Module 2 Skills

Republic of the Philippines
UNIVERSITY OF NORTHERN PHILIPPINES

Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
Website: www.unp.edu.ph Mail: unp_nursingvc@yahoo.com
CP# 09177148749, 09175785986
Module 2 (SKILLS)
FAMILY NURSING PROCESS
MODULE DESCRIPTION
This module presents the concepts and principles in the care of individual, families, population
groups and community with the application of guidelines and principles of evidence-based practice of
community health.
LEARNING OUTCOMES
Given actual clinical setting with supervision the Level II students will:
1. Assess with the individual and family one’s health status/competence.
2. Formulate with the client a plan of care to address the health conditions, needs, problems, and
issues based on priorities.
3. Implement safe and quality interventions with the client to address the health needs, problems
and issues.
4. Provide health education using selected planning models to targeted clientele (individual and
families) in the community.
5. Implement safe and evidenced-based quality interventions to address health needs, problems
and issues.
6. Participate in a research study as member of a research team.
7. Provide safe, appropriate and evidence-based nursing interventions in the different categories of
health care.
8. Ensure a working relationship with individual and family based on trust, respect and shared
decision-making using appropriate communication/ interpersonal techniques/ strategies.
9. Ensure intra-agency, inter-agency, multidisciplinary and sectoral collaboration in the delivery
of health care.
10. Implement strategies/ approaches to enhance/ support the capability of the client and care
providers to participate in decision-making by the inter-professional team
PRETEST
A link will be sent by your instructor.

Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
Topic I. Family Health Assessment
Family Nursing Assessment

◦ A deliberate and systematic process of gathering and analyzing data to identify and continuously validate
health and nursing problems of families
◦ Is the first major phase of the nursing process.
◦ It includes data collection, data analysis or interpretation, and nursing diagnosis or problem definition
A. DATA COLLECTION
o First Level Assessment – gathering of data which generates the categories of health
conditions or problems of the family:
a. Family structure, characteristics and dynamics
➢ Family composition and demographic data, type of family,
decision making and patterns, interpersonal relationships, and
communication processes or patters
b. Socio-economic and cultural characteristics
➢ Occupation, workplace, income of each member, educational
attainment, ethnic and religious affiliations, traditions, practices
c. Home and environment
➢ Housing and sanitation, neighborhood and availability of social,
health, communication and transportation facilities
d. Health status of each member
➢ Past, and present health conditions, beliefs and practices to
illness and health, nutritional and developmental status,
complete physical assessment, laboratories and diagnostics
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
e. Values and practices on health promotion/ maintenance and disease prevention
➢ Immunization status, rest and sleep, exercise, relaxation
activities, management of stress and other lifestyle practices
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
o Second Level Assessment – describes the family’s realities, perceptions about and
attitudes related to the assumption or performance of family health task during the first
level assessment
Data- Gathering Methods and Tools

- Used to ensure quality assessment data.
1. Observation
o use of sensory capacities
o gather state of being and behavioral responses
2. Physical Examination
o inspection, palpation, percussion, auscultation
3. Interview
o Questions and communication techniques must be guided by theoretical perspectives in
family health care
a. Determine if the family recognizes the existence of the condition or problem. If the family
does not recognize the presence of the condition or problem, explore the reasons why:
Sample Interview Questions:
What does the family think about the situation/condition of…?
What do you think is the reason why he/she appears (e.g. thin, tired,
lethargic)? Or, Why do you think he/she is behaving this way…?
What do you think is happening to your…?
Why do you think he/she is…? (Ano ang palagay/tingin ninyo ang dahilan
niya…?)
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
b. If the family recognizes the presence of the condition or problem, determine if something
has been done to maintain wellness state or resolve the problem. If the family has not done
anything about it, determine the reasons why. If the family has done something about the
problem or condition, determine if the solution is effective.
Sample Interview Question:
What has been done to improve the condition or situation?
What is the family’s plan regarding this?
What improvements in the condition of… have been observed?
What do you think the family should do about …?
c. Determine if the family encounters other problems in implementing the interventions for
the wellness state/potential, health threat, health deficit or crisis. What are these
problems?
What were the problems or barriers encountered in …?
What do you think are the reasons why there is no improvement in the
condition of …?
Why did you stop doing what you used to do regarding …?
Why did you not continue doing what we have discussed regarding …?
How did you do it? Or, how often did you do it?
d. Determine how the other family members are behaving towards each other or how they are
affected by the health condition or problem.
How are the other members affected by …?
How are the other members reacting to…?
4. Record Review
o Review of existing records and reports pertinent to the client
o Laboratories, diagnostics reports, immunizations
5. Laboratory or Diagnostic Test
o Performing tests, diagnostic procedures carried out by health workers
B. FAMILY HEALTH TASK

- to achieve wellness and reduce or eliminate health problems, family must
perform following health tasks
1. recognize the presence of wellness state or health condition or problem
2. make decisions about taking appropriate health action to maintain wellness or manage the
health problem
3. provide nursing care to the sick, disabled, dependent, or at-risk members
4. maintain a home environment conducive to health maintenance and personal development
5. utilize community resources for health care
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
C. Family Coping Index
- Alternative tool for nursing diagnosis
- It provides a system of identifying areas that may require nursing intervention and areas
of family strengths that may be used to help the family deal with health needs and
problems
- Has nine areas of assessment
- * a family is treated as unit if one is unable to cope but others are able to compensate, the
family is still rated as adequately coping
- Nine Areas:
a. Physical independence – family members mobility and ability to perform ADL’s
b. Therapeutic competence – ability to comply with prescribed or recommended procedures
or treatments to be done
e.g. dietary recommendations, medications, exercise, application of wound dressings
c. Knowledge of health condition – understanding of health condition or essential care
according to the developmental stages of family members
e.g. degree of knowledge of responsible family members in terms of communicability
of diseases and its MOT
d. Application of principles of personal and general hygiene – practice of general health
promotion and recommended preventive measures
e. Health care attitudes – family’s perception of health care in general. Their response to
promotive, preventive and curative responses
f. Emotional competence – concerned with the degree of maturity of family members
according to their developmental stage.
eg. Their ability to sacrifice for others
g. Family living patterns – interpersonal relationships among family members, finances
and the type of discipline in the home
h. Physical environment – home, school, work, and community environment that may
influence the health of the family members
i. Use of community facilities – ability to seek and utilize, as needed, both government-run
and private health, education, and other community services
D. Typology of Nursing Problems in Family Nursing Practice

- Used to facilitate the process of defining family nursing problems, classification system was
developed and field tested (year 1978)
- *the nurse deals mostly with problems within the domain of human behavior or human response
to health and illness
- It contains six main categories:
1. FIRST LEVEL ASSESSMENT – a process where data about the current health status are
compared against norms within the family system
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
The result of data analysis is identified and categorized as:
1.1 wellness state

▪ potential readiness
▪ a clinical judgement about a client in transition from a specific wellness or
capability to a higher level.
1.1.1 wellness potential – a nursing judgement based on client’s performance or clinical
data but has no explicit expression of client desire
1.1.2 readiness for enhanced wellness state – based on client’s current competencies or
performance to achieve a higher level of state or function in a specific area on
health promotion and maintenance
1.2 health threats

▪ conditions that are conducive to disease and accident, or may result to failure to
maintain wellness or realize health potentials
1.3 health deficits

▪ instances of failure in health maintenance
1.4 foreseeable crisis/ stress points

▪ anticipated periods of unusual demand on the individual or family in terms of
adjustment/ family resources; transitions
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
2. SECOND LEVEL ASSESSMENT – specifies the nursing problems that the family
encounters in performing health tasks with respect to a given health condition or problem,
and the causes, barriers or etiology of the family’s inability to perform the health task
2.1 Inability to recognize the presence of the condition or problem due to
2.2 Inability to make decisions with respect to taking appropriate health action d/t
2.3 Inability to provide adequate nursing care o the sick, disabled, dependent or vulnerable/
at risk member of the family
2.4 Inability to provide a home environment conducive to health maintenance and personal
development due to
2.5 Failure to utilize community resources for healthcare due to:

Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
Topic II. FAMILY DATA ANALYSIS
ASSESSMENT DATA BASE supported by other family assessment tools:

i. Genogram – displays information about family for over at least three generations
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
ii. Ecomap – visual diagrams of family relationships with external resources

Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
iii. Family-life technology – captures family interactive processes

Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
DATA ANALYSIS
o Sorting of data – related with health status or practices of family members or data about
home and environment
o Clustering of related cues – determine relationships among data
o Distinguishing relevant from irrelevant data – decide pertinent information
o Identifying patterns – physiologic function, developmental, communication patterns and
others
o Relating family data – comparing patterns with standards of health or norms
o Interpreting results – based on characteristics, values, attitudes, perceptions, lifestyle
associate with health conditions or problems identified
o Making inferences – drawing conclusions about the existence of health conditions or
problem
- Standards or norms utilized in determining the status of the family as a client can be classified
into:
a. Normal health of individual members – physical, social well-being of each family
member
b. Home and environmental conditions conducive to health development – physical,
psychological and socio-cultural milieu
c. Family characteristics, dynamics or level of functioning conducive to family growth
and development – client’s ability to maintain its boundary integrity and achieve its
purposes through a dynamic interchange
FORMULATION OF DIAGNOSIS
o Definition of wellness state / potential or health condition or problems as an end
product of first-level assessment
o Definition of family nursing problems as an end result of second-level assessment
* Nursing Diagnosis - end product of assessments in family nursing practice from the first and second
level assessment.
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
Topic III: FAMILY NURSING CARE PLAN

FORMULATING FAMILY NURSING CARE PLAN
 Formulation of the care plan is the next step in the nursing process after assessment, when health
and family nursing problems have been clearly defined
DEFINITION
A family nursing care plan is the blueprint of the care that the nurse designs to systematically
minimize or eliminate the identified health and nursing problems through explicitly formulated outcomes
of care and deliberately chosen set of interventions, resources and evaluation criteria, standards, methods
and tools.
CHARACTERISTICS OF A FAMILY NURSING CARE PLAN

1. The nursing care plan focuses on actions which are designed to solve or minimize existing
problem.
2. It is a product of a deliberate systematic process. The planning process is characterized by
logical analyses of data that are put together to arrive at rational decisions.
3. It utilizes the past and what is happening in the present to determine patterns.
4. Based upon identified health and nursing problems. The problems are the starting point for the
plan and the foci of the objectives of care and interventions measures.
5. The nursing care plan is a means to an end, not an end itself.
6. It is a continuous process, not one-shot deal. The results of the evaluation of the plan’s
effectiveness trigger another cycle of the planning process until the health and nursing
problems are eliminated.
Desirable Qualities of a Nursing Care Plan

 It should be based on clear, explicit definition of the problems.
 A good plan is realistic.
 The nursing care plan is prepared jointly with the family.
 The nursing care plan is most useful in written form.
Importance of Planning Care

 They individualize care to clients.
 Nursing care plan help in setting priorities by providing information about the client as well as
the nature of his problems.
 The nursing care plan promotes systematic communication among those involved in the health
care effort.
 Continuity of care is facilitated by use of nursing care plans.
 Nursing care plan facilitates the coordination of care by making other members of the health
team what the nurse is doing.
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
Steps in Developing Family Nursing Care Plan

 Prioritized problems
 The goals and objectives of nursing care
 Plan of interventions (Consider alternatives, decide on appropriate intervention measures,
Determine the methods of nurse/family contact, Specify Resources Needed)
 The plan of evaluating care (Criteria, Standards, Methods and Tools)
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
PRIORITIZING HEALTH PROBLEMS
Criteria for determining priorities among health problems

1. 1. Nature of problem presented- categorized into health threat, health deficit and foreseeable
crisis
2. 2. Modifiability of the problem- refers to the probability of success in minimizing, alleviating
or totally eradicating the problem through intervention.
3. 3. Preventive Potential- refers to the nature and magnitude of future problems that can be
minimized of totally prevented if intervention.
4. 4. Salience- refers to the family’s perception and evaluation of the problems in terms of
seriousness and urgency of attention needed.
SCALE FOR RANKING FAMILY HEALTH PROBLEMS

ACCORDING TO PRIORITIES
CRITERIA CLASSIFICATION WEIGHT
Nature of the Problem Wellness State (3) 1

presented Health Deficit (3)
Health Threat (2)
Foreseeable Crisis (1)
Modifiability of the Easily removable (2) 2

problem Partially Modifiable (1)
Not modifiable (0)
Preventive Potential High (3) 1

Moderate (2)
Low (1)
Salience Scale Serious problem immediate attention 1

needed (2)
Problem but not needing immediate
attention (1)
Not a felt need/problem (0)
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
Scoring:
 Decide on a score for each of the criteria
 Divide the score by the highest possible score and multiply by weight.
 Sum up the score for all the criteria. The highest score is five which is equivalent to the total
weight.
➢ Scores nearer five are the priority conditions and problems
Goals and Objectives of Care
Goal - is a broad desired outcome toward which behavior is directed
- Tell where the family is going

- Goals must be set jointly with the family (ensures commitment)
- Nurse must ascertain the knowledge and acceptance of the problem and the desire to take
actions (Done during assessment phase).
BARRIERS IN SETTING GOALS
1. Failure to perceive the existence of the problem
2. Realizes existences but preoccupied and with other concerns
3. Don’t see it as serious to attend
4. Refuses to do something about the situation
a. Fear of consequence of taking action
b. Respect for tradition/ cultural beliefs, values
c. Failure to perceive the benefits of action proposed
d. Failure to relate the proposed action to the family’s goals
5. Failure to develop working relationship
OBJECTIVES – refers to more specific statements of the desired outcomes
- Milestones to reach the destination
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
INTERVENTION PLAN
• Selection of appropriate nursing interventions based on formulated goals and objectives
• Must establish a good family-nurse contact
a. home visit
b. clinic conference
c. visit workplace
d. school visit
e. telephone call
f. group approach
g. mails
SELECTION OF APPROPRIATE INTERVENTIONS

• Analyze with the Family the Current Situation and Determine Choices and Possibilities based on lived
experience
• Develop/enhance family’s competencies as thinker, doer and feeler
• Focus on the intervention to help perform health tasks
• Catalyze behavior change through motivation and support
1. Analyze with the Family the Current Situation and Determine Choices and Possibilities
based on lived experience
Must be dependent with the lived experiences

Must be an active participant
Use of cyclical process to analyze antecedents contributing to or producing specific health problems
Analyzation can catalyze learning process
2. Develop/enhance family’s competencies as thinker, doer and feeler

Gains clearer understanding of self as:
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
3. FOCUS ON THE INTERVENTION TO HELP PERFORM HEALTH TASKS
a. HELP THE FAMILY RECOGNIZE THE PROBLEM

(broadening the base of the family’s information on the nature,
magnitude, and cause of the problem; helping the family see the
implications of the condition; relating health needs to the goals
of the family; encouraging positive or wholesome emotional
attitude toward the problem.
b. GUIDE THE FAMILY ON HOW TO DECIDE ON

APPROPRIATE HEALTH ACTIONS TO TAKE
(identifying or exploring with the family the courses of action
available and the resources needed; discussing the consequences
of each course of action available; analyzing with the family the
consequences of inaction)
c. DEVELOP THE FAMILY’S ABILITY AND

COMMITMENT TO PROVIDE NURSING CARE TO ITS
MEMBERS
d. ENHANCE THE CAPABILITY OF THE FAMILY TO

PROVIDE A HOME ENVIRONMENT CONDUCIVE TO
HEALTH MAINTENANCE AND PERSONAL
DEVELOPMENT
e. FACILITATE THE FAMILY’S CAPABILITY TO

UTILIZE COMMUNITY RESOURCES FOR
HEALTHCARE
4. CATALYZE BEHAVIOR CHANGE THROUGH MOTIVATION AND SUPPORT

Have a learning environment that nurtures change
Must have the feeling of stability
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
Topic IV. IMPLEMENTING OF CARE PLAN

IMPLEMENTATION
• It is the step when the family and/or the nurse execute the plan of action.
• The nurse should be conscious of possible barriers to implementing planned strategies, which
may be:
• family-related
• nurse-related
CATEGORIES OF INTERVENTION
Primary health care ensures people receive comprehensive care - ranging from promotion and prevention to
treatment, rehabilitation and palliative care - as close as feasible to people’s everyday environment.
WHO has developed a cohesive definition based on three components:
• meeting people’s health needs through comprehensive promotive, protective, preventive, curative,
rehabilitative, and palliative care throughout the life course, strategically prioritizing key health care
services aimed at individuals and families through primary care and the population through public health
functions as the central elements of integrated health services.
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
PROMOTIVE
Health service is an activity and / or a series of health service activities that prioritize health promotion
activity.
The example is dental and oral health education.
PROTECTIVE
Actions linked to decreasing risk factors, reducing negative health outcomes, and facilitating
a healthy lifestyle.
PREVENTIVE
Designed to keep something undesirable such as illness, harm, or accidents from occurring. Health
service is a preventive activity against a health problem / illness.
The example is topical application on the teeth.
CURATIVE
Health service is an activity and / or a series of treatment activities aimed at healing of disease, the
reduction of suffering from the disease, disease control, or disability control in order to control the
quality of the patient that can be maintained as optimal as possible.
The example is dental fillings.
REHABILITATIVE
Health service is an activity and / or a series of activities to return the former patients into the
community, so that they can take part again as the useful members of society for themselves and for the
community as much as possible according to their ability.
The example is the manufacture or installation of dentures.
In addition to the medicine above, there is a health service carried out by the general public, this is
called a traditional health service.
PALLIATIVE
Relieving pain without managing the condition
Topic V. TOOLS OF PUBLIC HEALTH NURSE

THE BAG TECHNIQUE
The bag technique is a tool by which the nurse, during her visit will enable her to perform a nursing
procedure with ease and deftness, to save time and effort, with the end view of rendering effective nursing care to
clients.
PRINCIPLES OF BAG TECHNIQUE
• Performing the bag technique will minimize, if not prevent the spread of any infection
• It saves time and effort in the performance of nursing procedures
• The bag technique should show the effectiveness of total care given to an individual or family
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
• It can be performed in a variety of ways depending on the agency’s policy, the home situation,
or as long as principles of avoiding transfer of infection is always observed.
Contents of Public Health Bag
• Paper lining • 1 pair of sterile gloves

• Extra paper for making waste bag • Baby’s scale
• Plastic/ linen lining • Alcohol lamp
• Apron • 2 test tubes
• Hand towel • Solutions of:
• Soap in a soap dish • Betadine
• Thermometers • Zephiran solution
• 2 pair of scissors (surgical and bandage) • Spirit of ammonia
• 2 pair of forceps (curved and straight) • Acetic acid
• Disposable syringes with needles • 70% alcohol
• Hypodermic needles (g. 19, 22, 23, 25) • Hydrogen peroxide
• Sterile dressing • Ophthalmic ointment
• Cotton balls (dry and with alcohol) • Benedicts solution
• Cord clamp • Sphygmomanometer and stethoscope
• Micropore plaster are carried separately
• Tape measure
Important points to consider in the use of the bag:

• The bag should contain all the necessary articles, supplies and equipment’s that will be used to answer
emergency needs
• The bag and its contents should be cleaned very often, the supplies replaced, and ready for use anytime
• The bag and its contents should be well protected from contact with any article in the patient’s home.
Consider the bag and its contents clean and sterile, while articles that belong to the patients as dirty and
contaminated
• The arrangement of the contents of the bag should be the one most convenient to the user, to facilitate
efficiency and avoid confusion.
Steps in Performing the Bag Technique Actions
1. Upon arrival at the patient’s home, place the bag on the table lined with a clean paper. The clean
side must be out and the folded part touching the table
2. Ask for a basin of water or a glass of drinking water if tap water is not available
3. Open the bag and take out the towel and soap
4. Wash hands using soap and water. Wipe to dry
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
5. Take out the apron from the bag and put it on with the right side out
6. Put out all the necessary articles needed for the specific care
7. Close the bag and put it in one corner of the working area
8. Proceed in performing the necessary nursing care and treatment
9. After giving the treatment, clean all things that were used and perform handwashing
10. Open the bag and return all things that were used in their proper places after cleaning them
11. Remove apron, folding it away from the person, the soiled side in and the clean side out. Place it
in the bag
12. Fold the lining, place it inside the bag and close the bag
13. Take the record and have talk with the mother or client. Write down all the necessary data that
were gathered, observations, nursing care and treatment rendered. Give instructions for care of
patients in the absence of the nurse
14. Make appointment for the next visit taking note of the date and time
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
Topic VI. TYPES OF FAMILY NURSE CONTACT
CLINIC VISIT
• Patient visits the health center/clinic to avail of the services thereto offered by the facility
primarily for consultation on matters that ailed them physically.
• Nowadays patients are becoming aware of the other services that the health center offer such as
pre-natal and post-partum care, well baby check-up, immunization, free medicines under DOTS
and other health care.
• Patients utilized the facility mainly for the said purpose
• The nurse plays a very important role in building a closer tie with the patient to gain their trust
and confidence and particularly in the implementation and promotion of health care
Pre-consultation conference
A pre-clinic lecture is usually conducted prior to the administration of patients, which is one way of providing
health education.
Standard procedures:
• Registration/ admission
• Waiting Time
• Triaging
• Clinic Evaluation
• Laboratory and other diagnostic examinations
• Referral system
• Prescription/ dispensing
• Health education
Registration/ admission
• Greet the client upon entry and establish rapport
• Prepare the family record of new patients or retrieve records of old clients
• Elicit and record the client’s chief complaint and clinical history
• Perform physical examination on the client and record it accordingly
Waiting Time
• Give priority numbers to clients
• Implement the “first come, first served” policy except for emergency/ urgent cases
Triaging
• Manage program-based cases
• Refer all non-program-based cases to the physician. For all other cases which has no potential
danger, treatment/ management is initiated by the nurse and she decides to do her own nursing
diagnosis and then refer to the physician for medical management
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
• Provide first-aid treatment to emergency cases and refer when necessary to the next level of
care
Clinical Evaluation
• Validate clinical history and physical examination
• The nurse arrives at evidence-based diagnosis and provides rational treatment based on DOH
programs
• Identify the patient’s problem
• Formulate or write the nursing diagnosis and validate
• Give or perform the nursing intervention
• Evaluate the intervention if it has enabled the patient to achieve the desired outcome
• Inform the client on the nature of the illness, the appropriate treatment and prevention and
control measures
Laboratory and other diagnostic examinations

• Identify a designated referral laboratory when needed
Referral system
• Refer the patient if he needs further management following the two-way referral system (BHS
to RHU, RHU to RHU, RHU to Hospital)
Prescription/ Dispensing
• Give proper instructions on drug intake
Health Education
• Conduct one-on-one counseling with the patient
• Reinforce health education and counselling messages
• Give appointments for the next visits
HOME VISIT
• A face to face contact of the nurse and the family
• It allows the health worker to assess the home and family situations in order to provide the
necessary nursing care and health related activities.
• It is essential to prepare a plan of visit to meet the needs of the client and achieve the best
results of desired outcomes
Purpose:
• To give nursing care to the sick, to a postpartum mother and her newborn with the view to
teach a responsible family member to give the subsequent care
• To assess the living condition of the patient and his family and their health practices in order to
provide the appropriate health teaching
• To give health teachings regarding the prevention and control of diseases
• To establish close relationship between the health agencies and the public for the promotion of
health
• To make use of the inter-referral system and to promote the utilization of community services
• To provide necessary health care activities and to further attain objectives of the agency
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
Principles:
• A home visit must have a purpose or objective
• Planning for a home visit should make use of all available information about the patient and his
family through family records
• In planning for a visit, we should consider and give priority to the essential needs of the
individual and his family
• Planning and delivery of care should involve the individual and family
• The plan should be flexible
Guidelines to Consider Regarding the Frequency of Home Visits:

1. The physical needs, psychological needs and education needs of the individual and the family
2. The acceptance of the family for the services to be rendered, their interest and the willingness to
cooperate
3. The policy of a specific agency and the emphasis given towards their health programs
4. Take into account the health agencies and the number of health personnel already involved in
the care of a specific family
5. Careful evaluation of past services given to a family and how the family avail of the nursing
services
6. The ability of the patient and his family to recognize their own needs, their knowledge of
available resources and their ability to make use of their resources for their benefits
Steps in Conducting Home Visits:

1. Greet the patient and introduce yourself
2. State the purpose of the visit
3. Observe the patient and determine the health needs
4. Put the bag in a convenient place the proceed to perform the bag technique
5. Perform the nursing care needed and give health teachings
6. Record all important data, observation and care rendered
7. Make appointment for a return visit
Other forms of nurse contact:
• Group Conference
• Telephone Calls
• Written Communications
Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
CP# 09177148749, 09175785986
Topic VII. FAMILY HEALTH CARE RESEARCHES
PARTICIPATORY ACTION RESEARCH (PAR)

As a facilitating strategy for maximum community involvement, through collective identification and
analysis of community health problems and collection health action.
It is an active process where the expected beneficiaries of research are the main actor in the entire research process.
This process is based on a system of discussion, investigation and analysis. This also enables the community to
experience collective consciousness about the issue(s) at hand.
The output of PAR and Project Management is the creation of development action plan or project proposal.
POSTTEST
REFLECTION
A link will be sent by your instructor.
EXTERNAL RESOURCES
www.who.int › whr › media_centre › 50facts)

apps.who.int › iris › bitstream › ccsbrief_phl_en
https://www.rnpedia.com/nuring-notes/community-health-nursing-notes/community- health-
nursing-overview/
REFERENCES
Bailon-Reyes, S.G. (2006). Community health nursing the basics of practice. Philippines: National
Book Store.
Cuevas, FP L., Reyala, J.P., Cruz-Earnshaw, R., Bonito,S., Sitioco, J.M., Serafica, L.C., (2007) Public
Health Nursing in the Philippines. Philippines. National League of Philippine Government
Nurses, Incorporated.
Maglaya, Araceli S. (2009) Nursing practice in the Community. 5th ed. Manila, Philippines:
Argonauta Corporation.

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Republic of the Philippines

UNIVERSITY OF NORTHERN PHILIPPINES

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Topic I. Family Health Assessment

Family Nursing Assessment

Data- Gathering Methods and Tools

B. FAMILY HEALTH TASK

D. Typology of Nursing Problems in Family Nursing Practice

1.1 wellness state

1.2 health threats

1.3 health deficits

1.4 foreseeable crisis/ stress points

2.5 Failure to utilize community resources for healthcare due to:

Topic II. FAMILY DATA ANALYSIS

ASSESSMENT DATA BASE supported by other family assessment tools:

ii. Ecomap – visual diagrams of family relationships with external resources

iii. Family-life technology – captures family interactive processes

Topic III: FAMILY NURSING CARE PLAN

CHARACTERISTICS OF A FAMILY NURSING CARE PLAN

Desirable Qualities of a Nursing Care Plan

Importance of Planning Care

Steps in Developing Family Nursing Care Plan

PRIORITIZING HEALTH PROBLEMS

Criteria for determining priorities among health problems

SCALE FOR RANKING FAMILY HEALTH PROBLEMS

CRITERIA CLASSIFICATION WEIGHT

Nature of the Problem Wellness State (3) 1

Modifiability of the Easily removable (2) 2

Preventive Potential High (3) 1

Salience Scale Serious problem immediate attention 1

Goals and Objectives of Care

Goal - is a broad desired outcome toward which behavior is directed

- Tell where the family is going

SELECTION OF APPROPRIATE INTERVENTIONS

Must be dependent with the lived experiences

2. Develop/enhance family’s competencies as thinker, doer and feeler

a. HELP THE FAMILY RECOGNIZE THE PROBLEM

b. GUIDE THE FAMILY ON HOW TO DECIDE ON

c. DEVELOP THE FAMILY’S ABILITY AND

d. ENHANCE THE CAPABILITY OF THE FAMILY TO

e. FACILITATE THE FAMILY’S CAPABILITY TO

4. CATALYZE BEHAVIOR CHANGE THROUGH MOTIVATION AND SUPPORT

Topic IV. IMPLEMENTING OF CARE PLAN

Topic V. TOOLS OF PUBLIC HEALTH NURSE

• It saves time and effort in the performance of nursing procedures

• Paper lining • 1 pair of sterile gloves

Important points to consider in the use of the bag:

Topic VI. TYPES OF FAMILY NURSE CONTACT

• Patients utilized the facility mainly for the said purpose

Laboratory and other diagnostic examinations

Guidelines to Consider Regarding the Frequency of Home Visits:

Steps in Conducting Home Visits:

Other forms of nurse contact:

Topic VII. FAMILY HEALTH CARE RESEARCHES

PARTICIPATORY ACTION RESEARCH (PAR)

A link will be sent by your instructor.

www.who.int › whr › media_centre › 50facts)

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