Community Health Nursing Process

COMMUNITY HEALTH
NURSING PROCESS
NURSING PROCESS
Is a systematic ,scientific, dynamic,

on going interpersonal process in
which the nurse and the clients
are viewed as a system with each
affecting the other and both
being affected by the factors
within the behavior
STEPS in COMMUNITY HEALTH NURSING
PROCESS
I. ASSESSMENT
A. Collection of data
-demographic data
- vital health statistics
-studies of disease surveillance
- economic
- cultural and environmental
characteristics
Collection of data
-utilization of health services by the
population
- health status
-education
- religious and occupational background
- socio-cultural
- family dynamics and patterns of coping
VARIOUS METHODS in DATA COLLECTION
Community Surveys
Interview of individuals, families,
groups and significant others
Observation of health related
behaviors
Methods in Data Collection
Review of statistics, epidemiological
and related studies
Individual and family health records
Laboratory and screening test
Physical examinations of individuals
CATEGORIES OF HEALTH PROBLEM
1. Health Deficit
- occurs when there is a gap between
actual and achievable health status.
2. Health Threats
- are condition that promote disease or
injury and prevent people from realizing their
health potential
Categories of Health Problem
3. Foreseeable crisis
- includes stressful occurrences such as
death or illness of a family member
4. Health Need
-exist when there is a health problem that
can be alleviated with medical or social
technology
Categories of Health Problem
5. Health Problem
-is a situation in which there is a
demonstrated health need combined with
actual or potential resources to apply remedial
measures and a commitment to act on the
part of the provider or the client
The process of assessment in Community
Health Nursing includes:
1. Intensive fact finding
2. The application of professional judgment in

estimating the meaning and importance of
this facts to the family and the community
Process of Assessment in CHN
3. The availability of nursing resources that can
be provided
4. The degree of change which nursing

intervention can be expected to effect
Assessment Data for Individuals, Families
and Communities
INDIVIDUAL FAMILY COMMUNITY
Signs and symptoms structure and characteristics Population characteristics

Medical/nursing history Socioeconomic and cultural Physical characteristics
Ability to cope factors Environmental factors
Lifestyle Environmental factors Health/ Illness data
Health assessment of each Community Resources
Help seeking behavior member Leadership and
Utilization of health Value place on the communication
services prevention of disease Culture
Competencies on the Family Socio economic
Health Care People’s participation in
Health Programs
Reason for the failure of
past health programs
Assessment Process
B. Diagnosis
- is the identification of the clients‘ needs

and problems based on an analysis of the
data/information gathered.
II. PLANNING NURSING
ACTION/CARE
STEPS in PLANNING NURSING ACTION
1. Goal Setting
 Goal - is a declaration of purpose or
intent that gives essential
direction to action.
-should be stated in behavioral terms
S–M–A–R-T
STEPS in PLANNING
2. Constructing a Plan of Action
Possible course of action
-may have possible and/or
negative effect
- The positive consequences must
be weighed against those with
negative aspects
Constructing a Plan of Action
The most appropriate action
- is selected such as those that
the clients could not perform
by themselves, those that
facilitate actions that remove
barriers to care and those that
improve the capacity of the
clients to act in their behalf
Constructing a Plan of Action
The appropriate resources
- Include family; neighborhood, school;
industrial population: the whole
medical system- the hospitals, clinics,
public and private practitioner of
medicine, health unit of welfare
department and other health related
agencies and non health facilities such
as social educational and counseling
agencies
Developing an Operational Plan
Plan of care should are prioritized in order
of urgency to determine those that need
the earliest action or attention such as
those that actually threaten the health of
the client (individual, family or community)
Periodic evaluation and modification of

the plan is necessary.
Developing Operational Plan
The plan and activities should be
coordinated with the various services
so that it will be synchronize with the
total health program of the
community.
IMPORTANCE OF PLANNING CARE
1. Individualize care to clients
 Whether an individual patient ,
family or the entire community ,
clients are different from each other.
 Planning facilitates the delivery of
the most appropriate care by
considering the uniqueness of each
client.
IMPORTANCE OF PLANNING
2. Helps in setting priorities by providing
information about the client as well as the
nature of his problem.
3. Promote systematic communication among
those involved in the health care effort.
4. Continuity of care is facilitated. Gaps and
duplications in the services provided are
minimized if not totally eliminated
IMPORTANCE OF PLANNING
5. Facilitate the coordination of care by making
known to others members of the health team
what the nurse is doing .
Coordination of care prevent fragmentations of
services and increases the efficiency of health
service delivery system
III. IMPLEMENTATION OF PLANNED
CARE
IMPLEMENTATION
 Involves various nursing interventions which have
been determined by the goals/objectives which
has been previously set.
 Patient and her/his family should be involve in

the care provided .
a. in order to motivate them to assume responsibility for
their care.
b. To be able to teach and maintained a desired level of
functioning.
Involve patient and their family
c. explaining and answering questions to clarify
doubts
d. To maximize the client’s confidence and ability

to care for himself/themselves
The role of the Community Health Nurse shifts from

direct care giver to that of a teacher.
DOCUMENTATION
Importance of Documentation:
1. Provides data which is needed to plan the

client’s care and ensure its continuity.
> serves as important communication
tool for various team member
Importance of Documentation
2. Furnishes written evidence of the quality of care
that the clients received and their response to it.
3. Legal records to protect the agency and the health

care providers or the client himself/herself.
4. Provide data for research and education.

IV.EVALUATION OF CARE AND
SERVICES PROVIDED
EVALUATION OF CARE
• EVALUATION- is an interwoven in every
nursing activity and every step of the public
health nurses.
- specifies the worth of nursing
interventions/actions and public health
programs.
- performance of health facilities/human
resources, public health programs and nursing
care given to client .
Three(3) Classic Frameworks from which
Nursing Care is delivered
1. STRUCTURE ELEMENTS
 Include the physical settings,
instrumentalities and conditions through
which nursing care is given such as
philosophy, objectives, building,
organizational structure, financial
resources such as budget, equipment and
staff
Frameworks
2. PROCESS ELEMENTS
Include the steps of the nursing process itself-
assessing, planning, implementing and evaluating
Such as taking the family health data base;

performing physical examination, making a nursing
diagnosis, determining nursing goals, writing a
nursing care plan; performing the necessary
nursing interventions and coordination of services
and measuring success of nursing action
Frameworks
3. OUTCOME ELEMENTS
Are changes in the client’s health status that
result from nursing intervention
This changes include modification of the

signs and symptoms, knowledge, attitude,
satisfaction, skill level and compliance with
treatment regimen
Frameworks
• OUTCOME ELEMENTS
 refer to the results of care provided
and the clients served, changes in
knowledge, skills and attitudes and
satisfaction of those served including
members of nursing and health team
EVALUATION
ASSESMENT DIAGNOSIS PLANNING IMPLEMENTATION
Determine Determine if the Determine if the Analyze how the
whether there are problem/s requiring interventions are plan was
changes in health nursing care are appropriate and implemented
status. resolved, improved adequate to
or controlled. achieve client Determine what
Make sure that outcomes. factors are related
assessment data Consider if there with the success of
are accurate and are new problems. Specify client’s implementing the
complete status based on plan
expected outcomes
of care Specify what
factors created
problems or
barriers of care.

Community Health Nursing Process

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COMMUNITY HEALTH

Is a systematic ,scientific, dynamic,

1. Intensive fact finding

2. The application of professional judgment in

4. The degree of change which nursing

Signs and symptoms structure and characteristics Population characteristics

- is the identification of the clients‘ needs

-should be stated in behavioral terms

Periodic evaluation and modification of

 Patient and her/his family should be involve in

d. To maximize the client’s confidence and ability

The role of the Community Health Nurse shifts from

1. Provides data which is needed to plan the

3. Legal records to protect the agency and the health

4. Provide data for research and education.

Such as taking the family health data base;

This changes include modification of the

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