perceptions, communications, and interactions in
performing the functions of the role. In your role as
a nurse, after interacting with a patient, sit down
and write down your behavior and that of the pa-
tient. It is my belief that you can identify your per-
ceptions, mental judgments, mental action, and
reaction (negative or positive). Did you make a
transaction? That is, did you exchange information
and set a goal with the patient? Did you explore the
means for the patient to use to achieve the goal?
Was the goal achieved? If not, why? It is my opinion
that most nurses use this process but are not aware
that it is based in a nursing theory. With knowledge
of the concepts and of the process, nurses have a
scientific base for practice that can be articulated
clearly and documented to show quality care. How
can a nurse document this transaction model in
practice?
Documentation System
A documentation system was designed to imple-
ment the transaction process that leads to goal at-
tainment (King, 1984a). Most nurses use the
nursing process of assess, diagnose, plan, imple-
ment, and evaluate, which I call a method. My
transaction process provides the theoretical knowl-
edge base to implement this method. For example,
as one assesses the patient and the environment
and makes a nursing diagnosis, the concepts of per-
ception, communication, and interaction represent
knowledge the nurse uses to gather information
and make a judgment. A transaction is made when
the nurse and patient decide mutually on the goals
to be attained, agree on the means to attain goals
that represent the plan of care, and then implement
the plan. Evaluation determines whether or not
goals were attained. If not, you ask why, and the
process begins again. The documentation is
recorded directly in the patient’s chart. The pa-
tient’s record indicates the process used to achieve
goals. On discharge, the summary indicates goals
set and goals achieved. One does not need multiple
forms to complete when this documentation sys-
tem is in place, and the quality of nursing care is
recorded. Why do nurses insist on designing critical
paths, various care plans, and other types of forms
when, with knowledge of this system, the nurse
documents nursing care directly on the patient’s
chart? Why do we use multiple forms to complicate
a process that is knowledge-based and also provides
essential data to demonstrate outcomes and to
evaluate quality nursing care?CHAPTER 16 Imogene M. King’s Theory of Goal Attainment 239FeedbackREACTION INTERACTION TRANSACTIONPERCEPTIONJUDGMENTACTION
NURSEPATIENTACTIONJUDGMENTPERCEPTIONFeedbackFIGURE 16–2 Transaction process model. From King, I. M. (1981).A theory for nursing: Systems, concepts, process(p. 145) New York: John
Wiley & Sons, Inc.