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 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.  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 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. Collection of data  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. Categories of health problems  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 setting  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. Activities of daily living b. Adaptive functioning based on remaining capabilities resulting from their condition or environment c. Stated in behavioral terms: SMART b. Construction of a plan of action  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. Developing an operational 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 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 of care that clients received and then response  Provides a legal record to protect the agency 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. Structural: physical settings, instrumentalities and conditions through which nursing care is given such as philosophy, objectives, building, organizational structure, financial resources. (budget, equipment, staff) b. Process: nursing process: family health data base, 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. Outcome: changes in the client’s health status that result from nursing intervention. These changes include modification of: signs and symptoms, knowledge, attitudes. Satisfaction, skill level and compliance with treatment regimen. Source: Cuevas, Frances Precilla L., et.al. (2007) Public Health Nursing in the Philippines (10th ed). Philippines: Publications Committee, National League of Philippine Government Nurses.

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