evaluation is the last step of nursing process. which help to re assess the all things which is done by a health care provider for patient care and better health.

1. Evaluation in nursing process
Presented by:-
Mr. Naveen Pareek
Vice principal

2. DEFINITION:-
• Evaluation is a planned, ongoing,
purposeful activity, in which clients and
health care professionals determine,
• The clients progress towards goal
achievement.
• The effectiveness of the Nursing care
plan.

3. DEFINITION cont.…
• “Evaluation is one of the most critical
phase of the Nursing process because it
support the basis of the usefulness and
effectiveness of nursing practice, which is
client driven and client centered”.
- Lin

4. PURPOSE OF EVALUATION:
It serves multiple purposes
• To evaluate the clients program towards
meeting specified outcomes and to direct
future Nurse Client interactions.
• To Judge the effectiveness of the nursing
process.
• To design and implementing accurate care
plans and Judging the effectiveness of their
Nursing action.
• To determine overall quality of care.

5. Types of Evaluation:-
Formative evaluation:- ensures that a program
or program activity is feasible, appropriate,
and acceptable before it is fully implemented.
It is usually conducted when a new program
or activity is being developed or when an
existing one is being adapted or modified.
Process/implementation evaluation determines whether
program activities have been implemented as
intended.

6. Outcome/effectiveness evaluation:- measures program
effects in the target population by
assessing the progress in the outcomes or
outcome objectives that the program is to
achieve.
Impact evaluation:- assesses program
effectiveness in achieving its ultimate
goals.

7. Measurement Criteria:
• Evaluation is systematic and ongoing.
• Client’s responses to interventions are
documented.
• The effectiveness of interventions is
evaluated in relation to outcome.

8. Measurement Criteria cont…
• Ongoing assessment data are used to
revise diagnoses, outcomes, and the plan
of care as needed.
• Revisions in diagnoses, outcomes and the
plan of care are documented.
• The client, significant others and health
care providers are involved in the
evaluation process, when appropriate.

9. Assessin
g
Diagnosin
g
Planning
Implementin
g
Evaluation
• Evaluation.
final phase of the Nursing
process
in which the nurse
determines the Clients
progress toward
goal/outcome
achievement and the
effectiveness of the
Nursing care plan The
plan may be continued,
modified or terminated.

10. EVALUATING CLIENT
RESPONSE:
• The evaluation process has six
components.
• Identifying the expected outcomes that the
nurse will use to measure client goal
achievement. (This is done in the Planning
step).

11. • Collecting data related to the expected
outcomes.
• Comparing the data with the expected outcomes
and judging whether the goals have been
achieved.
• Relating Nursing actions to clients outcomes.
• Drawing conclusions about problem status.
• Reviewing and modifying the clients care plan if
needed

12. Identifying expected outcomes:
• The expected outcomes formulated in the
planning step are the Criteria used to evaluate
the clients response to Nursing care.
Expected outcomes serve two purposes. They
are:
• Establish the kind of evaluative data that need to
be collected and
• Provide standard against which the data are
Judged.

13. Collecting data
• Using the clearly stated, precise and
measurable expected outcomes as a
guide, the nurse collects data

14. Judging goal achievement:
• The goal was met, that is, the client
response is the same as the expected
outcome.
• The goal was partially met, that is either
a short-term goal was achieved, but the
long term goal was not of the expected
outcome was only partially attained.
• The goal was not met.

15. Relating nursing actions to
client outcomes:
• The fourth aspect of the evaluating
process is determining whether the
Nursing actions had any relation to the
outcomes

16. Drawing conclusions about
problem status:
• The actual problem stated in the Nursing
diagnosis has been resolved or the
potential is being prevented, and risk
factors no longer exist. In these instances,
the nurse documents that the goals have
been met and discontinuous the care for
the problem.

17. Drawing conclusions about
problem status cont…
• The potential problem stated in the nursing
diagnosis is being prevented, but the risk
factors are still present in this case the
nurse keeps the problem on the care plan.

18. Reviewing and Modifying the
Nursing care plan:
• After drawing conclusions about the status of the
client’s problems, the Nurse modified the care
plan as indicated. Depending on the agency,
Modifications may be made by drawing a line
through portion of the care plan, using a Hi-Liter
Pen or writing “Discontinued (dc`d)” and the date
whether or not goals were met , there are
Number of decision to make about continuing ,
Modifying or terminating Nursing care for each
problem.

19. Assessing:
Nursing Diagnosis
Planning : Expected outcomes:
Planning: Nursing orders:
Implementing:

20. Evaluation according to the
theorist
• Dorthea E Orem- Relates to
monitoring progress of Mrs.
James with regard to self-care
activities and making
adjustments and
recommendation as
necessary. is self care agency
equal to or greater than
therapeutic self care demand.
• Betty Neuman Relates to the
degree of reconstitution
achieved Mrs. James is able to
feed self with right hand with
little assistance. Needs help to
cut neat. Able to use walker to
get to bath room. Incontinence
occurring less often. Mrs.
James tries hard to improve
the strength of her right side.
She is determined to go home
as quickly as possible. She
tries to cheer the other people
in the room

21. Assessing
Are data complete, accurate and validate?-
Do New data require changes in the care
plan?

22. Diagnosing
Are nursing diagnoses relevant and
accurate?- Are Nursing diagnoses
supported by the data?- Has problem
status changed (i.e. potential actual,
possible)?- Are the diagnoses stated
clearly and in correct format?- Have any
nursing diagnoses been resolved?

23. Planning
• Expected Outcomes
• Do new nursing diagnoses require new
goals?- Are goals realistic?- Was enough
time allowed for goal achievement?- Do
the goals address all aspects of the
problem?Does the client still concure with
the goals?- Have client priorities changed?

24. Nursing Orders
• - Do Nursing orders need to be written for
new Nursing diagnoses or new goals?- Do
the Nursing orders seem to be related to
the stated goals?- Is there rational to
Justify each Nursing orders?- Are the
Nursing orders clear, specific and
detailed?- Are new resources available?-
Do the Nursing orders address all aspects
of the client`s goals?- Were all Nursing
Orders clearly effective?

25. Implementing
• - Was client input obtained at each step of
the Nursing process?- Were goals and
Nursing interventions acceptable to the
client?- Did the care givers have the
knowledge and skill to perform the
interventions correctly?

26. EVALUATING THE QUALITY OF
NURSING CARE
• Evaluating the quality of nursing care is an
essential part of professional
accountability. Other terms are used for
this measurement are quality assessment
and quality assurance

27. • Quality assessment
• Quality assurance

28. Approaches to quality
Evaluation:
• Three aspects of care can be evaluated.
– Structure
– Process
– Outcome

29. Approaches to quality
Evaluation:
1. Structure evaluation:
2. Process evaluation:
a. Concurrent Evaluation:
b. Retrospective Evaluation:
3. Outcome evaluation: