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Evaluation: 5th Phase of the Nursing Process

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What is Evaluation?

Evaluation is the last phase of the nursing process.

It includes two main activities:

  • examination of the client’s condition or situation
  • judgement on whether change has occurred

In the evaluation phase, the nurse discovers the reason behind the success or failure of the client’s plan of care.

What is the purpose of evaluation?

The purpose of evaluation is to determine client’s achievement of expected outcomes and the effectiveness of the nursing care plan in achieving client goals.

What are the classic elements of evaluation?

These are the five classic elements of evaluation:

  1. identification of evaluative criteria
  2. collection of data to check whether criteria were met
  3. interpretation and summary of findings
  4. documentation
  5. termination, continuity or modification of the plan of care

identification of evaluative criteria

The nurse goes back to the outcome criteria identified during the planning phase. Such information serves as criteria and standards for evaluation.

collection of data to check whether criteria were met

This is similar to the assessment phase but rather than collecting data on the client’s health problems, the nurse identifies whether there is outcome achievement.

interpretation and summary of findings

The nurse interprets findings to make sure there was achievement of outcomes. It is necessary to determine whether the data  is  a one-time or a consistent incident.

documentation

The nurse summarizes findings through documentation. It is usually written in a two-part evaluative statement which include the following information:

  1. decision on how well the outcome was met 
  2. supportive data and behaviors that support this decision

Documentation allows all members of the health care team to identify client’s progress.

termination, continuity or modification of the plan of care

Nursing Process Evaluation
Nursing Process Evaluation

Termination of the plan of care is done when each expected outcome is achieved.

Continuation of the plan of care is done if more time is needed to achieve expected outcomes.

Modification of the plan of care is done if difficulties in achieving the outcomes are identified.

When is evaluation done?

Evaluation is a continuous process. It can be done:

  • during or after implementing nursing activities allowing timely modification of the plan of care
  • at specified intervals, for example once a week
  • after discharge to determine need for home care

What else is done during evaluation?

Apart from evaluation of the achievement of client’s outcomes, the nurse also evaluates quality of care rendered to clients. This is important to improve future client care. Factors to be considered in evaluating the quality of nursing care include:

  • the effect of the setting on the quality of care
  • how care was given
  • changes in client’s health status as a result of nursing care

This type of evaluation can be done by the nurse personally or by the health care agency as a whole.

Key Points

  • The purpose of evaluation is to determine client’s achievement of expected outcomes and the effectiveness of the nursing care plan.
  • Documentation allows all members of the health care team to identify client’s progress.
  • The nurse can either terminate, modify or continue plan of care depending on the results identified during evaluation.