VIRGEN MILAGROSA COLLEGE OF

UNIVERSITY FOUNDATION NURSING

 
Name: MENDOZA, SHEINA L. Year Level & Section: Level 3 - A
Instructor: Ma’am Shirley Catabay Subject Code: NCM 113

Nursing Process in the Care of Population Groups and Community

Introduction
The community is not simply a context of the existence of the families, groups, subpopulations, or populations nor just a
setting for our nursing interventions, it is seen as the primary client of the nurse for two important reasons. First, has a direct influence
on the health of the individuals, families, and sub-populations. Second it is at this level that most health service provision occurs.
(Spradley, 1990).
Community health nurses need to know the defining characteristics of a community to set the stage in understanding the different
aspects that directly or indirectly influence the health status of the community. Also deals with these community characteristics in
planning and developing specific programs and in ensuring the delivery of effective health services. (Maglaya, 2004)
THE COMMUNITY HEALTH NURSING PROCESS
The community health nursing process, like nursing process in general, is composed of Assessment, Diagnosis, planning,
implementation, and Evaluation (ADPIE). However, for purposes of tradition, community assessment is already integrated into process
of community diagnosis.
A. COMMUNITY HEALTH ASSESSMENT TOOLS
 a companion piece to communities in action
 a guide to effective service projects
 provides detailed descriptions planning tips and samples for several types of assessment
 can be found in assess needs and resources under prepared to assess and identify community assets and resources

1. COLLECTING PRIMARY DATA.

Primary Data
 are collected first-hand through surveys, listening sessions, interviews, and observations
 community itself is the primary source of data
 data that have not been gathered before
 expensive and time consuming compared to secondary data collection
Collected by the nurse through:
 Observation.
 To avoid raising expectations among the community members, it may be necessary to use the observation method. ▪ Using
this method, you go into the community and observe what is going on, listen to what they are talking about or discussing or
even the noises they make.
 By observing and listening, you are learning about their needs and problems, including about their health and health related
events.
 This method will also enable you to learn about available resources and activities the community is engaged in.
 The observation method can be structured where what is to be observed is known in advance and the observation procedure
is set in advance, or unstructured where what is to be observed is not known in advance and the procedure for observation is
not laid down.
 Survey
 Surveys are a useful method of obtaining information about knowledge, attitudes, attributes, or practices of the general
population.

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 It is based on the notion that people know the characteristics and situations of their communities but often lack a way of
expressing their views to local leaders or public officials.
 Surveys can be used to find out how people feel about alternative programs, what services the community needs, and how
well current services are meeting public expectations.
 Surveys are predetermined sets of questions and usually answer options which are asked of all individuals in a group or
sample of people.
 Informant Interview.
 Informant interviews are conducted with selected individuals in a community who are involved with or have knowledge of
situations.
 A way to get "insider information" about an issue, situation, or problem.
 These interviews can be used to define the nature and extent of an issue, to explain important issues related to a particular
situation, to identify community groups or organizations interested or involved in an issue, to get an insider's view of the
situation, or to describe possible goals or approaches from the perspective of those who are involved with or affected by the
issue.
 Community Forum.
 A community forum is, quite simply, a public meeting held to discuss a certain topic, issue, or opportunity.
 There is a set of short presentations at the beginning of the forum describing the situation or topic to be discussed or outlining
several options, viewpoints or approaches to be considered.
 A community forum is an excellent way to assess the viewpoints or opinions of citizens about the topic under discussion.
 Focus group discussion
 Made up of a much smaller group usually only 6 to 12 members
 Membership is. More homogenous
 a primary source of data collection because the data is collected directly from the participants, they are people with similar
characteristics or who possess common traits
 seek open ended thought and contributions from participants and slightly similar to interviews but this involves discussions
and interactions rather than questions and answers
 less formal and the participants are the ones who do most of the talking with moderators there to oversee the process and
effective in the assessment of health needs of specific groups in the community
 Ex: focus group of first- time pregnant women

2. SECONDARY DATA SOURCES.

 secondary data are collected by another entity or for another purpose

 Registry of Vital. Events.

 a civil registration system is used to record vital statistics on events and it creates a permanent record on an event
 registration of vital events is based on the civil code and the law of civil registration and different regulation in civil registries
Registration of birth
o is by place of occurrence and done in district the child is born
o residence of mother is also mentioned in birth certificate
ACT 3753 (Civil Registration Law, Philippine Legislature)
o Enacted in 1930, established the civil registry system in the Philippines
o requires the registration of vital events, such as births, marriages, and deaths
NSO
o serves as the central repository of civil registries and the NSO Administrator and the Civil Registrar General of the
Philippines
Reliable civil registration and vital statistics provide a realistic basis for program planning and implementation
REGISTRATION OF DEATH
o should be by placed of occurrence and residence of the diseased is mentioned in death certificate
o No cost for registration of death

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 Health Records and Reports.
 A record is a permanent written communication that documents information relevant to a client’s health care management,
e.g. a client chart is a continuing account of client’s health care status and need
 records are facility- based and is kept in the barangay health station, RHU, or health center and contain a day to day account
of the activities of health workers
 Disease Registries
 listing of persons diagnosed with a specific type of disease in a defined population
 DOH has developed and maintained registries for HIV/AIDS and chronic non communicable diseases, particularly cancer,
diabetes mellitus, chronic obstructive pulmonary disease, & stroke
 Tool for tracking the clinical care and outcomes of a defined patient population
 Paper based registries have long been used with chronic disease
 Computerized registries provide users with automated way to store data, create, sort and display lists of pt and other data for
use in planning, quality improvement, reporting and direct care delivery
 Importance; help improve healthcare quality and safety
 Census Data
 periodic governmental enumeration of the population
 census is the procedure i=of systematically acquiring and recording info about the members of a population
 used in connection with national population and housing census (other: agricultural, traditional culture, business, supplies,
traffic census)
 people may be assigned to a locality by:
o DE JURE METHOD - based on legally established place of residence of people
o DE FACTO METHOD - is according to the actual physical location of people

3. METHODS TO PRESENT COMMUNITY DATA.

PURPOSES:
1. to inform the health team and members of the community of existing health and health- related condition in the community in
an easily understandable manner
2. To make members of the community appreciate the significance and relevance of health information to their lives.
3. to solicit broader support and participation in the community health process
4. validate findings
5. to allow for a wider perspective in the analysis of data
6. to provide a basis for better decision making
DEPENDING ON THE CONTEXT AND PURPOSES OF THE PRESENTATION, THIS MAY BE PRESENTED AS TEXT, TABLES,
PICTORIAL FORM SUCH AS MAPS ANDS GRAPHS
1. BAG GRAPHS - used to compare values across diff categories of data
- Ex: population pyramid made up of 2 horizontal bar graphs representing the age structure of male and female population
2. LINE GRAPHS - visual image of trends in data over time or age and appropriate for time series
3. PIE CHART - used to show percentage distribution or composition of a variable such as population or household
- Effective tool in highlighting a value in a group in relation to whole population
- Illustrate only a small number of categories; not more than 6
4. SCATTER PLOT OR DIAGRAM - used to show correlation between 2 variables. Values of both variables and subject are
plotted in a graph with x and y axis

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B. THE COMMUNITY DIAGNOSIS
Determining health status is the start in caring for the community as client, need to collect data in order, to identify the different
factors that may directly or indirectly influence the health of the population. Then proceed to analyze and seek explanations for the
occurrence of health needs and problems. The community health nursing diagnoses are then derived and will become the bases for
developing and implementing community health nursing interventions and strategies. This process is called community diagnosis or
others call it community assessment or situational analysis.
1. Types.
 Traditional.
 Community diagnosis generally refers to the identification and quantification of health problems in a community as a whole in
terms of mortality and morbidity rates and ratios, and identification of their correlates for the purpose of defining those at risk
or those in need of health care.
 Participatory Action Research
 is an approach to enquiry which has been used since the 1940s. It involves researchers and participants working together to
understand a problematic situation and change it for the better.
2. Schemes in Stating Community Diagnosis.
What is a Problem Classification Scheme?
o Provides structure, terms, & system of cues & clues for a standardized assessment of individuals, families, & communities.
o It helps practitioners collect, sort, document, classify, analyze, retrieve, and communicate healthrelated needs and strengths.
A. NANDA
 Now known as NANDA, International
 NANDA International (NANDA-I) NANDA– International earlier known as the North American Nursing Diagnosis Association
(NANDA) is the principal organization for defining, distribution and integration of standardized nursing diagnoses worldwide
 Recent versions included nursing diagnostic labels for community labels
B. SHUSTER AND GOPPINGEN
In 2004, Shuster and Goeppinger proposed format of nursing diagnoses for population group. Three-part statement consists
of:
● Health risk or specific problem
● Specific aggregates or community
● Related factors - influence how the community will respond to the health risk or problem
C. OMAHA SYSTEM.
o Problem Classification Scheme consists of four levels of abstraction. Four domains appear at the first or most general
level. These are Environmental Domain, Psychosocial Domain, Physiological Domain, Health-related Behaviors Domain
o Forty-two client problems or areas of concern are at the second level; by definition, problems are neutral, not negative.
o The third level consists of two sets of problem modifiers: health promotion, potential, and actual as well as individual,
family, and community.
o Clusters of signs and symptoms that describe actual problems are at the fourth or most specific level.
o Using the Problem Classification Scheme with the Intervention Scheme and Problem Rating Scale for Outcomes creates
a comprehensive problemsolving model for practice, education, and research.

C. PLANNING COMMUNITY HEALTH INTERVENTIONS.

 Refers to the process of constructing a program, formula, or alternative model that will be used as a basis for a course of
action or decision. The main purpose of planning is to improve the present state of affairs. It deals with deciding what ought
to be done and how things are to be done utilizing the available resources. The essence of planning is forecasting, whether

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the plan is short term or long term. Process of Planning in community health in order involves: assessing health problems &
needs of community

1. Priority Setting WHO Special Considerations (Famorca, 2013)

- Significance of the Problem - based on the number of people in the community affected
- Level of Community Awareness members health concern
- Ability to Reduce Risk – related to the availability of Expertise
- Cost of Reducing Risk – PHN considers economic, social & ethical requisites & consequences of planned action.
- Ability to identify the target population – intervention is a matter of availability of data resources
- Availability of Resources – intervene in the reduction of risk, financial & other material resources of the community, nurse
& health agency
2. Formulating Goals and Objectives.
 The phase refers to the process of formulating the objectives of the health program and nursing services in order, to change
the status quo.
o Goals – broad and not constrained by time and resources; states the ultimate desired end pint of all activities,
directed towards solving health status problems
o Objectives – stated in specific and measurable terms, client-centered, and outcome-focused; concerned with the
resolution of the health problem itself. An adequate statement of objective specifies both the criteria as well as the
standards of evaluation.
3. Deciding on Community Interventions/Action Plan
o By designing and implementing interventions in a clear, systematic manner, you can improve the health and well-being of
your community and its residents.
o Interventions promote understanding of the condition you are working on and its causes and solutions. Simply put, when
you do something well, people notice, and the word slowly spreads. In fact, such an intervention can produce a domino
effect, sparking others to understand the issue you are working on and to work on it themselves.
- Program planning
- Project planning
- Summary of planning

D. IMPLEMENTING COMMUNITY HEALTH INTERVENTIONS.

1. Importance of Partnership and Collaboration.
 Partnership and collaboration can go a long way in creating a strong and better community. In addition to pushing your
mission forward, partnership and collaboration can provide stability (financial and non-financial) while achieving shared goals.
 Collaborative partnerships aim to change the environment in which behaviors and factors that are related to health occur. The
premise is that, by changing the environment, partnerships can effect widespread behavioral change and improve population-
level health outcomes.

2. Activities Involves in Collaboration and Advocacy.

 Community advocacy efforts can be implemented on a group, local, national, or transnational basis. The level at which
advocacy is conducted is often determined by a number of factors, including the scope of the issue, the short term and/or long
term nature of the issue, and the availability of resources. 
 Community Equity Organization’s Parent, Student and Staff Advocacy and Collaboration Workshops will cover the importance
of advocacy in education, ensuring that participants can effectively engage in the support of a safe and healthy learning
environment for all students and staff, as well as be an essential contributing member of their school district.

3. Community Organizing and Social Mobilization.

 Community organizing involves mobilizing a group of people to address common issues and concerns and enabling them to
take action. It focuses on collective action, the power derived from the synchronized actions of people in unity, as opposed to

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separate individuals. A participatory decision-making process to help rural communities undertake health promotion and
disease prevention projects.

4. Core Principles in Community Organizing

 The principles of community practice act as guides to practice because they emanate from acceptance of certain ethical
values. Knowledge of the principles provide a professional thrust to the community worker. Principles provide moral and
ethical legitimacy for field practice while empowering people, communities and workers. Application of values and principles,
therefore, lies at the core of community practice.

5. Goals of Community Organizing.

 The goals of community organizing particularly neighborhood-based organizing, vary, but generally include forming groups;
bringing about social justice obtaining, maintaining or restructuring power; developing alternative institutions; and maintaining
or revitalizing neighborhoods (Kuyek, 2011).

6. Community Organizing Participatory Research.

 Community Organizing Participatory Action Research (COPAR) is a widely used framework in public health nursing that aims
to empower marginalized communities by giving them the opportunity to engage in the research process where they play an
active role as participants (Jimenez, 2008).
E.
1. Proper Excreta Disposal.
o An excreta disposal system is designed from the household level toward centralized / semi-centralized treatment and safe
disposal processes. To ensure the service lasts, four components need to be considered, designed, built, and maintained with
users and local authorities.
2. Food Safety.
o Food safety refers to routines in the preparation, handling and storage of food meant to prevent foodborne illness and injury.
From farm to factory to fork, food products may encounter any number of health hazards during their journey through the
supply chain. Safe food handling practices and procedures are thus implemented at every stage of the food production life
cycle in order to curb these risks and prevent harm to consumers.
3. Sanitation.
o Sanitation refers to public health conditions related to clean drinking water and treatment and disposal of human excreta and
sewage. Preventing human contact with feces is part of sanitation, as is hand washing with soap.
4. Vermin and Vector Control.
o The most effective way to reduce vermin numbers is to remove their food source and remove or monitor potential harborage
areas. Complaints regarding vermin harborage or breeding on a neighboring property can be lodged with Council's
Environmental Health Department.
5. Built Evaluation
o A building-evaluation study comes with the implied promise to the occupants that if is there is a problem with the building
something will be done about it. Whenever a study is carried out, the researcher always needs the cooperation of the
occupiers

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References:
 https://www.com/file/67076816/NURSING-CARE-FOR-POPULATION-GROIUPpdf/
 file:///CHN2-PLANNING-COM-DX-OCT2020.pdf
 https://www. com/u/file/90589880/Module-5pdf/

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