y

y y

Community Health Nursing Process The nursing process is central to all nursing actions; it is the very essence of nursing, applicable in any setting, in any frame of reference, and within any philosophy. The nursing process is a systematic, scientific, dynamic, on-going interpersonal process in which the nurses and the clients are viewed as a system with each affecting the other and both being affected by the factors within the behavior. The process is a series of actions that lead toward a particular result. Community Health Nursing Process Assessment provides an estimate if the degree to which a family, group or community is achieving the level of health possible for them, identifies specific deficiencies or guidance needed and estimates the possible effects of the nursing interventions. Community Health Nursing Process Collection of Data

y
y

y
y

Relevant data are collected on the health status of the family, groups, and community: demographic data, vital health statistics, and community dynamics. Categories of Health Problems

Health deficits, health threats and foreseeable crisis or stress points are categories of health problems Community Health Nursing Process Categories of Health Problems (cont.)

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A health deficit occurs when there is a gap between actual and achievable health status Health threats are conditions that promote disease or injury and prevent people from realizing their health potential Foreseeable crisis includes stressful occurrences such as death or illness of a family member

y Planning Nursing Actions/Care

y
The plan for nursing action or care is based on the potential problems that were identified and prioritized.

y Planning Nursing Actions/Care

Goal Setting

y y

Specific objectives of care These objectives are stated in behavioral terms: specific, measurable, attainable, realistic and time bounded.

y Planning Nursing Actions/Care

Constructing a Plan of Action

The planning phase of community health nursing process is concerned with choosing form among the possible courses of action, selecting the appropriate types of nursing intervention, identifying appropriate available resources for care and developing an operational plan. The courses of action may have positive and/or negative effects.

y Planning Nursing Actions/Care

Constructing a Plan of Action (cont.)

The most appropriate action is selected such as those that the clients could not perform themselves, those that facilitate actions that remove barrier to care and those that improve the capacity of the clients to act in their behalf. The appropriate resources are identified which include the family, the neighborhood, the schools, the industrial population; the whole medical system

y Planning Nursing Actions/Care

Developing an Operational Plan

Plans of care are prioritized in order or urgency to determine those that in need the earliest action or attention such as those that actually threaten the health of the client (individual, family or community). Development of evaluation parameters is done the in the planning stage and based on the standards set by the nursing services, problems identified, goals and priorities as reflected in the plan or program of nursing care for the clients.

y Implementation of Planned Care

y y
Implementation involves various nursing interventions which have been determined by the goals/objectives which have been previously set. Carry out nursing procedures which are consistent with the nursing care plan, are adopted to present situations which promote a sage and therapeutic environment.

y Implementation of Planned Care

y
Involve the patient and his/her family in the care provided in order to motivate them to assume responsibility for his/her care.

To maintain his/her optimum level of functioning, the client needs the support of his own knowledge and that of those around him/her.

y Implementation of Planned Care

y
The public health nurses monitor the health services provided, make proper referrals as necessary and supervise midwives and barangay health workers.

y Implementation of Planned Care

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y y
Documentation is an important function of the public health nurses. This provides data which is needed to plan the clients care and ensure its continuity Serves as an important communication tool for various team members

y Implementation of Planned Care

y
y y y
Documentation is an important function of the public health nurses. Furnishes written evidence of the quality of care Legal records to protect the agency and the health care providers or the client Provide data for research and education

y
y

Evaluation of Care and Services Provided Evaluation is woven in every nursing activity and every step of the public health nurses. Three classic frameworks from which nursing care is delivered.

Structural elements include the physical settings, instrumentalities and conditions through which nursing care is given

y
y

Evaluation of Care and Services Provided Process elements. The steps of the nursing process itself-assessing planning, implementing and evaluating:

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Taking the family health data base Performing physical examination Making a nursing diagnosis

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y

Evaluation of Care and Services Provided Process elements. The steps of the nursing process itself-assessing planning, implementing and evaluating (cont.):

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Determining nursing goals Writing a nursing care plan Performing the necessary nursing interventions

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y

Evaluation of Care and Services Provided Outcome elements changes in the clients health status that result from nursing intervention

Process can be examined by focusing on the actions and decisions of the public health nurse in providing care

Outcome elements refer to the results of care provided and the clients served, changes in the knowledge, skills and attitudes and satisfaction of those served/including members of the nursing and health team

y
y y

Evaluation of Care and Services Provided Quality assurance efforts now recommend that evaluation of structure, process and outcomes criteria be made, evaluate the effectiveness of nursing care dont or changes in behavior, condition, or compliance. Evaluation based on professional practice

y
y

Evaluation of Care and Services Provided Evaluation of structure include cost-benefit ratio, qualifications and number of members of the health team especially nurses in proportion to the populations served and the material resources in terms of quantity and quality. Evaluation based on information gathered is utilized to improve community health nursing services as a part of the total community health services