October 18, 2022

NCM 113 CHN Theory

Week
Topics Syllabus Contents Assessment
Date
Week 3
09/13 Nursing Process in the care of population Nursing Process in the Care of population Groups and Community
groups and the community
A. Community Health
1.1 Community Health assessment
tools Assessment tools

1.2 Secondary data sources 1. Collecting Primary Data

 Observation
 Survey
1.3 Methods to present community  Informant Interview
data  Community forum

2. Secondary Data Sources

 Registry of vital events
 Health records and reports
 Disease registries
 Census Data

3. Methods to present Community data

Nursing Process in the Care of population Groups and Community

 Nursing process in the community entails the utilization of a number of processes to respond to the health needs and problems of the clients, manage health
programs and resources, and influence decisions that affect the delivery of health services. (Maglaya)

Nursing Processes in Community Health Nursing

 Focus / Target Processes
Clients, Individuals, Families Nursing Process ADPIE
Program planning, implementation and Evaluation

Health Care Unit (Health Center) Management and supervision

Quality assurance
Nursing Research / Health System Research

Political Leaders, Decision-makers Advocacy and political action

Critical Thinking in Community Health Nursing

 “Rational examination of ideas, inferences, assumptions, principles, arguments, conclusions, issues, statement, beliefs, and actions” in CHN.
 Critical Functions in Nursing:
1. Use the process of critical thinking in all day activities
2. Discriminate among the uses and misuses of Language in Nursing
3. Identify and formulate Nursing Problems
4. Analyze meanings of terms in relation to their indication, for their cause of purpose and their significance
5. Analyze arguments and issues into premises and conclusions
6. Examine Nursing assumptions
7. Report data and clues accurately
8. Make check and inferences based on data
9. Formulate and clarify beliefs
10. Verify, justify claims, beliefs, conclusions, decisions, actions
11. Give relevant reasons for beliefs and conclusions
12. Formulate and clarify value judgments
13. Seek reason, criteria, and principles that effectively value judgments
14. Evaluate soundness of conclusions

These are the “Basic Phases of the Nursing Process” according to Wilkinson
1. Establishing a working relationship
 Establishing rapport and working relationships
 Establishing strategies or approaches depending on the co-worker or client
 Contract setting
Goals and objectives of the Nurse-Client relationship
Duration and frequency of the Nurse-Client contact
Expectations from each other to address effectively and efficiently the client’s needs and problems.

2. Assessment and Diagnosis

 The process of collecting and processing data and information about the client

Assessment Data
Individual Family Community
Signs and symptoms Family Structure Characteristics Population characteristics
Medical and nursing history Socioeconomic and cultural factors Physical characteristics
Ability to cope Environmental factors Environmental factors
Lifestyle Health assessment of each member Health and illness data
Help-seeking behavior Value placed on prevention of disease Community resources
Utilization of health services Competencies on family health care Leadership and communication
Culture
Socioeconomic stratification
People’s participation in health programs
Reason for failure of past health programs

3. Planning of outcomes and interventions

 S
 M
 A
 R
 T

4. Implementation
  Translation of care plan into concrete action

5. Evaluation
 Process of making judgments as to the extent the objectives were met

6. Documentation
 Documentation should include the following

Client assessment
Health needs identified
Interventions
Client’s response to intervention
Outcome of the intervention
Future plans of care

 Documentation serves a number of purpose

Serves as “Poof” of the critical thinking and decision making of the nurse
Legal protection (it is generally believed that what is not written - was not done.)
It gives decision makers an idea of the workload of the Nurse
It provides information that could be used in research and quality assurance activities and for training purposes

Nursing Assessment in Family Nursing Practice (Maglaya, Chapter 2)

 This involves a set of actions by which the nurse measures:

 the status of the family as a client,
 its ability to maintain itself as a system and functioning unit,
 its ability to maintain wellness
 its ability to prevent, control or resolve problems in order to achieve health and wellbeing among its members.

Three Major Steps in Family Nursing Assessment

 1. Data Collection
2. Data Analysis
3. Health Conditions, Health Problems, and Family Nursing Diagnosis

DATA COLLECTION

 Data collection for the first level assessment involves gathering five types of data which will generate the categories of health conditions of the family.
 These data include
1. Family Structure
2. Socio-economic characteristics
3. Home and environment
4. Health Status of each member
5. Values and practices on their health promotion, health maintenance, and disease prevention.

 Second-level assessment data include

1. Description of family realities
2. Perception and attitude related to the assumption of health, health tasks, or health problem identified in the first level assessment

Data-gathering Methods and Tools

 The nurse then selects a data-gathering method depending on the availability of resources such as materials, manpower, time, and facilities.
 Choice of concern must also consider validity, reliability, and adequacy of data.
 Poor quality, inaccurate, and inadequate data will lead to a poorly designed Family Nursing Care Plan

1. Observation
 Data collection is done through the use of sensory capabilities
 Sigh, hearing, smell, touch

2. Physical Examination
 Direct examination – Inspection, palpitation, percussion, auscultation
3. Interview
  Direct data gathering of health status and significant health history
 Genetics
 Family experiences

4. Records Review
 Reviewing existing records and reports pertinent to the client

5. Laboratory / Diagnostics Test

 Performing laboratory tests and other diagnostic procedures

DATA ANALYSIS

 Data analysis in community diagnosis aims to establish trends and patters in terms of health needs and problems of the community.
 It also allows for comparison of data with standard values

 Involves the following sub steps

1. Sorting of data
2. Clustering of related cues
3. Distinguishing relevant from irrelevant data
4. Identifying patterns
5. Comparing patterns
6. Interpreting results
7. Making inferences, drawing conclusions

Data Presentation

 Descriptive data are presented in narrative reports

 Numerical data may be presented into tables and graphs

Type of Graph Data Function

Line Graph Shows Trend data or changes with time or age with respect to another variable

Bar graph / pictograph For comparison of absolute or relative counts and rates between categories
Histogram / Frequency polygon Graphic presentation of frequency distribution or measurement

Proportional, component bar Shows breakdown of a group or total where the number of categories is not too many
graph / pie chart
Scattered diagram Correlation data for two variables