COMMUNITY

HEALTH NURSING
PROCESS
AMIT SINGH
 INTRODUCTION

Nursing process is a scientific method for

providing nursing care to a patient’s , it is
helpful in providing well planned, timely
amd effectives nursing care to a patient.
 DEFINITION

Nursing process is an orderly and

systematic manner of determining the
patient problems , making plan to solve
them, initating the plan or assigning
others to implement it and evaluating the
extent to which the plan was effective in
resolving the problems indentified.
 CHARACTERSTICS OF NURSING
PROCESS
It is universal applicable-
1. It is purposeful
2. It is a scientific method which helps the nurse in providing
excellent care
3. It is an orderly process
4. It is planned
5. It is systematic
6. It is problem oriented
7. It provide foundation for patient care
8. It is flexible, not rigid
9. It is goal oriented
 PURPOSE OF NURSING
PROCESS
To help the nurse in providing comprehensive
nursing care in an orderly and planned way.
Comprehensive nursing care includes
 Preventive care
 Curative care
 Promotive care
 Rehabilitative care
 CONTINUE………
a) To make the nursing care systematic and more effective
b) To ensure proper use of available resources .
c) To assess patient’s health status.
d) To identify patient health problems and needs.
e) To establish a plan of nursing care to meet identified
health needs.
f) To performs various nursing intervention to meet
patient’s need and to solve his problems
g) To evaluate the effectivity of nursing care provided to
the patient.
 ADVANTAGES OF NURSING
CARE
a) It helps the nurse in providing comprehensive nursing
care to the planned way needy persons in an orderly and
Planned way.
b) It offers a framework for thinking and provides some
organization to a nurse's critical thinking skills.
c) It makes the nursing care systematic and more effective.
d) It helps the nurse in identifying actual/potential health
problems and needs of the patient. On the basis of this
identification, planning is done. Then various nursing
activities are performed as per planning. Evaluation is the
final step of nursing process in which effectivity of nursing
care provided to the patient, is found out.
 CONTINUE………

e) As it makes the nursing care planned and

systematic, thus it ensures saving of time, money
and material.
f) It ensures proper use of available resources
g) It encourages innovative nursing care.
h) It helps the nurse in providing alternative
nursing, if required.
i) It ensures implementation of priority based
nursing care.
 STEPS OF NURSING PROCESS

1)ASSESSMENT
2)NURSIN PROBLEMS/ NURSING
DIAGNOSIS
3)PLANNING
4)IMPLEMENTATION
5)EVALUATION
 ASSESSMENT

It is the first step of nursing process. It is an important

step of nursing process on which whole of the nursing
care depends. In this step the nurse collects data and
gathers informations from the patient and/or his relatives.
This is done to identify health related problems and needs
of the patient. In this step, informations are gathered
about physiological, psychological, social and spiritual
status of the patient.During this step, mainly two
activities are performed by the nurse-
1. Collection of dats
2. Analysis of data
CONTINUE……..
Collection of data- During this phase data are
collected from various sources to find out health
problems and health needs of the patient.
Usually following sources are used for gathering
patient related data –
(i) History taking
(ii) Physical examination
(iii) Clinical records
(iv) Laboratory tests
HISTORY TAKING:
History taking: During history taking, following
informatin,s are collected from the patient
and/or his relatives –
 Identification data such name as of the patient,
husband/father's name, age, religion, marital status,
occupation , address etc.
 History of present medical or surgical illness.
 Medical or History of past surgical illness .
 Obstetrical history.
 Family history .
 Personal history.
 Socio-economic history
 PHYSICAL EXAMINATION

Physical examination: During physical

examination, head to feet examination is done to
detect any abnormality. During this, whole body or
any part of the body is examined as per need .
Following four techniques are used for physical
examination-(a) Inspection
(b) Palpation
(c) Percussion
(d) Auscultation
CLINICAL RECORDS:
Clinical records: Patient related health records also provide
informations regarding health status of the patient.
(iv) Laboratory tests : Several laboratory tests are also done
to assess health status of the patient. Some of these are as
follow-Blood examination:
1. Hb level
2. TLC‫܀‬
3. DLC…
4. ESR
5. Blood sugar
6. Serum creatinine
7. serum urea, serum uric acid , serum electrolytes level,
CONTINUE……..
8. Serum urea,
9. Serum uric acid ,
10. Serum electrolytes level
11. Malaria Parasite test ,
12. SGOT and SGPT,
13. Widal test, VDRL test etc.
14. Urine examination
15. Amount ,Colour , Ph ,Specific gravity, Appearance ,
Presence of RBC, pus cells , Bacteria.
16. Stool examination
17. Sputum examination- In above tests, one or more tests are
done as per need, based on clinical manifestations of the
patient.
ANALYSIS OF DATA

Analysis of data -After collection of data from

various sources, these are analyzed to find out
actual and potential problems of the patient.
Actual problems - Actual problems are the
problems that are present at the time of
assessment.Potential problems Potential
problems are the problems that are not
present at the time of assessment but may
arise in future.
 NURSING PROBLEM/ NURSING
DIAGNOSIS
After the identification of problem through data collection and
analysis, it has to be stated in a diagnostic statement.
i. To write down patient's actual or potential health problems
based on data collection and analysis during assessment
phase, is known as nursing diagnosis.
ii. Following activities are performed during this step of
nursing process
iii. Analysis and interpretation of collected data
iv. Identification of strengths and weaknesses of the patient.
v. Identification of health problems
 CONTINUE……….

Nursing diagnosis is different from medical or

surgical diagnosis. Medical or surgical diagnosis
refers to any medical or surgical disease present in
the patient where as nursing diagnosis expresses the
difficulties experienced by the patient due to that
medical or surgical diseases.
Under one medical or surgical disease , several
nursing diagnosis can be formulated .
PLANNING

Planning is a major fundamental element of

nursing process Proper planning is essential for
providing effective nursing care to the patient and
for his early recovery. Once the patient and nurse
agree on the diagnosis, a plan of action can be
formulated. If more than one nursing diagnoses are
formulated then nurse will prioritize each
diagnosis.
 PRINCIPLES OF PLANNING
1. Planning should be goal oriented. It means it should
be done according to pre- determined goals.
2. Planning is a continuous and never ending activity so
there should be continuity in making planning
regarding care of the patient.
3. It should be flexible so that it could be changed if
required.
4. It should be done in a manner that it ensures optimum
use of available resources
5. It should be clear and errorless.
6. It should be well balanced.
7. It should be in written
 ADVANTAGES OF PLANNING
1. Planning leads to more effective and faster achievements of pre-
decided goals .Thus it helps in early recovery of the patient
2. It ensures optimum use of available resources, manpower material
and money
3. It prevents duplicacy and overlapping of activities.
4. Proper planning ensures unity of purpose and effort by focusing
attention or goals.
5. Following four activities are performed during planning step of
nursing process-
 Establishing priorities among nursing diagnosis.
 Setting goals /outcome
 Select nursing interventions
 Prepare nursing care plan
 ESTABLISHING PRIORITIES AMONG
NURSING DIAGNOSES
After identification of health problem of the patient, priority
is established. Following three criteria are used for
establishing priorities among health problems-
 Severity of the problem
 Urgency of the problem
 Feasibility of possibility to control the poblem within
available resources, manpower, money and material.
If the pt has three health problems (pain in abdomen,
difficulty in breathing and anxiety. On the basi of above
criteria , top priority is given to difficulty in breathing. Pain
in abdomen and anxiety are given 2nd and 3rd rank
respectively.
 CONTINUE…….

It means first of all nursing actions will be taken to

solve the problem of difficulty in breathing.
These interventions include –
1. To provide calm, comfortable and well ventilated
environment.
2. To provide fowler's position, clear the airway,
required etc.
3. To perform suctioning to administer oxygen
4. After it, actions will be taken to solve the problems
of abdominal pain and anxiety respectively.
 SETTING GOALS/OUTCOMES

After establishment of priority among health

problems, nurse determines the goals of nursing
actions to be performed by her. Setting of goals not
only provides direction and guidance to the nurse
during planning and implementation steps but also
helpful in evaluation of nursing care. Usually two
types of goals are set-
i. Short term goals.
ii. Long term goals
 SELECT NURSING INTERVENTIONS

A Nurse has two perform several nursing activities

to solve the problems of patient. These nursing
activities/ interventions are selected during planning
phase of the nursing process.
These nursing interventions are selected on the basis
of –
 Health problems of the patient
 Available resources to solve these problems.
 PREPARE NURSING CARE PLAN

A nursing care plan outlines the nursing care to be

provided by a nurse to the patient. It is a set of
nursing activities that will be performed by a nurse
to solve the health related problems of the patient.
In other words we can say that it focuses on
nursing interventions which are designed to solve
the existing health problems of the patient.
Main objectives of preparing nursing care plan is
to provide evidence based holistic care to the
patient.
 IMPLEMENTATION

This phase contains all the procedures and tasks carried out
by the nurse. In the phase , several nursing activities
decided upon as being most effective , are carried out by the
nurse in order to fulfil patient’s health needs and to resolve
his health problems.
This is an important phase of nursing process. The nursing
activities and tasks performed by the nurse are specific to
each patient and focus on achievable outcomes.
In hospital setting, most of nursing activities are performed
as per Doctor’s Prescription.
 EVALUATION

This is the final step of nursing process. In the step ,

evaluation of nursing interventions which have been
carried out , is done. Once all the nursing activities
have been carried out , the nurse completes an
evaluation to find out effectivity of nursing care .
After evaluation the possible outcome are usually
described under three terms-
 Fully effective
 Partially effective
 Ineffective
 FORMAT OF NURSING CARE PLAN

S. NO NURSING OBJECTIVE NURSING EVALUATIO

DIAGNOSIS S IMPEMENTA N
TION