Confusing with EO time frame!!!

You are basing your outcomes on interventions that you will be ordering and performing. Think about this for a minute. Are all of your outcomes going to wait for days and days until suddenly they appear after days of waiting? No. It is like a race. Advancement occurs bit by bit with every step of the way. What people remember though is the end and who won. What you have to do is break down the steps of success as they occur each day and write them as outcomes. (1) Today you will see xxxx. (2) Tomorrow you will see this next step of improvement. (3) By day 3 this next step should be realized. Do you see what I mean. The evaluation then is to judge whether these things have happened or not. Perhaps the patient is just not able to achieve them; perhaps better interventions need to be performed.

This breakdown into these small steps is probably one of the most difficult things to do. We are used to seeing things happening quickly or just seeing the final result. We don't stop to think about or notice all the little results that lead up to the big final finish.

And, yes, the careplan is more complex than just changing a tire. But if you were just thrown into doing a care plan you would really be lost in the woods, wouldn't you.

What is the patient problem? What are you trying to write outcomes for?

let's say a patient has skin redness because they are incontinence. that's pretty common in long term care. the nursing diagnosis would be impaired skin integrity r/t presence of urine aeb reddened skin (erythema) of the perineum. you need to do something about the cause of the skin breakdown (the urine) which is causing moisture and humidity that will contribute to further skin impairment. redness of the skin is actually a stage i skin ulceration so the nursing treatment for this is to keep the skin as dry as possible.

• outcome #1 - in one day the skin of the patient's perineum will be cleansed of urine within 30 minutes of incontinence as evidenced by the skin surface of the perineum will be dry.
  
• outcome #2 - in four days the skin of the perineum will show improved color as evidenced by the skin of the perineum will return to a dark pink color compared to the surrounding skin.
  

the evaluation is how you will assess each outcome. and, as you see, i have written the assessment criteria for each outcome into it's statement. the short term (first thing) i would predict to happen is that the skin will remain dry. the long term (next thing) i predict to happen is that the red skin will clear up and return to a dark pink color which indicates improvement.