Community Health Nursing Process

 Community health purposes and goals are realized

through the application of a series of steps that lead to described
results.

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.
 The process is a series of actions that lead toward a
particular result.
 This process of decision making results in the
optimal health care for the clients to whom the nurse applies the
process.

1. Assessment
 Provides an estimate of the degree to which a
family, group, community is achieving the level of health
possible for them.
 Identifies specific deficiencies or guidance needed.
 Estimates the possible effects of the nursing
interventions.
 Involves the following steps which are taken with
the active participation of the clients especially in decisions
made:
a. Collection of data
 Demographic data
 Vital health statistics
 Utilization of health services
 Health status
 Family dynamics
 Environment
 Patterns of coping
 Community dynamics
 Education, socio-cultural, religious, occupational
background
b. Methods of collecting data
 Community surveys
 Interview of individuals, families and groups
 Observation of health related behaviors and
environment
  Review of statistics: epidemiological and relevant
studies
 Individual and family health records
 Screening tests and P.E. of individuals
c. 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 crises – anticipated periods of
unusual demand on the individual or family in
terms of adjustment/ family resources.
Note:
 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.

2. Planning Nursing Action

 Is based on the actual and potential problems
that were identified and prioritized.
 Includes the following steps:
a. Goal setting
 Goal – is a declaration of purpose or intent that
gives essential direction to action.
 Specific objectives – are made with the individual
family in terms of:
a. Activities of daily living
b. Adaptive functioning based on remaining
capabilities resulting from their condition or
environment
c. Stated in behavioral terms: SMART
b. Construction of a plan of action
 Choosing from among the possible courses of
action
 Selecting the appropriate types of nursing
intervention
 Identifying appropriate and available resources for
care
  Developing an operational plan
c. Developing an operational plan
 PHN must establish priorities phase and
coordinate activities
 Plans of care are prioritized according to urgency
down to manageable units and properly
sequenced
 Periodic evaluation must be done in order to
determine whether re-planning or modification of
the plan is necessary
 The plan and activities should be coordinated to
with the various services to synchronize with the
total health program of the community.
 Development of evaluation parameters based on
the standard of nursing services, problems
identified, goals and priorities in the plan or
program of nursing care for the client.

3. Implementation of Planned Care

 Involves various nursing interventions which have
been determined by the goals/ objectives previously set.
 Involves the patient and his family in the care
provided in order to motivate them to assume responsibility
for his/her care and to be able to reach and maintain desired
level of functioning at a specified time.
 Demonstration, repetition, explanation, answering
questions to clarify doubts, maximizing the client’s confidence
and ability to self-care.
 Utilization of client support system provides a
harmonious, orderly care to enable the client to function
optimally.
 Community health nurses monitor health services
provided, making proper referrals as necessary
 Documentation:
 Provides data which is needed in planning
patient’s care and ensure continuity.
 Important communication tool for the heath team
 Furnishes a written evidence of the quality of care
that clients received and then response
 Provides a legal record to protect the agency and
health care provider or the client
 Provides data for research and education

4. Evaluation of Care and Services Rendered

  Is interwoven in every nursing activity and every
step of the public health nurses.
a. Structural: physical settings, instrumentalities and
conditions through which nursing care is given such as
philosophy, objectives, building, organizational
structure, financial resources. (budget, equipment,
staff)
b. Process: nursing process: family health data base,
performing physical assessment, making nursing
diagnosis, determining goals, writing a nursing care
plan, performing necessary interventions and
coordination of services and measuring success of
nursing actions.
c. Outcome: changes in the client’s health status
that result from nursing intervention. These changes
include modification of: signs and symptoms,
knowledge, attitudes. Satisfaction, skill level and
compliance with treatment regimen.

Source: Cuevas, Frances Precilla L., et.al. (2007) Public Health

Nursing in the Philippines (10th ed). Philippines: Publications
Committee, National League of Philippine Government Nurses.