ENGLISH IN NURSING II

EVALUATION IN NURSING PROCESS

Hasanah Eka Wahyu Ningsih

131411123048
B 17 AJ 2

PENDIDIKAN NERS FAKULTAS KEPERAWATAN

UNIVERSITAS AIRLANGGA
SURABAYA
2014

Nursing Evaluation
In nursing process, evaluation is the fifth and the final steps. A continous
process essential to ensuring the quality and appropriateness of the care provide; it
is done by reviewing client responses to determine effectiveness of the plan of
care in meeting client needs (Doenges & Mary, 2013). Evaluation is an ongoing
process. It deals with the comparison of the actual patient outcome against the
expected outcome. Information gained in this manner regarding the progress of
patient care becomes the basis for communication among nurses (Sirra, 2006)
Evaluation should actually be a constructive opportunity to provide
positive feedback to the client and caregivers for their efforts and encourage them
to continue to strive for a higher level of functioning or wellness. It is an
opportunity for problem solving and personal growth (Doenges & Mary, 2013).
According to (Alfaro,2006) to ensure through monitoring of the health
care practice, QI studies consider three types of evaluation:
1. Structure evaluation
Structure refers to the administrative support provided for quality care and
the environment in whichhealth care occurs. Adecuacy of supplies and
equipment, number and proficiency of helath care personnel, the hospital
environment and barries and facilitators to access are structural
components. The category of structure are patients characteristics like age,
comorbidity, risk and beliefs (Brosnan,2012)
Example: Were the physical environment, staffing patterns, and
organization communication practices adequate for efficient care
management?
2. Process evaluation
Process comprises practioner-patient interactions and the prationers
technical proficiency in their therapeutic relationships with patients.
Process measures offer a direct approach to evaluating health care quality
becaus health care that meets best practice standadrds in a specific time
and place quality care. Inherent in the selection of process criteria is the
assumption that a strong link exist between how providers interact with

patients and the outcomes of care. The type and number of diagnostic
tests ordered, differential diagnoses listed, interpretation of test results,
treatment prescribed, and type of patient education are all process
characteristics. Process indicators reflect current standards of practice and
as a result, evolve overtime (Brosnan, 2012)
Example: Were assesments and interventions performed consistently and
in a timely way?
3. Outcome Evaluation
Outcomes refer to a measurable change in patient health status that results
from health care delivered. Measuring outcomes does not provide as direct
path as process in evaluating quality but outcomes are the ultimate
validators of the effectiveness and quality of medical care. An advantage
of outcomes is that they are recognizable to both practioners and patients.
Practioners can measure the effect of a treatment and patients can report if
a treatment made them feel better or worse. Another advantage is that
desired outcomes can be standardized across setting. A 10% reduction of
nasocomial infections in a hospital is a beneficial outcome that can be
compared to other hospital regardless of geographic location.
Example: Were outcomes achieved within desired timeframes? Are people
satisfied with care?

Referencess:
Alfaro, R.2006. Applying Nursing Process: The Foundation for Clinical
Reasoning 8th Edition. Philadelphia: Lippincot Williams & Wilkins

Brosnan, C.A. 2012. Evaluation of Health Care Quality in Advanced Practice

Nursing.Texas: Springer Publishing Company
Doenges, M.E. & Mary F.M. 2013. Application of Nursing Process and Nursing
Diagnosis: An Interactive Text For Diagnostic Reasoning. Philadelphia: F.A.
Davis Company
Sirra. 2006. Nursing Process 2/e. Delhi: Elsevie