Community Health Nursing Process

Community Health Nursing Process
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Community health purposes and goals are realized through the application of a series of steps that lead to described results.
Nursing Process
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Is a systematic, scientific, dynamic, ongoing interpersonal process in which the nurses and the clients are viewed as a system with each affecting the other and both being affected by the factors within the behavior?
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The process is a series of actions that lead toward a particular result.
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This process of decision making results in the optimal health care for the clients to whom the nurse applies the process.
1. Assessment
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Provides an estimate of the degree to which afamily, group, community is achieving the level of healthpossible for them.
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Identifies specific deficiencies or guidance needed.
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Estimates the possible effects of the nursinginterventions.
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Involves the following steps which are taken withthe active participation of the clients especially in decisionsmade:a.Collection of data
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Demographic data
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Vital health statistics
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Utilization of health services
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Health status
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Family dynamics
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Environment
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Patterns of coping
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Community dynamics
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Education, socio-cultural, religious, occupationalbackground
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Methods of collecting data
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Community surveys
Interview of individuals, families and groups
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Observation of health related behaviors andenvironment
Review of statistics: epidemiological and relevantstudies
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Individual and family health records
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Screening tests and P.E. of individualsc.Categories of health problems
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Health deficit – occurs when there is a gapbetween actual and achievable health status.
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Health threats – are conditions that promotedisease or injury and prevent people fromrealizing their health potential.
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Foreseeable crises – anticipated periods of unusual demand on the individual or family interms of adjustment/ family resources.Note:
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Health need – exists when there is a healthproblem that can be alleviated with medical orsocial technology.
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Health problem – is a situation in which there is ademonstrated health need combined with actualor potential resources to apply remedial measuresand a commitment to act on the part of theprovider or the client.
2. Planning Nursing Action
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Is based on the actual and potential problemsthat were identified and prioritized.
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Includes the following steps:a.Goal setting
Goal – is a declaration of purpose or intent thatgives essential direction to action.
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Specific objectives – are made with the individualfamily in terms of:a.Activities of daily livingb.Adaptive functioning based on remainingcapabilities resulting from their condition orenvironmentc.Stated in behavioral terms: SMARTb.Construction of a plan of action
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Choosing from among the possible courses of action
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Selecting the appropriate types of nursingintervention
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Identifying appropriate and available resources forcare
Developing an operational planc.Developing an operational plan
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PHN must establish priorities phase andcoordinate activities
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Plans of care are prioritized according to urgencydown to manageable units and properlysequenced
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Periodic evaluation must be done in order todetermine whether re-planning or modification of the plan is necessary
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The plan and activities should be coordinated towith the various services to synchronize with thetotal health program of the community.
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Development of evaluation parameters based onthe standard of nursing services, problemsidentified, goals and priorities in the plan orprogram of nursing care for the client.
3. Implementation of Planned Care
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Involves various nursing interventions which havebeen determined by the goals/ objectives previously set.
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Involves the patient and his family in the care
provided in order to motivate them to assume responsibilityfor his/her care and to be able to reach and maintain desiredlevel of functioning at a specified time.
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Demonstration, repetition, explanation, answeringquestions to clarify doubts, maximizing the client’s confidenceand ability to self-care.
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Utilization of client support system provides aharmonious, orderly care to enable the client to functionoptimally.
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Community health nurses monitor health servicesprovided, making proper referrals as necessary
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Documentation:
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Provides data which is needed in planningpatient’s care and ensure continuity.
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Important communication tool for the heath team
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Furnishes a written evidence of the quality of carethat clients received and then response
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Provides a legal record to protect the agency andhealth care provider or the client
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Provides data for research and education
4. Evaluation of Care and Services Rendered
Is interwoven in every nursing activity and everystep of the public health nurses.a.Structural: physical settings, instrumentalities andconditions through which nursing care is given such asphilosophy, objectives, building, organizationalstructure, financial resources. (budget, equipment,staff)
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Process: nursing process: family health data base,performing physical assessment, making nursingdiagnosis, determining goals, writing a nursing careplan, performing necessary interventions andcoordination of services and measuring success of nursing actions.c.Outcome: changes in the client’s health statusthat result from nursing intervention. These changesinclude modification of: signs and symptoms,knowledge, attitudes. Satisfaction, skill level andcompliance with treatment regimen.