Prepared By: Mary Eleanor N.

Usis, MSN, RN
NCM 21104 Community Health Nursing 1
Related Learning Experiences
Objectives of the FSPR:

• Facilitate the operationalization of the concept of family-

centered nursing care.
• Ensure a systematic approach in the delivery of nursing services
to families, specifically the application of the nursing process.
• Serve as a tool in planning and evaluating care at the family
level.
• Demonstrate and document the full range of services that
nurses provide at the family level.
Description of FSPR

The FSPR consists of four parts, organized according to

the steps in the nursing process.
• Assessment of the family, home, and environmental
conditions
• Health condition and Problem Sheet
• Nursing Care Plan
• Service and Progress Record
 The FSPR is kept in the family
folder/envelope together with the individual
clinical records of family members. It is the
exclusive responsibility of the community health
nurse to keep it updated. Other members of
the health team, however, may and should be
encouraged to utilize the data contained in it.
Instructions on Filling Out the FSPR

A. Identifying Information
1. Head of the Family – write the name of the recognized
head of the household, family name first, followed by
the first name. Example: Santos, Jose
2. Address – write the full address, to include house
number, street, municipality, district and/or city.
3. Family Number – this is obtained from the family
registry and is usually written in the family
folder/envelope.
Cont. Instructions on Filling Out the FSPR

B. Members of the Household

1. Family member number – each family number is assigned a
number starting with 1 for the head, 2 for the spouse, and
so on consecutively for the children and other members of the
household.
2. Name – write the names of all the members of the
household, surname first then the given name. in the case of
the wife, indicate her maiden name. in extended household,
group members by family. If several members with the same
surname are listed in order, the surname need not be written
for those following after the head.
Example:
Santos, Jose head
Maria Cruz wife
Pedro son
Anita daughter
Cont. Instructions on Filling Out the FSPR

3. Relation to head – indicate the relationship of members

to the head of the household, e.g., wife, son,
daughter or mother.
4. Sex – enter M for male and F for female
5. Birthdate – enter the month and year of birth
Cont. Instructions on Filling Out the FSPR
6. Marital Status – enter any one of the following
statuses:
a. Single (S) – who is not and has never been married
b. Married (M) – a person living with another as a couple,
married by legal rite/s.
c. Common-law (CL) – a person living with another as a
couple without the benefit of a legal marriage.
d. Widowed (W) – a person whose spouse is dead and who
has not remarried.
e. Separated/Divorced (Sep.) – a person legally separated
from his/her spouse or who is living apart from his/her
spouse because of marital discord or similar reasons; a
person whose bond of marriage has been dissolved and
therefore can remarry.
Cont. Instructions on Filling Out the FSPR
7. Highest Education Completed – this refers only to the highest
level completed in the regular and formal system of
education, i.e. elementary, high school and collegiate
education. Excluded are attendance in nursery and
kindergarten schools and in purely vocational courses such as
dressmaking or carpentry.
a. Enter only the last level of education completed and not the one
the person is in at the time of assessment. For the elementary
level, write G-1 to G-6 (Grade I- Grade IV); for high school, HS-1
to HS-4, and for college education, C-1 to C-4 or C-5, as the case
may be. For degree holders, write the degree, e.g., BSN or BSE.
b. Write NONE of the person is over seven years old and has not gone
to school. Leave the column blank for children below seven years
old.
Cont. Instructions on Filling Out the FSPR
8. Occupation
a. Type of work – indicate the nature of work the person
is engaged in. Example: farming.
b. Place – specify the location of work: city, municipality,
province or country (if outside the Philippines).
Example: Cavite
c. Remarks – write important events that happened to
any member which may in any way alter the family’s
composition, e.g., births, deaths, marriages, and
migration.
d. Date – enter the date when entry on the “Remarks”
column was written.
Cont. Instructions on Filling Out the FSPR
C. The Home and Environment
1. Home
a. Ownership – check the appropriate box
b. Construction materials used – check the appropriate box.
• Light-refers to such materials as bamboo, nipa, sawali, coconut
leaves or cardboard
• Mixed – refers to a combination of light materials, wood and/or
concrete
• Strong – refers to a predominantly concrete house.
c. Numbers of rooms used for sleeping – this refers to the
number of rooms in the house, not necessarily private
bedrooms that are used for sleeping areas. Write the
number.
d. Lighting facilities – check the appropriate box
Cont. Instructions on Filling Out the FSPR
d. General sanitary condition – write your impression of the general
state of cleanliness of the house. Include objective data to
support your impression. Example: House dirty and disorderly.
Unwashed dirty clothes, pots and pans scattered in lone multi-
purpose room.

2. Water Supply
a. Drinking water
• Source – check the appropriate box
• Potability – specify if safe fro drinking purposes.
• Distance from the house – write the distance of the water
source from the house in meters. Include if there is a faucet
connected to a public or private source inside the house.
• Storage – check the appropriate box.
Cont. Instructions on Filling Out the FSPR
3. Kitchen
a. Cooking facility – check the appropriate box
b. Sanitary Condition – describe briefly the state of
cleanliness of the kitchen area. Support your impression
with objective data. Example: generally clean. Pots and
pans washed and kept in cupboards. No flies or
cockroaches noted.
c. Drainage facility – check the appropriate box
• None – when there is no drainage system. Waste water
from kitchen flows directly to the ground, oftentimes
forming a nearly permanent pool.
• Open drainage – waste water flows through a system of
pipes (could be improvised from bamboo) to an open pit
or canal.
• Blind drainage – waste water flows through a system of
closed pipes to an underground pit or covered canal
Cont. Instructions on Filling Out the FSPR
4. Waste Disposal
a. Refuse and garbage
• Container – check the appropriate box
• Method of disposal – check the appropriate box. If more than one
method is used, check the two most commonly utilized methods:
Hog feeding – garbage is used as hog feed
Open Dumping – refuse and/or garbage piled in a dumping place (with
or without pit) with no soil covering
Burial pit – refuse/garbage is placed in a pit and covered when filled
up. There is no intention to dig it up later for use as a fertilizer.
Composting – involves burying or stacking of alternating layers of
organic-based refuse/garbage and “treated soil” arranged so as to
hasten rapid decay and decomposition into compost. This organic
mixture can later be used as fertilizer.
Garbage collection – refuse/garbage collected by garbage truck or any
type of garbage collection in the community.
Cont. Instructions on Filling Out the FSPR

5. Toilet
a. Type – check appropriate box
• Pail system – a pail or box is used to receive the excreta and
disposed later when filled. This includes the “balot” system
wherein excreta is wrapped in a piece of paper or plastic and
thrown later.
• Open pit privy – consists of a pit covered by a platform with a
hole. The hole is usually not covered. The platform may, in its
simplest form, consists only of two pieces of wood or bamboo.
• Closed pit privy – a pit privy in which the hole over the platform
or toilet floor is provided with a cover.
• Bored-hole latrine – consists of a deep (usually more than 10
feet) but relatively narrow (less than two feet in diameter-hole
made with a boring equipment.
Cont. Instructions on Filling Out the FSPR
• Overhung latrine – the toilet house is constructed over a body of
water (stream, lake, or river) into which excreta is allowed to
fall freely.
• Antipolo type – the toilet house is elevated and the shallow pit
is extended upwards to the platform (toilet floor) by means of a
chute or pipe made of clay, metal, aluminium or board.
• Water-sealed latrine – an Antipolo type of toilet, bored-hole
latrine or any pit privy wherein water-sealed toilet bowl is placed
instead of the simple platform hole.
• Flush-type – a toilet system where waste is disposed by flushing
through pipes (sewers) into a public sewerage system or into an
individual disposal system like an individual septic tank.
b. Distance from the house – write distance of toilet from the house
in meters. If toilet is inside the house, write “inside the house”.
c. Sanitary condition – describe briefly the state of cleanliness of the
toilet. Substantiate impression with objective data. Example: very
dirty, flies all over; stinks.
Cont. Instructions on Filling Out the FSPR

6. Domestic Animal
a. Kind – write the kind of animal kept in the house. Example:
Dog
b. Number – indicate the number of each kind of animal kept
in the house.
c. Where kept – indicate where the domestic animal is kept.
Example: tied in backyard.
Cont. Instructions on Filling Out the FSPR
7. The Community in General
a. General sanitary condition – Briefly describe the state of
sanitation of immediate vicinity where house is located. Mention
specific data to substantiate general impression. Example: street
cluttered with litter.
b. Housing congestion – check appropriate box
c. Presence of Breeding Sites of Vectors of Diseases – check
appropriate box. Specify the type of breeding site and vector/s
of disease. Example: Slow flowing mountain stream; Anopheles
mosquitoes.
d. Recreational Facilities – write recreational facilities available in the
community
e. Availability of Healthcare Facilities – Health facilities include
government health centers and hospitals, private clinics and
hospitals, private medical and dental practitioners, practicing
nurse and midwives.
f. Distance of house from the nearest healthcare facility – indicate
the approximate distance of the house from the nearest health
care facility.
Cont. Instructions on Filling Out the FSPR
HEALTH CONDITION AND PROBLEM SHEET

1. Health Conditions, Wellness States/s, Problems – These

refers to health deficits (diagnosed or not), health
threats or foreseeable crises identified during the
assessment process. Examples: threat of cross-infection
from a communicable disease; malnutrition, pregnancy.
2. Nursing Problems – relate to the family’s inability to
assume one or more health tasks with respect to a
particular health condition or problem. For each health
condition or problem, write the nursing problems
specifying the major and contributory causes. Example:
Health problem – Malnutrition; Nursing Problem –
inability to recognize the presence of Malnutrition in a
preschool member due to lack of knowledge about the
health condition.
Cont. Instructions on Filling Out the FSPR
HEALTH CONDITION AND PROBLEM SHEET

3. Supporting Data/Cues – These are the data gathered during

the assessment process that provides evidence that the
health and nursing problems identified really exist. Write
your entries briefly and concisely in telegraphic form. Include
only data that prove the existence of the problems
identified.
4. Date
a. Identified – write the complete data (day, month, year)
when the health and nursing problems were identified
b. Resolved – write the complete date when the health and
nursing were resolved.
Cont. Instructions on Filling Out the FSPR
NURSING CARE PLAN

1. Health Conditions or Problems and Family Nursing Problems – this

column is for health conditions/problems and family nursing problems
the nurse decides to tackle.
2. Objective/s of Nursing Care – For each health condition/problem,
write the objectives of nursing care in terms of family outcomes.
Example: the family will decide to have the primigravida member
deliver in the hospital.
3. Plan of Intervention – write all the nursing measures and activities
designed to meet the objectives. Make entries brief and concise.
4. Evaluation Plan – Specify:
a. Outcome criteria or Indicators: Specify objective measurements of
performance, behaviour, circumstances or clinical status indicating
progress to or achievement of client outcomes.
b. Methods and Tools: Indicate how evaluation data will be gathered.
Cont. Instructions on Filling Out the FSPR
SERVICE and PROGRESS NOTES
1. Date – for each nurse-family contact or service, write the
complete date when entries were written about the health
condition/problem.
2. Health condition/nursing problem – refers to the health
condition and nursing problem for which nursing interventions
have been or are being done.
3. Nursing Observations, Actions Taken, Responses, and
Evaluation of Progress/Outcomes – this is the column for
the “nurses notes”. Write briefly and concisely and in
telegraphic form. Specify the outcomes of each nurse-family
contact, e.g. reactions or responses to interventions, changes
in decisions or health status and problem areas identified.
These data provide the bases for re-planning and/or
termination of services. Select the appropriate type of
charting using Mnemonics.
4. Signature – put your signature on top of your printed name
for every entry on this “Service and Progress Notes”.
 Charting Nursing Care, Progress
Notes and Client
Responses/Outcomes
PURPOSES
1. Communicate care to other team members who need
information on what the nurse has done and how the
client is doing.
2. Help identify patterns or responses and changes in
status.
3. Provide data for evaluation, research and improvement
of quality of care.
4. Document data to supply validation for insurance or
legal purposes.
 Types of Charting using
Mnemonics
1. AIR –A (Assessment, Intervention, Response, Action). Chart the
assessment data observed/ gathered. The interventions done. The
client’s response/s to the interventions and any action/s taken based
on the response/s.
2. DAR (Data, Action, Response). Chart the data observed/gathered.
The actions performed and the response/s of the client.
3. DIE (Data, Intervention, Evaluation). Chart the data
observed/gathered. The interventions done and evaluation of the
client’s response/s.
4. PIE (Problem, Interventions, Evaluation). Chart the status of the
problem/s, the interventions performed and the evaluation of the
client’s response/s to the interventions.
5. SOAP, SOAPIE. Chart subjective data, objective data, analysis of
assessment data to reflect nursing problem statement/s, intervention
plan, implementation results and evaluation findings.