Desired Outcomes/Goals? HELP!

  1. 0
    I am a 1st term nursing student and I am having trouble differentiating goals from outcomes. I have a final exam on Tues that I have to pass and it seems like reading its not helping me find how to differentiate these two. ANY HELP WILL BE GREATLY APPRECIATED. I know for sure there will be many questions on the nursing process. Thanks.
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  3. 12 Comments so far...

  4. 1
    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
    mzrenegade68 likes this.
  5. 0
    Quote from 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
    Perfect! Any info that will help me I will appreciate. Your explanation is wonderful too. I think I am finally catching on. The more and more I read them the more I am understanding and knowing what to look for. You just dont know how much I appreciate this. I have finals next week. This is my 2nd time taking this Concepts course (Fundamentals) and I am really stressing the areas in which the mistakes were made (all in one area) just because I didnt understand. This is really helping me. I dont have any friends in the program that I can form a study grp with, I basically keep to myself. So I am really tryin to do this on my own. I am on borderline now (80% is a C our grading scale) Any point less and I am out the door I know. I am trying to stay encouraged.
  6. 0
    I thought goals and outcomes were interchangable??
  7. 0
    Quote from truesn
    I thought goals and outcomes were interchangable??

    Not exactly. I have more information on writing good care plans but I am cleaning my desk right now. When I get to that I will post it ASAP.

    Basically the goal is aimed at the nursing diagnosis it self.

    The expected outcomes are "steps in the process of meeting the goal".

    The interventions are basically aimed at meeting the expected outcomes.

    Example:
    Decreased cardiac output r/t a reduction in stroke volume as a result of mechanical malfunction

    Goal: The pt will resume and maintain an adequate cardiac output as indicated by a heart rate and rhythm WNL by 03/22/05.

    Expected Outcomes:
    The pt will maintain BP wnl by 03/22/05.
    the pt will experience strong peripheral pulses by 03/22/05.
    The pt will have no dysrhythmias present by 03/22/05.
    The pt will not experience side effects or adverse reactions to medications by 03/22/05.

    There are other expected outcomes you may use... but hopefully this is a better example.
    This is a more complex nursing care plan. But for AREALQT if you are in your first semester of Nursing 100 the care plans are usually less complex. So if you give me an example of a Nursing Dx that you would like help on... I can come up with something for you.

    Good luck,
    Angie
    Last edit by Nrs_angie on Apr 29, '05
  8. 0
    Quote from arealqt
    Perfect! Any info that will help me I will appreciate. Your explanation is wonderful too. I think I am finally catching on. The more and more I read them the more I am understanding and knowing what to look for. You just dont know how much I appreciate this. I have finals next week. This is my 2nd time taking this Concepts course (Fundamentals) and I am really stressing the areas in which the mistakes were made (all in one area) just because I didnt understand. This is really helping me. I dont have any friends in the program that I can form a study grp with, I basically keep to myself. So I am really tryin to do this on my own. I am on borderline now (80% is a C our grading scale) Any point less and I am out the door I know. I am trying to stay encouraged.

    My best advice to you is find some one you can be friends with. Having support is the only way to make it through nursing school. Nursing 101 is much more difficult. So make sure to get a good grasp on the basics now. Make some friends because you will need them. They will help you as much as you help them. Remember that when you have clinicals with these people... you may need their help. So be friendly and form a good circle of friends. I can't tell you how many times I have been sooo busy on clinicals doing total cares, total feeds, total assists, ect for several patients and I felt like pulling my hair out. If it weren't for my friends who helped me to feed some of my patients ( cuz the trays all come at the same time, hard to feed 3 people at the same time ) I would have never made it through the day without my friends. I am working on getting more information on care plans for you... but i am cleaning my desk. When i get to it i will post it ASAP. So stay tuned!
  9. 0
    OP, try this site and see if things make more sense....


    http://www.everything2.com/index.pl?node_id=1417020

    Nrs_angie, it would seem I've already been writing outcomes and just didn't know it
  10. 1
    Quote from 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.
    mzrenegade68 likes this.
  11. 0
    Quote from VickyRN
    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.

    #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.
    Vicky,
    That is a great point you made. Actually we never learned about the "pattern of reversal". I guess it was just sort of assumed that we (students) would know to do that. Maybe that is why I sort of struggled with care plans for a while. But somewhere along the way it just 'clicked' and careplans are kind of fun now. :hatparty: hehehe.
    Great, thourough, advice there Vicky!

    Have a great day,
    Angie
  12. 0
    thank you much for pointing out the differences and the examples help out too.


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