COMMUNITY HEALTH NURSING PROCESS

Definition:
Defined as a systematic method for assessing health status,
diagnosing health care needs, formulating plan of care,
initiating plan and evaluating the effectiveness of the plan.
Characteristics Of Nursing Process:
 Purpose
 Organization
 properties
Purposes:
• To maintain optimal wellness
• To provide quality care
• To achieve purposes of nursing
Organization
• Assessment phase
• Planning phase
• Action phase
• Evaluation phase
Properties:
• Purposeful
• Systematic
• Dynamic
• Interactive
• Flexible
• Theoretically based
COMPONENTS OF COMMUNITY HEALTH
NURSING PROCESS:
PHASE-I-ASSESSMENT PHASE
Community identification
 Plan of data collection
 Method and technique
 Data collection
 Data Analysis
 Community profile and diagnosis.
PHASE-II-PLANNING PHASE
Community health planning
 Analyzing health problems
 Establishing priorities
 Setting goals and objectives
 Formulating community health action
PHASE-III- ACTION PHASE ( IMPLEMENT ACTION PLAN)
 Considering nursing interventions
 Review and revise if needed
 Mobilization of resources
 Facilitating working environment
 Implementation and documentation
PHASE IV- EVALUATION PHASE
 Concurrent evaluation
 Terminal evaluation
PHASE – I COMMUNITY IDENTIFICATION
 is the assessment phase
Refers to systematic process of knowing and
exploring the defined community for assessing its
health status and determining the possible factors
affecting the health of people in the community.
Purposes
• Provides comprehensive knowledge.
• Provides opportunity for establishing working relation
ship.
• Helps in making community diagnosis.
• Act as an instrument to community health planning
• Promotes community participation
Steps In Community Identification
A)Planning For Data Collection
:Derive information from the community related to:
1. Information regarding geographic area
 Geographical location and boundary
 Physical setup
 The natural resources
 Important land marks and institutions
 Environmental sanitation
2. Population characteristics
 Size of population
 Density of population
Composition
Vital events
Vulnerable and high risk groups
3. Social system
Formal and informal laws and rules
Socio-cultural, political and
administrative sub systems
B) Method And Technique
1. Community forum method
Holding formal and informal meeting with community
people, leaders, panchayat members, school teachers,
mahila mandals, youth club, traditional leaders etc.
Meetings should be planned properly
Invitation should be given in person ahead of time
Initial meeting can be open discussion
The purpose should be made clear to the participant
Is a useful and less expensive method of gathering data
2)Observation method
3) Questioning method
4) Record review method
5) Conversation and discussion method
6) Other methods like
-physical examination
-clinical examination
-investigation etc.
C) Data Collection
The steps of data collection include:
1. Define the community to be studied
2. Determine the objectives for community identification
3. Determine specific information
4. Identify the population under study
5. Decide sample size and sampling methods
6. Decide the tool for data collection
7. Develop the tool
8. Organize and conduct survey.
D) Data Analysis
Consist of putting all the information collected into an
order, compile, and summarize according to the
variables to be studied.
The steps of compiling and analysis of data include:
• Coding, key punching, organizing and arranging of data
for tallying.
• Presentation of data from tally sheet to tables and
graphs
• Statistical analysis of data collected
• Interpretation of data
• Reporting of findings
E) Community Profile And Diagnosis.
• Community identification process helps to
determine community profile
• Helps in drawing conclusion
• Make diagnosis of health needs and health
problems
Eg:- large and young population, incomplete
immunization, early marriage, poor education
status, high mortality and morbidity, malnutrition,
unsafe water supply, open air defecation ect.
PHSE II-PLANNING PHASE
Community Health Planning
Determine the course of action to be implemented to
meet community health needs and to resolve
community health problems.
It is a systematic process that involve four steps.
1. Analyzing health needs and health problems
2. Establishing priorities
3. Setting goals and objectives
4. Formulating community health action plan to
achieve objectives.
1. Analyzing Health Needs And Health
Problems
• The identified problems are further analyzed to
clarify the nature and extant of problems, the factors
associated with problems and the resultant
consequences.
• It require some more specific information about the
problem already collected and known as second
level of assessment. Eg:-incomplete immunization,
malnutrition.
• Problem analysis helps in making specific diagnosis which
becomes the basis for setting goals and objectives and
formulating community health action plan
• Analysis of health problems should be done by the health
team members.
2. Establishing Priorities
• Is the ranking of health problems with respect to their
relative importance on the basis of pre-determined
criteria.
• It is necessary for proper utilization of limited available
resources.
• There are some criteria suggested by the health team
members.
3.Setting Goals And Objectives
• A goal is a broad statement of desired outcome and
directions to resolve identified problem.
• Objectives are specific statement determining actions
relevant to the goal.
• The goal should be stated clearly
• The outcome should be measurable and time related.
Eg:-To ensure desirable comprehensive maternal care
to all mothers in a defined area served by sub centre
to reduce infant mortality rate from 80 per 1000 live
birth to 60 per 1000 live birth during a period of 5
years from 2015.
4.Formulating Community Health Action Plan
• Refers to identification of appropriate community health
and nursing intervention and preparing an operational
plan to be implement to achieve the established goals
and objectives.
• The interventions are identified on the basis of objective.
• The criteria for choosing interventions are
The nature of the problem
The resources available
The community’s interest
The competencies of health personals
Practicability and efficiency
• Plan the interventions with the help of community
members.
PHASE III ACTION PHASE
Implement Action Plan
In this phase the interventions planed with respect to
identified needs and problems based on priority is
implemented with the full participation of
community members by:-
1.Considering nursing intervention
2.Review and revise if needed on the basis of
concurrent evaluation.
3.Mobilization of resources
4.Facilitating working environment
5.Implementing and documentation
Active participation of the community should be motivated
during this phase for the effectiveness of the programme.
 PHASE IV EVALUATION PHASE
1.Concurrent evaluation:-refers to evaluation of the process during
the course of action
2.Terminal evaluation:-refers to the evaluation after the course of
action
Evaluation is the process of assessing the effectiveness of organized
activity or program with respect to their goals and objectives.
Evaluation is done at each step of process to get feedback in
concurrent evaluation.
It begins from assessment phase.
It helps in taking remedial measures and appropriate
decision through out the community health nursing
process.
The progress of result ,difficulties and constraints
encountered are compiled and computed at the end of
each day, week , month and year.
The terminal evaluation is done at the end of 6 months or
one year by comparing the outcome with set standards
and known as outcome evaluation or terminal evaluation.