the evaluation process to nursing care?
    • A. identifying evaluative criteria and standards: you evaluate nursing care by knowing what to look for. A client's goal and expected outcomes give you the objective criteria needed to judge a clients response to care.
    • B. collecting data to determine whether the criteria or standards are met: The primary source for data for evaluation is the client, however we'll use input from the family and other caregivers. It's important to evaluate whether each client reaches a level of wellness or recovery that the health care team and client establish as a goal.
    • C. interpreting and summarizing findings: a client's condition changes often minute by minute during acute illness; In contrast chronic illness result in slow subtle changes. Comparing expected and actual findings allow us to interpret and judge the clients condition and whether predicted changes have occurred.
    • D. documenting findings and any clinical judgment: accurate information needs to be present in client's medical records for nurses to make an ongoing clinical decision. Present a clear argument from the evaluative data as to whether a client is progressing or not.
    • E. documenting findings
    • 1. Care plan revision: Evaluate and determine if the goals of care have been met.
    • 2. Discontinuing a care plan: Then decide if the plan of care needs to be adjusted (because goals have been met) or discontinued.
    • 3. Goals and expected outcomes: ¬†When goals are not met you identified the factors that interfere with the goal achievement.
    • 4. Interventions: That way we can revise care plans for needed changes
    • All of this is an important step in critical thinking¬óknowing how the client is progressing and how problems either resolve or worsen.
  4. What is the relationship between the evaluation process and quality improvement?
    As a system or institutional level evaluation involves quality improvement (QI) and performance improvement (PI) activities that focus on the delivery of care provided by an agency or specific nursing division within the agency. Through the continuous evaluation of care nurses play a key role in the ongoing improvement of client care.