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Planning – SMART Goals in Nursing Care

by Samantha Rhea

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    00:01 Now, once we've considered priorities, and of course, including our patient, we have reevaluated our nursing diagnosis to make sure, it's still appropriate at this time.

    00:11 Now, once we've done this, we can set goals.

    00:14 Now, this is a great little acronym that we like to use to create Specific, Measurable, Attainable, Realistic, and Timely goals.

    00:24 Now, this is a really important acronym for us as nursing students or nurses.

    00:29 I know this may seem a little silly, but it's actually really helpful.

    00:32 Reason being here is a great example.

    00:34 When we're setting goals, we need to make sure we can measure it ,right? And to see if it's working, and to evaluate it later.

    00:41 So if I say something for a goal like, "I hope the patient gets better." Well, that's true, right? That's a true statement.

    00:48 But how do we measure that? What does better mean? So make sure you follow this acronym, and this will be really helpful in the evaluation piece.

    00:56 So here's another example of this.

    00:59 So our scenario, is Mrs. Smith is having severe pain in her right leg that is limiting her mobility.

    01:05 Now, our goal using the SMART acronym is Mrs. Smith pain will be controlled to a reported score of five or less by the end of the shift.

    01:16 Now, look at the difference here.

    01:18 When you see a reported score, that's pretty specific, I can measure five or less, right? We've got to also see for this particular patient, is that attainable? Is that a realistic goal? Now, you've got to take your clinical judgment and decide, if this is appropriate for your patient.

    01:36 And of course, timely.

    01:38 So I don't want Mrs. Smith pain to be less by maybe three days, right? That's not timely.

    01:45 It needs to be appropriate for your patient.

    01:47 So in this goal, we're saying by the end of the shift.

    01:50 So make sure you keep this in mind, and use that SMART acronym when you're creating goals for your patient.

    01:57 So when we're talking about goals of care, of course, they've got to be patient centered.

    02:01 So this needs to reflect the patient's highest level of wellness and function.

    02:06 So we want the patient to do as much for themselves as possible.

    02:10 Now, again, when we're talking about goals, many times we're going to create a short-term, and long-term goal.

    02:18 So we're talking about short-term goals.

    02:20 We're talking about hours, maybe a week.

    02:23 Usually, when we're talking about short-term, it's pretty quick.

    02:26 It's usually within that shift.

    02:28 A great example of the short-term, maybe the patient Oh, is able to get up to the or transfers to the chair before lunch today.

    02:36 That's a pretty short-term goal.

    02:39 We also got to remember to use our SMART acronym.

    02:43 Also, we've got to create a long-term goal for a patient.

    02:46 Is this attainable? Is this realistic? Something we can evaluate.

    02:50 So maybe our long-term goal would be the patient ambulates to the end of the hall, once by the time of discharge.

    02:58 So you can kind of see the difference between short-term and long-term goal.

    03:02 Now, the trick here, when we're talking about goals, it's all individual to your patient.

    03:08 And as a nurse, you have to assess, you have to make a informed diagnosis, and decide, is this achievable for our patients? We don't want to make goals that are so unattainable, that we're not creating a good appropriate plan of care.

    03:25 So again, when we're talking about plan of care, we always want to partner with our patient.

    03:30 And of course, go back to make sure it's individualized for them.

    03:34 Now, with the patient, you may be able to have them participate in their ADLs, for example.

    03:39 Like brushing their teeth, maybe getting dressed, helping to feed themselves, for example.

    03:45 They also need to be able to participate in the problem solving, and also the decision making of their care.

    03:50 That gives them a little bit of autonomy, and also self-esteem, and confidence with their treatment.

    03:56 Also, the patient needs to understand the value of the therapies that we're giving.

    04:01 If they don't understand why we're doing an intervention or providing a goal, probably going to be less compliant here, right? Also, they're not going to understand where we're going with their goal for that day.

    04:15 Don't forget about those expected outcomes.

    04:18 So, we've talked a lot about goals.

    04:20 But goals aren't going to help you, unless we know, where we want to be, right? So, each goal will have at least one expected outcome that defines if we met the goal, or we didn't.

    04:31 Now, let's take a look at an example.

    04:33 So in this scenario, we've talked about this before Mrs. Smith having severe pain in her right leg that's limiting her mobility.

    04:42 So, our goal, is maybe to reduce that pain again by the end of the shift.

    04:47 Now, due to this scenario, we're wanting to see an expected outcome is if we reduce that pain by using that goal? We're going to help her mobility to be able to transfer from bed to chair.

    05:01 So with our expected outcomes, remember, they must be specific and measurable much like our goals.

    05:07 Now, the help support our nursing practice, we have the Nursing Outcomes Classification, otherwise known as NOC.

    05:14 Now, these were developed to help accompany each NANDA goal.

    05:18 So what that's going to look like is you're going to have your nursing diagnosis, otherwise known as NANDA.

    05:23 And if you remember, these are specific common language that's going to help us communicate between healthcare professionals.

    05:30 Then we have our goal that's client centered.

    05:33 And also our expected outcome to accompany that NANDA goal.


    About the Lecture

    The lecture Planning – SMART Goals in Nursing Care by Samantha Rhea is from the course Five-step Nursing Process (ADPIE).


    Included Quiz Questions

    1. Specific, measurable, attainable, realistic, and timely
    2. Specific, measurable, attainable, realistic, and teachable
    3. Specific, monitored, assessable, realistic, and timely
    4. Sporadic, measurable, assessable, reversible, and timely
    5. Specific, monitored, attainable, realistic, and teachable
    1. The client’s pain will be controlled to a score of three out of ten or less by 7 PM tonight.
    2. The client’s pain will be controlled to a score of three out of ten or less by the end of the week.
    3. The client will no longer be in pain.
    4. The client’s pain will go down to a score of three out of ten or less.
    5. The client’s pain will be controlled by the end of shift tonight.
    1. “I sat down with my client today and asked them about their own goals.”
    2. “I came up with a few different goals, and asked my client if they agreed with them before putting them in the care plan.”
    3. “I made sure to make my client’s goals very difficult to achieve so that it will motivate them.”
    4. “I do not need to include my client in the goal-setting process.”

    Author of lecture Planning – SMART Goals in Nursing Care

     Samantha Rhea

    Samantha Rhea


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