The most important purpose of the evaluation step of the nursing process is to:

Simply put, the nursing process is a guide to everything that nurses do. Have you ever thought about it? 

The American Nurses Association defines the nursing process as the “essential core of practice for the registered nurse to deliver holistic, patient-focused care“ and consists of five different components: assessment, diagnosis, outcomes/planning, implementation, and evaluation.  

Although you probably remember seeing these five components during nursing school, the nursing process cannot be fully learned through memorization, but rather through practice and developmental experience. 

Let’s break it down.

Assessment

In order to be able to offer a potential diagnosis, the patient and all external factors must be assessed.

As we mentioned in our blog, listening to a patient and understanding their concerns and hopes for treatment must be the first step in the nursing process.

By doing so, we increase our chances of reaching a diagnosis, developing a treatment plan that meets the patient‘s needs, and increases the overall quality of care given.  

Diagnosis

This phase in the nursing process is one of the most important.

We must consider all external factors of the patient (environmental, socioeconomic, and physiological etc.) when developing a diagnosis, which can be challenging at times.

However, along with your experience and clinical knowledge, there are additional resources available in order to help you!

For example, the North American Nursing Diagnosis Association (NANDA) provides a continuously revised guide of all nursing diagnoses.

Outcomes/Planning

Once you have reached a diagnosis, care panning is the next essential step in the nursing process.

When considering a holistic care approach, it is necessary to factor in the already-determined external factors of the patient and their concerns when setting attainable health goals.

By utilizing resources such as the Nursing Outcomes Classification or Maslow’s Hierarchy of Needs, it can provide insight as to how you should develop a care plan specifically for your patient based on their goals and the level of urgency.

Implementation

This phase involves both direct and indirect patient care, whether that is administering medication, educating the patient, or continuously checking their vitals.

This point in the nursing process should actively follow the care plan that was developed in the previous step and should actively work toward accomplishing the patient‘s health goals.  

Evaluation

Lastly, the evaluation phase should be a direct assessment of if the implemented care plan was effective and if the intended outcomes were reached.

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

Sample Case Study

Nursing Diagnosis : Impaired skin integrity related to physical mobility

Expected Outcomes : The patient will be able to get recovery of pressure sore.

Planning:

• Pressure sore dressing
  • Rationale: Cleansing the area will prevent further infection
• Back care
  • Rationale: It will promote blood circulation
• Change the position frequently
  • Rationale: It will put little pressure on the sore site
• Encourage the patient to ambulate
  • Rationale: It will put little pressure on the sore site
• Take protein rich diet
  • Rationale: Protein helps in repair of tissues

Evaluation : Wound healing was observed (tissues were red, healthy)

1. Determine client’s behavioral response to nursing interventions.
2. Compare the client’s response with predetermined outcome criteria.
3. Appraise the extent to which client’s goals were attained.
4. Assess the collaboration of client and health care team members.
5. Identify the errors in the plan of care.
6. Monitor the quality of nursing care.

Components of Evaluation

1. Collecting the data related to the desired outcomes
2. Comparing the data with outcomes
3. Relating nursing activities to outcomes
4. Drawing conclusion about problem status
5. Continuing, modifying, or terminating the nursing care plan

• The nurse collects the data so that conclusion can be drawn about whether goals have been met. It is usually necessary to collect both subjective & objective data. Data must be recorded concisely and accurately to facilitate the next part of the evaluating process.

•  If the first part of the evaluation process has been carried out effectively , it is relatively simple to determine whether a desired outcome has been met. Both the nurse and client play an active role in comparing the client’s actual responses with the desired outcomes.

• The third aspect of the evaluating process is determined whether the nursing activities had any relation to the outcome.

Drawing conclusion about problem status

• The nurse uses the judgement about goal achievement to determine whether the care plan was effective in resolving, reducing or preventing client problems. When goals have been met the nurse can draw one the following conclusions about the status of the client’s problem.
  • The actual problem stated in the nursing diagnosis has been resolved , or the potential problem is being prevented and the risk factors no longer exist. In these instances , the nurse documents that the goals have been met and discontinues the care for the problem.
  • The potential problem is being prevented, but the risk factors still present. In this case , the nurse keeps the problem on the care plan.
  • The actual problem still exists even though some goals are being met. In this case the nursing interventions must be continued.

After drawing conclusion about the status of the client’s problems , the nurse modifies the care plan as indicated. Whether or not goals were met, a number of decision need to be made about continuing, modifying or terminating nursing care for each problem.

Before making individual modification, the nurse must first determine why the plan as a whole was not completely effective. This require a review of the entire plan.

Factors Affecting Goal Attainment

1. Family Members
2. Health Team Members
3. Nurse

Evaluation Skill Required for Nurses

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

Exam

Evaluation Practice Exam (PM)**

Please wait while the activity loads.
If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled.

If loading fails, click here to try again

Choose the letter of the correct answer. Good luck!

Start

Congratulations - you have completed Evaluation Practice Exam (PM)**. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

Your answers are highlighted below.

Question 1

The nurse has identified a nursing diagnosis of knowledge deficit regarding the need to monitor blood glucose levels daily. Which of the following statements best reflects the client’s understanding of the need for therapy?

A

Client is observed testing his blood glucose level before breakfast.

B

Client is able to demonstrate the proper technique for performing a finger stick.

C

Client records blood glucose levels for a 3-week period.

D

Client agrees to test blood glucose levels 4 times a day.

Question 2

A client shares with the nurse that they have, “almost reached the goal of smoking only one-half pack of cigarettes a day.” The best example of a nursing intervention to correct this unmet outcome is:

A

Reevaluate the time frame originally decided upon for achievement of the goal

B

Suggest that the strength of the prescribed nicotine patches be increased to 21 mg

C

Suggest that the client use another smoking cessation tool to achieve the goal

D

Discuss with the client the desire to comply with the ordered therapy

Question 3

The client is able to ambulate without signs or symptoms of shortness of breath. Which statement by the nurse is the best example of an objective evaluation of the client’s goal attainment?

A

“Client has no evidence of respiratory distress when ambulating.”

B

“Client has no manifestations of nausea while up in hall.”

C

“Client walked well and did not have any problem when up.”

D

“Client has no pain after ambulating.”

Question 4

Which of the following statements best reflects a goal based on a clinical standard of practice?

A

Client will lose 10 pounds in 90 days.

B

Client’s chronic pain will be managed with oral medication by discharge.

C

Client will walk 30 feet with minimal assistance.

D

Client’s peripheral intravenous site will be free of redness.

Question 5

When modifying a care plan to meet a client whose status has changed significantly over the past few days, the nurse should:

A

Perform a complete reassessment of all client factors

B

Add more nursing interventions from a standardized plan of care

C

Redevelop the entire client care plan

D

Focus on changing the nursing diagnoses and goals

Question 6

Which of the following outcomes best reflects a nurse-sensitive client outcome?

A

Client will report lessened anxiety regarding surgical procedure.

B

Client will perform personal hygiene daily.

C

Client will experience no falls during hospitalization.

D

Client will consume 75% of all meals.

Question 7

The nurse has determined the following outcome for a client with a skin impairment: “Erythema will be reduced in 3 days.” Evaluation will specifically focus on:

A

Selection of appropriate wound care

B

Notation of the odor and color of drainage

C

Inspection of the color and condition of the area

D

Measurement of the diameter of the ulceration daily

Question 8

The primary purpose of the nursing evaluation process is to:

A

Identify interventions that are ineffective in achieving client goals

B

Critique the nurse’s ability to implement appropriate nursing interventions

C

Establish the progress the client is making towards health and wellness

D

Determine the effectiveness of the nursing care provided

Question 9

Based on the following outcome criterion determined by the nurse: “Client will independently complete necessary assessments prior to administration of digoxin (cardiotonic)” the nurse will evaluate the client’s ability to:

A

Inspect color of the skin

B

Palpate the radial pulse

C

Assess the respiratory rate

D

Review dietary habits

Question 10

The client has a nursing diagnosis of impaired gas exchange as a result of excessive secretions. An outcome for the client is that the airways will be free of secretions. A positive evaluation will focus upon the client’s:

What is the purpose of evaluation in the nursing process?

Why is the evaluation step important to the nursing process quizlet?

What is the most important step in nursing process?

What is nursing evaluation in nursing process?