Nursing Process in the care of
Population Groups and
Community
A. Community Health
Community Assessment
An essential process for understanding the
community, identifying its needs or
weaknesses, and assets or strengths that is
useful to achieve healthy communities
Fundamental step that supports other nursing
actions
Community Assessment
Otherwise termed as Community Health
Needs Assessment
The data that need to be collected depends on
the objectives of community assessment
In general, the nurse needs to collect data on
the 3 features of a community – people, place,
and social system.
Community Assessment
Approaches
Comprehensive Needs Assessment
The nurse gathers information about the
entire community using a systematic process
where data are collected regarding all aspects
of the community to be able to identify actual
and potential health problems
Useful when health assessment is done for the
first time
Problem-oriented assessment
Focused on a particular aspect of health
This is done with a certain community
problem in mind
Workable if the nurse is familiar with the
community such as when a Comprehensive
Needs Assessment has been previously done
Tools for community assessment
PRIMARY DATA – data that have not been
gathered before
SECONDARY DATA – taken from existing data
sources
-going over secondary data first, gives the nurse
a picture of what is already known, which may
facilitate collection of primary data
Collecting Primary Data
1. Observation
2. Survey
3. Informant Interview
4. Community Forum
5. Focus Group
1. Observation
RAPID OBSERVATION
o May be done through ocular or windshield
survey – driving or riding a vehicle or
walking
o Observe people, take note of environmental
conditions and existing facilities
o Spot for vulnerable groups
PARTICIPANT OBSERVATION
o Purposeful observation of formal and
informal community activities, by sharing, if
possible, in the life of the community.
o Helps determine community values, beliefs,
norms, priorities, concerns, and power and
influence structures
2. Survey
Maybe necessary when there is no available
information about the community or specific
population group to be studied
Used by the nurse in identifying patterns of
utilization of health services
3. Informant Interview
• Purposeful talks with either key informants or
ordinary members of the community
4. Community Assessment
• Addresses the important role of primary data
in community health assessments, and
provides guidance on key informant
interviews, focus groups, community
surveys, community forums, and direct
observation.
• Pulong-pulong sa barangay
Secondary Data Sources
a. Registry of vital events
b. Health Records and reports
c. Disease Registries
d. Census data
a. Registry of Vital Events
Philippine Statistics Authority (formerly
National Statistics Office) – serve as the
central repository of civil registries
Reliable civil registration and vital statistics
provide a realistic basis for program planning
and implementation
• Facility based births - facility administrator
shall be responsible for the registration
a. Registry of Vital Events
Outside facility – physician, nurse midwife, or
anybody who attended the delivery
Either parent may also register the birth
Should be done within 30 days from the
occurrence of birth
The physician who last attended to the
deceased shall be responsible for preparing the
death certificate and forwarding it to the health
officer within 48 hours
a. Registry of Vital Events
If death occurred without medical attention,
the nearest relative or any person who has
knowledge should report it to the health
officer within 48 hours.
Health officers certifies death and directs
registration
Registration of death shall be made within 30
days from death
b. Health Records and Reports
Field Health Service Information System (FHSIS)
is the official recording and reporting system of
the DOH
FHSIS is an essential tool in monitoring the
health status of the population at different
levels
FHSIS provides a standardized, facility-level
database
c. Disease Registries
• A listing of persons diagnosed with a specific
type of disease in a defined population.
d. Census data
Periodic governmental enumeration of the
population
Done every 5 years to ensure updated information is
used
PSA conducts a national census using the de jure
method.
Census population consists of Filipino nationals
residing in and out of the Philippines and foreigners
having their usual residence in the Philippines
Methods of presenting data
Maps show the differences or similarities
across geographic areas
Numeric data are usually more clearly
presented through tables, graphs, and charts
Purpose of presenting data
To inform the health team and members of
the community of the existing health and
health-related conditions in the community in
an understandable manner
To make members of the community
appreciate the significance and relevance of
health information to their lives
Purpose of presenting data
To solicit broader support and participation in
the community health process
To validate findings
To allow for a wider perspective in the analysis
of data
To provide a basis for better decision making
Steps to community needs
assessment
1.Identify and engage stakeholders
2.Define the community
3.Collect and analyze data
4.Select priority health issues
5.Document and communicate
6.Plan improvement strategies
7.Implement improvement plans
8.Evaluate progress
B. Community Diagnosis
Process of determining the health status of the
community and factors responsible for it
Allows identification of problems and areas of
improvement, thereby stimulation action
The health worker makes a judgment about the
community’s health status, resources, and health
action potential or the likelihood that the
community will act to meet health needs or resolve
health problems
Schemes for diagnosis
NANDA I
NANDA‐I diagnosis: Deficient Community
Health
Definition: Presence of one or more health
problems or factors that deter wellness or
increase the risk of health problems
experienced by an aggregate.
NANDA‐I diagnosis: Ineffective Community
Coping
Definition: A pattern of community
activities for adaption and problem‐
solving that is unsatisfactory for meeting
the demands or needs of the community
Shuster and Goeppinger
Three-part – statement
Consists of:
The health risk or specific problem
The specific aggregate or community
Related factors
The Omaha System
Comprehensive and research based
classification system for client problems
The classification has three components:
oProblem classification scheme
oIntervention scheme
oProblem rating scale for outcomes
Social Diagnosis
Represents the impact of the health
problem in terms of the overall quality of
life of the people in the community
Looks at quality of life as a subjectively
defined problem of individuals or
communities.
