Nursing Process: Evaluation
George Ann Daniels, MS, RN
Evaluation
Evaluation includes determining
whether the desired outcomes have
been met
This in an on going process that
determines how well the plan of care is
working and if the plan of care needs to
be modified
A Time for reassessment
Evaluation requires continued
reassessment of the client’s condition,
and determines
Appropriateness of nursing actions
Need to revise interventions
Development of new client problems/needs
Need to rearrange priorities to meet
changing demands
How do you evaluate?
Direct observation
Client interview
Review of records
Progress notes, flow sheets, nursing notes
Components of evaluation
expected outcomes
Identification of expected outcomes
Collect data related to expected
outcomes
Relate nursing actions to expected
outcomes
Draw conclusions about problem status
Resolved
Revised
continue
Expected outcomes are either:
Met
Not met
Partially met
EO: Met
Document what client assessment
findings show that the expected
outcome is met
How do you know as a nurse that this
expected outcome is met?
What has happened to prove the problem
is resolved
Which intervention can be terminated?
How easily where the outcomes achieved?
Can timelines be shortened
Actual problem resolved
Nursing diagnosis is discontinued
High risk problem resolved
Risk factors no longer exist
Nursing diagnosis is discontinues
Problem still exists
Revise interventions
EO: Partially Met
Document the assessment findings that
indicate that progress has been made,
but there is still work to do.
How do you know that progress has been
made?
What needs to be done to make continued
progress?
EO: Not met
Document what has been done that
hasn’t worked so other HCP will be
aware.
How do you know that the client has not
met the EO?
What are the assessment findings that
support this?
What are you ideas for change?
If EO is not met ask these
questions
Were the outcomes realistic and
appropriate?
Was the client involved in setting the
outcomes?
Does the client believe the outcomes
were important?
Does the client know why the outcomes
have not been met?
Have all of the interventions that were
planned been carried out and in the
timeframe specified?
If not, why not? Were they too vague or
misinterpreted?
What variables may have affected
achievement of the outcomes?
Were new problems and adverse client
responses detected early enough to make
appropriate changes in the plan of care?
Modification of the plan of care
When evaluation indicates a change in
the plan of care is needed, “back up”
through the nursing process to see
where areas for change lie
How to write evaluations
EO was met, partially met, or not met.
Any new or additional data
Any changes that were made in the
intervention as a result of ongoing
assessment
How the interventions helped achieve
the goal
ANA Standard VI
Evaluation: The nurse evaluates the
client’s progress toward attainment of
outcomes
1. Evaluation is systematic ongoing, and
criterion-based.
2. The client, family, and other healthcare
providers are involved in the evaluation
process as appropriate.
3. Ongoing assessment data are used to
revise diagnosis, outcomes, and the plan of
care, as needed.
4. Revision in diagnoses, outcomes, and
the plan of care are documented.
5. The effectiveness of interventions is
evaluated in relation to outcomes.
6. The patient’s responses to interventions
are documented.