Document

Report
The Family Health Nursing Process
Cristina Marie Manzano, RN, RM, MAN
Assistant Professor II, School of Nursing
Global City Innovative College
Nursing Process in Family Health
 Reflect sequential progress, interdependent and overlapping
in their execution
Sequence of Activities in FHN

Establishes a working relationship with the client

Conducts an initial assessment

Categorizes Health Problems

Determine the nature and extent of the family’s performance of
the health tasks on each of the health problems

Determine priorities among the list of health problems

Ranks health problems according to priorities.

Decides on what problems to tackle in the order of
immediacy/urgency

Defines nursing objectives in realistic measurable terms

Plans approaches, strategies of action

Implements the nursing care plan

Evaluates the effectiveness of the interventions

Re-defines nursing problems and re-formulates
Initial Data Base for Family Nursing Practice
Family Structures, Characteristics & Dynamics
 Members of the household and
relationship to the head of the family
 Demographic Data or Rank in the family
 Place of residence of each member
 Type of family structure and government
 Dominant family members in terms of
decision making in matters of health care
 General family relationship/ dynamics
Socio-Economic & Cultural Factors
 Income and Expenses
 Educational attainment of each
member
 Ethnic Background and
Religious Affiliation
 Significant Others
 Relationship of the family to
larger community
Home and Environment
 Housing
 Kind of neighborhood
 Social & Health facilities available
 Communication & Transportation Facilities Available
Health Status of Each Family Members
 Medical & Nursing history
 Nutritional Assessment
 Developmental Assessment
 Risk Factor Assessment
 Physical Assessment
 Results of Diagnostic or
Laboratory Tests
Values, Habits, Practices on Health Promotion,
Maintenance and Disease Prevention
 Immunization
 Healthy lifestyle practices
 Adequacy of rest and sleep,
exercise and use of protective
measures
 Use of promotive-preventive
health services
Typology of Nursing Problems
FIRST LEVEL ASSESSMENT
1.Wellness Condition
 Wellness Potential
 A nursing judgment on wellness state or
condition based on client’s performance,
current competencies or clinical data
BUT NO explicit expression of client
desire.
 Readiness for Enhanced Wellness
 A nursing judgment on wellness state or
condition based on client’s performance,
clinical data and explicit expression of
desire to achieve a higher level of state or
function in a specific area on health
promotion and maintenance.
FIRST LEVEL ASSESSMENT
2. Health Threats
 Family history
 Threat of infection
 Family size beyond what family can






adequately provide
Accident Hazards
Faulty/unhealthy eating habits
Stress provoking factors
Poor home/environment condition
Unsanitary food handling and
preparation
Unhealthy lifestyle and personal
habits/practices
FIRST LEVEL ASSESSMENT
Health Threats
 Unhealthful lifestyles
 Physical inactivity
 Inadequate relaxation





techniques
Non-use of self protection
methods
Inherent personal characteristics
Health history which induce the
occurrence of a health deficit
Inappropriate role assumption
Lack of immunization
FIRST LEVEL ASSESSMENT
3. Health Deficits
 Illness states
 Failure to thrive/develop
according to normal rate
 Disability
FIRST LEVEL ASSESSMENT
4. Foreseeable Crisis Situations
 Marriage
 Pregnancy
 Parenthood
 Abortion
 Adolescence
 Loss of Job
 Death of a member
 Divorce
SECOND LEVEL ASSESMENT
 Inability to recognize the presence of a problem
 Inability to make decisions with respect to
taking appropriate health action
 Inability to provide adequate nursing care to the
sick disabled, dependent or vulnerable/ at risk
member of the family
 Inability to provide a home environment which
is conducive to health maintenance and
personal development
 Failure to utilize community resources for
health care
Criteria in Different Priorities
Nature of the Problem
Presented
 Categorized whether a Health
Threat, Health Deficit or
Foreseeable Crisis
Modifiability of the Problem
 Refers to the probability of success
in minimizing alleviating or totally
eradicating the problem through
health intervention
Criteria in Different Priorities
Preventive Potential
 Refers to the nature and magnitude
of the future problem that can be
minimized or totally prevented if
intervention is done in the
problem.
Salience
 Refers to the family perception &
evaluation of the problem in terms
seriousness & urgency of attention
needed.
SCALE FOR RANKING FAMILY HEALTH PROBLEMS
ACCORDING TO PRIORITIES
Criteria
Weight
1.Nature of the problem
presented
Scale:
 Wellness state
 Health Threat
 Health Deficit
 Foreseeable Crisis
1
 3
 3
 2
 1
SCALE FOR RANKING FAMILY HEALTH PROBLEMS
ACCORDING TO PRIORITIES
Criteria
2.Modifiability of the
Problem
Scale:
 Easily modifiable
 Partially modifiable
 Not modifiable
Weight
2
 2
 1
 0
SCALE FOR RANKING FAMILY HEALTH PROBLEMS
ACCORDING TO PRIORITIES
Criteria
3. PreventivePotential
Scale:
 High
 Moderate
 Low
Weight
1
 3
 2
 1
SCALE FOR RANKING FAMILY HEALTH PROBLEMS
ACCORDING TO PRIORITIES
Criteria
4. Salience
Scale:
 A serious problem,
immediate attention
 A problem but not
needing immediate
attention
 Not a felt need /
problem
Weight
1
 2
 1
 0
SCORING
1. Decide on a score for each of the criteria.
2. Divide the score by the highest possible score and multiply by the
weight.
Score
----------------- X Weight
Highest Score
3. Sum up the scores for all the criteria. The highest score is 5,
equivalent to the total weight.
 The higher the score (near 5 and above) of a given problem, the
more likely it is taken as a PRIORITY.
 With the available scores, the nurse then RANKS health problems
accordingly.
Example
Cues/Data
Family Nursing Problem
 37 year old mother of seven at 21
 Possible Complicated
weeks AOG, with BP of 140/90
and slight pedal edema
 Mother verbalized, “…I did not
have problems during my previous
pregnancies, and even with my
present pregnancy… it just
happened that I passed by the
health center on my way to my inlaws… so I thought of dropping by
the clinic… but actually I feel
alright, I don’t think I have to
worry.
Pregnancy
 Inability to recognize presence
of a possible complication of
pregnancy due to lack of
knowledge
 Inability to provide adequate
nursing care to a pregnant
member due to lack of
knowledge on the nature and
management of health condition
 Failure to utilize community
resources for health care
Possible Pre-eclampsia
Criteria
Computation
Actual
Score
Nature of the
Problem
3/3 x 1
1
The problem is a health deficit and
requires more immediate intervention
Modifiability
of the
Problem
2/2 x 2
2
The resources and interventions needed
to solve the problem are available
Justification
Preventive
Potential
3/3 x 1
1
Possibility of complications during labor
and delivery and occurrence
odabnormalities in the infant are
prevented if pre-eclampsia is eliminated
as early as possible
Salience of
the Problem
0/2 x 1
0
The family doesn’t recognize the
existence of the problem
Total Score
4

similar documents