Effective Nursing Evaluation: Critical Thinking & Patient Outcomes

Chapter 20: Evaluation

Critical Thinking and Evaluation

Critical thinking is how a nurse gathers patient data from nursing diagnoses to develop a plan of care and implement interventions. Evaluation, the final step of the nursing process, determines whether the patient's condition or well-being improves after applying the nursing process. Nurses apply their knowledge and previous experiences to evaluate the effectiveness of nursing care.

Evaluative Measures vs. Assessment

Assessment identifies existing problems, while evaluation determines if those problems have remained the same, worsened, or changed.

Importance of Evaluative Measures

Using the right evaluative measures increases the likelihood of accurately identifying changes in the patient's condition.

Goals of Care, Expected Outcomes, and Evaluative Measures

The goal is the expected response indicating resolution of a nurse's diagnosis. An expected outcome is the measurable, desirable, and observable patient behavior that indicates the effectiveness of interventions. Evaluative measures involve assessment skills and techniques perceived from patient interviews and recognizing patterns of improvement or deterioration.

Example:

• Goal: Patient's pressure ulcer will heal within 7 days.
• Evaluative Measures: Inspect color, condition, and location of pressure ulcer.
• Expected Outcomes: Erythema will be reduced in 2 days.

Evaluation and Errors in Care

Evaluation involves observation skills, critical thinking, intellectual standards, knowledge, and reflection to recognize errors so changes can be made.

Revising a Plan of Care

Identify factors that interfere with achieving goals, which usually involves changes in the patient's condition, needs, or abilities.