00:01
Welcome to the evaluation phase
of the ADPIE process
otherwise known
as the nursing process.
00:08
This is the piece to figure out,
did our plan of care work?
Do we need to revise it?
Or was it effective for
our patients?
So when we're talking
about evaluation,
sometimes it works out great,
and it's positive,
sometimes it does not.
00:22
So we're talking about a
positive desired evaluation
at the end of our plan of care.
00:28
This occurs
when our desired outcomes
or our SMART goals
were met.
00:32
Also, our interventions
were successful here,
and it was effective
for our patients treatment.
00:37
But sometimes we can have
unmet or undesired evaluations
where of course,
our SMART goals or
desired outcomes were not met,
and those interventions
were not successful.
00:50
Here are five things
that are recommended
from the AMA or
American Nurses Association
in regard to evaluation
with our plan of care.
00:58
So we need to make sure
we communicate the results
of that plan of care,
and use criterion-based
evaluation measures.
01:05
We need to collaborate
with others
and be systematic
in the way we evaluate.
01:11
And of course,
we need to reassess
and if that plan of care
was ineffective,
we need to revise the care plan
as needed for patient.
01:20
So when we're talking
about evaluation,
we're looking at two big things.
01:24
We're looking at the patient's
goal and the expected outcome.
01:27
So we're talking about
a patient's SMART goal.
01:30
This is a specific statement
that we create
that describes a desired change
in a patient's condition.
01:37
Then we're going to look
at the expected outcome.
01:39
This is what we create
as an end result
that is measurable, desirable,
and we want to observe this.
01:46
So an evaluation,
we're going to look at the goal
and the expected outcome.
01:49
Did we meet it, or did we not?
So we're evaluating
the effectiveness
of those interventions.
01:56
We have to make sure
in that evaluation,
and even during this process,
we're collaborating
with the patient in the family.
02:04
We're using those
evaluative measures,
then we're going to interpret
and summarize those findings
and of course,
document the results.
02:11
Now,
upon evaluation,
we've got to remember,
was this effective?
Did we reach those goals,
or did we not?
And we need to revise
the care plan as needed.
02:21
As you can imagine,
the patient condition
can change,
priorities in the patient treatment
can change as well.
02:27
So again, be flexible here
and revise as needed.
02:31
Now, we're talking about
evaluating outcomes.
02:34
Here are a couple of steps
that we need to think about.
02:37
So first,
on the top of this list,
we've got to look
at our desired outcomes.
02:41
We're going to review these.
02:42
If you remember,
going back to those outcomes.
02:45
So an example of this is,
we hope that
the patient's O2 sat
is going to be above
90% on room air.
02:52
So we've got to review
the actual outcome,
not our desired.
02:56
So when we assess our patient,
the actual outcome was
the O2 saturation
was 86% on room air.
03:04
Now, we're going to
compare the both
the desired of what we set,
and what actually is occurring.
03:10
So here you can see
the actual outcome
of the oxygen saturation
was 86%.
03:16
If it did not meet our goal,
our desired outcome of 90%
on room air.
03:22
So now we're looking
at these discrepancies saying
"Okay, well, the patient's
oxygen saturation is too low
when they're on room air.
03:31
And lastly,
we've got to identify any barrier
and revise that
care plan as needed.
03:36
So because the patient's
oxygen saturation was low,
maybe we were trying
to get them to use
their incentive spirometer
for breathing.
03:43
But we've looked at
and see the barrier
that maybe the patient can't use
that incentive spirometer
because of delirium,
or confusion.
03:51
So of course, this isn't
going to work for our patients.
03:54
So we've got to revise
our pair plan for a patient.
03:57
So when we're
talking about evaluation,
if it was effective,
we can discontinue a care plan.
04:03
That is good news
for us as nurses.
04:05
This means the patient goal
was met successfully
and the patient agreed
to that plan of care.
04:10
Then we document
that discontinued plan of care.
04:15
Now, sometimes, again,
like we've talked about
throughout this presentation,
we've got to modify that a bit.
04:20
That could mean because
priorities have changed.
04:24
Patient needs have changed.
04:25
Or those interventions
were not effective,
and they're no longer
appropriate.
04:31
If this is the case,
we've got a document
that we'd have to modify or revise
that care plan for our patient.