What is Evaluation in nursing process?

In the nursing process, Evaluation is the final and most critical step.

It is the phase where nurses determine effectiveness of the care provided and decide whether the patient’s goals have been met.

Evaluation is not just the “end” of the process; it is a continuous, purposeful activity that ensures nursing practice remains safe, effective, and patient-centered.

Definition and Purpose

Evaluation is a systematic comparison of a patient’s current health status against the “Expected Outcomes” (goals) established during the Planning phase.

Why it is important?

• It determines if the patient is getting better, staying the same, or getting worse.
• It provides evidence that the nursing interventions were actually performed and effective.
• It helps the nurse decide whether to continue, modify, or terminate the current care plan.
• It identifies gaps in care and helps improve nursing standards for future patients.

Five Steps of Evaluation Process

1. The nurse performs a reassessment to gather new subjective and objective data (e.g., measuring a new blood pressure reading or asking the patient to rate their pain).
2. Nurse compares new data with the goals set.
3. Example: If the goal is “Pain level below 3/10 within 30 minutes,” and the current data shows “Pain is 2/10,” the goal is compared.
4. Nurse analyzes if the improvement (or lack thereof) was actually due to the nursing interventions or other external factors.
5. Nurse makes a clinical judgment on whether goal was:
   1. Met: The goal is met.
   2. Partially Met: Some progress was made, but goal wasn’t fully reached.
   3. Not Met: No progress was made, or the condition worsened.
6. Based on conclusion, nurse decides the next step (e.g., if the goal was not met, the nurse might change the intervention or re-diagnose the problem).

Once evaluation is complete, nurse document an Evaluative Statement in the patient’s record.

This statement consists of two parts:

1. The Conclusion: (Met, Partially Met, or Not Met).

2. Supporting Data: The specific evidence used to reach that conclusion.

Example: > * Goal: Patient will ambulate 50 feet without shortness of breath by the end of the shift.

• Evaluative Statement: “Goal Met. Patient ambulated 60 feet in the hallway with a steady gait; respirations remained at 18/min and oxygen saturation at 98%.”

In nursing, the acronym ADPIE (Assessment, Diagnosis, Planning, Implementation, Evaluation) is see as a circluar process.

If the Evaluation shows that a goal was Not Met, the nurse essentially starts the cycle via:

• Re-Assess: Is there a new symptom I missed?
• Re-Diagnose: Was initial nursing diagnosis is incorrect?
• Re-Plan: Do we need a different goal or a new intervention?