Evaluation is an essential step in the nursing process that helps to measure the effectiveness of care and identify areas for improvement. Evaluation involves comparing the actual outcomes of care with the expected outcomes, and making judgments about the quality of care. Evaluation can be done at different levels, such as individual, group, or system level, and by different methods, such as randomised controlled trials, comparison group designs, or pre-post designs.
In this article, we will focus on the evaluation of outcome attainment for a client, which is the individual level of evaluation. We will discuss what outcome attainment means, why it is important, how to do it, and which statement related to it is correct.
What is Outcome Attainment?
Outcome attainment is the degree to which a client has achieved the desired outcomes of care that were set forth in the plan of care. Outcomes are measurable changes in the client’s health status, behavior, or knowledge that result from nursing interventions. Outcomes can be classified into different types, such as physical changes, cognitive changes, psychomotor changes, affective changes, or quality of life changes.
For example, a physical change outcome could be “The client will have normal blood pressure by discharge”. A cognitive change outcome could be “The client will verbalize appropriate cast care on discharge”. A psychomotor change outcome could be “The client will demonstrate proper use of crutches before discharge”. An affective change outcome could be “The client will express satisfaction with pain management by discharge”. A quality of life change outcome could be “The client will report improved mood and energy level by discharge”.
Why is Outcome Attainment Important?
Outcome attainment is important for several reasons:
- It provides evidence of the effectiveness and quality of nursing care.
- It helps to determine whether the nursing interventions were appropriate and sufficient for the client’s needs.
- It helps to identify areas for improvement or modification of the plan of care.
- It helps to communicate the results of care to the client, family, and other health care providers.
- It helps to justify the use of resources and reimbursement for nursing services.
How to Do Outcome Attainment?
To do outcome attainment, the nurse needs to follow these steps:
- Collect data related to the outcomes that were established in the plan of care. The data can be obtained from various sources, such as observation, interview, physical examination, records, or standardized instruments. The data should be valid, reliable, and sensitive to changes in the client’s condition.
- Compare the actual outcomes with the expected outcomes. The expected outcomes are the criteria that define the desired level of performance or achievement for each outcome. The criteria should be specific, measurable, attainable, realistic, and time-bound. For example, “The client will have normal blood pressure (120/80 mmHg) by discharge”.
- Make an evaluative statement that summarizes the client’s outcome achievement. The evaluative statement should indicate whether the outcome was met, partially met, or not met. For example, “The outcome ‘The client will have normal blood pressure by discharge’ was met. The client’s blood pressure was 118/76 mmHg on discharge”.
- Modify or terminate the plan of care based on the evaluation findings. If the outcome was met or partially met, the plan of care may be continued or modified as needed. If the outcome was not met, the plan of care may need to be revised or discontinued. The nurse should also identify factors that influenced the outcome achievement, such as client factors (e.g., motivation, compliance), nurse factors (e.g., skill, knowledge), or environmental factors (e.g., resources, support).
Which Statement Related to Outcome Attainment for a Client is Correct?
Based on the above discussion, we can conclude that the correct statement related to outcome attainment for a client is:
Collecting data related to outcome attainment requires the nurse to know when to collect the data, based upon established time criteria.
This statement is correct because it reflects one of the essential steps in doing outcome attainment. The nurse needs to know when to collect data related to each outcome based on the time frame that was specified in the criteria. For example, if an outcome states “The client will have normal blood pressure by discharge”, then the nurse needs to collect data on the client’s blood pressure on the day of discharge. Collecting data at the right time ensures that the evaluation is accurate and timely.
The other statements related to outcome attainment for a client are incorrect for the following reasons:
- The nurse and client measure achievement of planned outcomes of care. This statement is incorrect because it describes the evaluation step of the nursing process, not outcome attainment. Outcome attainment is a part of evaluation, but not the whole process.
- Nurses perform the review. This statement is incorrect because it refers to peer review, not outcome attainment. Peer review is a method of evaluating professional performance, not client outcomes.
- They enable nursing to be accountable for the quality of care. This statement is incorrect because it refers to quality-assurance programs, not outcome attainment. Quality-assurance programs are systematic methods of monitoring and evaluating the quality of care, not individual client outcomes.
Outcome attainment is an important aspect of evaluation that helps to measure the effectiveness and quality of nursing care. Outcome attainment involves collecting data related to the outcomes that were set forth in the plan of care, comparing the actual outcomes with the expected outcomes, making an evaluative statement that summarizes the client’s outcome achievement, and modifying or terminating the plan of care based on the evaluation findings. The correct statement related to outcome attainment for a client is: Collecting data related to outcome attainment requires the nurse to know when to collect the data, based upon established time criteria.