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By Susan A. Newfield, Mittie D. Hinz, Donna Scott-Tilley, Kathryn L. Sridaromont, Patricia Joy Maramba

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Additional info for Cox's Clinical Applications of Nursing Diagnosis: Adult, Child, Women's, Psychiatric, Gerontic, and Home Health Considerations 5th Edition

Example text

The system makes extensive use of flow sheets and is becoming increasingly popular because of its streamlined format and cost-effectiveness. A patient care plan is established based on described standards. Nursing actions are used as the base for documentation. Flow sheets are used to highlight significant findings and define assessment parameters and findings. For example, for the postpartum patient, the standard for the cardiovascular assessment is: Cardiovascular assessment: Apical pulse, CRT, peripheral pulses, edema, calf tenderness.

M. by 9/11. 4. Expected outcomes are directly observable by use of at least one of the five senses. EXAMPLE POOR GOOD Understands how to self-administer insulin by 9/11. Accurately return-demonstrates selfadministration of insulin by 9/11. 5. Expected outcomes are patient centered rather than nurse centered. EXAMPLE POOR GOOD Teaches how to measure blood pressure by 9/11. Accurately measures own blood pressure by 9/11. 19,23 1. Assists in “pacing” the care plan. Pacing helps keep the focus on the patient’s progress.

Because so many published sets of standards and JCAHO talk in terms of outcome standards or criteria, we have chosen to use the term “expected outcomes” in this book. Several authors23–25 give guidelines for writing clinically useful expected outcomes: 1. Expected outcomes are clearly stated in terms of patient behavior or observable assessment factors. EXAMPLE POOR GOOD Will increase fluid balance by time of discharge. Will increase oral fluid intake to 1500 mL per 24 hours by 9/11. 2. Expected outcomes are realistic, achievable, safe, and acceptable from the patient’s viewpoint.

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