Class notes
NCM 104 Ch 4 - Community Health Nursing Process
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Lecture notes of 5 pages for the course NCM 104 at San Lorenzo Ruiz College of Ormoc, Inc. (It contains notes.)
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Chapter 4 - Community Health Nursing ProcessDefinition of Terms
Nursing process
- is a systematic, scientific, dynamic, on-going interpersonal process in which
the nurses and the clients are viewed as a system with each affecting the
other and both being affected by the factors within the behavior.
Phases of Nursing Process
A. Assessment and Diagnosis
1. Collection of Data
- Relevant data are collected on the health status of the family, groups and
community: demographic data, vital health statistics, community dynamics,
health status, education, socio-cultural, religious and occupational
background, family dynamics, environment and patterns of coping.
- Various methods are employed to collect data: community surveys,
interview of individuals, observation of health-related behaviors of
individuals, review of statistics, epidemiological and relevant studies,
individual and family health records, laboratory and screening tests and
physical examinations of individuals.
- These data are collected systematically and continuously, then are recorded
in appropriate forms and kept systematically so that retrieval of information
is facilitated.
2. Categories of Health Problems
- Health deficit occurs when there is a gap between actual and achievable
health status.
- Health threats are conditions that promote disease or injury and prevent
people from realizing their health potential.
- Foreseeable crisis includes stressful occurrences such as death or illness of
a family.
- Health need exists when there is a health problem that can be alleviated
with medical or social technology.
- 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.
B. Planning Nursing Actions/Care
1. Goal Setting
- A goal is a declaration of purpose or intent that gives essential direction to
action.
- Specific objectives of care are made with the individual family in terms of
activities of daily living and adaptive functioning and capability to cope
with stress.
- These objectives are stated in behavioral terms: specific. measurable,
attainable, realistic and time bounded.
2. Constructing a Plan of Action
- The courses of action may have positive and/or negative effects. The
positive consequences must be weighed against those with negative
aspects.
- The most appropriate action is selected such as those that the clients could
not perform themselves, those that facilitate actions that remove barriers to
care and those that improve the capacity of the clients to act in their behalf.
- The appropriate resources are identified which include the family, the
neighborhood, the schools, the industrial population and the whole medical
system.
3. Developing an Operational Plan
, - Plans of care are prioritized in order of urgency to determine those that
need the earliest action or attention such as those that threaten the health
of the client.
- These plans are broken down to manageable units and properly sequenced.
- Periodic evaluation and modification of the plan is necessary.
- The plan and activities should be coordinated with the various services so
that it would synchronize with the total health program of the community.
C. Implementation of Planned Care
- Public health nurses involve the patient and his/her family in the care
provided in order to motivate them and to maximize the client's confidence
and ability to care for him/herself.
- To maintain his/her optimum level of functioning, the client needs the
support of his own knowledge and that of those around him/her.
- The public health nurses monitor the health services provided, make proper
referrals as necessary and supervise midwives and barangay health
workers.
- Documentation is an important function of the public health nurses. They
are legal records to protect the agency and the health care providers or the
client himself/herself.
D. Evaluation of Care and Services Provided
1. There are three classic frameworks from which nursing care is delivered.
- Structural elements include the physical settings, instrumentalities and
conditions through which nursing care is given.
- Process elements include the steps of the nursing process itself: assessing,
planning, implementing and evaluating.
- Outcome elements are changes in the client's health status that result from
nursing intervention.
2. Quality assurance efforts now recommend that evaluation of structure,
process, and outcomes criteria be made.
- Evaluation based on professional practice include conformity with accepted
community and public health standards of practice, continued refinement
and enhancement of nursing skills.
- Evaluation of structure include cost-benefit ratio, qualifications and number
of members of the health team and the material resources in terms of
quantity and quality.
- Evaluation based on information gathered is utilized to improve community
health nursing services as part of the total community health services.
Nursing Procedures
A. Clinic Visit - patient visits the clinic to avail of the services thereto offered
by the facility primarily for consultation on matters that ailed them
physically.
1. Procedure
- Registration/admission
- Waiting time
- Triaging
- Clinical evaluation
- Laboratory and other diagnostic examinations
- Referral system
- Prescription/dispensing
- Health education
B. Blood Pressure Measurement - measuring and monitoring blood pressure is
a very common procedure and yet, is often performed incorrectly.
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