NURSING EVALUATION – FIFTH COMPONENT

           Nursing evaluation is the fifth step in the nursing process, it is crucial to determines whether client goals have been met, partially met, or not met especially after the implementation of nursing process. Through the nursing evaluation, nurse know about the patient’s condition, as well as experience with previous clients, to evaluate whether nursing care was effective. Nursing evaluation nurse also measure to determine if expected outcomes are met.

           When a goal is met, the nurse decides whether nursing interventions should stop or continue for the status to be maintained. When a goal is partially met or not met, the nurse reassesses the situation. The reasons the goal is not met and modifications to the plan of care are determined by more data collection. The evaluation process will determine the effectiveness of care, make necessary modifications, and to continuously ensure favorable client outcomes.

Types of Nursing Evaluation
           To evaluate mean to judge that aim, target or goal is achieved or not. It is process to judge the actions which has two main types

Formative evaluation
Summative evaluation

Formative evaluation done during nursing actions. Taking temperature during sponging is formative evaluation.
Midterm examination is also formative evaluation.

Summative evaluation done after the completion of any procedure or project.
Final examination is an example of summative evaluation

Purpose Nursing Evaluation

• Determine client’s behavioral response to nursing interventions.
• Compare the client’s response with predetermined outcome criteria.
• Appraise the extent to which client’s goals were attained.
• Assess the collaboration of client and health care team members.
• Identify the errors in the plan of care.
• Monitor the quality of nursing care.
• To determine whether to continue, modify, or terminate the plan of care.

Reasons that goals are not met or are only partially met in Nursing Evaluation include:

• Initial assessment data were incomplete.
• Goals and expected outcomes were unrealistic.
• Time frame was not adequate.
• Nursing interventions were not appropriate for the client or situation.

Evaluation is a fluid process that depends on all the other components of the nursing process. Evaluation affects and is affected by the other four parts. Ongoing evaluation is essential for the nursing process to be implemented appropriately. Early evaluation enhances our ability to act safely and effectively.

Activities in Nursing Evaluation phase

Collaborate with client and relate nursing actions to client outcomes Determine if goals/outcomes have been met/achieved. If not, re-evaluate as:

• Data – did you collect enough/correct data?
• Diagnosis – did you analyze the data accurately?
• Etiology – is it accurate?
• Outcome – patient centered, measurable and realistic?
• Interventions – realistic and doable?
• Revise/modify the care plan as indicated.

Components of Nursing Evaluation

• Collecting the data related to the desired outcomes
• Comparing the data with outcomes
• Relating nursing activities to outcomes
• Drawing conclusion about problem status
• Continuing, modifying, or terminating the nursing care plan

Evaluation skill required for nurses

• Nurse must know the hospital policies, procedure and protocols of interventions and recording.
• Nurse must have up to date knowledge and information of many subject.
• Nurse must have intellectual and technical skill to monitor the effectiveness of nursing interventions.
• Nurse must have knowledge and skill of collecting subjective data and objective data.

Nursing 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}

NURSING EVALUATION – FIFTH COMPONENT | POST RN BSN NURSING RESOURCES