IMPLENTING AND EVALUATION
 Implementing
- Action phase in which the
nurse performs the nursing
intervention
- Consists of doing and
documenting the activities
that are specific nursing
actions needed to carry out
the nurse intervention
IMPLEMENTING SKILLS
 Cognitive Skills (intellectual)
- Include problem solving,
decision making, critical
thinking, clinical reasoning,
and creativity
 Interpersonal Skills
- All of activities, verbal and
nonverbal, people use when
interacting directly with one
another
- Nurses use therapeutic
communication
understand the client and in
turn be understood
 Technical Skills
- Purposeful “hands-on” skills
- Require knowledge and
frequently manual dexterity
 Psychomotor Skills
- Refers to physical actions
that are controlled by the
mind, not by reflex
PROCESS OF IMPLEMENTING (5)
 Reassessing the client
 Determining the nurse’s need for
assist
 Implementing the nursing
intervention
 Supervising the delegated care
 Documenting nursing activities
 Evaluation
- Fifth nursing process
- Planned, ongoing, purposeful
activity in which clients and
health care professionals
determine:
 Client’s progress
towards achievement
of goals/outcomes
 Effectiveness of the
nursing care plan
Five Components:
 Collecting data related to the desired
outcomes
 Comparing the data with desired
outcomes
 Relating nursing activities to
outcome
 Continuing, modifying, or terminating
the nursing care plan
to  Evaluation Statement
- Consist of conclusion and
supporting data
 Conclusion
- Statement that the
goal/desired outcome was
met, partially met, or not met
 Supporting Data
- List of client responses that
support the conclusion
EVALUATING THE QUALITY OF
NURSING CARE
o An essential part of professional
accountability
 Quality Assurance Program
- Ongoing, systematic process
designed to evaluate and
 promote excellence in the - Uses a systematic approach
health care provided to with the intention of
clients improving the quality of care
 Structure Evaluation rather than ensuring the
- Focuses on the setting in quality care
which care is given
NURSING AUDIT
- Structural standards describe
desirable environmental and  Audit
organizational characteristics - Refers to the examination or
that influence care such as review of records
equipment and staffing
 Retrospective Audit
 Process Evaluation
- Evaluation of a client’s record
- Focuses on how the care
after discharge
was given - Retrospect = relating to past
- Focus on the manner in events
which nurses uses the
 Concurrent Audit
nursing process
- Evaluation of a client’s health
 Outcome Evaluation
care while the client is still
- Focuses on demonstrable
receiving care form the
changes in the client’s health agency
status as a result of nursing
 Peer Review
care
- Appraise the quality of care
QUALITY IMPROVEMENT or practice performed by
other equally qualified nurses
 Sentinel Event  Individual Review
- Unexpected occurrence - Focuses on the performance
involving death or serious of an individual nurse
physical or psychological  Nursing Audit
injury or the risk thereof - Focuses on evaluating
 Root Cause Analysis nursing care through the
- Process for identifying the review of records
factors that bring about
deviations in practices that
lead to the event
- It focuses on primarily on
systems and processes, not
individual performance
 Quality Improvement
- Follows client care rather
organizational structure
- Focuses on process rather
than individuals