Nursing Process in the care of

Population Groups and

Community
 A. Community Health

Community Assessment
 An essential process for understanding the
community, identifying its needs or
weaknesses, and assets or strengths that is
useful to achieve healthy communities
 Fundamental step that supports other nursing
actions
 Community Assessment

 Otherwise termed as Community Health

Needs Assessment
 The data that need to be collected depends on
the objectives of community assessment
 In general, the nurse needs to collect data on
the 3 features of a community – people, place,
and social system.
 Community Assessment
Approaches

Comprehensive Needs Assessment

 The nurse gathers information about the
entire community using a systematic process
where data are collected regarding all aspects
of the community to be able to identify actual
and potential health problems
 Useful when health assessment is done for the
first time
Problem-oriented assessment
 Focused on a particular aspect of health
 This is done with a certain community
problem in mind
 Workable if the nurse is familiar with the
community such as when a Comprehensive
Needs Assessment has been previously done
Tools for community assessment
 PRIMARY DATA – data that have not been
gathered before
 SECONDARY DATA – taken from existing data
sources
-going over secondary data first, gives the nurse
a picture of what is already known, which may
facilitate collection of primary data
 Collecting Primary Data
1. Observation
2. Survey
3. Informant Interview
4. Community Forum
5. Focus Group
 1. Observation

 RAPID OBSERVATION
o May be done through ocular or windshield
survey – driving or riding a vehicle or
walking
o Observe people, take note of environmental
conditions and existing facilities
o Spot for vulnerable groups
 PARTICIPANT OBSERVATION
o Purposeful observation of formal and
informal community activities, by sharing, if
possible, in the life of the community.
o Helps determine community values, beliefs,
norms, priorities, concerns, and power and
influence structures
 2. Survey

 Maybe necessary when there is no available

information about the community or specific
population group to be studied
 Used by the nurse in identifying patterns of
utilization of health services
 3. Informant Interview

• Purposeful talks with either key informants or

ordinary members of the community
 4. Community Assessment

• Addresses the important role of primary data

in community health assessments, and
provides guidance on key informant
interviews, focus groups, community
surveys, community forums, and direct
observation.
• Pulong-pulong sa barangay
 Secondary Data Sources

a. Registry of vital events

b. Health Records and reports
c. Disease Registries
d. Census data
 a. Registry of Vital Events
 Philippine Statistics Authority (formerly
National Statistics Office) – serve as the
central repository of civil registries
 Reliable civil registration and vital statistics
provide a realistic basis for program planning
and implementation
• Facility based births - facility administrator
shall be responsible for the registration
 a. Registry of Vital Events
 Outside facility – physician, nurse midwife, or
anybody who attended the delivery
 Either parent may also register the birth
 Should be done within 30 days from the
occurrence of birth
 The physician who last attended to the
deceased shall be responsible for preparing the
death certificate and forwarding it to the health
officer within 48 hours
 a. Registry of Vital Events
 If death occurred without medical attention,
the nearest relative or any person who has
knowledge should report it to the health
officer within 48 hours.
 Health officers certifies death and directs
registration
 Registration of death shall be made within 30
days from death
b. Health Records and Reports

 Field Health Service Information System (FHSIS)

is the official recording and reporting system of
the DOH
 FHSIS is an essential tool in monitoring the
health status of the population at different
levels
 FHSIS provides a standardized, facility-level
database
 c. Disease Registries

• A listing of persons diagnosed with a specific

type of disease in a defined population.
 d. Census data

 Periodic governmental enumeration of the

population
 Done every 5 years to ensure updated information is
used
 PSA conducts a national census using the de jure
method.
 Census population consists of Filipino nationals
residing in and out of the Philippines and foreigners
having their usual residence in the Philippines
Methods of presenting data

 Maps show the differences or similarities

across geographic areas
 Numeric data are usually more clearly
presented through tables, graphs, and charts
 Purpose of presenting data

 To inform the health team and members of

the community of the existing health and
health-related conditions in the community in
an understandable manner
 To make members of the community
appreciate the significance and relevance of
health information to their lives
 Purpose of presenting data

 To solicit broader support and participation in

the community health process
 To validate findings
 To allow for a wider perspective in the analysis
of data
 To provide a basis for better decision making
 Steps to community needs
assessment

1.Identify and engage stakeholders

2.Define the community
3.Collect and analyze data
4.Select priority health issues
5.Document and communicate
6.Plan improvement strategies
7.Implement improvement plans
8.Evaluate progress
 B. Community Diagnosis

 Process of determining the health status of the

community and factors responsible for it
 Allows identification of problems and areas of
improvement, thereby stimulation action
 The health worker makes a judgment about the
community’s health status, resources, and health
action potential or the likelihood that the
community will act to meet health needs or resolve
health problems
 Schemes for diagnosis

NANDA I
 NANDA‐I diagnosis: Deficient Community
Health
 Definition: Presence of one or more health
problems or factors that deter wellness or
increase the risk of health problems
experienced by an aggregate.
NANDA‐I diagnosis: Ineffective Community
Coping
 Definition: A pattern of community
activities for adaption and problem‐
solving that is unsatisfactory for meeting
the demands or needs of the community
Shuster and Goeppinger
 Three-part – statement
Consists of:
 The health risk or specific problem
 The specific aggregate or community
 Related factors
The Omaha System
 Comprehensive and research based
classification system for client problems
 The classification has three components:
oProblem classification scheme
oIntervention scheme
oProblem rating scale for outcomes
 Social Diagnosis
 Represents the impact of the health
problem in terms of the overall quality of
life of the people in the community
 Looks at quality of life as a subjectively
defined problem of individuals or
communities.