Hawler Medical University

College of Nursing
Community Health Nursing
4th stage
The lecturer: Assist. Professor
Dr.Kareem Fattah Aziz
Al-Barzinjy
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Lecture D (nursing process):
Definition: The nursing process is a systematic problem-solving method by which
nurses can plan and provide care for clients. This process enables the nurse to
identify clients’ actual or potential problems. The nursing process consists of five
dynamic and interrelated phases assessment, diagnosis, planning, implementation
and evaluation.

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The purpose of nursing process

• To identify client’s health status, actual or potential healthcare problems

or need.
• To establish plans to meet the identified needs and to deliver specific
interventions to meet those needs.
• It provides a framework in which to practice nursing.
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Characteristics of a nursing process as general:

1. Dynamic and cyclic

2. Patient centered
3. Goal directed
4. Open and Flexible
5. Problem Oriented

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 6. Planned
7. Universally accepted
8. Interpersonal and collaborative
9. Holistic

10. Systematic

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Benefits of Nursing Process

• Improves the quality of care that the client receives

• Ensures a high level of client participation together with continuous
evaluation designed to meet the client’s unique needs
• Enables nurses to use time and resources efficiently to both their own and
their client’s benefit
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The steps of the Nursing Process

1. Assessment
2. Nursing Diagnosis
3. Planning
4. Implementation
5. Evaluation
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1- Nursing Assessment

• The process of collecting, validating and recording data

about a client’s health status.

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 • Phase which identifies patient’s strengths and limitations
and is done continuously throughout the nursing process.
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This assessment data can be described and classified as:

• Current or retrospective،‫ بأثر رجعي‬, historical data

• Subjective and objective data
• Primary and secondary data
• Qualitative and quantitative data
• Physical, psychological, social, cultural and spiritual data

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• Subjective and objective data

In nursing, objective data is any information you can gather through observation and
testing. It's information you can see, hear, smell or otherwise observe for yourself.
Subjective data, on the other hand, is information that comes from the patient and
includes symptoms and any information the patient tells you.

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What are some examples of objective data?

Other examples of objective data: Heart rate; Blood pressure; Respirations; Wound
appearance. Subjective Data. This is where we all get ourselves into trouble.
Subjective data is gathered from the patient telling you something that you cannot
use your five senses to measure.
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2- Nursing Diagnosis

• In this phase the nurse sort,‫ فرز‬clusters and analyzes data.

• These questions could serve as guidelines:
o What are the actual and potential health problems for which the
client needs nursing assistance?
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 o What factors contributed to this problem?
• Nursing diagnoses are identified through actual and potential health
problems or responses to life processes.

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Types of nursing diagnosis:

It can be ACTUAL, POTENTIAL or WELLNESS DIAGNOSIS:

• ACTUAL – identifies an occurring health problem

• POTENTIAL – identifies a high-risk health problem
• WELLNESS‐ focused on promoting or enhancing a
patient’s level of wellness.

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In nursing diagnoses may use the following words:
• Deficient
• Chronic
• Decreased
• Increased
• Altered
• Ineffective
• Imbalanced and

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3. Planning

• Planning expected outcomes to resolve or minimize the identified problems of

the client.
• In collaboration with the client, the nurse develops specific nursing intervention
for each nursing diagnosis.

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The care planning should be:

• Complete
• Current
• Accurate
• Unbiased
• Done in a timely manner
• An interdisciplinary process
• Collaboratively agreed to and participated in by the client and significant
others.

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4.Implementation

• Also called intervention; putting the nursing care plan into action to
achieve goals and outcomes
• As you implement your plan, you continue to assess your patient’s
responses and modify plan as needed.
• Care done should always be documented.

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The Implementation should be focused on:

• Critical thinking skills

• Professional clinical judgment
• Problem solving skills
• Priority setting skills
• High quality and effective interpersonal skills
• High quality and competent psychomotor and technical skills

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5- Evaluation

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 • Assessing the client’s response to nursing interventions and then comparing
the response to the goals or outcome criteria written in the planning phase.
• Once all nursing intervention actions have taken place, the nurse
completes an evaluation to determine the goals for patient wellness
have been met

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What is Community Health Nursing Practice?

The effectiveness of community health nursing practice depends on how well the
nursing process is used as a tool to enhance aggregate or population health. The
nursing process involves appropriate application of a systematic series of actions
with the goal of helping clients achieve their optimal level of health.
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What are the characteristics of community nursing?

1.It is a specialty field of nursing.
2.Its practice combines public health with nursing.
3.It is population based.
4.It emphasizes on wellness and other than disease or Illness.
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Definition of Community Health Nursing process:
Community Health Nursing Process is a systematic, scientific, dynamic, on-going
interpersonal process in which the nurses and the clients are viewed as a system with
each affecting one and another and both being affected by the factors within the
behavior.

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Nature or Concept of Community Health Nursing process:

1.The nursing process provides a framework for the practice of nursing. It
involves both art and science.
2.The nursing process refers to a series of planned steps and actions directed at
meeting the needs and solving the problems of patients.
3.The nursing process is a deliberative problem-solving approach that requires
cognitive, technical, and interpersonal skills and is directed to meeting the needs
of the patient.
4.The nursing process is a goal-oriented humanistic and systemic plan of
individualized care that is both effective and efficient.
5.The nursing process is a problem-solving process that addresses community
health problems at all aggregate levels and aims to prevent illness.

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 6.The nursing process is a deliberate intellectual activity whereby the practice of
nursing is approached in a dynamic, systematic manner to patient care in a
dynamic, continuous method to assist the patient to achieve and maintain health.
7.The nursing process is dynamic and continuous. It provides blueprint care and
responds to the client’s needs in a timely and reasonable manner to improve or
maintain the client’s level of health.
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Characteristics of Community Health Nursing process:

1.The nursing process provides a framework or structure upon which community

health nursing actions are based.
2.The application of the process varies with each situation, but the nature of the
process remains the same.
3.Certain elements are important for community health nurses to emphasize in their
practice.
4.In every discipline, the nursing process is used to their professional practice
differently using various names, prevention of illness, and maintenance of health
care common goals in all areas of community health.
5.The nursing process which is otherwise known as the problem-solving approach
is a tool or guide for the provision of quality nursing care.
6.A community health nurse provides skilled nursing care by making professional
judgments and give good nursing care to the family and the community.
7.Nursing process must aim to apply philosophy of community health nursing that
is preventive, promotion, curative and rehabilitative.
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References:
1.Kamalam. S (2012). Essentials in Community Health Nursing Practice (2nd Edition).
New Delhi: Jaypee Brothers Medical Publishers (P) Ltd.

2.Coombs T,, Curtis J. & Crookes P. (2011). What is a comprehensive mental health nursing assessment?
A review of the literature. International Journal of Mental Health Nursing. 20 364-370 EBSCO Industries
Inc.
3.(2012) Full Text for Top Nursing and Allied Health Literature, Plus Additional Resources.
http://www.ebscohost.com/academic/cinahl-plus-with-full-text/ (retrieved: 10.5.2013)
Eldh A.C., Ekman
4.G.K, da Graça Oliveira Crossetti M. (2012). Theoretical model of critical thinking in diagnostic processes
in nursing. Online Brazilian Journal of Nursing. 11(2) (retrieved 15.1.2014) Hansebo G., Kihlgren M.
Nursing home care: ch