Discuss ways outcomes can be classified Implementing an innovation, policy or procedure does not necessarily guarantee that it will become the standard of care. Ongoing evaluation of an innovation through outcome measurements is necessary to ensure successful incorporation into clinical practice.
An outcome is defined as the consequence or visible result (Webster, 2001). Nursing outcomes measure states, behaviors, or perceptions of individuals, families, or communities (Moorehead, Johnson, & Maas, 2004). Outcomes research examines the effects of care and treatments on individuals and populations (Rubenfeld et al., 1999). In nursing research, the outcome is frequently known as the dependent variable (Polit & Hungler, 2006).
Outcomes may be classified by several different methods. One way outcomes can be classified is by focusing on who is being measured. Nurses may measure outcomes for individuals, groups, or organizations.
Another way that outcomes can be grouped is by type: care-related, patient-related, and performance-related outcomes (Kleinpell, 2001). An example of a care-related outcome is the rate of pressure ulcer formation in patients on bed rest for more than 24 hours. Patient knowledge related to fluid restriction is an example of a patient-related outcome. Nursing staff adherence to best practice guidelines when providing discharge education to a heart failure patient is an example of a performance-related outcome.
KEY TERMS
Outcome: Consequence or visible result
Nursing outcomes: Measures of states, behaviors, or perceptions of individuals, families, or communities
Outcomes research: Studies about the effects of care and treatments on individuals and populations
Care-related outcomes: Category of outcomes that measures the effect of nursing interventions
Patient-related outcomes: Type of outcome related to patient behaviors or actions
Performance-related outcomes: Type of outcome related to how nurses perform their jobs
Short-term outcomes: Results achieved in a brief period of time
Time is another way of classifying outcomes. Short-term outcomes are results achieved in a relatively brief period of time that usually involve a change in condition, such as absence of postoperative pain, or an increase in knowledge or skills, such as a patient’s ability to draw up insulin. Another category of outcome classified by time is intermediate outcomes. They exist when changes occur after an innovation is introduced. Lifestyle modifications, such as weight loss and smoking cessation after enrolling in a wellness program, can be examples of intermediate outcomes. Long-term outcomes are primary changes in patients’ behaviors or status, such as a reduction in blood cholesterol levels (Plantz, Greenway, & Hendricks, 1996).
Nursing administrators are responsible for reporting nursing-sensitive outcomes at their institutions to demonstrate effectiveness of nursing care. Outcomes of nursing care should be measurable. These measurements can assist in determining responsibility in patient care (Krau, 2001). One nursing-sensitive outcome considered a National Patient Safety Goal mandated by The Joint Commission (JC) is to reduce the risk of patient harm resulting from falls (Joint Commission, 2007a). The Joint Commission requires healthcare organizations to have fall reduction programs. Two desirable outcomes that may result from an evidence-based fall prevention protocol are a reduction in the number of patient falls and fewer fall-related injuries.
Outcome-based measurements are a means used to establish evidence-based practice (EBP) and to evaluate the care delivered. In healthcare organizations, many activities are outcome driven. The rising costs of health care, increasingly stringent accreditation standards, and public reporting are several reasons why outcomes are closely scrutinized and are integral to ensuring the successful implementation of an innovation. In health care, outcomes are typically quantitative, not qualitative.
CRITICAL THINKING EXERCISE 17-1
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