GOAL STATEMENT
At the heart of the care plan is a goal statement that specifies an expected out-
come of the health care team’s intervention with the patient. Think of a goal
statement as what you want to happen to the patient. For example, a typical
goal is that a patient will report a reduction in pain from 8 to 4 on a scale of
0 to 10 in three hours.
A goal statement is a nursing orderthat must be patient centered and specify a
desired behavior to occur at a specified time. The behavior must be observable and
measurable and the goal statement must specify criteria for measuring the behavior.
Ideally, both the nurse and the patient develop and accept the goal. If the
patient’s decision-making ability is impaired, then the patient’s family or another
support person becomes the patient’s advocate in the planning process. It is
critical that the patient adopts the goal statement; otherwise, the goal might not
be achieved. For example, if the patient doesn’t believe in taking pain medica-
tion, then a goal of reducing pain by taking analgesics will not be met. The nurse
will then have to explore alternatives to pain medication such as a massage or
imagery. The care plan should be shared with the patient’s family, the healthcare
team and others who are caring for the patient so that everyone is working
toward the same goals.
DEADLINES AND MEASUREMENT
It is important that the care plan establish realistic deadlines for reaching the goal,
otherwise the patient and those caring for the patient will become frustrated when
the goal is not met. For example, it isn’t realistic to say that the patient will no
longer cough after taking dextromethorphan (Robitussin DM) simply because
the medication isn’t an instant cure for coughing. A more realistic goal is for the
frequency of the patient’s coughing to decrease after each dose. The deadline
might be that the patient will take dextromethorphan for 48 hours and report a
decrease in frequency of coughing and experience uninterrupted rest. This goal is
both observable and measurable since the nurse can observe if the patient is cough-
ing and measure the frequency of the cough to determine if the goal is reached.
INTERVENTIONS
The care plan must also specify the intervention for each goal statement. An
intervention is a clear statement that specifies the action that must be taken to
CHAPTER 3 Pharmacology and the Nursing Process^49