FORMAT FOR FAMILY NURSING CARE PLAN WRITTEN OUTPUT

Introduction

I. Family Initial Database (Use Guide by Maglaya)

II. First and Second Level Assessment

A. Health Strengths
Health Strengths Supporting Cues

B. Health Problems
Health Problem (First Level Supporting Cues Second Level Assessment (Family
Assessment) Nursing Diagnosis)
A. Health Deficits
B. Health Threats
c. Foreseeable Crisis Situation

III. Prioritization of Health Problems

A. Computations
Example:
Problem: Cough as a Health Deficit
Criteria Computation Score Justification
1. Nature of the
Problem
2. Modifiability of the
Problem
3. Preventive Potential
4. Salience of the
Problem
TOTAL SCORE
B. List of Prioritized Health Problems
Health Problem Rank Total Score

IV. Family Nursing Care Plan (Top 2 Problems)

Example:
A. Health Problem (First Level Assessment): Cough as a Health Deficit
1. Family Nursing Diagnosis/es (Second Level Assessment):
a.
b.
2. Supporting Cues
a. Subjective Data:
b. Objective Data:
3. Goal/s:
4. Objectives
a. Long-term Objectives:
B. Short-term Objectives:
5. Nursing Interventions
Interventions Rationale Method of Nurse- Resources Needed Remarks
Family Interaction

6. Evaluation

V. Learning Insights