Situation: The nurse works on an acute psychiatric unit that… | 마이메르시 MyMerci
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Nursing Practice V — Care of Clients with Maladaptive Patterns of Behavior; Care of Clients with Life-Threatening Conditions, Acute Multi-Organ Problems, High Acuity and Emergency Situations
문제

Situation: The nurse works on an acute psychiatric unit that uses milieu therapy, attitude therapy, and planned activity groups. Each client has an individual plan of care with measurable outcomes. A 30-year-old man with schizophrenia attends social skills training. His outcome reads: "Starts a conversation with a peer at least twice daily on 3 consecutive days by day 14." Before day 12 he had started no conversations with peers. The nurse's records show: Day 12: started 2 conversations with peers and 1 with staff Day 13: started 1 conversation with a peer and 2 with staff Day 14: started 2 conversations with peers and 0 with staff How should the nurse evaluate this outcome?

해설
An outcome is evaluated against every element of its criterion: who (a peer), how often (at least twice daily), and for how long (3 consecutive days) by the deadline. Day 13 had one peer conversation, so the outcome is not met even though his total contacts rose. A total count is not the measure the outcome sets.
같은 주제 다음 문제Situation: A 29-year-old man is admitted to the psychiatric unit of a general hospital aft…이 문제가 수록된 문제집PLNE Question Bank 150014,000원 · 무료 체험 가능

심화 해설

Evaluate against every element of the criterion
The outcome reads: "Starts a conversation with a peer at least twice daily on 3 consecutive days by day 14." Each part is a separate requirement: who the conversation is with, how often it happens each day, and how many consecutive days it must be sustained, all by the deadline. On day 12 he started 2 peer conversations, on day 13 only 1, and on day 14 2. Because day 13 had only one conversation with a peer, the daily minimum was not met on 3 consecutive days, so the outcome is not met.

DayPeer conversationsStaff conversationsMeets daily minimum (2 with peers)?
1221Yes
1312No
1420Yes

Why the other evaluations are wrong
Counting conversations with staff gives at least two every day, but the outcome specifies peers, so staff contacts do not count toward it. Adding up five peer conversations over 3 days uses a total, but the criterion is a daily minimum on consecutive days, not a total over the period. Judging only by day 14, the deadline, ignores the requirement that the behavior be sustained on 3 consecutive days. Each of these errors partly reads the outcome but drops one of its elements.

Writing and evaluating measurable outcomes
A well-written outcome is specific, measurable, achievable, relevant, and time-bound. It names the behavior, the condition, the criterion, and the time frame, as this one does. Evaluation then compares the client's actual behavior with each element and concludes whether the outcome is met, partially met, or not met. When it is not met, the nurse reviews the plan, for example by adding more structured opportunities for peer contact in social skills groups, and may revise the time frame.

Watch out! His progress is real: he went from no peer conversations to several. Progress is documented, but the outcome as written is still not met. Evaluation is judged against the criterion, not against effort or improvement alone.

Exam takeaway
Key point! An outcome is met only when every element of its criterion is met: who, how often, how long, and by when. Watch for distractors that substitute totals for daily minimums or include the wrong people.

임상 시나리오

Evaluating a Measurable OutcomeSocial skills training in schizophrenia

The outcome requires conversations with a peer, at least twice daily, on 3 consecutive days, by day 14.

Day 13 had only 1 peer conversation, so the outcome is not met, even though his total contacts rose.

Document his progress, review the plan, and add structured opportunities for peer contact; revise the time frame if needed.

Caution

Staff conversations and totals over the period do not count toward a daily peer criterion.

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