Nursing Process in the Care of Population Groups and Community PDF

NURSING PROCESS IN THE CARE OF POPULATION GROUPS AND COMMUNITY | Topic 4 COMMUNITY HEALTH NURSING 2 | A. Y. 2023 - 2024 Outline: 4. In selecting appropriate activities, focus of pri...

NURSING PROCESS IN THE CARE OF POPULATION GROUPS AND COMMUNITY | Topic 4 COMMUNITY HEALTH NURSING 2 | A. Y. 2023 - 2024 Outline: 4. In selecting appropriate activities, focus of primary I. Introduction prevention II. Nursing Process in the Care of Population 5. Promote a healthful physical and psychosocial Groups and Community environment III. Principles of Community Health Nursing 6. Reach out to all who may benefit from a specific IV. Steps of the Family Nursing Process service V. Features Of Community 7. Promote optimum use of resources VI. Community Health Assessment Data: 8. Collaborate with others working in the community Collecting Primary Data  Collecting Primary Data  Secondary Data Sources Steps of the Family Nursing Process LEGEND: RED for CI’s additional infos ASSESSMENT Data collection, data organizing, data validating and Nursing Process in the Care of Population documenting client data Groups and Community 1ST LEVEL ASSESSMENT NURSING PROCESS 1. Family structure, characteristics and dynamics A logical, systematic, organized and dynamic method 2. Socio-economic and cultural characteristics of providing care to clients/patients. 3. Home and environment It is methodological and orderly approach to the 4. Health status of each member planning and delivery of nursing care that is utilized 5. Values and practices on health to systematized the helping process and promotion/maintenance & disease prevention standardized the nurse’s approach to her 2nd LEVEL ASSESSMENT client/patient in an attempt to effect improvement in the latter’s health status, as well as increase his 1. Determine if the family recognizes the existence of capabilities to cope with health problems. the condition/problem 2. If the family recognizes the presence of the condition/problem, determine if something has been ASSESSMENT done 3. Determine if the family encounter other problem in implementing intervention EVALUATION DIAGNOSIS 4. Determine how all the other members are affected NURSING PROCESS by the wellness, health threat and stress points IMPLEMENTATION PLANNING Features Of Community Community has three features: Principles of Community Health Nursing 1. PEOPLE o Refers to the educational attainment of the 1. Focus on the community as the unit of care members of the community and their life 2. Give priority to community needs status 3. Work with the community as an equal partner of the health team  NURSING PROCESS IN THE CARE OF POPULATION GROUPS AND COMMUNITY | Topic 4 COMMUNITY HEALTH NURSING 2 | A. Y. 2023 - 2024 2. PLACE Secondary Data Sources o Is the variable that is affected by natural and man-made problems Refers to the existing data that has been collected by 3. SOCIAL SYSTEM someone else for a different purpose but can be used by o Refers to the economy, family beliefs, researchers or organizations for their own research, religion, and culture analysis, or decision-making. o Individual serves as a part of social system I. REGISTRY OF VITAL EVENTS therefore each member is affected by the Act 3753 (Civil Registration Law, Philippine decision made by the community Legislature), enacted in 1930, established the civil registry system in the Philippines and requires the registration of vital events, such as births, marriage Community Health Assessment Data: and death Collecting Primary Data II. HEALTH RECORDS AND REPORTS Primary data are data that have not been gathered The Field Health Services Information System (FHSIS) before and are collected directly from its source is the official recording and reporting system of the Collecting Primary Data Department of Health, this is to generate health statistics I. OBSERVATION Essential in monitoring health status of the this may be done through an ocular survey community take note of the vulnerable group (young & pregnant) It is therefore a basis for: a) Priority setting by local government II. SURVEY b) Planning and decision making at different levels A survey is made up of a series of questions for (barangay, municipality, district, provincial and systematic collection of information from a sample of national) individuals or families in a community, and may be c) Monitoring and evaluating health program written or oral (Maurer and Smith, 2009) implementation Survey is expected to be expensive, but is necessary if there is no available data from the community RECORDING TOOLS III. INFORMANT INTERVIEW THE INDIVIDUAL TREATMENT RECORD (ITR) – Informant interview are purposeful talks with either contains the date, name, address of patient, key informants or ordinary members of the presenting symptoms or complaint of the patient on community consultation and the diagnosis (if available) IV. COMMUNITY FORUM TARGET CLIENT LIST (TCL) – maintained in RHUs and A community forum is an open meeting of the health center members of the community @Prenatal Care Example of community forum include “pulong @Postpartum Care pulong sa barangay” @Under 1-year-old Children @Family Planning @National Tuberculosis Program @National Leprosy Control Program  NURSING PROCESS IN THE CARE OF POPULATION GROUPS AND COMMUNITY | Topic 4 COMMUNITY HEALTH NURSING 2 | A. Y. 2023 - 2024 THE MONTHLY CONSOLIDATION TABLE (MCT) – is Methods To Present Community Data accomplished by the nurse based on the summary table To inform the health team and the members of the community of existing health and health-related THE SUMMARY TABLE – columns correspond to the conditions in the community in an early 12 month of the year and has two components: understandable manner. Health Program Accomplishment and Morbidity To make members of the community appreciate the Diseases significance and relevance of health promotion to their lives. To solicit broader support and participation in the REPORTING FORMS community health process. To validate findings. Monthly Forms To allow for a wider perspective in the analysis of Quarterly Forms data. Annual Forms To provide a basis for better decision making. III. DISEASE REGISTRIES TYPES OF GRAPHS A disease registry is a listing of persons diagnosed with a specific type of disease in a defined population A. Bar graphs Serves as the basis for monitoring, decision-making B. Line graphs and management C. Pie chart D. Pictograph IV. CENSUS DATA A census is a periodic governmental enumeration of the population (Merriam-Webster Online Dictionary, GRAPHS FOR PRESENTING COMMUNITY 2021a). Batas Pambansa Blg. 72 provides for a DATA AND THEIR USES national census of population and other related data in the Philippines every 10 years. I. BAR GRAPH Census data has two methods of acquisition: To compare values across different categories of data 1. DE JURE Information easy to understand even without enumeration of individuals as of where they reading the whole text usually reside, regardless of where they are on census day II. LINE GRAPH written record To have a visual image of trends in data over time of age. This is appropriate for time series. 2. DE FACTO Total massive campaign of family planning resulted in enumeration of individuals as of where they a decease in fertility rate. are found in the census, regardless of where they normally reside III. PIE CHART To show percentage distribution or composition of a variable, such as population or household. Effective tool in highlighting the value of a group to the whole population. 3  NURSING PROCESS IN THE CARE OF POPULATION GROUPS AND COMMUNITY | Topic 4 COMMUNITY HEALTH NURSING 2 | A. Y. 2023 - 2024 Use category not more than six (6). Examples are o to determine if resources are available normal, underweight, severely underweight, and o set priorities for planning overweight. ALTERNATIVE TOOLS FOR NURSING IV. SCATTER PLOT OR DIAGRAM DIAGNOSIS To show correlation between two variables. A. FAMILY COPING INDEX – this tool is based on the Variables are directly proportional to one another. top premises that nursing action may help a family in providing for a health need or resolving a health problem by promoting the family’s Family Nursing Diagnosis coping capacity. The Family Coping Index provides a system of DIAGNOSIS – is the identification of client’s needs and identifying areas that may require nursing problems based on analysis of data/information intervention and areas of family strengths that gathered. may be used to help the family deal with health This is a statement that defines the health strength, needs and problems. health problems, or health risks. A community diagnosis forms the basis for community-based intervention. The process of 9 AREAS OF ASSESSMENT OF THE FAMILY determining the health status of the community and COPING INDEX (FREEMAN & HEINRICH, the factors responsible for it. It is a quantitative and qualitative description of the 1981) health of citizens and the factors that influence their 1. PHYSICAL INDEPENDENCE health. Refers to the family members mobility and ability Allows identification of problems and areas of to perform ADL (Activities of Daily Living). improvement, thereby stimulating action (WHO, 1994). 2. THERAPEUTIC COMPETENCE It is the END RESULT of two nursing assessment (1st and 2nd level of assessment) Is the family’s ability to comply with prescribed Caring for the community as a client start with or recommended procedures and treatments to determining its health status. be done at home. As nurses, CHN, PHN, collects data to determine the If a patient can follow therapeutic instructions, factors that directly or indirectly influence the health recommendations and prescriptions, then they population of the community. are therapeutic competent. After collecting data, DATA ANALYZING is expected in 3. KNOWLEDGE OF HEALTH CONDITION order to determine the health needs or health related problems of the individual or the community Understanding of the health condition or group. essentials of care according to the Once health needs and problems are determined, developmental stages of family members. COMMUNITY DIAGNOSIS will be derived which Awareness of each member of the family in serves as the basis for planning and implementation. terms of the communicability of the disease. Nursing diagnosis may be formulated at INDIVIDUAL LEVELS, COMMUNITY GROUPS and FAMILY LEVELS. Purpose of community diagnosis: o to define the existing health problems 4 NURSING PROCESS IN THE CARE OF POPULATION GROUPS AND COMMUNITY | Topic 4 COMMUNITY HEALTH NURSING 2 | A. Y. 2023 - 2024 4. APPLICATION OF PRINCIPLES OF PERSONAL AND FAMILY COPING INDEX IS MEASURED WITH THE GENERAL HYGIENE FOLLOWING SCORES: Practice of general health promotion and recommended preventive measures. 1 - No Competence Example is handwashing before and after meal; 3 - Moderately Competence every after using the toilet 5 - Complete Competence 5. HEALTH CARE ATTITUDES Health Indicators Refer to the family’s perception of health care in Are the variables used for the assessment of general. community health. Indicators must be valid, reliable, sensitive, specific, 6. EMOTIONAL COMPETENCE feasible, and relevant. Is concerned with the degree emotional maturity of family members according to their CLASSIFICATIONS OF HEALTH INDICATORS developmental stage. 1. Mortality Indicators How the family deal with different challenges 2. Morbidity Indicators and their acceptance of their responsibility. 3. Disability Rates 4. Nutritional Status Indicators 7. FAMILY LIVING PATTERNS 5. Health Care Delivery Indicators Refer to interpersonal relationships among 6. Utilization Rates family members, management of family 7. Indicators of Social and Mental Health finances, and the type of discipline in the home. 8. Environmental Indicators 9. Socio-Economic Indicators 8. PHYSICAL ENVIRONMENT 10. Health Policy Indicators Includes home, school, work and community 11. Indicators Of Quality of Life environment that may influence the health of family members. Includes the internal and external surrounding of Types Of Community Diagnosis the members of the family not only in their home I. COMPREHENSIVE COMMUNITY DIAGNOSIS but also in their environment. Aims to obtain general information about community like demographic variables, socio- 9. USE OF COMMUNITY FACILITIES economic/cultural, health and illness pattern, health Is the ability of the family to seek and utilize, as resources, political/leadership pattern. needed, both government and private health services. ELEMENTS OF COMPREHENSIVE As an advocate of health, provide health COMMUNITY DIAGNOSIS teaching, health promotion and disease prevention as this is our role as health A. DEMOGRAPHIC VARIABLES professionals. 1. Total population and geographical distribution including urban-rural index and population density 2. Age and sex composition 3. Selected vital indicators (growth rate, birth rate, death rate and life expectancy at birth) 5 NURSING PROCESS IN THE CARE OF POPULATION GROUPS AND COMMUNITY | Topic 4 COMMUNITY HEALTH NURSING 2 | A. Y. 2023 - 2024 4. Patterns of migration o Cardiovascular diseases (e.g., 5. Population projections hypertension, heart failure) As a public health nurses/community health nurses, o Digestive diseases (e.g., irritable bowel we should identify groups such as refugees and syndrome, inflammatory bowel disease) indigent people during calamities and disasters. o Neurological disorders (e.g., migraine, epilepsy) B. SOCIO-ECONOMIC AND CULTURAL VARIABLES o Skin diseases (e.g., eczema, psoriasis) 1. Social Indicators (communication network, o Infectious diseases (e.g., HIV/AIDS, transportation system, educational level, housing tuberculosis) condition) o Endocrine disorders (e.g., thyroid 2. Economic Indicator (poverty level income, disease, diabetes) unemployment rates, wage earners to total o Renal and urological diseases (e.g., economically active population, types of industry chronic kidney disease, urinary tract present in the community, occupation common in infections) the community) 3. Leading causes of infant mortality 3. Environmental Indicators (physical/geographical o Birth defects and topographical characteristics; water supply; o Preterm birth and low birth weight waste disposal; air, water and land pollution) o Sudden infant death syndrome (SIDS) 4. Cultural Factors o Injuries (e.g., suffocation) a) Ethnicity, social class, language, religion, o Maternal pregnancy complications race, political orientation 4. Leading causes of maternal mortality b) Cultural beliefs and practices o Severe bleeding (mostly bleeding after c) Concepts about health and illness childbirth) o Infections (usually after childbirth) C. HEALTH AND ILLNESS PATTERN o Blood pressure disorders of pregnancy, The nurse may collect primary and secondary data to including preeclampsia and eclampsia analyze health and illness pattern. o Complications of labor and delivery 1. Leading causes of mortality o Unsafe abortion o Heart disease 5. Leading causes of hospital admission o Cancer o Childbirth and pregnancy-related o COVID-19 complications o Unintentional injuries (e.g., accidents) o Heart disease o Stroke o Pneumonia and other respiratory o Chronic lower respiratory disease infections o Alzheimer's disease o Mental health disorders o Diabetes o Digestive disorders o Influenza and pneumonia o Injuries (e.g., falls, motor vehicle o Kidney disease accidents) 2. Leading causes of morbidity o Skin infections and disorders o Mental health disorders (e.g., o Kidney disease depression, anxiety) o Cancer o Musculoskeletal disorders (e.g., back o Diabetes pain, arthritis) o Respiratory diseases (e.g., asthma, chronic obstructive pulmonary disease) 6  NURSING PROCESS IN THE CARE OF POPULATION GROUPS AND COMMUNITY | Topic 4 COMMUNITY HEALTH NURSING 2 | A. Y. 2023 - 2024 2. Defining the Study Population D. HEALTH RESOURCES It may include the entire population or a focus This is very important in the delivery of basic health group such as elderly, infants, women, or services. The nurse must determine the resources vulnerable groups. (either manpower or material resources). 3. Determining the Data to be Collected 1. Manpower resources The objectives will guide you in identifying that 2. Material resources data that is needed in data gathering. 4. Collecting the Data E. POLITICAL/LEADERSHIP PATTERNS To generate data by using different methods in This now reflects on the action of the government to data collection address the issues that is related to health needs and 5. Developing Instrument problems in the community. These are used in data collection 1. Power structures in the community 6. Actual Data Gathering 2. Attitudes of the people toward authority You should meet first the individual that is 3. Conditions/events/issues that cause conflict or involved in the study. that lead tom social bonding Discuss the instruments. Instruments should be 4. Practices/approaches that are effective in simplified for those who have limitations in settling issues and concerns with the community terms of educational level. After collecting the data, the field of instruments should be checked in terms of reliability, II. PROBLEM-ORIENTED COMMUNITY DIAGNOSIS completeness, accuracy of information collected. Type of assessment that responds to a particular 7. Data Collation need or problem (Spradley) Numerical or descriptive Focus-oriented To facilitate the collation of data, you need Problem-oriented meaning other elements will not categorize or collate be considered (i.e., politics, religions,etc.) Either exclusive or exhaustive Exclusive are categorization based on gender In exhaustive categorization, you anticipate all STEPS IN CONDUCTING COMMUNITY the possible answer that will be given by the DIAGNOSIS respondents. Fixed response questions are used to acquire Aside from determining the objectives in order to information with a fixed answer. decide, the nurse also determine the environment, After categorizing, summarize the data. the socio economic, the behavior or the individual. Can be manual tallying or computer (excel) This is to lessen or to control (e.g., communicable In descriptive data, presentation is narrative disease and to promote health. If numerical data, presented through graphs, Before collecting data, you should determine what charts, bar, diagrams, etc. type of community diagnosis (comprehensive or 8. Data Analysis problem-oriented diagnosis) will you use. This is to establish pattern in terms of health and problems of the community. 1. Determining the Objectives After analyzing, determine the implication in To decide what type of community diagnosis will terms of the health status of the community be used 9. Identifying the Community Health Problems Community health nursing problems will be categorized with health status problems, health 7 NURSING PROCESS IN THE CARE OF POPULATION GROUPS AND COMMUNITY | Topic 4 COMMUNITY HEALTH NURSING 2 | A. Y. 2023 - 2024 resources problems, and health related problems. For health status problem, this can be described in terms of increase or decrease in mortality or morbidity rate. For health resources problems, this may be described in terms of lacking material due to lack of finance or manpower to solve the problem For health-related problem, this may be described if the social, environmental, or economic factor exists and aggravates the illness. 8