Originally Posted by Nrs_angie The goal is aimed at the nursing diagnosis.
The expected outcomes are aimed at meeting the goal.
1. must be patient-centered.
2. Address only ONE response.
3. include observable and measurable factors.
4. need a target date
5. use behaviorable verbs.
it is usually written like this:
The patient will state 3 ways to treat hypoglycemia by 05/01/05.
It was patient centered (the patient will), only one response (treat hypoglycemia), was observable and measurable (3 ways), had a target date (by 05/01/05), and used a behaviorable verb (will state).
You should not say the pateint will state 3 ways to treat hypoglycemia and will know signs and symptoms of hypoglycemia by ...
Because that is addressing two responses. And using the word 'know' is not very measurable. You can not prove they "know" or they "understand" something.
a few Behaviorable verbs to use:
list
name
participate
perform
state
verbalize
express
demonstrate
identify
I hope this helps you. I do have more information on creating a basic care plan that explains the rules and such. But I can not find it at the moment. I am cleaning up my desk though. So later this weekend I will post.
Good Luck,
Angie
Wonderful advice, Angie. Thanks so much. What I have been teaching my students is much along these lines, but I go a little further and teach the "pattern of reversal" method.
#1. The student obtains objective/ subjective assessment data.
#2. From this assessment data, the student formulates high priority nursing diagnoses (in PES format - problem, etiology, and signs/ symptoms). Make sure the nursing dx are current and NANDA-approved. (Every few years or so, NANDA changes the wording on their diagnoses ever-so-slightly.) Write the nursing diagnosis based on the major/ minor defining characteristics. This is the nursing diagnosis stem.
#3. Next, write the "related to" portion of the nursing diagnosis. The "related to" (etiology) part of the nursing diagnosis phrase is very important, because this makes the nursing diagnosis unique and precise to the individual client situation. The "related to" statement directs the independent and collaborative nursing interventions and gives direction for client care.
#4. The student writes the client goal, by reversing the nursing diagnosis stem. Nursing diagnoses are written in negative language, such as "Decreased Cardiac Output," "Imbalanced Nutrition: Less Than Body Requirements," or "Ineffective Individual Coping." For the client goal, the stem is simply written in reverse, "The client will demonstrate increased cardiac output...." or "The client will cope effectively..."
The nursing diagnosis stem points to the goal and ultimate client outcome.
The goal is simply the nursing diagnosis stem written positively (in reverse) in measurable terms, with a time element ("by end of student nurse's shift on...," "by hospital discharge," "throughout hospital stay," etc.). Make sure, as Angie pointed out, that measurable verbs are used.
The "related to" (etiology) points to the nursing interventions. In other words, the nursing interventions for "Decreased cardiac output r/t atrial tachydysrhythmia" must be directed not towards the "Decreased cardiac output" stem, but towards assisting with the "atrial tachydysrhythmia" etiology instead. Remember, each intervention must be accompanied by a scientific rationale.
The outcome is simpy the final evaluation of the
achievement of the earlier stated client goal
AFTER the nursing interventions have been performed. (This is the
difference between the goal and outcome). You are adding an element of
judgment to the earlier stated goal (i.e., achievement or non-achievement). To do this, the student must
evaluate the client's progress/ lack of progress towards the expected outcome. A new set of assessment data are gathered to "back up" the claim of achievement of/ non-achievement of client goal. Hence, the "circular" nature of the nursing process. So, you would state one of three choices:
Goal met
Goal not met
Unable to evaluate goal due to lack of time
For all three, the student will need to give "AEB" data. For the last one, the student should state, "Unable to evaluate goal, due to lack of time. However, if I were present at time of discharge (or other designated date), I would state 'Goal Met" if the following outcome criteria were achieved:..." Then give the outcome criteria that would satisfactorily meet this goal.
Desired Outcomes/Goals? HELP!
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