Chapter 13 Flashcards
(30 cards)
Goal of Outcome Identification and Planning Step
- Establish priorities.
- Identify and write expected patient outcomes.
- Select evidence-based nursing interventions.
- Communicate the plan of care.
Three Elements of Comprehensive Planning
- Initial
- Ongoing
- Discharge
Initial Planning
- performed by the nurse with the admission nursing history and the physical assessment.
- Addresses each problem listed in the prioritized nursing diagnoses and identifies appropriate patient goals
Ongoing Planning
- Carried out by any nurse who interacts with patient
- Keeps the plan up to date, manages risk factors, promotes function
- States nursing diagnoses more clearly
- Develops new diagnoses
- Makes outcomes more realistic and develops new outcomes as needed
- Identifies nursing interventions to accomplish patient goals
Discharge planning
- Carried out by the nurse who worked most closely with the patient
- Begins when the patient is admitted for treatment
- Uses teaching and counseling skills effectively to ensure that home care behaviors are performed competently
High priority Nursing Diagnoses
greatest threat to patient well-being
Medium priority Nursing Diagnoses
nonthreatening diagnoses
Low priority Nursing Diagnoses
diagnoses not specifically related to current health problem
Maslow’s Hierarchy of Human Needs
Physiologic needs Safety needs Love and belonging needs Self-esteem needs Self-actualization needs
Long-term outcomes
require a longer period to be achieved and may be used as discharge goals.
Short-term outcomes
may be accomplished in a specified period of time.
IOM’s Six Aims to be Met by Health Care Systems Regarding Quality of Care
- Safe: avoiding injury
- Effective: avoiding overuse and underuse
- Patient-centered: responding to patient preferences, needs, and values
- Timely: reducing waits and delays
- Efficient: avoiding waste
- Equitable: providing care that does not vary in quality to all recipients
Cognitive Outcomes
describes increases in patient knowledge or intellectual behaviors
Psychomotor Outcomes
describes patient’s achievement of new skills
Affective Outcomes
describes changes in patient values, beliefs, and attitudes
Clinical Outcomes
- describe the expected status of health issues at certain points in time, after treatment is complete.
- address whether the problems are resolved or to what degree they are improved
Functional Outcomes
describe the person’s ability to function in relation to the desired usual activities
Quality-of-life outcomes
focus on key factors that affect someone’s ability to enjoy life and achieve personal goals.
Common Errors in Writing Patient Outcomes
- Expressing patient outcome as nursing intervention
- Using verbs that are not observable or measurable
- Including more than one patient behavior or manifestation in short-term outcomes
- Writing vague outcomes
Parts of a Measurable Outcome
Subject Verb Conditions Performance criteria Target time
Nurse-initiated Interventions
actions performed by a nurse without a physician’s order
Physician-initiated Interventions
actions initiated by a physician in response to a medical diagnosis but carried out by a nurse under doctor’s orders
Collaborative Interventions
treatments initiated by other providers and carried out by a nurse
Actions Performed in Nurse-Initiated Interventions
- Monitor health status.
- Reduce risks.
- Resolve, prevent, or manage a problem.
- Facilitate independence or assist with ADLs.
- Promote optimum sense of physical, psychological, and spiritual well-being.
