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ACTION PLAN

GOAL: Decrease incidence of Diabetes Mellitus by 20%


Specific Objectives Strategies/Activities Time Frame Locus of
Responsibility
Resources Evaluation
1. Increase
awareness on
DM.

2. Increase
management of
diet and
lifestyle
towards
healthy living.

3. Increase
training and
education to
health workers


4. Increase
monitoring and
surveillance of
Diabetes
Mellitus.
1. Conduct health
education/lecture to
families regarding the ff:
1.1 Signs/symptoms of
disease.
1.2 Risk factors of the
disease
1.3 Management of disease
1.4 When to return back for
follow-up

2. Conduct house visits for
assessment of DM.

2.1 Discuss the importance
of diet and lifestyle.

2.2 Plan with the family
about the diet and
cleaning of wounds.

3. Train volunteered health
workers of the needed skill
in assessing DM.

3.1 CBG Monitoring
30
minutes/session










1 hour










1 hours for 2
sessions

CEU/BHW










CEU/BHW











CEU/BHW


Powerpoint
presentation









Printed pictures
Food plate model














Increased awareness
about DM


Increased
management of diet
and lifestyle by
families.

Increased
knowledge of health
workers



Increased reportable
DM cases.








3.2 V/S monitoring
3.3 Physical Assessment

4. Assign volunteered health
workers in the barangay for
proper monitoring of
disease incidence.














BHW/CEU







Monitoring forms




Delegated task for
monitoring of
disease incidence.













FAMILY NURSING CARE PLAN
Family:Alcantara
Risk Member: Maria AdoniAlcanatara, 17 y.o delivered a premature infant
HEALTH
PROBLEMS
FAMILY NURSING
PROBLEMS
GOAL OF CARE OBJECTIVES OF
CARE
INTERVENTION PLAN
Health Threat

1. Opened
suture






2. Parenting


1. Failure to utilize
community
resources for health
care due to busy
schedule.
2. Inability to provide
adequate nursing
care to the risk
member of the
family due to:
2.1 Members pre-
occupation with
ones own
concerns and
interest.
2.2 Lack of
knowledge about
the health
condition on
complications,
prognosis and
management

After nursing
intervention, the
opened suture will be
manage appropriately
and will heal in 1
week time.

After nursing
interventions, the
family will decide of
appropriate actions to
prevent or manage a
postpartum risk
member from infection
due to open suture
NURSING INTERVENTIONS

1. Discuss with the family the
importance of :

1.1.Postpartum check-up to
mother and infant, its
benefits in the prevention
of further complications.

1.1 Management of time

2. Discuss with the family the
stages of family development
and its parenting roles.

3. Demonstrate to the family the
proper cleaning of
wounds/suture.

4. Encourage the family to seek
consultation to health facility
by citing services and
programs available at the
health center
METHOD

Home Visit
RESOURCES

Time: 1hr/ 2 sessions

Visual Aid

Family Service and
Progress Record

Assessment
tool/equipments