FAMILY NURSING PROCESS

Course Content:

 A. Family Data Analysis

 B. Family Nursing Diagnosis
 C. Formulating Family Nursing Care Plan
 1. Priority Setting
 2. Establishing Goals and Objectives
 3. Selecting Appropriate Family Nursing Interventions/Strategies
 D. Implementing Family Care Plan
 D.1. Categories of Intervention
 a. Supplemental
 b. Facilitative
 c. Developmental
 D.2 Tools of Public Health Nurse
 a. PHN Bag and Contents
 b. Principles and Techniques in the Use of PHN Bag
 D.3 Types of Nurse Family Contact
 a. Clinic Visit
 b. Home Visit
 c. Group Conference
 d. Telephone Calls
 e. Written Communications
 E. Evaluating of Family Nursing Care
 A. Family Data Analysis
1. The nurse organizes data into clusters (data synthesis)
2. sets aside data that may be considered irrelevant at this point.
3. seemingly inaccurate or conflicting data are validated with the family respondent(s).

 Data analysis is done by comparing findings with accepted standards for individual family
members and for the family unit.

 Current information should be compared with previous information if available.

 In addition, the nurse correlates findings in the different data categories and checks for
significant gaps in the information or the need for more details related to a finding.
 Systems of Organizing a Family Data (Nies and McEwen,
2011)

1. Family Structure and Characteristics

 are reflected in data on household membership
 demographic characteristics,
 family members living outside the household,
 family mobility,
 and family dynamics :
a. emotional bonding,
b. authority and power structure,
c. autonomy of members,
d. division of labor,
patterns of communication, decision making, and problem and conflict resolution).
d. Data on family structure can be visualized clearly through graphic tools such as
genogram, ecomap, and/or family health tree.
 Con’t. Systems of Organizing a Family Data (Nies and McEwen,
2011)
 2. Socioeconomic characteristics
a. include data on social integration (ethnic origin, languages
and/or dialects spoken, and social networks)
b. educational experiences and literacy,
c. work history,
d. financial resources,
e. leisure time interests,
f. cultural influences,
g. including spirituality or religious affiliation.
Con’t. Systems of Organizing a Family Data (Nies and
McEwen, 2011)
3. Family environment – refers to the physical environment inside
the family’s home/residence and its neighborhood.

4. Family health and health behavior take into account the family’s
activities of daily living, self-care, risk behaviors, health history,
current health status, and health care resources (home remedies
and health services).
 B. Family Nursing Diagnosis
 Nursing diagnoses may be formulated at several levels:
a. as individual family members,
b. as a family unit, or as the family in relation to its
environment/community.
Specific diagnoses as proposed by NANDA – International
(NANDA-I, 2011) serve as a common framework of expressing
human responses to actual and potential health problems.
 An alternative tool for nursing diagnosis is the Family
Coping Index. This tool is based on the premise that nursing
action may help a family in providing for a health need or
resolving a health problem by promoting the family’s coping
capacity.
 C. Formulating Family Nursing Care Plan
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 (goals and objectives) and deliberately chosen set of
interventions, resources and evaluation criteria, standards, methods and tools.
 FNCP FEATURES
● focuses on actions which are designed to solve or minimize existing problem.
● The plan is a blueprint for action.
● The cores of the plan are the approaches, strategies, activities, methods and
materials which the nurse hopes will improve the problem situation.
Continuation of Formulating Care Plan

● 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.
● The interventions the nurse decides to implement are
chosen from among alternatives after careful analysis and
weighing of available options.
 Steps in Making Family Nursing Care Plan
● The assessment phase of the nursing process generates the health and nursing
problems which become the bases for the development of nursing care plan. The
planning phase takes off from there.

 Process in making the Family Nursing Care Plan

 1. Assessment Phase – Happens on the first and succeeding home visits. Making
objective observation can be coupled with subjective statements by each family
member.

 2. Identification of the Problem/s – Make a list of the problems sited. Prioritization of

the needs must be applied.
 3. Formulation of Goals and Objectives – Referring on the problems, goals
and objectives must be measurable, attainable, realistic and time-
oriented.
 4. Plot Nursing Interventions – The objectives must be the guidelines in
making nursing interventions. Nursing interventions must be rational
enough.
 5. Evaluate the outcomes – This stage will be the determining stage
whether the goals and objectives have been met or not. Nursing
interventions can be modified at this stage.
 1.Formulation of Goals and Objectives
● GOAL-is a general statement of condition or state to be
brought about by specific courses of action.

● OBJECTIVE-refers to a more specific statement of the

desired results or outcomes of care. They specify the
criteria by which the degree of effectiveness of care is to
be measured.
 Characteristics of a workable, well-stated objectives
● Specific: the objective clearly articulates who is expected to do what. Example: the
family or a target family member will manifest a particular behavior.
● Measurable:Observable,measurable, and whenever possible, quantifiable indications of
the family’s achievement as a result of their efforts toward a goal provide a concrete
basis for monitoring and evaluation.
● Attainable: the objective has to be realistic and in conformity with available resources,
existing constraints, and family traits, such as style and functioning.
● Relevant: the objective is appropriate for the family need or problem that is intended to
be minimized, alleviated, or resolved.
● Time-bound: having a specified target time or date helps the family and the nurse in
focusing their attention and efforts toward the attainment of the objective (Doran,
1981).
 3.Selecting Appropriate Family Nursing Interventions/Strategies

 Focus on Interventions to Help The Family Performs Health Tasks:

1. Help the family recognize the problem

o Increasing the family’s knowledge on the nature, magnitude and cause of the problem.

o Helping the family see the implications of the situation or the consequences of the condition.

o Relating the health needs to the goals of the family.

o Encouraging positive or wholesome emotional attitude toward the problem by affirming the
family’s capabilities/qualities/resources and providing information on available actions.
Continuation of..Selecting Appropriate Family Nursing
Interventions/Strategies

2. Guide the family on how to decide on appropriate health actions

to take.
o Identifying or exploring with the family courses of action
available and the resources needed for each.
o Discussing the consequences of action available.

o Analyzing with the family of the consequences of inaction.

 Continuation of..Selecting Appropriate Family
Nursing Interventions/Strategies

3. Develop the family’s ability and commitment to provide nursing care to each member.

o Contracting-is a creative intervention that can maximize the opportunities to develop

the ability and commitment of the family to provide nursing care to its members.

4. Enhance the capability of the family to provide home environment conducive to health
maintenance and personal development.

o The family can be taught specific competencies to ensure such home

environment through environmental manipulation or management to minimize or
eliminate health threats or risks or to install facilities of nursing care.
 Continuation of..Selecting Appropriate Family
Nursing Interventions/Strategies
5. Facilitate the family’s capability to utilize community resources for health care.

o Involves maximum use of available resources through the coordination, collaboration

and teamwork provided by effective referral system.

 Criteria for Selecting the Type of Nurse Family Contact

1. Effectivity

2. Efficiency

3. Appropriateness
 D. Implementing Family Care Plan

 D.1. Categories of Intervention

 Depending on identified family needs and the goals and objectives,

interventions may range from the simple or immediate such as
offering information about health resources available to the family,
to the complicated or prolonged, such as providing care to a family
with a member newly diagnosed with a pulmonary tuberculosis
(PTB).
Three Types of Nursing Interventions ( Freeman and Heinrich, 1981)

1.Supplemental interventions – are actions that the nurse performs on behalf of the family
when it is unable to do things for itself. Example: providing direct nursing care to a sick or
disabled family member.
2.Facilitative interventions – refer to actions that remove barriers to appropriate health
action. Example: assisting the family to avail of maternal and early child health care services.
3. Developmental interventions – aim to improve the capacity of the family to provide for its
own health needs. This is directed toward family empowerment. Example: guiding the family to
make responsible health decisions.

Interventions may be a mix of two or all three of these categories, with the nurse making sure
that they are appropriate to the family situation.
 D.2 Tools of Public Health Nurse
● PHN Bag and Contents
● Principles and Techniques in the Use of PHN Bag
 D.3 Types of Nurse Family Contact
 a. Clinic Visit
 b. Home Visit
 c. Group Conference
 d. Telephone Calls
 e. Written Communications

 Continuation of Types of Nurse Family Contact

 Clinic or Office Conference

● It is less expensive for the nurse and provides the opportunity to use equipment that can’t be
taken to the home. In some cases, the other team members in the clinic may be consulted or
called in to provide additional service.
 Home Visit
● While it is expensive in terms of time, effort and logistics for the nurse, it is an effective and
appropriate type of family nurse contact if the objectives and outcomes of care require accurate
appraisal of family relationship, home and environment and family competencies. i.e. The best
opportunity to serve the actual care given by family members.

 Group Conference

● Conference of mothers in the neighborhood, provides an opportunity for initial

contact between the nurse and target families of the community that may take
place at a health facility or in the community.
● Appropriate for developing cooperation, leadership, self-reliance, and/or
community awareness among group members
● Attendance usually requires motivation and availability of target family members.
 Telephone Conference

● May be effective, efficient, and appropriate if the objectives and outcomes of

care require immediate access to data given problems on distance or travel time.
Such data include monitoring of health status or progress during the acute phase
of an illness state, change in schedule of visit or family decision, and updates on
outcomes or responses to care and treatment.
 Written Communication

● It is another less time consuming option for the nurse in instances when there
are large number of families needing follow-up on top of problems of distance
or travel time.

● Is used to give specific information to families, such as instructions given to

parents through school children.

● It’s a one-way method and requiring literacy and interest, and the nurse cannot
be certain that the information will reach the intended recipient.
 E. Evaluating of Family Nursing Care


-in family nursing, evaluation is determining the value of nursing care that has been given
to a family.
 the product of this step is used for further decision making: to terminate, continue, or
modify the intervention (s). well-formulated goals and objectives in the nursing care plan
serve as the framework for evaluation.
 - formative evaluation is judgment made about effectiveness of nursing interventions as
they are implemented (Maurer and Smith, 2009). This is ongoing and continuing while
family nursing care is being implemented and family-nurse interaction are taking place.
 - Summative evaluation is determining the end results of family nursing care and usually
involves measuring outcomes or the degree to which goals have been achieved (Maurer
and Smith, 2009).
Thank you for Listening