An Educational Intervention on Mutual Goal Setting for Hospital Nurses: A Mixed-Methods Study

Abstract

Background:

Including patients in mutual goal setting is one mechanism to personalize care delivery and improve patient outcomes.

Objective:

The purpose of this study was to examine the impact of a nurse educational intervention about mutual goal setting on nurse engagement and self-efficacy for goal setting and the nurse/patient experience of goal setting.

Methods:

During this explanatory, sequential mixed-methods study, nurse engagement in goal setting and goal quality was assessed through chart audits 1-month pre-intervention (n = 173) and 1 and 3-months (n = 144, n = 137) post-intervention. Nurse self-efficacy was measured with the Appraisal Inventory Tool. Patient experience was examined with the Patient Experience of Mutual Goal Setting Tool 1-month pre-intervention (n = 111) and 1 and 3-months post-intervention (n = 111, n = 109), and nurse experience was examined using focus groups (n = 16).

Results:

Goals were present in charts twice as often 1-month post-intervention when compared to 1-month pre-intervention, and goal quality significantly improved at the 1st and 3rd month post-intervention. Nurse self-efficacy in goal setting was significantly higher following the intervention and patients’ goal achievement improved. Nurses discussed their experience in terms of facilitators (education, engaging others, using visual cues, and taking small steps), barriers (patients not prepared, medical obstacles, and system constraints), and benefits to their practice.

Conclusion:

Educating nurses is just one strategy to improve the multi-faceted mutual goal setting process. Involving patients in care planning at its inception, when goals are constructed, can assist with early identification of barriers by eliciting the patient voice and ensures that care is individualized to each patient’s unique situation.

Protocol Registration:

The study was registered at Clinicaltrials.gov, ID:NCT04977206.