FORMULATING FAMILY NURSING CARE
FAMILY NURSING CARE PLAN
- Is the blueprint of the care that the nurse
designs to systematically minimize or
eliminate the identified health and family
nursing problems through explicitly
formulated outcomes of care and
deliberately chosen set of interventions,
resources and evaluation of criteria,
standards, methods and tools.
CHARACTERISTICS OF FAMILY NURSING
CARE PLAN:
 It focuses on actions which are designed to
solve or minimize existing problem.
 It is the product of a deliberate systematic
process.
 It relates to the future.
 It is based upon identified health and
nursing problems.
 It is a means to an end, not an end itself.
 It is a continuous process, not a one-shot-
deal.
DESIRABLE QUALITIES OF A NURSING
CARE PLAN:
 Clear and explicit definition of the problems
 Realistic
 Preparedly jointly with the family
 Useful in written form
IMPORTANCE OF PLANNING OF CARE:
 They individualize care to clients
 Helps in setting priorities by providing
information about the client as well as the
nature of his problems
 Promotes systematic communication among
those involved in the health care effort.
 Continuity of care is facilitated through the
use of nursing care plans
 Facilitate the coordination of care by making
down known to other members of health
team what the nurse is doing.
STEPS IN DEVELOPING A FAMILY
NURSING CARE PLAN:
FIRST STEP: PRIORITIZED CONDITIONS OR
PROBLEMS
 It starts with a list of health condition or
problems prioritized according to the nature,
modifiability, preventive potential and
salience. The prioritized health condition or
problems and their corresponding nursing
problems become the basis for the next
step which is the formulation of goals and
objectives of nursing care.
SECOND STEP: FORMULATION OF GOALS
AND OBJECTIVES
 The goals and objectives specify the
expected health/ clinical outcomes, family
response/s, behavior or competency
outcomes.
THIRD STEP: SELECTION OF NURSING
INTERVENTIONS
 It focuses on alternatives and decision on
appropriate intervention measures based on
the specific objectives formulated. The
interventions specify the nursing actions to
help the family eliminate the barriers to the
performance of health tasks or the
underlying cause/s of non-performance of
expected health tasks. These interventions
include family focused alternatives or
strategies to help members
recognize/detect health problems or
opportunities to enhance wellness state or
condition monitor, eliminate, control, and
manage health problems or enhance
wellness condition.
FOURTH STEP: PLAN FOR EVALUATING
CARE
 It specifies the criteria or outcomes as
explicit measures that determine
achievement of formulated objectives.
 FORMULATING FAMILY NURSING CARE

FIGURE 1: STEPS IN DEVELOPING THE FAMILY NURSING CARE PLAN

PRIORITIZE THE HEALTH CONDITIONS AND PROBLEMS BASED ON:

 Nature of condition or problem

 Modifiability
 Preventive potential
 Salience

DEFINE GOALS AND OBJECTIVES OF CARE:

FORMULATE:

EXPECTED OUTCOMES

 Conditions to be observe to show problem is prevented, controlled, resolved, or eliminated.

 Client response/s or behavior

SPECIFIC, MEASURABLE, CLIENT-CENTERED STATEMENTS/COMPETENCIES

STEPS IN DEVELOPING THE FAMILY NURSING CARE PLAN

DEVELOP THE INTERVENTION CARE PLAN:

DECIDE ON:

Measures to help family eliminate:

 Barriers to performance of health tasks

 Underlying cause/s of non-performance of health tasks
 Family-centered alternatives to recognize defect, monitor, control or manage health condition or
problems

DETERMINE METHODS OF NURSE-FAMILY CONTACT

SPECIFY RESOURCES NEEDED

DECIDE ON:

Measures to help family eliminate:

 Barriers to performance of health tasks

 Underlying cause/s of non-performance of health tasks

Family-centered alternatives to recognize defect, monitor, control or manage health condition or

problems

DETERMINE METHODS OF NURSE-FAMILY CONTACT

SPECIFY RESOURCES NEEDED

DEVELOP THE EVALUATION PLAN:

SPECIFY:

Criteria/outcomes based on objectives of care methods/tools

 FORMULATING FAMILY NURSING CARE

SCALE FOR RANKING HEALTH CONDITIONS AND PROBLEMS ACCORDING TO PRIORITIES

 This tool aim to objectivise priority setting. There are four criteria for determining priorities among
health condition/s or problems. These include:
1. NATURE OF THE CONDITION OR PROBLEM PRESENTED
- Categorized into wellness state/potential, health threat, health deficit and foreseeable crisis
2. MODIFIABILITY OF THE CONDITION OR PROBLEM
- Refers to the probability of success in enhancing the wellness state, improving the condition,
minimizing, alleviating or totally eradicating the problem through intervention
3. PREVENTIVE POTENTIAL
- Refers to the nature and magnitude of future problems that can be minimized or totally
prevented if intervention is done on the condition or problem under consideration.
4. SALIENCE
- Refers to the family’s perception and evaluation of the condition or problem in terms of
seriousness and urgency of attention needed or family readiness

TABLE 1: SCALE FOR RANKING HEALTH CONDITIONS AND PROBLEMS ACCORDING TO

PRIORITIES

CRITERIA WEIGHT
1. Nature of the condition or problem presented 1
- Wellness state (3)
- Health deficit (2)
- Health threat (1)
- Foreseeable crisis (0)
2. Modifiability of the condition or problems 2
- Easily modifiable (2)
- Partially modifiable (1)
- Not modifiable (0)
3. Preventive potential 1
- High (3)
- Moderate (2)
- Low (1)
4. Salience 1
- A condition or problem, needing immediate attention (2)
- A condition or problem not needing immediate attention (1)
- Not perceived as a problem or condition needing change (0)
SCORING:  Is general statement of the condition or
state to be brought about by specific
 Decide on a score for each of the courses of action
criteria
 Divide the score by the highest possible Example:
score and multiply by the weight:
- After family nursing interventions, the
(score/highest score) x Weight
family will be able to take care of the
 Sum up the score for all the criteria.
disabled child completely.
The highest score is 5, equivalent to
- It should be realistic or attainable
the total weight.
- It is best stated in term of client
FOMULATION OF GOALS AND outcomes, whether at the individual,
OBJECTIVES OF CARE: family or community levels.
- Tells where the family is going after the
GOAL interventions.

OBJECTIVES
 FORMULATING FAMILY NURSING CARE
 Refer to more specific statements of the
desired results or outcomes of care.
 They specify the criteria by which the
degree of effectiveness of care are to be
measured
 Milestones to reach the destination or
the goal
 The more specific the objectives, the
easier is the evaluation of their
attainment
Example:
After nursing intervention the family will be
able to:
- Feed the mentally retarded child
according to prescribes quantity and
quality of food
- Teach the mentally retarded child simple
skills related to the activities of daily
living
- Apply measures taught to prevent
infection in the mentally retarded
member.
Objectives vary according to the times
span required for their realization
SHORT TERM OR IMMEDIATE
OBJECTICES- are formulated for problem
situations which require immediate attention
and results can be observed in a relatively
short period of time. They are accomplished
with few family contacts and the use of
relatively less resources.
E.g. the sick members will take the drugs
accurately as to dose, frequency, duration,
and drug combination.
LONG TERM OR ULTIMATE
OBJECTIVES- require several nurse-family
encounters and an investment of more
resources.
E.g. all members will carry out mosquito
vector control measures.
MEDIUM-TERM OR INTERMEDIATE
OBJECTIVES- are those which are not
immediately achieved and are required to
attain the long-term ones.
E.g. all members will have medical check-
up and laboratory confirmation to diagnose
malaria.
DEVELOPING THE INTERVENTION
PLAN
 This involves selection of appropriate
nursing interventions based on the
formulated goals and objectives.
GUIDE IN SELECTION OF APPRORIATE
NURSING INTERVENTIONS
1. Analyze with the family the current
situation and determine choices and
possibilities based on a lived
experience of meanings and outcomes.
2. Develop/enhance family’s
competencies as thinker, doer, and
feeler.
3. Focus on interventions to help perform
the health tasks.
4. Catalyze behavior through motivation
and support.
DEVELOPING THE EVALUATION PLAN
 The evaluation specifies how the nurse
will determine changes in health status,
condition or situation and achievement
of the outcomes of care specified in the
objectives of the family nursing care
plan. The plan includes evaluation
criteria/indicators, standards, methods,
and tools/evaluation data sources.
 FORMULATING FAMILY NURSING CARE

OUTCOMES EVALUATION/CRITERIA/ EVALUATION EVALUATION

INDICATORS STANDARDS METHOD TOOL/
DATA
SOURCE
Goal: improve the Weight (as nutritional status Increase of at Weight Weighing
nutritional status of criterion) least 1 kilo gram in monitoring scale, early
the two-year-old six weeks childhood
family member care and
development
card for 0-6
years

Objective: the family Performance Correct Dietary Food recall

will be able to: criteria/indicators: identification of history form or food
inadequacies in taking frequency
1. Provide adequate 1.A identify inadequacies in intake of specific record
care to the two- specific nutrients generated macronutrients,
year-old member from the baseline dietary vitamins, minerals,
intake of the child critical to growth,
bone development
and strong
immune system.

Accurate
1.B prepare meals based on application of Daily Record Menu plan
cycle menu plan nutrients guide review
pyramid for
Filipino children 1-
6 years.
Preparation of
meals guided by Observation Performance
principles such as evaluation
nutrient checklist
preservation,
increased variety
and appealing to
taste.

Child’s daily food

1.C feed the child based on intake based on Record Estimated
agreed upon quality and recommended review food record
quantity of food energy and observation performance
nutrient intake for and evaluation
age group interview checklist

Appropriate and
1.D carry out effective measures Interview Performance
strategies/measures to based child’s age and evaluation
address child’s eating and observation checklist
idiosyncrasies and problems nature/magnitude
of eating/feeding
problems

Clinic follow-up at
2. Utilize community 2.A bring the child to the least once during Record Early
resources for health center for regular the month review childhood
care early childhood growth care and
 FORMULATING FAMILY NURSING CARE

monitoring and care development

card for 0-6
years old.
BARRIERS TO JOINT GOAL SETTING
BETWEEN THE NURSE AND THE
FAMILY INCLUDE THE FOLLOWING:

 Failure on the part of the family to

perceive the existence of the problem.
 The family may realize the existence of
heath condition or problem but is too
busy at the moment with other concerns
and preoccupations
 Sometimes the family perceives the
existence of a problem but does not see
it as a serious enough to warrant
attention.
 The family may perceive the presence
of the problem and the need to take
action however refuses to face and do
something about the situation.
 Failure to develop a working
relationship.

DEVELOPING THE INTERVENTION

PLAN:

 Analyze with the family the current

situation and determine choices and
possibilities base on a lived experience
of meetings and concerns
 Develop/enhance family’s competencies
as thinker, doer, and feeler
 Focus on interventions to help perform
the health tasks
- Help the family recognize the problem
- Guide the family on how to decide on
appropriate health actions to take
- Develop the family’s ability and
commitment to provide nursing care to
its members
- Enhance the capability of the family to
provide a home environment conductive
to health maintenance and personal
development
- Facilitate the family’s capacity to utilize
community resources for health care.
 Catalyze behavior change through
motivation and support.