DEVELOPING THE

NURSING CARE PLAN

 ❖ BLUEPRINT OF THE CARE THAT THE NURSE
DESIGNS TO SYSTEMATICALLY MINIMIZE OR
ELIMINATE THE IDENTIFIED HEALTH AND FAMILY

THE FAMILY NURSING PROBLEMS THROUGH EXPLICITLY

FORMULATED OUTCOMES OF CARE (GOALS

CARE PLAN AND OBJECTIVES) AND DELIBERATELY CHOSEN

SET OF INTERVENTIONS, RESOURCES AND
EVALUATION CRITERIA, STANDARDS, METHODS
AND TOOLS
FEATURES

The nursing care plan

The nursing care plan
focuses on actions The nursing care plan,
is a product of a
which are designed as with all other plans,
deliberate systematic
to solve or minimize relates to the future.
process.
existing problems.

The nursing care plan Nursing care planning

The nursing care plan
is based upon is a continuous
is a means to an end,
identified health and process, not a one-
not an end in itself.
nursing problems. shot- deal.
 ❖ IT SHOULD BE BASED ON CLEAR, EXPLICIT
DESIRABLE DEFINITION OF THE PROBLEM(S).

QUALITIES OF A ❖ A GOOD PLAN IS REALISTIC.

❖ THE NURSING CARE PLAN IS PREPARED
NURSING CARE JOINTLY WITH THE FAMILY.

❖ THE NURSING CARE PLAN IS MOST USEFUL IN

PLAN WRITTEN FORM.
 ❖ THEY INDIVIDUALIZE CARE TO CLIENTS.
❖ THE NURSING CARE PLAN HELPS IN SETTING
PRIORITIES BY PROVIDING INFORMATION ABOUT THE
CLIENT AS WELL AS THE NATURE OF HIS PROBLEMS.

IMPORTANCE ❖ THE NURSING CARE PLAN PROMOTES SYSTEMATIC

COMMUNICATION AMONG THOSE INVOLVED IN THE

OF PLANNING HEALTH CARE EFFORT.

❖ CONTINUITY OF CARE IS FACILITATED USING

CARE NURSING CARE PLANS.

❖ NURSING CARE PLANS FACILITATE THE

COORDINATION OF CARE BY MAKING KNOWN TO
OTHER MEMBERS OF THE HEALTH TEAM WHAT THE
NURSE IS DOING.
The prioritized condition/s or
problems

The goals and objectives of

STEPS IN
nursing care DEVELOPING
A FAMILY
The plan of interventions NURSING
CARE PLAN

The plan for evaluating care

 Prioritize the Health
Conditions and
Problem based on:
❖ Nature of
Condition or
Problem
❖Modifiability
❖Preventive Potential
❖Salience
Define Goals and Objectives of
Care
Formulate:
❖Expected Outcomes:
▪ Conditions to be observed
to show problem is
prevented, controlled,
resolved or eliminated.
▪Client responses or
behavior
❖ Specific, Measurable
Client-centered Statements/
Competencies
Develop the Evaluation Plan
Specify:
❖ Criteria/ Outcomes Based
on Objectives of Care
❖Methods/ Tools
Develop the Intervention Plan
❖Decide on:
• Measures to help family
eliminate:
- barriers to performance
of health task
- underlying causes of
nonperformance of health
tasks
• Family centered alternatives
to recognize/detect, monitor,
control or manage health
condition or problems.
❖ Determine Methods of Nurse-
Family Contact
❖Specify Resources Needed
 SCALE FOR RANKING HEALTH CONDITIONS AND PROBLEMS
ACCORDING TO PRIORITIES
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

PRIORITIZING OR TOTALLY ERADICATING THE PROBLEM THROUGH

INTERVENTION.

HEALTH 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

PROBLEMS 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.
 • THE NURSE CONSIDERS THE AVAILABILITY OF THE FOLLOWING FACTORS
IN DETERMINING THE MODIFIABILITY OF A HEALTH CONDITION OR
PROBLEM

• CURRENT KNOWLEDGE, TECHNOLOGY AND INTERVENTIONS TO

FACTORS •
ENHANCE THE WELLNESS STATE OR MANAGE THE PROBLEM.

RESOURCES OF THE FAMILY- PHYSICAL, FINANCIAL AND

MANPOWER

AFFECTING •
•
RESOURCES OF THE NURSE – KNOWLEDGE, SKILLS AND TIME
RESOURCES OF THE COMMUNITY – FACILITIES AND
COMMUNITY ORGANIZATION OR SUPPORT

PRIORITY TO DECIDE ON AN APPROPRIATE SCORE FOR THE PREVENTIVE

POTENTIAL OF A HEALTH CONDITION OR PROBLEM, THE FOLLOWING
FACTORS ARE CONSIDERED:

SETTING •
•
GRAVITY OR SEVERITY OF THE PROBLEM.
DURATION OF THE PROBLEM
• CURRENT MANAGEMENT
• EXPOSURE OF ANY VULNERABLE OR HIGH-RISK GROUP
 CRITERIA WEIGHT
1. Nature of the condition or problem presented
Scale **: wellness state 1

SCALE FOR health deficit

health threat
foreseeable crisis
3
3
2

RANKING 2. Modifiability of the condition or problem

Scale**: easily modifiable
1
2
partially modifiable 2
HEALTH 3.
not modifiable
Preventive Potential
1
0

CONDITIONS Scale**: high

moderate
low
3
2
1

AND 4. Salience
Scale**: a condition or problem, needing immediate
attention
1

2
1

PROBLEMS a condition or problem not needing immediate

attention
not perceived as a problem or condition needing
1

ACCORDING change
Scoring:
0

TO PRIORITIES 1. Decide on a score for each of the criteria.

2. Divide the score by the highest possible score and multiply by the weight. (Score/ Highest
Score) x Weight
3. Sum up the scores for all the criteria. The highest score is 5, equivalent to the total weight.
Family Size beyond what family resources can adequately provide
CRITERIA COMPUTATION ACTUAL JUSTIFICATION
SCORE

1. Nature of the 2/3 x 1 2/3 It is a health threat

problem

2. Modifiability of 2x2 2 Current knowledge,

the Problem interventions and
resources are available
CASE
to solve the problem.

3. Preventive 3/3 x 1 1 The possibility of

ILLUSTRATION
Potential increasing family size is
reduced; the available
family resources can be
ON PRIORITY
utilized to encourage
growth promoting SETTING
experiences for
members.
4. Salience of the 2/2 x 1 1 The family perceives it
Problem as a serious problem
needing attention to
ensure that this fifth
pregnancy will be the
last
TOTAL SCORE 4 2/3
 ❖ FAMILY SIZE BEYOND FAMILY RESOURCES 4 2/3
THE ❖ POSSIBLE PREECLAMPSIA 4
PRIORITIZED ❖ MALNUTRITION 4
❖ SCABIES AS THREAT AND DEFICIT
HEALTH ❖ IMPROPER REFUSE DISPOSAL
4
3 2/3
PROBLEMS ❖ UNSANITARY WASTE DISPOSAL 3 2/3
❖ INADEQUATE LIVING SPACE 2 2/3
 GOAL- A GENERAL STATEMENT OF THE CONDITION OR
STATE TO BE BROUGHT ABOUT BY SPECIFIC COURSES
OF ACTION.

BARRIERS TO JOINT GOAL SETTING BETWEEN THE NURSE

FORMULATION ❖
AND THE FAMILY INCLUDE:

FAILURE ON THE PART OF THE FAMILY TO PERCEIVE

THE EXISTENCE OF THE PROBLEM.
OF GOALS ❖ THE FAMILY MAY REALIZE THE EXISTENCE OF A HEALTH
CONDITION OR PROBLEM BUT IS TOO BUSY AT THE

AND MOMENT WITH OTHER CONCERNS AND

PREOCCUPATIONS.

❖ SOMETIMES THE FAMILY PERCEIVES THE EXISTENCE OF

OBJECTIVE OF A PROBLEM BUT DOES NOT SEE IT AS SERIOUS ENOUGH
TO WARRANT ATTENTION.

CARE ❖ THE FAMILY MAY PERCEIVE THE PRESENCE OF THE

PROBLEM AND THE NEED TO TAKE ACTION.

❖ A BIG BARRIER TO COLLABORATIVE GOAL SETTING

BETWEEN THE NURSE AND THE FAMILY IS FAILURE TO
DEVELOP A WORKING RELATIONSHIP
OBJECTIVES STATED AS OUTCOME OF CARE IN FAMILY HEALTH NURSING
PRACTICE SPECIFY PHYSICAL, PSYCHOSOCIAL STATE OR FAMILY BEHAVIOR (
OR COMPETENCIES).

EXAMPLE:
1. AFTER NURSING INTERVENTION, THE MALNOURISHED PRESCHOOL MEMBERS
OF THE FAMILY WILL INCREASE THEIR WEIGHTS BY AT LEAST ONE POUND PER
MONTH

2. AFTER NURSING INTERVENTION, THE FAMILY WILL BE ABLE TO:

• FEED THE MENTALLY RETARDED CHILD ACCORDING TO PRESCRIBED
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 TIME SPAN REQUIRED
FOR THEIR REALIZATION.
THE MORE SPECIFIC
THE OBJECTIVES, THE 1. SHORT TERM/IMMEDIATE OBJECTIVE
EASIERS IS THE 2. MEDIUM TERM/INTERMEDIATE OBJECTIVES
EVALUATION OF 3. LONG TERM OBJECTIVES
THEIR ATTAINMENT.
SPECIFICALLY
STATED OBJECTIVES AS WITH GOALS, OBJECTIVES SHOULD BE:
DEFINE THE CRITERIA SPECIFIC MEASURABLE ATTAINABLE
FOR EVALUATION. REALISTIC TIME BOUNDED
 • THE NEXT STEP IN DEVELOPING THE FAMILY
NURSING CARE PLAN IS FORMULATING THE

DEVELOPING INTERVENTION PLAN.

• THIS INVOLVES SELECTION OF APPROPRIATE

NURSING INTERVENTIONS BASED ON THE

THE FORMULATED GOALS AND OBJECTIVES.

THE FOLLOWING GENERAL DIRECTIONS FOR

NURSING INTERVENTIONS CAN GUIDE

INTERVENTION SELECTION OF APPROPRIATE NURSING

INTERVENTIONS:

1. ANALYZE WITH THE FAMILY THE CURRENT

PLAN SITUATION AND DETERMINE CHOICES AND
POSSIBILITIES BASED ON LIVED EXPERIENCE
OF MEANING CONCERNS.
2. DEVELOP/ENHANCE FAMILY’S COMPETENCIES AS
THINKER, DOER AND FEELER
3. FOCUS ON INTERVENTIONS TO HELP PERFORM THE HEALTH
TASKS
1. HELP THE FAMILY RECOGNIZE THE PROBLEM
2. GUIDE THE FAMILY ON HOW TO DECIDE ON
APPROPRIATE HEALTH ACTIONS TO TAKE

3. DEVELOP THE FAMILY’S ABILITY AND COMMITMENT TO

PROVIDE NURSING CARE TO ITS MEMBERS.

4. ENHANCE THE CAPABILITY OF THE FAMILY TO PROVIDE A

HOME ENVIRONMENT CONDUCIVE TO HEALTH

MAINTENANCE AND PERSONAL DEVELOPMENT.

5. FACILITATE THE FAMILY’S CAPABILITY TO UTILIZE

COMMUNITY RESOURCES FOR HEALTH CARE.

4. CATALYZE BEHAVIOR CHANGE THROUGH MOTIVATION AND

SUPPORT.
 Intervention Plan

Health Family Nursing Goal of Objectives Nursing Method of N-P Resources

Problems Problems Care Of Care Interventions Contact Required

Family size Inability to make After nursing After the nursing 1. Analyze with the Home Visit Material resources:
beyond what decisions with intervention the intervention, the couple: couple critical issues Visual Aids on methods
family respect to taking family will a. Can explain what related with marital of regulating fertility.
resources can appropriate health decide on planning the family is relationship and the
adequately action due to lack appropriate all about parent’s responsibility Human resources:
provide of knowledge as to actions to b. Can enumerate the for love and life as basis Time and Effort of both
alternative courses maintain family various ways of for maintaining family the nurse and the
of action open to size based on a maintaining the size size family
the family sense of of the family; 2. Discuss with the couple
responsibility for c. Will select a method the alternatives courses Financial resources:
love and life. most appropriate for of action. Money for the nurse
them; transportation.