Case Study of ADPIE: Evaluation (Nursing)

by Samantha Rhea, MSN, RN

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    00:01 So now, we've got to go into the evaluation phase after plan of care.

    00:05 So now looking back at those outcomes, if you look at the oxygenation was Mrs. Meyer able to maintain her oxygen saturation greater than 90%.

    00:15 Well, with our update she was? So our goal is met and we can discontinue this plan of care, because why? Well, it was effective.

    00:23 Now, if we're talking about our pain, if you remember, our outcome here, our desired outcome was, will she verbalize better pain control? And is she more of where a winter request pain medication? Well, if you remember, her pain was still having a little bit of issues, because she wasn't tolerating her pain medicine.

    00:42 So here, our goal was not met, and we're going to have to modify that plan of care.

    00:48 So anytime, you're talking about care planning is perfectly okay, that you're going to have desirable and undesirable evaluation.

    00:56 So what does that mean for us? We just go back to our ADPIE, and we circle back to the beginning.

    01:02 It's very common that we have to modify our care plan, because sometimes our interventions are effective.

    01:08 Sometimes they're partially effective.

    01:11 And sometimes they may not be effective at all, in regard to meeting our desired outcomes.

    01:16 So therefore, again, we go back to our ADPIE.

    01:19 We modify our care plan, go back into the circle.

    01:23 After evaluation, we're going to reassess and then we're going to go through those ADPIE process steps.

    01:30 Now, again, if that goal was not met, then again, it needs to be revised.

    01:34 What do we consider here? Well, were the interventions implemented as intended? Did we perform those interventions correctly? Now, are there any barriers for example? These are all things we need to consider, and we need to look at if those goals were not met, and we need to modify our care plan.

    01:51 We need to take a little bit of a look of why that wasn't effective.

    01:55 So with a new consideration that needs to be, is there something new that needs to be integrated in the plan of care? Did we miss something the first time on assessment maybe, or the planning period? Well, that's quite possible.

    02:07 And then we just go back to the beginning.

    02:10 Now, just know as an update, Mrs. Meyer was not able to take her pain medication because she wasn't tolerating them.

    02:17 Let's say she was nauseated, she was sick and vomiting, this is causing her pain score to be greater than a 5 out of 10.

    02:25 So if you recall, Mrs. Meyer was not able to meet her pain goal.

    02:28 So we have to repeat the ADPIE process and modify her plan of care.

    02:33 So Mrs. Meyer was not able to take her pain medication, because she's not tolerating it well, again, because of nausea and vomiting.

    02:40 Causing her pain scale to be a greater than 5 out of 10, which was our goal for her 5 or 10, or less.

    02:47 So our goal again, was to lessen that acute pain.

    02:51 Now, our outcome that we created for her is that we wanted her to report her pain scale of five out of 10, or less by the end of the shift.

    03:00 Now, here's where the thing that happens when we're talking about modifying plan of care.

    03:04 Sometimes unexpected events occur such as Mrs. Meyer's nausea and vomiting.

    03:09 So we have to adjust, and flex, and modify a new plan of care for her that's going to meet her need.

    03:16 So if you look at the new interventions here, it says they use cooling to supplement her pain control.

    03:22 Because right, we're going to have to do some other interventions, guys. Think outside the box, because taking the pain medications wasn't working, right? because of nausea and vomiting.

    03:32 Also, we could offer Mrs. Meyers here a snack with her pain medication that may also help with the nausea and vomiting and her ability to tolerate her medicine.

    03:41 And then we're going to create new outcomes such as reporting the pain level is decreased and her incidence of nausea and vomiting will also decrease.

    03:49 So, I hope today, guys, that the application of ADPIE was help for you with the patient scenario.

    03:54 Thank you for watching.

    About the Lecture

    The lecture Case Study of ADPIE: Evaluation (Nursing) by Samantha Rhea, MSN, RN is from the course Nursing Process – Assessment, Diagnosis, Planning, Interventions, and Evaluation.

    Included Quiz Questions

    1. A plan of care is discontinued if the goal is met, and modified if the goal is not met.
    2. A plan of care is discontinued if the goal is not met, and modified if the goal is met.
    3. A plan of care is only ever modified, not discontinued.
    4. A plan of care is only ever discontinued, not modified.
    1. “I was unable to assist my client to ambulate this morning as I had planned. This could have contributed to the goal not being met.”
    2. “The client’s high pain level is a barrier that needs to be addressed.”
    3. "I need to determine if there is anything I need to integrate into the plan of care."
    4. “The client’s high pain level is a barrier that means the plan of care should be discontinued.”

    Author of lecture Case Study of ADPIE: Evaluation (Nursing)

     Samantha Rhea, MSN, RN

    Samantha Rhea, MSN, RN

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