COMMUNI TY HEALTH

NURSI NG PRACTI CE
PROCESS:

I NTRODUCTI ON:

Nursing process is orderly, systematic
manner of determining the patients
problem ,making plan to solve them,
initiating the plan and evaluating the
extent to which the plan was effective
in resolving the problems identified .

DEFI NI TI ON:

Nursing process has traditionally been
defined as a systematic method for
assessing health status ,diagnosing
health care needs ,formulating plan of
care, initiating plan & evaluating the
effectiveness of the plan.

CHARACTERI STI CS OF A
NURSI NG PROCESS:

PURPOSE
ORGANIZATION
PROPERTIES

PURPOSES:

To maintain optimal wellness
To provide quality care
To provide quality of life
To achieve purposes of nursing


ORGANI ZATI ON :

Assessment phase
Diagnosis phase
Planning phase
Implementation phase
Evaluation phase

PROPERTI ES:

Purposeful
Systematic
Dynamic
Interactive
Flexible
Theoretically based




COMPONENTS
OF
NURSING
PROCESS
COMMUNITY
IDENTIFICATION /
ASSESSMENT PHASE

Systematic process of knowing and
exploring the defined community for
assessing its health status and
determining the possible factors
affecting the health of people in the
community
ASSESSMENT
It is continuous, systematic critical,
orderly& precise method of collecting,
validating, analysing and interpreting
information about physical,
psychological & social needs of an
individual nature of self care deficit and
other factors influencing .

PURPOSES
Provides comprehensive knowledge
Provides opportunity
Help in making community diagnosis
Instrumental to community health
planning
Promotes community participation
DETAI LS OF I NFORMATI ON :

Geographical area
Demographical
Social system
Environmental
Knowledge, attitude &Practice Of
Health.
Health Problem &
Influencing Factors.

GEOGRAPHI CAL
I NFORMATI ON:

Name of locality or area
Location and boundary
Physical structure
Important landmarks & institutions
Seasonal variation &month
Map of the area


DEMOGRAPHI CAL
I NFORMATI ON:

Total population , size, density,
composition
Total families
Vital health events
Specific vulnerable groups
Social structure


ENVI RONMENTAL:

Physical environment
Social environment
Environmental communication
Environmental resources

PHYSI CAL ENVI RONMENT :

House
Water supply
Sanitation
SOCI AL ENVI RONMENT:

Social organization
Community organization
Voluntary welfare organization
Trade unions
Statutory bodies
Leadership structure -Formal Informal

ENVI RONMENTAL
COMMUNI CATI ON:

Official & non official channels
Common meeting places
Events of communication
Media of communication

ENVI RONMENTAL
RESOURCES:

Economic resources
Institutional resources
Human resources
Natural resources

KNOWLEDGE,ATTI TUDE &
PRACTI CE OF HEALTH:

KAP of health & disease existed in the
community
Superstitions about health & disease
Existing food & health practices

HEALTH PROBLEMS &
I NFLUENCI NG FACTORS:

Health problems & felt needs of the
community
Factors that can help or hinder health
actions in community.
INFORMATION SOURCES
Area map
Community
Health department
Weather bureau
Agricultural bureau
Community leaders
Census

APPROACH AND METHODS
Descriptive survey approach
Community forum method
Observation method
Questioning method
Record review methods
Discussion
Others-examinationj

DATA ANALYSI S
Coding, organizing, arranging data
Presenting data-tally sheet
Statistical analysis
Interpretation of data
Reporting of the findings



COMMUNIT
YNURSING
DIAGNOSIS:

NURSI NG DI AGNOSI S:

It is a statement of a potential or actual
altered status of a patient which is
derived from nursing assessment and
which requires intervention from the
domain of nursing practices.

CHARACTERI STI CS:

A nursing diagnosis:
Is a statement of patients problem.
Refers to health state or a problem .
Is based on subjective data and
objective data that can be confirmed.
Refers to the physical, psychological,
sociocultural & spiritual condition



Refers to the condition that can be
treated independently by a nurse.
Should be validated with the patient
whenever possible.

COMPONENTS OF NURSI NG
DI AGNOSI S:

Patients Problem
Related Factors


PATI ENTS PROBLEM :

It is a condition faced by the patients
that professional nurse can describe it,
alleviate it by virtue of their education
& experience, are capable & licensed to
treat it.

RELATED FACTORS:

It reflects the environmental,
psychological, sociocultural,
physiological or spiritual elements
believed to be contributing to health
problem.
Related factors identifies specific
nursing intervention that will prevent
correct or alleviate the problem.

.. Eg. Altered nutrition
related to body requirement ,
related to Loss of appetite.
Feeling of loneliness. difficulty
in swallowing.
COMMUNI TY HEALTH
DI AGNOSI S:

It may be defined as determining the
pattern of health problems in a
community , including factors which
influences this pattern.
Community health diagnosis has the
aspects of social medicine.

ASPECTS OF SOCI AL
MEDI CI NE:

Social Anatomy
Social Physiology
Social Pathology
Social Diagnosis
Social Therapy

SOCI AL ANATOMY:

It deals with the structure &
stratification of society according to :
Socioeconomic group
Professional group
Religions & castes
Rural and urban communities

SOCI AL PHYSI OLOGY :

It refers to the function of society
growth of society depends upon birth
rate food supply.


SOCI AL PATHOLOGY:

it is pathology of families , group,
societies or communities.

Indicators of health services-
Doctors: patients
Nurse: patients
Patients :bed

SOCI AL DI AGNOSI S:

The community health diagnosis is to
identify the basic health needs and
current problem of the community By
conducting the surveys whole
community is examined

SOCI AL THERAPY:

Refers to a community treatment or
community health action as the step
decided upon to meet the health needs
of the community taking into account
the resources available & the wishes of
the people , as revealed by community
health diagnosis.


STATEMENT OF THE
NURSI NG DI AGNOSI S:

Potential for health hazards r/t to
breeding of mosquitoes as evidenced by
presence of stagnant water.

Knowledge deficit r/t to small family
norms as evidenced by large family .

COMMUNITY
HEALTH
PLANNING:

PLANNI NG:

It is a systematic approach in
developing a plan of action based on
careful assessment.
MAJOR 4 STEPS
Analyzing health needs/health problems
Establishing priorities
Setting goals and objectives
Formulating community health actions
plan
Planning phase consist of :

Establishing priorities for the problems
diagnosed.
Setting objective
Writing nursing intervention that will
lead to achievement of proposed
objective.
Recording nursing diagnosis, reasons,
objectives, and nursing interventions.


COMPONENTS OF
PLANNI NG:

Objective
Nursing Interventions


OBJ ECTI VE :

Objectives help the nurse and patient to
evaluate the patient progress towards
desired outcomes as well as the
effectiveness of the nursing
interventions.

Objectives should be:

Related to the problem statement.
Client centered.
Clear and concise.
Observable & measurable
Realistic
Time limited Determined by the nurse
and client

NURSI NG I NTERVENTI ONS:

Formulating community health
actions plan
Nursing interventions focus on the
activities required to promote,
maintain or restore the patients
health.

TYPES OF NURSI NG
I NTERVENTI ON:

Dependent Intervention
Interdependent Intervention
Independent Intervention


DEPENDENT
I NTERVENTI ON :

It is related to implementation of
medical orders.

Eg: discuss about the medicine regimen
with the patient as prescribed by doctor.

I NTERDEPENDENT
I NTERVENTI ON:

Describe the activities that nurse carries
out in cooperation with other health
team members.

eg:sterile instruments to be used Takes
out the record Gets the clinic personnel
to arrange the clinic

I NDEPENDENT
I NTERVENTI ON :

These are the activities performed by
the nurse without direct doctors order.

Eg: Community health nurse will Give
group teaching and health education
Assist the patient to identify potential
hazards at home


GUI DELI NES FOR
EFFECTI VE I NTERVENTI ON:

Precise
Action Verbs
Dated
Consistent With Plan Of Care
Based On Scientific Principles
Individualised To Client
Modification Of Standard Therapy
Signed
Contd.
Agency policy
Resources available
The nature of problem
The communitys interest & feasibility
Competencies of health personnel
Practicability & efficiency
I MPLEMENTATI ON OF
COMMUNI TY HEALTH
(ACTI ON PHASE):

Implementation in the nursing process is
to translate the planning into practice
according to principles of nursing.
Without implementation the plan
remains theoretical.

Eg: Administration of drugs, Health
teaching


EVALUATI ON:

It is the last step in the nursing process
that determines the extent to which the
goal of the care has been achieved.
Nurse assess the progress of the patient,
Institute corrective measures if required
and revises the nursing care plan as
needed.

Activities involved are-
Selection of observable criteria related
to the desired goals of patients.
Collection of relevant information
Comparison of the information collected
with the selected criteria
Judgment and decision making
Feedback and modification of nursing
care plan


Some correct evaluative methods are:
Direct observation
Rating scales or administration
questionaries
Performing process recording
Performing family analysis

FORMAT OF NURSI NG CARE
PLAN:

Assessment
Nsg diagnosis
Objective
Plan of action
Implementation
Rationale
Evaluation


ADVANTAGES OF
NURSI NG PROCESS :

Helps to create a health data base of a
patient

Helps to identify actual or potential
health problems of a patient

Helps to establish priorities of nursing
actions for providing proper services to
the patient


CONTD:

Helps to define specific nursing
responsibility

Helps to develop planned, organised and
individualised nursing care

Helps to encourage for innovative
nursing care
Helps to provide for alternative of
nursing actions

Helps to develop nursing autonomy and
to faster nursing accountability

Helps to increase the effectiveness of
nursing care




SUMMARI SATI ON:

Introduction
Definition
Characteristics Of Nursing Process
Purpose
Organisation Properties
Components Of Nursing Process
Assessment ,Diagnose
,Planning,Implementation , & Evaluation .
Advantages

BI BLI OGRAPHY:

KK Gulani, community health nursing, principles &
practices, page number: 90-118
Kamalam S: Essentials in community health nursing
practice,Jaypee brothers,Pg-22-31
Stenhope: community health nursing, Jaypee
brothers,Pg-302-325
TNAI: A Community health nursing manul ,3 rd
Ed,New Delhi, Pg. 31-47.
Baswanthapa B T : Community health nursing, jaypee
brothers, Pg-45-63