Correctly Written Goals and Outcomes
There is a quick easy way to write goals and outcomes. Here is an example for the NANDA stem of
Altered nutrition less than body requirements:
The client will demonstrate increased nutritional status by 9/20 as evidenced by:
a.
an increase in body weight of 2 pounds
b.
identifying causative factors of weight loss
c.
selecting foods high in protein and calories
d.
describing the rationale for selecting foods high in protein and calories.
Lets examine this goal. Always start out with the client will. Starting out with the client will keeps the goal
focused on the client and not the nursing interventions (What the nurse will do to help the client meet the
goal.) Then turn around the NANDA stem to show improvement. Some examples are:
a.
decreased anxiety
b.
decreased pain
c.
improved gas exchange
d.
effective health maintenance
e.
no hyperthermia
Next, put in a time frame that is reasonable and reachable. Add as evidenced by and establish the
outcome criteria. Outcome criteria must be complete because if the outcome criteria are met the nursing
diagnosis should be resolved.
An alternative method of putting in the time is to place a date by each outcome criteria. This is especially
helpful when the criteria cannot all be attained at the same time, for example when teaching the client to
perform activities. If the NANDA is activity intolerance, the goal would be:
The client will demonstrate increased activity tolerance as evidence by:
a.
sitting on the side of the bed for 10 minutes by 9/19
b.
sitting in chair for 30 minutes for meals by 9/20
c.
ambulating in room for 10 minutes qid by 9/21
The use of time is important because the nurse is establishing when the outcome criteria will be
evaluated.
When writing outcome criteria never use normal or within normal limits. Outcome criteria must be specific
for each client. A normal blood pressure for a hypertensive client may be impossible to obtain. Establish
the values that are appropriate and be specific. Lab values are frequently used for outcome criteria and
specific values must be stated.
After the outcome criteria have been established review the criteria by asking “If these criteria have been
met by this client will the problem (NANDA stem) go away.” If the answer is yes the criteria are complete;
if the answer is no the criteria are probably incomplete.
It is the nurse’s professional responsibility to determine the outcome criteria using sound nursing
judgment.
A valuable way of thinking about nursing process is that the NANDA stem goes to the goal, while the
etiology goes to the interventions.