Setting goals to improve the outcomes for the patient is a primary focus of the nursing process. Based on the nursing diagnoses, what are the expectations for this patient? This not about nursing goals. They are patient goals. This is about improving the health status and quality of life for your patient. This is about what your patient needs to do to improve his health status and/or better cope with his illness.

Planning also involves making plans to carry out the necessary interventions to achieve those goals. The use of formal care plans or care maps and protocols is highly advised.

Setting goals and Priorities for the Client

In setting patient goals, the nurse should also include other professionals involved in the care of the patient. These may include physical and occupational therapists, dietitians, and pharmacists depending on what the patient needs.

Aside from multidisciplinary approach to care, the nurse should also use the nurse-patient relationship to discuss with the patient the goals they both need to achieve. Patient cooperation is an important factor because the success of the care plan will depend on how amenable the patient would be to the methods and how much the patient would want to achieve their set goals.

Criteria of Expected Outcomes Should be SMART

S – Specific and focused to the client – reflecting clients behavior

M – Measurable – to quantify desired response objectively

A – Attainable or perceivable – avoid statements “will be able to”

ex. “on the day of heart surgery, the client will demonstrate relief of anxiety by stating that all questions have been answered.”

R – Realistic – includes pts. Support system, emotional and physical condition,level of intelligence, health values, availability of workforce and equipments.

T – Time bound or time limited – so that nurse has a standard whether progress is being reasonable and to assist in setting priorities.

Prioritizing interventions to achieve desired goals

Like in the first steps of the care plan, the goals that are needed to be done first are problems that require immediate attention. Goals that are prioritized are given focused on in interventions.

a)Independent – practices that require no supervision or direction from others

b)Interdependent – teamwork with other staff ex. Protocol

c)Dependent – instructions and orders of another professional

Sample Situation

A newly diagnosed diabetic type 1 patient was prescribed regular insulin injections to control blood sugar levels and prevent hyperglycemia and serious complications like diabetic ketoacidosis. The nurse who conducts health teaching on proper insulin administration will have the following goal for the patient.

“after instruction on insulin therapy, the patient will successfully demonstrate the ability to accurately draw up the insulin by Monday and safely self inject by Tuesday.”

In forming plans and setting goals, nursing students should keep in mind the above mentioned tips.

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