Aklan State University

School of Arts and Sciences

Bachelor of Science in Nursing

COMMUNITY
HEALTH NURSING
MODULE
2020

Developed By:

CORTES, Ma.Ellen N.
ELEPONGGA, April Justine Glen R.
ESTANISLAO, Bergen Julie Fretch R.
FOSANA, Fides C.
INVINA, Joanna Grace T.
MACAHILIG, Lucelle Ann M.
MARCELINO, Ma. Jemalyn R.
NILLASCA, April Ann A.
Introduction
Community Health Nursing is a unique blend of nursing and public health practice designed into a
human service. Its responsibilities extend to the care and supervision of individuals and families in
their homes.

Community Health Nursing is one of the two major fields of Nursing other than Hospital Nursing
which uses interchangeably with public health nursing. Its goal is to promote, protect and preserve
the health of the public. It envision to respond the needs of the community health.

This is to introduce other field of nursing, that being a nurse is not only to focus on providing
treatment to our clients, but also to promote healthy lifestyle.

In this module, we will be familiar in different aspects of being a community health nurse, to
educate the public that includes the individual, the family, population and the community, on
practicing healthy lifestyle, and preventing common diseases.
Preface!
Change is inevitable. It’s a human nature and nursing education delivery is not exempted
from this. Nurse academicians are forced to adopt many approaches that includes modular, Open
Management System, self directed learning, problem based learning and simulation especially in
practicing Related Learning Experience of our students in the midst of this pandemic. Nursing
students exposures in the hospitals and health centers for their Nursing Skills and Related
Learning Experience will be replaced by multiple modules. Modules can help maintain connections
with our students during and in response to this COVID-19.

As per Instructor’s view, modular approach in giving quality nursing education is still
questionnable because students get minimum guidance from the skilled hands but with our
dedication to mold best nurses, modules could help build stronger student learning interest and
excitement
PART–I FAMILY
NURSING CARE
PLAN
LEARNING OBJECTIVES

Upon the completion of the topic, the students will be able to gain understanding in
Family Nursing Care Plan and Formulate a family care plan.

BACKGROUND OF FCP

- Is a blueprint of the nursing care designed to systematically enhance the family’s

capability to maintain wellness and or manage health problems through explicitly
formulated goals and objectives of careand deliberately chosen set of
interventions, resources and evaluation criteria, standards, methods and tools.

- Is regularly updated for modifications or changes based on family responses,

realities, behavioral processes and outcomes of care.

IMPORTANCE OF NURSING

• It is a systematic way to guide the nurse on how to enhance the family’s capability
for health and health care resource generation, allocation, and utilization to
achieve specific desired outcomes of prioritized health conditions/ problems.

• Planning enhances the nurse’s foresight for teamwork and coordination of services
to ensure adequacy and continuity of care.
 • In written form, that promotes systematic communication among those involved in
the health care effort, minimizing gaps and duplication of services in settings
where there is frequent turnover of staff or when several health workers are
providing care to the same family.

STEPS IN DEVELOPING A FAMILY CARE PLAN

1. Prioritized health condition/s or problems- list according to nature, modifiability,

preventive potential and salience.

2. Goals and objectives of nursing care- specify the expected health/ clinical
outcomes, family response/s, behavior or competency outcomes.

3. Intervention plan- specify the nursing actions to help the family eliminate the
barriers to the performance of health tasks or the underlying cause/s of non-
performance of expected health tasks./

4. Evaluation plan- specifies the criteria/ outcomes and evaluation standards as

explicit measures that determine achievement of formulated objectives based on a
required or desired level of performance or accepted change in health condition or
family reality.

PRIORITIZING HEALTH CONDITIONS AND PROBLEMS

- Scale for Ranking Health Conditions And Problems According To Priorities-

tool aims to objectivize priority setting.

4 CRITERIA FOR DETERMINING PRIORITIES AMONG HEALTH

CONDITION/S OR PROBLEMS

1. NATURE OF THE CONDITION OR PROBLEM PRESENTED- categorized into

wellness state/ potential, health threat, health deficit and foreseeable crisis

2. MODIFIABILITY OF THE CONDITION OR PROBLEM- refers to the probability of

success in enhancing the wellness state, improving the condition, minimizing,
alleviating or totally eradicating the problem through intervention.
 3. PREVENTIVE POTENTIAL- refers to the nature and magnitude of future problems
that can be minimized or totally prevented if intervention is done on the condition
or problem under consideration

4. SALIENCE- refers to the family’s perception and evaluation of the condition or

problem in terms of seriousness and urgency of attention needed or family
readiness.

Criteria
Scale
1. Nature of the condition or problem  Wellness State
presented  Health Deficit
 Health Threat
 Foreseeable Crisis
2. Modifiability of the Condition or  Easily Modifiable
problem  Partially Modifiable
 Not Modifiable
3. Preventive potential  High
 Moderate
 Low
4. Salience  A condition or problem,
needing immediate attention
 A condition or problem not
needing immediate attention
 Not perceived as a problem
or condition needing change

FORMULATION OF GOALS AND OBJECTIVES OF CARE

GOAL- is a broad desired outcome toward which behavior is directed

Example: After nursing intervention the family will be able to take care of the
disabled child competently.

Cardinal Principle in Goal Setting: Goals must be set jointly with the family.

BARRIERS TO JOINT GOAL SETTING BETWEEN THE NURSE AND THE FAMILY

1. Failure on the part of the family to perceive the existence of the problem.
 2. The family may realize the existence of a health condition or problem but is too busy
at the moment with other concerns and preoccupations.

3. The family perceives the existence of a problem but does not see it as serious
enough to warrant attention.

4. The family may perceive the presence of the problem and the need to take action. It
may, however, refuse to face and do something about the situation.

a. Fear of consequence/s of taking action

b. Respect for tradition/ cultural beliefs

c. Failure to perceive the benefits of action proposed

d. Failure to relate the proposed action to the family’s goals.

5. A big barrier to collaborative goal setting between the nurse and the family is failure
to develop a working relationship.

OBJECTIVES- refer to more specific statements of the desired results or outcomes of care.
They specify the criteria by which the degree of effectiveness of care is to be measured.

Example:NURSING GOAL: the family will manage malaria as a disease and threat in an
endemic area.

Short term/ immediate objective: The sick member/s will take the drugs
accurately as to dose, frequency, duration, and drug combination. All members will
use self-protection measures at night till early morning when biting time of the
mosquito vector is expected.

Medium-term/ intermediate objective: All members will have regular medical

check-up and laboratory confirmation (ex. Blood smear) to monitor presence of
malaria.

Long-term objective: All members will carry out mosquito vector control
measures.
DEVELOPING THE INTERVENTION PLAN

 This involves selection of appropriate nursing interventions based on the

formulated goals and objectives.

 In selecting the nursing interventions, the nurse decides on appropriate nursing

actions among a set of alternatives, specifying the most effective or efficient
method of nurse- family contact and the resources needed.

GENERAL DIRECTIONS IN SELECTING APPROPRIATE NURSING INTERVENTIONS

1. Analyze with the family the current situation and determine choices and possibilities
based on a lived experience of meanings and concerns.

2. Develop/ enhance family’s competencies as thinker, doer and feeler

3. Focus on interventions to help perform the health tasks.

4. Catalyze behavior change through motivation and support.

DEVELOPING THE EVALUATION PLAN

• Specifies how the nurse will determine changes in health status, condition or
situation and achievement of the outcomes of care specified in the objectives of
the family nursing care plan.

• The evaluation plan also includes evaluation methods and tools and/or evaluation
data sources. Examples or evaluation methods include direct observation,
interview, oral or written tests, record review, health/ physical examination.

EVALUATION STANDARD- refers to the desired or acceptable condition, clinical status or

level of performance corresponding to an evaluation criterion or indicator against which
actual condition, clinical status or performance is compared.

STEPS IN FAMILY NURSING ASSESSMENT

1. NURSING ASSESSMENT
 Is the first major phase of the nursing process. In family health nursing practice,
this involves a set of actions by which the nurse determines the status of the family
as a client, its ability to maintain itself as a system and functioning unit, and its
ability to maintain wellness, prevent, control or resolve problems in order to
achieve health and well- being among its members. Data about the present
condition or status of the family are gathered and analyzed based on how family
dynamics, realities, possibilities and vulnerabilities generate the antecedents or
factors associated with health and illness experiences.

Three major steps in nursing assessment as applied to family nursing practice:

1. Data Collection

2. Data Analysis

3. Formulation of Diagnosis

NURSING DIAGNOSIS- is the end result of two major types of nursing assessment in
family nursing practice based on the framework.

1. FIRST LEVEL ASSESSMENT- is a process whereby data about the current health
status of individual members, the family as a system and its environment are
compared against norms or standards of personal, social and environmental health
and interactions/ interpersonal relationships within the family system. as end result
of data analysis during the first level assessment, specific health conditions or
problems are identified and categorized as (a) wellness state (b) health threats (c)
health deficits and (d) stress points or forseeable crisis situations

2. SECOND LEVEL ASSESSMENT- specifies the nursing problems that the family
encounters in performing the health tasks with respect to a given health condition
or problem, and the causes, barriers or etiology of the family’s inability to perform
the health task. It also includes those that specify or describe the family’s realities,
perceptions about and attitudes related to the assumption or performance of family
health tasks on each health condition or problem identified during the first level
assessment.
Five types of data for first level assessment

1. Family structure, characteristics and dynamics

2. Socio- economic and cultural characteristics

3. Home and environment

4. Health status of each member

5. Values and practices on health promotion/ maintenance and disease prevention

Data for Second Level Assessment

1. The family’s perception of the condition or problem

2. Decisions made and appropriateness; if none, reasons and

3. Actions taken and results; if none, reasons; and

4. Effects of decisions and actions on other family members

DATA ANALYSIS

1. Sorting of data for broad categories such as those related with the health status or
practices of family members or data about home and environment.

2. Clustering of related cues to determine relationships between and among data

3. Distinguishing relevant from irrelevant data to decide what information is pertinent to

understanding the situation at hand based on specific categories or dimensions

4. Identifying patterns such as physiologic function, developmental, nutritional/dietary,

coping/adaptation or communication or interaction patterns and lifestyle.

5. Relating family data to relevant clinical/ research findings and comparing patterns
with norms or standards of health (ex. Nutritional intake, immunization status,
growth and development, social and economic productivity, environmental health
requisites) family functioning and assumption of health tasks
 6. Interpreting results based on how family characteristics, values, attitudes,
perceptions, lifestyle, communication, interaction, decision-making or role/task
performance are associated with specific health conditions or problems identified

7. Making inferences or drawing conclusions about the reasons for the existence of the
health condition or problem and risk factor/s related to non-maintenance of
wellness state/s which can be attributed to non-performance of family health tasks

FORMULATION OF DIAGNOSIS

1. Definition of wellness state/ potential or health condition or problems as an end

product of first level assessment

2. Definition of family nursing problems as an end result of second level assessment.

FAMILY NURSING PROBLEM- is stated as an inability to perform a specific health task and
the reasons (etiology) why the family cannot perform such task.

TYPES OF DATA IN FAMILY NURSING ASSESSMENT

1. FAMILY STRUCTURE, CHARACTERISTICS AND DYNAMICS-include family

composition and demographic data, type of family form and structure, decision-
making patterns, interpersonal relationships, interactional patterns/ interpersonal
relationships and communication patterns or processes affecting family
relatedness (ex. Expression of feelings or emotions particularly related with
addressing converging and diverging motivations or perceptions, such as during
conflict) consistency and congruence between intended and received messages;
and, explicitness of message for appropriateness, effectivity and efficiency of the
communication process related with role performance, individual members’ health
and family system integrity.

2. SOCIO-ECONOMIC AND CULTURAL CHARACTERISTICS-include

occupation, place of work and income of each working member; educational
attainment of each family member; ethnic background and religious affiliation;
family traditions, events or practices affecting members’ health or family
 functioning; significant others and the role(s) they play in the family’s life; and the
relationship of the family to the larger community.

3. HOME AND ENVIRONMENT- include information on housing and sanitation

facilities; kind of neighborhood and availability of social, health, communication
and transportation facilities in the community.

4. HEALTH STATUS OF EACH MEMBER-includes current and past significant

health condition/s or illness/es; beliefs and practices conducive to health and
illness; nutritional and developmental status; physical assessment findings and
significant results of laboratory/ diagnostic tests/ screening procedures.

5. VALUES AND PRACTICES ON HEALTH PROMOTION/MAINTENANCE AND

DISEASE PREVENTION-include use of promotive-preventive services as
evidenced by immunization status of at-risk members and use of other healthy
lifestyle related services; adequacy of rest/ sleep, exercise, relaxation activities,
stress management or other healthy lifestyle practices; opportunities which
enhance feelings of self-worth, self-efficacy and connectedness to self, others and
a higher power; essence of meaningfulness.

DATA GATHERING METHODS AND TOOLS

1. OBSERVATION- method of data collection is done through the use of the sensory
capacities- sight, hearing, smell and touch. Through direct observation, the nurse
gathers information about the family’s state of being and behavioral responses.
The family’s health status can be inferred from the signs and symptoms of problem
areas reflected in the following:

a. Communication, interaction patterns and interpersonal relationships expected, used

and tolerated by family members

b. Role perceptions/ task assumptions by each member, including decision-making

patterns

c. Conditions in the home and environment

Data gathered through this method have the advantage of being subjected to
validation and reliability testing by other observers.

2. PHYSICAL EXAMINATION- this is done through inspection, palpation,

percussion and auscultation and measurement of specific body parts and
reviewing the body systems.

3. INTERVIEW- One type of interview is completing a health history for each family
member. The health history determines current health status based on significant
past health history (ex. Developmental accomplishments, known illnesses,
allergies, restorative treatment, residence in endemic areas for certain diseases or
exposures to communicable diseases); family history (ex. Genetic history in
relation to health and illness) and social history such as intrapersonal and
interpersonal factors affecting the family member’s social adjustment or
vulnerability to stress and crisis.

A second type of interview is collecting data by personally asking significant family

members or relatives questions regarding health, family life experiences or
relatives questions regarding health, family life experiences, and home
environment to generate data on what wellness condition/s and health problems
exist in the family and the corresponding family nursing problems for each health
condition or problem. Ensuring confidentiality and respect for the family’s right to
self-determination are key principles to consider during all phases of the nursing
process.

4. RECORD REVIEW- the nurse may gather information through reviewing

existing records and reports pertinent to the client. These include the individual
clinical records of the family members, laboratory and diagnostic reports,
immunization records, reports about the home and environmental conditions, or
similar sources.

5. LABORATORY/ DIAGNOSTIC TESTS- another method of data collection is

through performing laboratory tests, diagnostic procedures or other tests of
integrity and functions carried out by the nurse herself and/or other health workers.
 ASSESSMENT DATA BASE (ADB)- is supported and complemented by other
family assessment tools to elicit generational information about family structure
and processes (genogram), factual data about family relationship with the external
environment and its resources (ecomap), and interactive processes and family
relationship problems/ difficulties and strengths (family- life chronology)

DATA ANALYSIS

 Sorts out and classifies or groups data by type or nature (ex which are wellness
states, threats, deficits, or stress points/ foreseeable crises

 Relates with each other and determines patterns or reoccurring themes among the
data

 Compares data and the patterns or recurring themes with norms or standards.

NURSING DIAGNOSES: FAMILY NURSING PROBLEMS

The end result of the second level assessment is a set of family nursing
problems for each health condition or problem.

Wellness condition- is a nursing judgment related with the client’s capability for
wellness.

Health condition or problem- is a situation which interferes with the promotion

and/or maintenance of health and recovery from illness or injury.

A wellness state or health condition/ problem becomes a family nursing problem

when it is stated as the family’s failure to perform adequately specific health tasks
to enhance or sustain the wellness state or manage the health problem. This is
called the NURSING DIAGNOSIS in family nursing practice.
TYPOLOGY OF NURSING PROBLEMS IN FAMILY NURSING PRACTICE

FIRST LEVEL SSESSMENT

I. PRESENCE OF WELLNESS CONDITION- stated as Potential or Readiness- a

clinical or nursing judgment about a client in transition from a specific level of
wellness or capability to a higher level. WELLNESS POTENTIAL is a nursing
judgment on wellness state or condition based on client’s performance, current
competencies or clinical data but NO explicit expression of client desire.
READINESS FOR ENHANCED WELNNESS STATE is a nursing judgment on
wellness state or condition based on client’s current competencies or performance,
clinical data and explicit expression of desire to achieve a higher level of state or
function in a specific area on health promotion and maintenance.

• A. Potential for Enhanced Capability for:

1. Healthy Lifestyle (ex. Nutrition/ diet, exercise/ activity)

2. Health Maintenance/Health Management

3. Parenting

4. Breastfeeding

5. Spiritual well-being- process of client’s developing/ unfolding of mystery through

harmonious interconnectedness that comes from inner strength/ sacred
source/God

6. Others, specify: ___________

• B. Readiness for Enhanced Capability for:

1. Healthy Lifestyle (ex. Nutrition/ diet, exercise/ activity)

2. Health Maintenance/Health Management

3. Parenting
4. Breastfeeding

5. Spiritual well-being

II. Presence of Health Threats- conditions that are conducive to disease and
accident, or may result to failure to maintain wellness or realize health potential.
Examples of these are the ff:

A. Presence of risk factors of specific diseases (ex lifestyle diseases, metabolic

syndrome)

B. Threat of cross infection from a communicable disease case

C. Family size beyond what family resources can adequately provide

D. Accident/ fire hazards. Examples:

1. Broken stairs

2. Pointed/ sharp objects, poisons and medicines improperly kept

3. Fire hazards

4. Fall hazards

E. Faulty/ unhealthful nutritional/ eating habits or feeding techniques or practices-

specify:

1. Inadequate food intake both in quality and quantity

2. Excessive intake of certain nutrients

3. Faulty eating habits

4. Ineffective breastfeeding

5. Faulty feeding techniques

F. Stress- provoking factors- specify:

 1. Strained marital relationship

2. Strained parent- sibling relationship

3. Interpersonal conflicts between family members

4. Care- giving burden

G. Poor home/ environmental condition/ sanitation- specify:

1. Inadequate living space

2. Lack of food storage facilities

3. Polluted water supply

4. Presence of breeding or resting sites of vectors of diseases (ex. Mosquitoes, flies,

roaches, rodents etc)

5. Improper garbage/ refuse disposal

6. Unsanitary waste disposal

7. Improper drainage system

8. Poor lighting and ventilation

9. Noise pollution

10. Air pollution

H. Unsanitary food handling and preparation

I. Unhealthful Lifestyle and personal habits/practices- specify:

1. Alcohol drinking

2. cigarette./ tobacco smoking

3. Walking barefooted or inadequate footwear

4. Eating raw meat or fish

5. Poor personal hygiene

6. Self-medication/ substance abuse

7. Sexual promiscuity

8. Engaging in dangerous sports

9. Inadequate rest or sleep

10. Lack of/ inadequate exercise/ physical activity

11. Lack of/ inadequate relaxation activities

12. Non-use of self- protection measures (ex. Non-use of bednets in malaria and
filariasis endemic areas)

J. Inherent personal characteristics- ex. Poor impulse control

K. Health history which may participate/induce the occurrence of a health deficit

(ex. History of difficult labor)

L. Inappropriate role assumption- ex. Child assuming mother’s role, father not
assuming his role

M. Lack of immunization/ inadequate immunization status specially of children

N. Family disunity- ex.

1. self-oriented behavior of member/s

2. Unresolved conflicts of member/s

3. Intolerable disagreement
III. Presence of Health Deficits- instances of failure in health maintenance. Examples
include:

A. Illness states regardless of whether it is diagnosed or undiagnosed by medical

practitioner

B. Failure to thrive/ develop according to normal rate

C. Disability- whether congenital or arising from illness; transient/ temporary (ex

aphasia or temporary paralysis after a CVA) or permanent (ex leg amputation
secondary to diabetes, blindness from measles, lameness from polio)

IV. Presence of Stress Points/ Foreseeable Crisis Situations- anticipated periods of

unusual demand on the individual or family in terms of adjustment/ family resources;
transitions (ex. Passage from one life phase, condition, or status to another, causing a
forced or chosen change that results in the need to construct a new reality). Examples of
these include:

A. Marriage I. Menopause

B. Pregnancy, labor, puerperium J. Chronic Illness

C. Parenthood K. Loss of job

D. Additional Member (ex. L. Hospitalization of a family

Newborn, lodger) member

E. Abortion M. Death of a member

F. Entrance at school N. Resettlement in a new

community
G. Adolescence
O. Illegitimacy
H. Divorce or separation

SECOND LEVEL ASSESSMENT

I. Inability to recognize the presence of the condition or problem due to:

A. Lack of or inadequate knowledge

B. Denial about its existence or severity as a result of fear of consequences of

diagnosis of problem, specifically:

1. Social stigma, loss of respect of peer/ significant others

2. Economic/cost implications

3. Physical consequences

4. Emotional/ psychological issues/ concerns

C. Attitude/ philosophy in life which hinders recognition/ acceptance of a

problem

II. Inability to make decisions with respect to taking appropriate health action due
to:

A. Failure to comprehend the nature/ magnitude of the problem/condition

B. Low salience of the problem/condition

C. Feeling of confusion, helplessness and/or resignation brought about by perceived

magnitude/severity of the situation or problem (ex. Failure to break down problems
into manageable units of attack)

D. Lack of/inadequate knowledge/insight as to alternative courses of action open to

them

E. Inability to decide which action to take from among a list of alternatives

F. Conflicting opinions among family members/ significant others regarding action to

take

G. Lack of/ inadequate knowledge of community resources of care

 H. Fear of consequences of action, specifically:

1. Social consequences

2. Economic consequences

3. Physical consequences

4. Emotional/psychological consequences

I. Negative attitude towards the health condition or problem by negative attitude is

meant one that interferes with rational decision making

J. Inaccessibility of appropriate resources for care, specifically:

1. Physical inaccessibility
2. Cost constraints or economic/ financial inaccessibility

K. Lack of trust/ confidence in the health personnel/agency

L. Misconceptions or erroneous information about proposed course/s of action

III. Inability to provide adequate nursing care to the sick, disabled, dependent, or vulnerable/
at risk member of the family due to:

A. Lack of/ inadequate knowledge about the disease/ health condition (nature, severity,
complications, prognosis and management)

B. Lack of/ inadequate knowledge about child development and care

C. Lack of/ inadequate knowledge of the nature and extent of nursing care needed

D. Lack of necessary facilities, equipment and supplies for care

E. Lack of or inadequate knowledge and skill in carrying out the necessary

interventions/ treatment/ procedure/ care (ex complex therapeutic regimen or
healthy lifestyle program)
 F. Inadequate family resources for care specifically:

1. Absence of responsible member

2. Financial constraints

3. Limitations/ lack of physical resources (ex. Isolation room)

G. Significant person’s unexpressed feelings (ex. Hostility/ anger, guilt, fear/ anxiety,
despair, rejection) which affect his/her capacity to provide care.

H. Philosophy in life which negates/ hinder caring for the sick, disabled, dependent,
vulnerable/ at risk member

I.Member’s preoccupation with own concerns/ interests

J. Prolonged disease or disability progression which exhausts supportive capacity of family

members.

K. Altered role performance- specify:

1. Role denial or
ambivalence

2. Role strain

3. Role dissatisfaction

4. Role conflict

5. Role confusion

6. Role overload
IV. Inability to provide a home environment conducive to health maintenance and
personal development due to:

A.Inadequate family resources, specifically:

1. Financial constraints/ limited financial resources

2. Limited physical resources- ex. Lack of space to construct facility

B. Failure to see benefits (specifically long-term ones) of investment in home environment

improvement

C. Lack of/ inadequate knowledge of importance of hygiene and sanitation

D. Lack of/ inadequate knowledge of preventive measures

E. Lack of skill in carrying out measures to improve home environment

F. Ineffective communication patterns within the family

G. Lack of supportive relationship among family members

H. Negative attitude/philosophy in life which is not conducive to health maintenance and

personal development

I. Lack of/ inadequate competencies in relating to each other for mutual growth and
maturation (ex. Reduced ability to meet the physical and psychological needs of other
members as a result of family’s preoccupation with current problem or condition)

V. Failure to utilize community resources for health care due to:

A. Lack of/ inadequate knowledge of community resources for health care

B. Failure to perceive the benefits of health care/ services

C. Lack of trust/ confidence in the agency/ personnel

D. Previous unpleasant experience with health worker

E. Fear of consequences of action (preventive, diagnostic, therapeutic rehabilitative)
specifically:

1. Physical/ psychological consequences

2. Financial consequences

3. Social consequences ex. Loss of esteem of peer/ significant others

F. Unavailability of required care/ service

G. Inaccessibility of required care/service due to:

1. Cost constraints

2. Physical inaccessibility ex. Location of facility

H. Lack of or inadequate family resources, specifically:\

1. Manpower resources ex. Baby sitter

2. Financial resources ex. Cost of medicine prescribed

I. Feeling of alienation to/ lack of support from the community ex. Stigma due to mental
illness, AIDS etc.

J. Negative attitude/ philosophy in life which hinders effective/ maximum utilization of

community resources for health care.
 Aklan State University
SCHOOL OF ARTS AND SCIENCES
Bachelor of Science in Nursing

ACTIVITY 1

Assess your family as an example of your FAMILY CARE PLAN. Use this format as your
guide in creating a FCP.

I. Introduction
II. Methodology
III. Objectives
 General
 Specific
IV. Demographic Data of the Family
 Father’s & Mother’s Name
 Age
 Sex
 Civil Status
 Highest Educational Attainment
 Religious Affiliation
 Estimated Monthly Income
 Children’s Profile
o Age
o Sex
o Civil Status
o Highest Educational Attainment
V. Family Structure
VI. Socio-Economic and Cultural Factors
(Customs and beliefs that may affect health)
VII. Estimated Family Expenses per month
VIII. Environmental Factors
1. Housing
 Adequacy of living space
 Sleeping Arrangement
 Presence of Accident Hazards
 Adequacy of the furniture
 Food storage and Facility
 Water Supply
  Toilet Facility
 Garbage Disposal
 Drainage System
2. Kind of Neighborhood
3. Social and Health Facilities Available
4. Communication and Transportation
IX. The Health Assessment
1. Past Medical History
2. Present Medical History (if necessary)
3. Maternal and Child health
4. Nutritional Assessment (BMI of each family member)
5. Value placed on disease prevetion
 RHU/Lying-in
 Hospital
 Others
X. Ranking Family Health Problems According to Priorities

CRITERIA COMPUTATION SCORE JUSTIFICATION

 Nature of the Problem

Scale: Health Threat 2
Health Deficits 3
Foreseeable Crisis 1
 Modifiability of the
Condition or problem
Scale: Easily Modifiable 2
Partially Modifiable 1
Not Modifiable 0
 Preventive potential
Scale: High 3
Moderate 2
Low 1
 Salience
Scale: A serious prob.
Immediate
 attention needed 2
A prob. But not
bleeding
immediate attention 1
Not a felt need/prob.

Total Score:

XI. Family Nursing Process

FIVE FAMILY HEALTH TASK
1. Ability to recognize presence of problem.
2. Ability to make appropriate actions or decisions.
3. Ability to take care of a sick/handicapped/ dependent family member.
4. Ability to make or maintain a home environment conducive for health and
development.
5. Ability to have reciprocal/relationship with the community/utilize community
resources.

Health Family Goal Objectives Nursing Method Resources Evaluation

Problem Nursing of of Care Interventions of Required
Problems Care Nursing

Good Luck and God bless!😊

PART-II
BAG
TECHNIQUE
LEARNING OUTCOMES

On completion of the learning module, the student must be able to:

1. To define bag technique.
2. Know the purpose of bag technique.
3. Identify the instruments and equipments included in a PHN bag.
4. To arrange the contents of the PHN bag to its proper place.

BAG TECHNIQUE

a tool making use of a public health bag through which the nurse, during his/her home
visit, can perform nursing procedures with ease and deftness, saving time and effort with the end
in view of rendering effective nursing care.

PUBLIC HEALTH BAG

is an essential and indispensable equipment of the public health nurse which he/she has to
carry along when he/she goes out home visiting. It contains basic medications and articles which
are necessary for giving care.

PURPOSE / RATIONALE

To render effective nursing care to clients and/or members of the family during home visit.

PRINCIPLE

1. The use of the bag technique should minimize if not totally prevent the spread of
infection from individuals to families, hence, to the community.
2. Bag technique should save time and effort on the part of the nurse in the performance of
nursing procedures.
3. Bag technique should not overshadow concern for the patient rather should show the
effectiveness of total care given to an individual or family.
 4. Bag technique can be performed in a variety of ways depending upon agency policies,
actual home situation, etc. as long as principles of avoiding transfer of infection is carried
out.

SPECIAL CONSIDERATIONS
1. The bag should contain all necessary articles, supplies and equipment which maybe use
to answer emergency needs.
2. The bag and its contents should be cleaned as often as possible, supplies replaced and
ready for use at anytime.
3. The bag and its contents should be well protected from contact with any article in the
home of the patients. Consider the bag and its contents clean and/or sterile while any
article belonging to the patient as dirty and contaminated.
4. The arrangement of the contents of the bag should be the one most convenient to the
user to facilitate efficiency and avoid confusion.
5. Hand washing is done as frequently as the situation calls for, helps in minimizing or
avoiding contamination of the bag and its contents.
6. The bag when used for a communicable case should be thoroughly cleaned and
disinfected before keeping and reusing.

CONTENTS OF BAG AND ITS ARRANGEMENT

 Front of bag, left to right

Oral Thermometer
Rectal Thermometer

 On Right near end of bag

Test tube and holder
Medicine dropper
On Left near end of bag
Medicine glass
Weighing scale
Bandage scissor

 Back of bag (left & right)

Alcohol 70%
Acetic acid
Aromatic spirit of ammonia
Benedict’s solution
Betadine
Ophthalmic ointment
Hydrogen peroxide
Zepheran solution
Spirit of ammonia
Acetic solution
  Center of bag
Forceps (straight & curved)
Roller bandage
Alcohol lamp with denatured alcohol
Kidney basin
Syringe and needles in container, 5 & 2 ml
Tape measure
Cotton applicator
Cord clamp
Rubber gloves

 On Top file center bag

Hand towel
Soap on a soap dish
Paper waste bag in pocket of bag
Newspaper to serve as lining
Apron
Plastic lining

PROCEDURES AND RATIONALE

PROCEDURES RATIONALE
1. Upon arriving at the client’s home, place bag  To protect the bag from contamination.
on the table or any flat surface lined with paper
lining clean side out (folded part touching the
table). Put bag handles or straps beneath the
bag.
2. Ask for a basin of water and a glass of water.  For hand washing and protect the work
If faucet is not available. Place these outside field from getting wet.
the work area.
3. Open the bag, take the liner/plastic lining &  To ensure asepsis in the field.
spread over work field area. The paper lining,
clean side out (folded part out).
4. Take out hand towel, soap dish and apron.  To prepare for hand washing.
Place them on one corner of the work area
(within the confines of the plastic lining).
5. Do handwashing. Wipe dry with towel. Leave  To prevent transfer of microorganisms.
the plastic wrappers of the towel in soap dish in
the bag.
6. Put on apron right side out and wrong side  To protect the health care provider from
touching the body, sliding the head into the contracting infection. Keeping the
neck strap. Neatly tie the strap at the back. crease creates aesthetic appearance.
7. Put out things mostly needed for specific  To make materials readily accessible.
case (e.g. Thermometer, kidney basin, cotton
balls, and waste paper bag) and place at one
corner of the work area.
8. Place waste paper bag outside of work area.
9. Close the bag.
10. Proceed to the specific nursing care
treatment.
11. After completing nursing care treatment
clean and sanitize the equipment used in the
procedure.
12. Perform hand washing again.
13. Open the bag and put back all articles in
their proper place.
14. Remove apron folding away from the body
with soiled side folded inward and the clean
side outward. Place it in between the flap cover.
15. Fold the linen/plastic lining in between the
flaps of the bag and close the bag.
16. Make past visit conference with the mothers
relevant to the health care, taking anecdotal
notes for final reporting.
17. Record all relevant findings in client and
members of family and document all nursing
care and treatment one.
18. Make an appointment for the next visit
(either home or clinic) taking note of the date,
time, and purpose.
 To prevent contamination.
 To prevent contamination of the bag
and its contents.
 To promote efficiency of the procedure.
 To protect health care provider and
prevent spread of infection to others.
 To prevent spread of infection.
 To establish systematic procedure
during reuse.
 To prevent contamination and spread of
microorganisms.
 To prevent contamination and spread of
microorganisms
 Notes to be used as a reference for
future visit and follow-up.
 To provide data for the next visit or
follow-up care.
 To ensure client’s availability.
 Aklan State University
School of Arts nnd Sciences
Bachelor of Science in Nursing

Activity 2

Return Demonstration of Bag Technique

NAME: DATE:

COURSE & SEC: RLE GROUP:

CHECKLIST ON BAG TECHNIQUE

Able to Able to Unable to

Procedure Perform Perform with Perform
Assistance
Assessment
1. Assess the completeness, neatness,
cleanliness and availability of bag contents
and its proper arrangement.
2. Determine the needs of the client on the
basis of findings during home visit.
Planning
3. Prepare all the equipment needed.
Implementation
4. Upon arriving at the client’s home, place bag
on the table or any flat surface lined with
paper lining.
5. Ask for the basin of water. Place this outside
work area.
6. Open the bag. Take out the plastic lining
and spread over the work field.
7. Take out the hand towel, soap dish and
apron. Place them on one corner of the work
area.
8. Do Handwashing. Wipe dry with hand towel.
9. Put on apron right side out and wrong side
touching the body.
10. Take out things that will be mostly needed
for a particular case and place in one corner
of the work field.
11. Place waste paper bag outside work area
12. Close the bag.
13. Proceed to the specific nursing care
treatment.
14. After completing nursing care treatment,
clean and sanitize all equipment’s used.
15. Do Handwashing again.
16. Open the bag and put back all articles in
their proper places.
17. Remove apron.
18. Fold the plastic lining. Clean and place it in
the flaps of the bag and close it.
19. Make post visit conference.
Evaluation
20. Reassess and evaluate the comfort of the
client after nursing care.
21. Look for other needs of client or family
pertaining to their living condition.
Documentation
22. Record/document all the nursing care and
treatment that have been done to the client
and family.

23. Write anecdotal report pertaining to the

health status of other members of the family
if there is any.
Remarks:

Grade:

Rating Scale:

Excellent : 96-100%
Very Satisfactory : 90-95%
Very Good : 85-89%
Good : 80-84%
Fair : 75-79%
Poor : 74 & below

Clinical Instructor Student’s Signature