COMMUNITY HEALTH NURSING

Ms. Lilibeth C. Dela Peña RPH, MAN, RN

ASSESSMENT CONTINUATION

Nursing assessment is the first major phase which 2. Educational Attainment of each Member
involves a set of actions by which the nurse 3. Ethnic Background and Religious Affiliation
measures the status of the family as a client, its 4. Significant others-role(s) they play in family’s
ability to maintain itself as a system and functioning life.
unit, and its ability to maintain wellness, prevent, 5. Relationship of the family to larger
control, resolve problems in order to achieve health community- nature and extent of
and well-being among its members. participation of the family in community
activities.
➢ In the initial contact, the nurse should
establish rapport and confidence. C. Home Environment

Methods and Tools of Data Collection: “PROIL” 1. Housing

A. Adequacy of living space
B. Sleeping in arrangement
P Physical Examination
C. Presence of breathing or resting sites
R Records Review of vectors of disease (e.g mosquitoes,
roaches, flies, rodents, etc.)
O Observation D. Presence of accident hazard
E. Food storage and cooking facilities
I Interview
F. Water supply-source, ownership, pot
L Laboratory/ Diagnostic Tests ability
G. Toilet facilities-type, ownership,
sanitary condition
INITIAL DATABASE
H. Garbage/refuse disposal-type,
sanitary condition
A. Family structure, characteristics and dynamics
I. Drainage system-type, sanitary
condition
1. Members of the household and relationship
to the head of the family. 2. Kind of Neighborhood, e.g congested, slum,
2. Demographic data-age, sex, civil status, etc.
position in the family. 3. Social and Health facilities available
3. Place of residence of each member- whether 4. Communication and transportation facilities
living with the family or elsewhere. available
4. Type of family structure- e.g patriarchal,
matriarchal, nuclear or extended. D. Health Status of Each Family Member
5. Dominant family members in terms of
decision making especially on matters of 1. Medical Nursing history indicating current or
health care past significant illnesses or beliefs and
6. General family relationship/ dynamics- practices conducive to health and illness
presence of any obvious/readily observable 2. Nutritional assessment
conflict between members; characteristics, 3. Developmental assessment of infants,
communication/interaction patterns among toddlers, and preschoolers- e,g. Metro Manila
members. Developmental Screening Test (MMDST)
4. Risk factor assessment indicating presence
B. Socio-economic and Cultural Characteristics of major and contributing modifiable risk
factors for specific lifestyle- e.g. hypertension,
1. Income and expenses physical inactivity, cigarette/tobacco
A. Occupation, place of work and smoking, etc.
income of each working member 5. Physical Assessment indicating presence of
B. Adequacy to meet basic necessities illness state(s)- diagnosed or undiagnosed
(food, clothing, shelter) 6. Results of laboratory/diagnostic and other
C. Who makes decisions about money screening procedures supportive of
and how it is spent. assessment findings.

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E. Values, Habits, Practices on Health Promotion, CONTINUATION
Maintenance and Disease Prevention
➢ Loss of job
1. Immunization status of family members ➢ Inadequate rest
2. Healthy lifestyle practices. Specify. ➢ Marriage
3. Adequacy of: ➢ Breastfeeding
➢ Rest and sleep ➢ Menopause
➢ Exercise/activities ➢ Strained marital relationship
➢ Use of protective measures- e.g.
adequate footwear in SECOND LEVEL ASSESSMENT
parasite-infested areas; use of bed
nets and protective clothing in ➢ Identifies the nature or type of nursing
malaria and filariasis endemic areas. problems.
➢ Relaxation and other stress ➢ Identify the “why” are the problems
management activities. - Inability to recognize the presence of
4. Use of promotive-preventive health services. the condition or problem.
- Inability to make decisions with
FIRST LEVEL ASSESSMENT respect to taking appropriate health
action.
➢ It identifies existing or potential health - Inability to provide adequate nursing
conditions. care to the sick, disabled, dependent,
➢ Identify the “what” or vulnerable/ at-risk member of the
family.
1. Wellness - Inability to provide a home
- readiness or potential; a clinical or environment conducive to health
nursing judgement about a client in maintenance and personal
transition from a specific level of development.
wellness or capability to a higher - Failure to utilise community
level. resources for health care.

2. Health Deficit PLANNING

- a gap between actual or achievable
health status, failure in health Steps:
maintenance.
➢ Disease/disability 1. Prioritise problems
➢ “Nahitabo na” 2. Formulate goals and objectives of nursing
➢ There is already an existing care
problem 3. Develop the plan of interventions
4. Develop the plan for evaluating
3. Health Threat
- conditions that promote disease or PRIORITIZATION OF HEALTH PROBLEMS
injury and prevent people from
realising their health potential.
Nature of Is the problem a wellness
➢ Risk or potential problem Condition condition, health deficit, health
➢ “Mahitabo pa”
threat or foreseeable crisis.
4. Foreseeable Crisis/ Stress points Modifiability Probability of success in
- stressful occurrences like death or of Condition enhancing wellness state
illness of a family member, marriage,
menopause, abortion, pregnancy or Preventive Refers to the nature and
hospitalisation. Potential magnitude of future problems
that can be minimised or totally
Examples: prevented if intervention is
➢ Poor lighting done.
➢ Stroke
➢ Noise pollution Salience Refers to the family’s
➢ Death of member perception and evaluation of
➢ Adolescence the problems.
➢ Walking barefoot
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 CONTINUATION

CRITERIA SCORE WEIGHT

Nature of the Condition 3. Outcome Evaluation

➢ Wellness 3 - changes in client’s health status
➢ Health deficit 3 1 result from nursing intervention.
➢ Health threat 2
➢ Foreseeable crisis 1

Modifiability of the
Condition
➢ Easily modifiable 2
➢ Partially modifiable 1 2
➢ Not modifiable 0

Preventive Potential
➢ High 3
➢ Moderate 2 1
➢ Low 1

Salience
➢ A condition needing 2
immediate attention
➢ A condition not
needing immediate 1 1
action
➢ Not perceived as a
condition needing 0
change

IMPLEMENTATION

➢ Putting nursing care to action, coordinating

services, utilising community resources,
providing health education and training, and
documenting responses to nursing action.

EVALUATION

TYPES OF EVALUATION

1. Ongoing Evaluation
2. Intermittent Evaluation
3. Terminal Evaluation

CLASSIC FRAMEWORKS OF EVALUATION

1. Structural Evaluation
- physical settings, instrumentalities
and conditions through which
nursing care is given.

2. Process Evaluation
- steps of nursing process itself
(ADPIE)

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