Community Healthy Nursing

Hospital Nurse - Community

Health Nursing
Community health Nurse
How do we Asses the health of a
family?
 TYPOLOGY OF NURSING PROBLEMS IN
FAMILY NURSING PRACTICE ( MAGLAYA
2009) /FAMILY NURSING PROCESS
(Gesmundo 2010)

A. FIRST LEVEL OF - nsg. judgement ( client

ASSESSMENT transition from specific
> determining existing level of wellness to a
potential health higher one).
condition.
> problems of family eg. Potential for enhanced
CATEGORIES: capability to a higher one.
1. Wellness condition
(potential readiness) (NANDA 2001)
 EXAMPLE
A. Potential for Enhanced
Capability for:
1. healthy lifestyle
(diet/exercise)
2.health
maintenance/manageme
nt
3. Parenting
4. Breast Feeding
5.Spiritual well-being
6. others
health threats
 Categories : first level of
Assessment
2. Health threats- d..Accident/fire hazards
conditions condusive (brocken stairs,sharp
to disease,accident,or objects.fire,fall)
failure to realize one's e.Faulty/unhealthful
health potential. nutrition/eating habits,feeding
or failure to maintain techniques- food
wellness (Maglaya) quality/quantity,eating
habits.ineffective breast
a. risk factors-diseases
feeding.
b.threat of cross- f. stress provoking factors-
infection strained marital
(communicable ds.) relationship,interpersonal
c.family tie-limited conflict(family
resources memebers),care-giving burden
 Presence of health threat
g. Poor home > imprope drainage
/environmental system
condition/sanitation.
> poor
>inadequate living space
lighting/ventilation
>lack of food storage
> noise pollution
> polluted water supply
> presence of breeding > air pollution
vector sites of ds. >unsanitary food
(flies,mosquitos,roaches) handling/preparation
> unsanitary waste disposal
 Presence of health threat
i.unhealthy > self medication/substance
lifestyle,personal abuse
habit/practices: >sexual promiscuity
> alcohol drinking >engaging in dangerous
sports
> cigarette smoking >inadequate rest or sleep
> walking barefooted > lack of exercise
> eating raw meat or >lack of relaxation
fish >non-use of self -protection
>poor personal hygiene measures.
 Presence of health threat
j. inherent personal > self-oriented behavior
characteritics (poor of members.
impulse control)
k. health history (history > unresolved conflict of
of difficulty labor) members
l. inappropriate role > intolerable
assumption- child disagreement.
assuming mothers
role/father not
assuming his role.
m. lack of immunization
n. family disunity
Health Deficits
 Presences of health deficits
. Health deficits-instances
of failure in health
maintenance .
1. illness
2.failure to thrive/develop
according to normal rate.
3.Disability-
congenital/illness
(transient,temporary-
paralysis after
cva,permanent.amputatio
n,blindness)
Stress Points
 Presence of stress Points
4. Stress points .eq. fifth pregnancy for
/foreseable crisis
situation-anticipated
periods of unusual
demand on the individual
or family in terms of
adjustment of family
resources.
unemployed
couple.,marriage,parent
hood,additional
member,abortion,entranc
e to
school,adolescence,divor
ce,separation,menopause
,chronic illness,loss of
job,hospitalization of a
member, death of a
member,resettlement in a
new
community,illegitimacy
how do we gather data?
 Data Collection
(first level of assessment)
Gathering types of Data: Data Gathering
a.Family structure and Methods:
characteristic
b. socio-economic and 1. observation
cultural factors 2. physical examination
c. environmental factors
3. interview
d. health assessment of
each memeber 4. review of records
e. value placed on health 5. laboratory/diagnostic
promotion,health disease.
maintenance,and
prevention of diseases
 Second Level of Assessment
> type of nursing Family Health task (
problems the family Typology of Nursing
experiences in their Problems in Family
Nsg. Practice )
performance of their
Framework
health task with (Ruth freeman)
respect to a certain 1. Ability to recognize the
health condition. existence of a health problem,
2. Ability to make decision and
relevant health actions.
3. Ability to provide Nsg .care to
the sick,disabled,depended,at
risk family member.
 Second Level of Assessment
Family Health task FIVE TYPES OF
4.Ability to provide home FAMILY NSG.
environment conducive to PROBLEMS
health maintenance and
(MAGLAYA)
personal development.
1.Inability to recognize
5. ability to utilize continually
health condition.
resources or health care.
a. lack of inadequate
knowledge
b.Denial about its
existence
 Second Level of Asessment
b 1.social stigma due to:
1.Failure to comprehend
2. economic
2. low salience of the
3.physical problem
consequences 3.Feeling of co9nfusion
4. emotional concerns 4.Lack of knowledge to
alternative courses of
C. Attitude action.
2. Inability to make 5.Inability to decide which
decision and health action to take
6.conflicting opinions
action.
 Second level of Assessment
7. lack of knowlwdge of 9. Negative attitude
community resources for towards health
care. condition
8.Fear of consequences of 10.Inaccessibility of
action appropriate resources
for care
a. social consequence a. physical
b. economic consequences b.cost constrainst
c. physical consequences 11. Lact of trust in
d. emotional consequences health personel
12.Misconception
 Second level Assessment
3.Inability to provide
. facilities,equipment,suplies for
nsg. care to the
disabled,dependede
nt member of the
family.
a. lack of knowledge about the
disease,
severity,complication,mgnt)
b.lack of knowledge about child
development.
c. lack of knowledge of the nature
and extend of nursing care
needed.
d. lack of necessary
care.
e. lact of inandequate knowledge
and skills in carrying out
necessary intervention.
f. inadequate family resources for
care.
1. absence of responsible
member
2. financial constraints
3. limitations
g. significant person unexpressed
feelings
h.philisophy in life. which hinders
care.
 Second level of Assessment
i. members preoccupation
with own concerns
j.Prolonged disease with
exshauts support
capacity of family
member.
k.Altered role performance
1. role denial
2.role strain
3. role dissastisfaction
4.role conflict
5.role confusion
6.role overload
 Second level of Assessment
4. Inability to provide
. b. Failure to see benefits of
home environment investment in home
conducive to health environment
improvement.
maintenance and
personal c. Lack of knowledge of
importance of hygiene
develpment. and sanitation.
a. Inadequate family d.Lack of knowledge of
resources preventive measure
1. financial constrainst e.Lack of skills in carrying
2. limited physical out
resources measures to improve
home environment.
 Second level of Assessment
f. ineffective
communication
g.Lack of supportive
relationship among
family members.
h.Negative attitude
i.lack of adequate
competencies in
relating to each other
 Second Level of Assessment
5. Failure to utilize
community
resources for health
care.
Gracias
 HOME VISIT AND NURSING BAG
Home vistit- face to face
contact between nurse
and client/family.
Purpose:
1. gather information.
2.confirm data
3.Prioritize health needs.
4.involve client & family in
assessment to the
implementatin phase.
3 phases of home
visit:
1. Preparatory phase-
review exisitng records
(inform,introduce,explain)
2.Home visit phase-
conduct
assessment,planning
health teaching,nsg
intervention.
3.Post visit Phase-
record data,plan next
visit,referral
Nursing Bag Technique
• Lilian Wald
originated first
Nursing Bag 1920's
• (1867-1940 )
All through the years
 Nursing Bag Technique
A Technique
A first line of
defense
against infection.
 Definition
(Estrada-Castro 2012)

• Bag technique -- a • Public health bag - is

tool making use of an essential and
public health bag indispensable
through which the equipment of the
nurse, during his/her public health nurse
home visit, can which he/she has to
perform nursing carry along when
procedures with he/she goes out
ease and deftness, home visiting. It
saving time and contains basic
effort with the end in medications and
view of rendering articles which are
effective nursing necessary for giving
care. care.
 Public Health Bag
(Castro 2012)
Seccosana,Gu
cci,Guess
bags
 Nursing Bag Technique
Rationale

To render effective
nursing care to
clients and /or
members of the
family during
home visit.
 Principles
Estrada-Castro 2012)
3. Bag technique should
1.The use of the bag not overshadow
technique should concern for the patient
minimize if not totally rather should show the
prevent the spread of effectiveness of total
infection from care given to individual
individuals to families, & family.
hence, to the 4.It should contain all
community. necesary articles &
2. Bag technique should equipment.
save time and effort 5.The bag & contents shld
on the part of the be cleaned as often as
nurse in the possible.
performance of
nursing procedures.
 Principles
(Estrada-Castro 2012)

6. It should be protected from

contact with any article in the
home of the patient.

7.The arrangement of the bag

should be convinient?

8. hand washing shld be done

frequently.

9.When used in communicable

case.it shld .be thoroughly
cleaned,disinfected before
keeping and re- using.
 Nursing Bag Contents
(Estrada-Castro 2012)
1. Thermometer 11. Weighing scale
2. Syringes
12. stetoscope
3. Alcohol
4. sputum cup 13. aqdhesive plaster
5. medicine dropper 14. soap in a soap dish
6. ephiran solution and sphymomanometer ( not
benedic soluttion
7. Tape measure
inside bag)
8.Hypodermic needles 15. umbrella
9. Paper lining
10. Apron & hand towel
 Assignment
Re: Group Work
Topic: Public Health Nursing Bag demonstration
Subject: CHN- 104 j (Section A, B, C.G)
Date: August 2019
Instructions:
1. Group into 5 - 7 individualsin a group.
2. Appoint a Team leader and a person to document
3. Prepare materials (PHN bag contents and a bag) prior
to thedate of activity. ( one group =one bag)
4. Simulate/role play a home visit done by a Public health
Nurse by following the given scenario using the PHN bag
technique.
5. Rubric of the role play will mostly be taken from the
Principles of Bag Technique.( role play: entering the
house, use of bag technique in assessment,and leavin.g
 Group work
scenario:
1. A Public health Nurse is doing a home
visit .
> House #1 Mother complaints fever of a
two year old daughter.
> House # 2- Grandmother complaints:
headache and dizziness for one day.
> House # 3 - Malnourish 10 month old
baby.
 Group work
• 4. House # 4 - PHN visits a suspected
PTB patient.
• 5. House # 5 - PHN visits a diabetic 45 yrs
old mother.