nursing care, and write mutually agreed-upon goals
and means to attain them. Goals that are achieved
are outcomes and represent effective nursing care.
Elements in the goal-oriented nursing record are:
(1) data base, (2) goal list, (3) nursing orders, (4)
flow sheets, (5) progress notes, and (6) discharge
summary. This information system can be designed
for any patient population and for current and fu-
ture computerization of records in a health-care
system.
RESEARCH
Several nurses have tested the theory in research on
aging, parenting, psychiatric-mental health, and
ambulatory care (Alligood et al., 1995; Benedict &
Frey, 1995; Norris & Hoyer, 1993; Woods, 1994).
Nurses in Japan, Sweden, and Canada have con-
ducted studies in their cultures to test the Theory of
Goal Attainment (Coker et al., 1990; Kameoka,
1995; Rooke, 1995).
Sieloff (1995) developed a theory of power for
nursing administration. Frey (1995) proposed a
theory of family, children, and chronic illness and
continues to test it in research. Killeen’s disserta-
tion (1996) studied patient-consumer perceptions
and responses to professional nursing care that
resulted in an instrument that measures patient
satisfaction.
VISION FOR THE FUTURE
My vision for the future of nursing is that nursing
will provide access to health care for all citizens.
The United States’ health-care system will be struc-
tured using my conceptual system. Entry into the
system will be via nurses’ assessment so individuals
are directed to the right place in the system for
nursing care, medical care, social services informa-
tion, health teaching, or rehabilitation. My transac-
tion process will be used by every practicing nurse
so that goals can be achieved to demonstrate qual-
ity care that is cost-effective. My conceptual system,
Theory of Goal Attainment, and Transaction
Process Model will continue to serve a useful pur-
pose in delivering professional nursing care. The
ideas have been tested in research and in practice,
and nurses in education and practice have used the
knowledge of the concepts. The relevance of
evidence theory–based practice, using my theory,
has been shown to join the art of nursing of the
CHAPTER 16 Imogene M. King’s Theory of Goal Attainment 243twentieth century to the science of nursing in the
twenty-first century.The U.S. health-care system is in constant
flux in an attempt to restructure health-care
delivery. How can a conceptual system and
the Theory of Goal Attainment provide the
structure, process, and outcomes that repre-
sent a way to manage and deliver quality
health care for all citizens? My conceptual
system and transaction process in the Theory
of Goal Attainment provides one approach to
accomplish the goal of access and quality in
the following ways:- For interaction between nurses and health-
care professionals and between health-
care agencies for continuity of care, respect
for roles, and responsibilities of eachhealth
profession; for case management and col-
laborative and integrated practice. - Essential knowledge to assess, diagnose,
plan, implement, and evaluate care. - For common discourse among health pro-
fessionals and between nurses and nursing
personnel. - A framework within health-care systems
and between health-care providers and
agencies. - Direct measure of outcomes resulting in
quality care and cost-effective care; that is,
goals are set and goals are attained. - A systematic and efficient documentation
system. - One valid and reliable assessment instru-
ment to assess activities of daily living as a
basis for goal-setting. - For continuity of care within and between
health-care agencies. - Results in satisfaction for patients, fami-
lies, physicians, and administrators.
When knowledge of the concepts and the
transaction process has been used in hospi-
tals, homes, nursing homes, and community
health agencies, nurses have been motivated
to seek additional knowledge in formal edu-
cational programs.