In what stage of the nursing process does the nurse determine the effectiveness of interventions and plans of health promotion actions?

Evaluation of nursing care with communities involves evaluation of programs of care for populations. Program evaluation includes evaluation of outcomes (program goals and outcome objectives), as well as evaluation of the structures and processes used to achieve the outcomes (Ervin, 2002). The ANA considers outcomes, structures, and processes as the primary categories of criteria to be used to measure the quality of nursing care. Outcomes are the end results; structures are the social and physical resources; and processes are the “sequence of events and activities” (ANA, 1986, p. 18) used by the nurse during the delivery of care. For example, evaluation of a health program designed to identify adults with high cholesterol levels would include the following:

Table 17-1 describes the following five categories of questions that can be answered by evaluation: (1) outcome attainment, also called effectiveness; (2) appropriateness of care; (3) adequacy of care in relation to the scope of the problem; (4) relationship of resources to results, also called efficiency; and (5) process. This set of questions includes the criteria of outcome, structure, and process evaluation and adds appropriateness and adequacy. Questions of appropriateness and adequacy evaluate the nursing care program in relation to the community health needs. Efficiency addresses the relationship of outcomes to structures and processes. Each of these sets of evaluation questions is discussed in more detail.

Table 17-1

Questions Answered by Evaluation

Data from Deniston, O., & Rosenstock, I. (1970). Evaluating health programs. Public Health Reports, 85(9), 835–840; Donabedian, A. (1980). The definition of quality and approaches to its assessment (Vol. 1). Ann Arbor, MI: Health Administration Press; Freeman, R. (1963). Public health nursing practice (3 rd ed.). Philadelphia: W. B. Saunders; and Suchman, E. (1967). Evaluative research: Principles and practice in public service and social action programs. New York: Russell Sage Foundation.

In which step of the nursing process are nursing interventions carried out?

What are the 5 stages of the nursing process?

During which step of the nursing process would the nurse review the patient's plan of care and determine whether a goal was met?

What are the 4 phases of nursing process and describe each?