Community Health Nursing Process Community health purposes and goals are realized through the application of a series of steps that lead to described results.
Nursing Process Is a systematic, scientific, dynamic, on going interpersonal process in which the nurses and the clients are viewed as a system with wi th each affecting the other and both being affected by the factors within the behavior. The process is a series of actions ac tions that lead toward a particular result. This process of decision making results in the optimal health care for the clients to whom the nurse applies the process.
1. Assessment Provides an estimate of the degree to which whi ch a family, group, community is achieving the level of health possible for them. Identifies specific deficiencies or guidance needed. Estimates the possible effects of the nursing interventions. Involves the following steps which are taken with the active participation of the clients especially in decisions made: a. Colle Collect ction ion of dat data a Demographic data Vital health statistics Utilization of health services Health status Family dynamics Environment Patterns of coping Community dynamics Education, socio-cultural, religious, occupational background b. Methods of collecting data Community surveys Interview of individuals, families and groups Observation of health related behaviors and environment
Review of statistics: epidemiological and relevant studies Individual and family health records Screening tests and P.E. of individuals c. Catego Categorie ries s of healt health h proble problems ms 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 crises – anticipated periods of unusual demand on the individual or family in terms of adjustment/ family resources. Note: Health need – exists when there is a health problem that can be alleviated with medical or social technology. Health problem – is a situation in which there is a demonstrated health need combined with actual or potential resources to apply remedial measures and a commitment to act on the part of the provider or the client.
2. Planning Nursing Action Is based on the actual and potential problems that were identified and prioritized. Includes the following steps: a. Goal Goal se sett ttin ing g Goal – is a declaration of purpose or intent that gives essential direction to action. Specific objectives – are made with the individual family in terms of: a. Activit Activities ies of daily daily living living b. Adaptive Adaptive functionin functioning g based based on remaining remaining capabilities resulting from their condition or environment c. Stated Stated in in behavio behavioral ral term terms: s: SMART SMART b. Constr Construct uction ion of a plan plan of actio action n Choosing from among the possible courses of action Selecting the appropriate types of nursing intervention Identifying appropriate and available resources for care
Developing an operational plan c. Develo Developin ping g an opera operatio tional nal plan plan PHN must establish priorities phase and coordinate activities Plans of care are prioritized according to urgency down to manageable units and properly sequenced Periodic evaluation must be done in order to determine whether re-planning or modification of the plan is necessary The plan and activities should be coordinated to with the various services to synchronize with the total health program of the community. Development of evaluation parameters based on the standard of nursing services, problems identified, goals and priorities in the plan or program of nursing care for the client.
3. Implementation of Planned Care Involves various nursing interventions which have been determined by the goals/ objectives previously set. Involves the patient and his family in the care provided in order to motivate them to assume responsibility for his/her care and to be able abl e to reach and maintain desired level of functioning at a specified time. Demonstration, repetition, explanation, answering questions to clarify doubts, maximizing the client’s confidence and ability to self-care. Utilization of client support system provides a harmonious, orderly care to enable the client to function optimally. Community health nurses monitor health services provided, making proper referrals as necessary Documentation: Provides data which is needed in planning patient’s care and ensure continuity. Important communication tool for the heath team Furnishes a written evidence of the quality quali ty of care that clients received and then response Provides a legal record to protect the agency ag ency and health care provider or the client Provides data for research and education
4. Evaluation of Care and Services Rendered
Is interwoven in every nursing activity and every step of the public health nurses. a. Stru St ruct ctur ural al:: phys physic ical al s set etti ting ngs, s, iins nstr trum umen enta tali liti ties es and and conditions through which nursing care is given such as philosophy, objectives, building, organizational structure, financial resources. (budget, equipment, staff) Process: nursing process: family health data base, b. performing physical assessment, making nursing diagnosis, determining goals, writing a nursing care plan, performing necessary interventions and coordination of services and measuring success of nursing actions. c. Outco utcome me:: chan change ges s in the the c cli lie ent’ nt’s heal health th sta statu tus s that result from nursing intervention. These changes include modification of: signs and symptoms, knowledge, attitudes. Satisfaction, skill level and compliance with treatment regimen.
Source: Cuev Cuevas, as, Fran France ces s Prec Precil illa la L., L., et.a et.al. l. (2007 (2007)) Pu Publi blic c Heal Health th th Nurs Nursin ing g in the the Ph Phili ilipp ppin ines es (10 (10 ed). Philippines: Philippines: Publications Publications Committee, National League of Philippine Government Nurses.
