associated with supervision and coordination of client care. In a health care facility in which nurses are assigned clients within a total client care management system, responsibilities for supervision might be minimal, whereas facilities that use a variety of ancillary personnel for certain client activities might require a large percentage of time devoted to supervision of care. In home health care, for example, the primary role of the professional nurse might be supervision of personnel who provide assistance with ADL. Although a nurse might dele- gate certain tasks to other personnel, it is still the nurse’s responsibility to ensure that the task was completed according to standards of care and to note the response of the client in order to evaluate progress toward expected outcomes.
Regardless of management style or type of facility, coor- dination of client activities among various health care pro- viders remains the nurse’s responsibility. For example, in acute care settings, the nurse needs to coordinate client activ- ities around the schedule of diagnostic tests or physical therapy.
Scheduling procedures, therapy, treatments, and medications for a number of clients often requires considerable organiza- tional skills, creativity, and resourcefulness.
resources, initiation of specific nursing interventions, and documentation of interventions and client responses.
• Ongoing assessment is necessary for determining effectiveness of interventions and for detecting new problems.
• Changing variables in clients and the environment demand clinical judgment and flexibility in organiz- ing care.
• Time management skills are essential in implement- ing client care.
• The nurse maintains responsibility for care dele- gated to other health care personnel.
• The most common management systems currently used include functional nursing, team nursing, pri-
mary nursing, total client care, modular nursing, and case management.
• Interventions can be nurse initiated, prescribing practitioner initiated, or collaborative in origin and thus are considered dependent, independent, or interdependent.
• NIC is a system for sorting, labeling, and describing nursing interventions.
• Nursing interventions include assisting with ADL, skilled therapeutic interventions, monitoring and surveillance of client response to care, teaching, dis- charge planning, and supervision and coordination of nursing personnel.
• Communication concerning interventions should be provided verbally and in writing.
REVIEW QUESTIONS
1. Which of the following best describes the purpose of ongoing evaluation when implementing nursing activities?
a. To be sure the activities performed are inde- pendent activities
b. To determine client progress toward expected outcomes
c. To ensure compliance with agency protocols d. To establish a nursing diagnosis
2. Establishing priority among several nursing inter- ventions depends on which of the following? Select all that apply.
a. Availability of resources b. Client perception
c. Client’s willingness to comply d. Education level of nurse
e. Length of time necessary for the intervention f. Nurse determination of importance
3. Which of the following is an example of the func- tional nursing approach to care delivery?
a. Team member has an assigned task to perform for the client.
b. Full responsibility for total client care rests upon the registered nurse.
c. The registered nurse coordinates care for the cli- ent across the entire care continuum.
d. The registered nurse works with licensed practi- cal/vocational nurses and unlicensed assistive personnel to deliver care.
4. Briefly answer the following question by filling in the blank:
The nursing management system in which a group of care providers (RN, LPN, and UAP) coordinates activities to deliver care is defined as the _______
_______________ nursing approach.
5. Which of the following should nurses do initially when performing a procedure they have never done before?
a. Double-check the prescribing order.
b. Seek help from another nurse who is proficient in performing the procedure.
c. Inform the nursing supervisor that they are unwilling to do the procedure because it is a new skill for them.
d. Try to remember all the steps of the procedure they learned in nursing school.
6. Which of the following statements made by a new nurse indicates a need for further guidance when giving a change-of-shift report?
a. ‘‘The client had a good night.’’
b. ‘‘The client is scheduled to have a CT scan this morning.’’
c. ‘‘The client slept 5 uninterrupted hours after receiving Demerol.’’
d. ‘‘We did not get all the blood glucose levels drawn this morning.’’
online companion
Visit the DeLaune and Ladner online companion resource atwww.delmar.cengage.comfor additional content and study aids. Click on Online Companions, then select the Nursing discipline.
—FRANCISBACON
CHAPTER 10
Evaluation
COMPETENCIES
1. Explain the purposes of evaluation in professional nursing practice.
2. Describe the components of comprehensive evaluation in nursing.
3. Describe the steps through which evaluation is conducted.
4. Describe the three types of evaluation.
5. Discuss the relationship between evaluation and accountability.
6. Explain the significance of multidisciplinary collaboration in evaluating client care.
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valuation is the fifth step in the nursing process and involves determining whether the client goals have been met, have been partially met, or have not been met.Even though it is the final phase of the nursing process, eval- uation is an ongoing part of daily nursing activities. The major purpose of evaluation is to determine the effectiveness of those activities in helping clients achieve expected out- comes. Evaluation is not only a part of the nursing process but also an integral process in determining the quality of health care delivered. This chapter discusses the purposes, components, and methods of evaluation. The relationship between evaluation and quality of care is described.