Evidence-Based Practice for Nurses

the intent is to develop partnerships between hospitals and physicians to
provide efficient quality care. The Centers for Medicare and Medicaid Services
(CMS) reimburses ACOs based on patient outcomes. There are currently 33
CMS quality outcome measures that ACOs are held accountable to that affect
reimbursement (CMS, 2015).

Evaluating outcomes is not static, but rather an ongoing process. Outcomes
must be well defined for the evaluation to be meaningful. The effectiveness
of any innovation is measured by the outcomes that result. These results are
compared to baseline data in order to draw conclusions about the effective-
ness of the innovation. The process continues as the innovation becomes
standard practice.

18.2 Choosing Outcomes

KEY TERMS

long-term

outcomes: Primary

changes in patient

behaviors or status

over time

nursing-sensitive

outcomes: Results

that demonstrate

the effectiveness of

nursing care

Consider your last clinical experience. Are you aware of any outcomes that are being monitored

on the unit or in the facility? If so, what are they and how would you classify them?

CRITICAL THINKING EXERCISE 18-1

Match the type of outcome with the indicator. (Select all that apply.)

1. Performance-related outcome a. Patient will not hemorrhage after delivery


2. Patient-related outcome b. Patient will maintain weight loss over 2 years


3. Care-related outcome c. Patient will be afebrile after surgery


4. Long-term outcome d. The rate of hospital-acquired infections


5. Short-term outcome e. Patient satisfaction will be 90% or greater

TEST YOUR KNOWLEDGE 18-1

How did you do? 1. e; 2. a, b, c; 3. d; 4. b; 5. a, c

At the end of this section, you will be able to:

‹ Discuss factors that should be considered when selecting outcomes

Choosing outcomes that appropriately fit an innovation
is vital. This allows for an accurate evaluation of prac-
tice changes. During the selection process, outcomes
should be considered for their significance and scope.
Considerations may include disease-specific outcomes,
response to interventions, quality of life, and fiscal impact

FYI

Outcome-based measurements are a means

used to establish EBP and to evaluate the care

delivered. The effectiveness of any innovation

is measured by the outcomes that result.

18.2 Choosing Outcomes 473