Evidence-Based Practice for Nurses

(Burns & Grove, 2015). Outcomes should be measured using specific quantita-

tive criteria, sometimes referred to as indicators. For example, if postoperative

pain control is of interest, then pain should be quantified through a recognized

indicator such as the numeric rating scale. If an outcome such as quality of life

is the focus, then using an established instrument, such as the SF-36, which

is a validated multipurpose health survey tool, is preferred (Contopoulos-

Loannidis, Karvouni, Kouri, & Ioannidis, 2009). Instruments that have been

tested for reliability and validity improve credibility of the evaluation process.

Table 18-1 lists examples of outcomes and associated indicators.

When determining outcomes to be measured, there are four major factors

to consider: patient populations, team membership, organizational priorities,

and mandated reporting. It is best when the selected outcomes address mul-

tiple factors. Journals, books, and websites are available to assist. Table 18-2

lists selected organizations with their associated websites that contain health

outcome information.

Patient Population

It is necessary to select outcomes that reflect the patient population served

by the healthcare facility. Use of a generic patient outcome is a good strategy

to measure outcomes when populations are diverse. For example, measuring

symptom control or increased knowledge may apply to many disease condi-

tions (Burns & Grove, 2015). The Nursing Outcomes Classification (NOC),

developed at the University of Iowa College of Nursing, is a standardized list of

generic patient outcome classifications that can be used to evaluate the efficacy

of nursing interventions (Moorehead et al., 2013). Currently, 490 outcomes in

the NOC system are associated with the North American Nursing Diagnosis

Association and the nursing interventions classification. Each outcome is coded

Outcome Indicator

Dyspnea reduction Dyspnea rating scale

Decrease in postoperative pain Pain numeric rating scale

Absence of skin ulcers Pressure sore staging

Reduction in patient falls Falls risk assessment tool

Knowledge: blood pressure

medication

Blood pressure

TABLE 18-1 Outcomes and Indicators

KEY TERMS

indicators:

Quantitative criteria

used to measure

outcomes

patient

populations: A

group of patients

with similar

characteristics

team membership:

The composition of

a team with respect

to expertise and

leadership

organizational

priorities: Situations

of high importance

because of volume

of patients or costs

mandated

reporting: Data that

must be shared

with supervising

or governmental

agencies by a

specified timeline

474 CHAPTER 18 Evaluating Outcomes of Innovations