Goal setting in nursing provides direction for planning nursing interventions and evaluating patient progress. Learn how to create measurable, patient-oriented nursing goal statements.
Goal Setting in Nursing
In another lesson, we looked at the steps of the nursing process: assessing, diagnosing, planning, implementing, and evaluating. Goal setting occurs in the third phase of the process, planning.
Because goal setting is so pivotal to nursing interventions and the plan of care, let’s explore how to develop goal statements for nursing.Is our goal for nursing care to heal patients? To help them get better? To help them get well? While these are certainly in the forefront of our minds, how do you evaluate these statements? What if the definition of wellness is different from one person to another? This is why nursing goal statements that are patient-centered and measurable are so important.
Smart Goal Criteria
Before we get into the specifics of nursing goals, let’s discuss goal criteria in general. One way to help you remember how to write goals is to make sure they are SMART. SMART goals are Specific, Measurable, Action-Oriented, Realistic and Timely.’Specific‘ refers to who, what, when, where, and why. ‘Measurable‘ means that you can actually measure and evaluate the progress of that goal in a concrete way.
‘Action-oriented‘ means there are actions that can be taken to reach the goal. ‘Realistic‘ includes the ability to work on the goal, having the resources, attitudes, abilities and skills to reach this goal, and how realistic it is to coming to fruition. Finally, ‘Timely‘ means that there is an end time frame or date at which the goal is going to be evaluated.Let’s look at one general example of a goal statement that a lot of us are familiar with: weight loss. Here is a common goal: ‘I am going to try hard to lose some weight.’ Now, let’s make this goal ‘SMART.’ ‘I will lose 10 pounds over the next month by exercising 3 times per week for 30 minutes and keeping a food diary each day.
‘Why is this goal SMART? It is specific. The goal is 10 pounds. It is measurable. We can measure the actual weight loss at the end, and we can evaluate the number of times you went to the gym.
It is realistic. Ten pounds over a month is not unreasonable, although a challenge, perhaps. Finally, the time frame is included as one month. At this time, we could review the plan and see if the goal was met or unmet. Let’s discuss how to apply this strategy to nursing.
Purpose of Goal Setting
The purpose of goal setting in nursing is to:
- Provide direction for planning nursing interventions
- Serve as criteria for evaluating patient progress
- Enable the patient and nurse to determine when the problem has been resolved and
- Help motivate the patient and the nurse by providing a sense of achievement
Both short and long-term goals can and should be included in a nursing care plan. Short-term goals are often used in acute care settings, like hospitals.
Here, most nursing care is focused on the patient’s immediate needs. Long-term goals are important for home care in addition to longer stay facilities, like nursing homes, extended care facilities, and rehab centers.
Nursing Goal Criteria
When developing goals for patients, the nurse needs to look at several factors. Think back to the SMART goal criteria.
In order to be specific, nurses focus on questions like ‘What is the problem? What is the response desired?’ To make it measurable, ‘How will the client look or behave if the healthy response is achieved? What can I see, hear, measure, observe?’Considering action-oriented, ‘Are there steps and nursing interventions needed to reach that goal? Is this a realistic outcome for the patient? Have we considered all of the factors involved, including the client’s capabilities and limitations? Does the patient have what he or she needs to reach that goal?’ And finally, ‘Is it timely? When do we expect the goal to be reached?’
Examples of Nursing Goal Statements
Here are some examples of vague goal statements one might see in nursing:
- Increase patient hydration.
- Reduce pain, and the patient will feel better.
- Patient should be able to breathe deeper soon.
Let’s rewrite those to make them ‘SMART.’ Here are some examples of excellent nursing goals:
- The patient will drink 100 mL of water every hour for the 12-hour daytime shift.
- The patient will report a pain level of 2 on a scale of 1-10 within 30 minutes of receiving pain medication.
- The patient will demonstrate the use of correct breathing and coughing techniques after instruction and repeat action every 2 hours during an 8-hour shift.
Can you see how, by incorporating the criteria, these goals give structure and purpose to nursing care?
Tips for Writing Nursing Goals
Here are some tips for writing goals. Always start with ‘The patient will,’ not what the nurse hopes to accomplish. Setting realistic goals can also decrease frustration and discouragement. In addition, the nurse should make sure to evaluate the goal statements in the time frame set up and revise as needed.As we have discussed, even though our goals for our patients are for them to heal, feel better and get well, these goals are difficult to measure and evaluate. It is much clearer to organize a care plan and empower the patient to see the progress and achievement of their wellness and health.
Let’s review how to write a nursing goal statement and the purpose of nursing goals. First, the goal needs to be specific. What is the response desired? ‘Specific‘ refers to who, what, when, where and why.
‘Measurable‘ means that you can actually measure and evaluate the progress of that goal in a concrete way. How will the client look or behave if the healthy response is achieved? What can I see, hear, measure, observe? ‘Action-oriented‘ means there are actions that can be taken to reach the goal. Are there nursing interventions needed to reach that goal? ‘Realistic‘ includes the ability to work on the goal – having the resources, attitudes, abilities and skills to reach this goal. Is this a realistic outcome for the patient considering all of the factors involved, including the client’s capabilities and limitations? Finally, ‘Timely‘ means that there is an end date at which the goal is going to be evaluated. When do we expect the goal to be reached?Finally, the purpose of goal setting is to provide direction for planning nursing interventions, serve as criteria for evaluating patient progress, enable the patient and nurse to determine when the problem has been resolved and help motivate the patient and nurse by providing a sense of achievement.
After watching this lesson, you should be able to understand the purpose of nursing goals, and how to effectively develop them using the SMART goal criteria.