NURSING PROCESS IN THE CARE OF THE
COMMUNITY o to intervene in the reduction of risks entails
PLANNING
 a logical process of decision making to
determine which of the identified health
concerns require immediate consideration
and what actions may be undertaken to
achieve goals and objectives
Planning is a logical process of decision-making
involving:
a) priority-setting
b) formulating goals and objectives
c) deciding on community interventions
PRIORITY SETTING
Significance of the problem
 based on the number of people in the
community affected by the problem or
condition
o If problem is about disease condition,
estimate in terms of its prevalence
rate
o If the concern is a potential problem,
its significance is determined by
estimating the number of people at
risk of developing the condition
Ability to reduce risk
 is related to the availability of expertise
among the health team and the community
itself
 involves the health’s team level of influence in
decision making related to actions in
resolving the community health concern
In determining the cost of reducing risk,
o the nurse has to consider economic, social
and ethical requisites and consequences of
planned action.
Ability to identify the target population for the
intervention
o a matter of availability of data sources, such
as FHSIS, census, survey, reports, case finding
or screening tools
Availability of resources
technological, financial, and other material
resources of the community, the nurse and
the health agency
NOMINAL GROUP TECHNIQUE
o meaning each group has an equal voice in
decision making
o group makes a list of the identified problem
or conditions
o each of the identified problems is treated
separately according to a set of criteria
agreed upon by the group such as those
recommended by the WHO
Nominal group technique suggestion given by Shuster
and Goeppinger:
A. From a scale of 1-10, 1 being the lowest, the
member give each criterion a weight based on
their perception of its degree of importance in
solving the problem.
Question: How important is significance of the
problem to its solution?
B. From a scale of 1-10, 1 being the lowest, the
member gives each criterion in terms of the
likelihood of the group being able to influence or
change the situation
Question: Can the group influence the significance
of the problem?
C. Collate the weight (from step 1) and ratings
(from step 2) made by the members of the group
D. Compute the total priority score of the problem
by multiplying collated weight and rating of each
criterion
E. The priority score of the problem is calculated
by adding the products obtained in step 4
F. Repeat the process on all identified problems,
then compare the total priority scores of the
problem.
 FORMULATING GOALS AND OBJECTIVES
DECIDING ON INTERVENTIONS
GOAL
o desired outcome at the end of interventions
OBJECTIVE
o short-term changes in the community that are
observed
o serve as instructions
o must be smart
o objectives serves as instructions, what to be
detected in the community as we are to
provide interventions
PLANNING MODELS IN COMMUNITY HEALTH
INTERVENTIONS
The Precede-Proceed Model
o provides structure for assessing health and
quality-of-life needs
o assists in designing, implementing and
evaluating health promotion and public
health programs to meet those needs
precede
 predisposing, reinforcing, and enabling
constructs educational diagnosis and
evaluation
 assess the diagnostic and planning process to
assist the development of focused public
health programs
proceed
 Policy, Regulatory and Organizational
Constructs in Educational and Environmental
Development)
 Guides the implementation o and evaluation
of the programs
PRECEDE-POCEED FRAMEWORK
 an approach to planning that examines factors
contributing to behavioral change:
a. predisposing factors: knowledge, attitudes
and behavior, beliefs and values before
intervention that affect willingness to
change
b. enabling factors: the environment of the
community of an individual that facilitates
or presents obstacles to change
c. reinforcing factors: the positive or negative
effects of adapting new behavior
PATCH: Planning Approach To Community Health
Model
o encourages the idea that health promotion is a
process that enables the population to have
more control over its own health
Elements of PATCH
o community participation is essential
o use of data to develop comprehensive health
strategies through;
a. mobilizing the community
b. collecting health data,
c. selecting health priorities
d. developing a comprehensive
intervention plan
o evaluating the process
APEX-PH PROGRAM: The Assessment Protocol for
Excellence In Public Health
o voluntary process for organizational and
community self-assessment, planned
improvements and continuing evaluation and
reassessment
MAPP MODEL: Mobilizing for Action through
Planning And Partnership
o health planning model that helps public health
leaders facilitate community priorities about
health issues and identify sources to address
them
Phases:
o mobilize the community
o guide the community toward a share vision for
long-range planning
o conduct four assessments:
1. identifying community strengths
2. local health systems
3. health status
4. forces of change within the population
 PLANNING STRATEGIES FOR COMMUNITY
HEALTH INTERVENTIONS

Planning Strategy
o defined as a disciplined process aimed at
producing fundamental decisions and actions
that will shape and guide what an
organization is, what it does, and why it does
Goal
o enhance community access to healthcare in
order to improve productivity and to
improve education performance across all
stages of the life cycle

5 Steps Strategy to Planning

1. Determine where you are

o conduct internal and external audits to get a
clear view of the community and your
competencies-the real not the perceived
2. Identify what is important
o focus on where you want to take your
community overtime.
o clearly define your mission and vision
3. Define what you must achieve
o define the expected objectives that clearly
state what you community must achieve to
address the priority issues
4. Determine who is accountable
o this is how you are going to get to where you
want to go
o the strategies, action plans and budgets are
all steps in the process
o end of planning
5. Review
o ensure the plan performs as designed, you
must hold regularly scheduled formal reviews
of the process and refine as necessary, at least
quarterly.

Remember: process is intended to enhance the

community’s capability in dealing with common
health conditions/problems

Implementation entails:

o Facilitating the process

o Coordinating the plan with the community
o Collaboration with other sectors and agencies