Lesson 1, Topic 1
In Progress

Outcomes Identification

May 1, 2021

The nurse, in collaboration with the patient, develops expected outcomes for the established nursing diagnosis. The outcomes statement indicates the degree of wellness desired, expected, or possible for the patient to achieve and contains a patient goal statement. The ANA uses the term outcome identification, but alternative terms for this statement are a patient goal, a patient-centered goal, an objective, a behavioral objective, or a patient outcome. A patient outcome statement provides a description of the specific, measurable behavior (outcome criteria) that the patient will be able to exhibit in a given time frame after the interventions. The nurse must avoid writing a goal statement that is centered on nursing interventions because this indicates what the nurse is meant to do rather than what the patient is to do.

Desired patient outcome statements serve two functions. First, they guide the selection of nursing interventions. Nursing interventions are selected to promote the achievement of the desired outcome. Second, the outcome statement establishes the measuring standard that is used to evaluate the effectiveness of the nursing interventions. Therefore, the outcome statement has to provide the specific details that can be used as the benchmark to judge progress or solution of the problem.

A well-written patient-centered goal or desired patient outcome statement does the following:

•Uses the word patient or a part of the patient as the subject of the statement
•Uses a measurable verb
•Is specific for the patient and the patient’s problem
•Does not interfere with the medical plan of care
•Is realistic for the patient and the patient’s problem
•Includes a time frame for patient reevaluation

Because the subject of the patient outcome statement is meant to be the patient or a part of the patient, the outcome statement should begin with the words, “The patient will” or “The patient’s  .  .  .  will.”

Measurable verbs indicate the precise behavior that the nurse anticipates hearing or seeing. Define, describe, list, walk, demonstrate, and verbalize are examples of measurable verbs.

The properly written patient outcome statement is specific to the patient and the patient’s health problem. A patient who is in traction because of a bone fracture has mobility restrictions. An outcome statement indicating that all joints will be moved through full range of motion is not safe for this patient’s problem.

The patient outcome statement also has to be realistic for the patient and the patient’s health problem. Although some 88-year-old patients are joggers, the expectation that an 88-year-old patient will learn to jog is probably not reasonable.

A time frame is written into the patient outcome statement to provide a deadline for evaluation of the patient’s progress. Nursing experience assists the nurse in accurate prediction of realistic time frames.

Patient outcome statements indicate a reversal of the problem identified by the NANDA-I nursing diagnosis label, as shown in the following example:

Patient outcome statements can be written in two ways. The previous example illustrates the simple reversal of the problem statement in a concise fashion. A second approach is to list the desired behavior in broader terms and then list exact criteria or standards; this may also be referred to as a long-term and short-term goal. The following example first lists the long-term goal, with the second example the short-term goal:

•The patient will use her walker to ambulate at all times rather than using her wheelchair within the next 2 months.
•The patient will participate in range-of-motion exercises on her lower extremities bilaterally two times a day.
•The patient will ambulate 20 feet every day with assistance of her walker, increasing distance ambulated by 5 feet daily.