How do you make goals for and evaluate a 'Deficient Knowledge' diagnosis?

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I'm a student who is working on a teaching project for clinical. We have to pick a topic related to our specific patient and make a detailed outline about how we would provide patient education for that topic.

My nursing diagnosis is: Deficient knowledge r/t health and safety practices s/t immunization status AEB refusal of hepatitis B vaccine for infant and Tdap and influenza vaccinations for self

I need to come up with three measurable goals and state how I would evaluate the outcome of the goals. The first goal I'm listing is "Patient will provide explanation for refusal of vaccines." Because, I need to know what sort of information to provide. The purpose isn't to convince the patient to get immunized, but rather to make sure she has the information to make an educated decision. I'm having trouble coming up with 2 more measurable goals and would appreciate any help. Thank you.

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Asking a patient "Why?" is considered non-therapeutic communication... I get where you are coming from, but it's better just to teach the information to the patient so she can make her own informed decision. Asking her to explain herself will make her defensive. I did some research into vaccination during my peds rotation and I found that many parents who choose not to vaccinate are not usually lacking in knowledge; they are actually well informed and many of them believe they know more than the healthcare providers. It really depends on who the patient is. The issue may not really be deficient knowledge. If she is willing to learn I believe there is a dx that is something like "Readiness for enhanced immunization status". If she is firm in her non-vaccination stance, then the best you can do is provide her with information, evaluate her understanding of your teaching by having her repeat it, and refer her to low-cost vaccination clinics or other resources from which she can seek information or treatment if she changes her mind in the future. You could also teach her the s/s of the illnesses that she is refusing to vaccinate for, so that she knows to seek immediate treatment if those symptoms arise.

There is a subset of the population who are well-read in anti-vaccine propaganda and they will immediately shut the healthcare provider out if they perceive you are just regurgitating the party line from the pharmaceutical companies or their affiliates. You have to tread carefully, provide information, but ultimately respect her decision if you want her to be compliant with other healthcare needs.

This was an article I used when I was writing my paper on vaccination: The Problem With Dr Bob's Alternative Vaccine Schedule It's pretty interesting and if you read it and check the references you could learn a lot about the reasons parents don't vaccinate.

In any case, you want to teach about the purpose of the vaccine, the disease it protects against, and the possible side effects. You can evaluate this by having the pt teach back the information. If your pt is the type that is well read in anti-vaccine literature, then you shouldn't make a goal that she should be vaccinated, as this would be unrealistic. A more realistic long-term goal would be that she would follow up or seek additional information.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Welcome to AN! The largest online nursing community!

go to your care pan book.....look up........

Readiness for enhanced Immunization status,

NANDA-IDefinition Ackley: Nursing Diagnosis Handbook, 9th Edition A pattern of conforming to local, national, and/or international standards of immunization to prevent infectious disease(s) that is sufficient to protect a person, family, or community and can be strengthened

Defining Characteristics

Expresses desire to enhance: behavior to prevent infectious disease; identification of possible problems associated with immunizations; identification of providers of immunizations; immunization status; knowledge of immunization standards; recordkeeping of immunizations

NOC Outcomes (Nursing Outcomes Classification)

Suggested NOC Outcomes

Health-Seeking Behavior, Immune status, Immunization Behavior, Knowledge: Infection Management

NOC Outcomes with Indicators

Immunization Behavior as evidenced by the following indicators: Acknowledges disease risk without immunization/Brings updated immunization card to each visit/Obtains immunizations recommended for age by the AAP or USPHS/Describes relief measures for vaccine side effects/Reports any adverse reactions/Confirms date of next immunization/Identifies community resources for immunization (Rate the outcome and indicators of Immunization Behavior: 1 = never demonstrated, 2 = rarely demonstrated, 3 = sometimes demonstrated, 4 = often demonstrated, 5 = consistently demonstrated)

And follow patient outcomes, NIC (nursing intervention outcomes), and nursing interventions rationales. You might also think of.....or deficient knowledge, or Ineffective self Health management, Parental role Conflict, or Risk for Infection

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I stated that it was not a goal that she should be vaccinated, but rather to provide information. Thanks for your response and input.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Look to your nursing diagnosis book.... what do you have so far?

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