nursing process-assessment

Assessment of Community Health Needs

APRIL U.GABOT-ALAP, RN., MAN.

Nursing ProcessIs a systematic method of

planning, delivering and evaluating individualized patient care.

Is a scientific method of solving problem at any state of health or illness.

Is the foundation for nursing practice (blueprint)

Characteristics of the Nursing ProcessHas a systematic and organized

components: AssessmentNursing DiagnosisPlanning ImplementationEvaluation

AssessmentIs a systematic collection and

analysis of data culminating in a nursing diagnosis.

Sources of Information:Primary Source. Client provides

subjective dataSecondary Source. Family,

caregivers, medical records, literature, nurse’s notes etc.

Cont.Methods of Data Collection:

Interview- process of talking to people

Observation. Synonymous to watching, surveillance, scrutiny. Use of senses

Physical Assessment.

Community Health NeedsNeeds Assessment – is a process of

looking at many kinds of information about a target group, population or community. Includes demographic/census data, surveys and interviews of population.

Health Needs Assessment. Is the process of systematically collecting information to enable the practitioners, team and policy-makers to identify , analyze, prioritize and meet the health needs of an individual, family or population

Cont.Community Health Needs

Assessment. Is a process that describes the state of health of local people, enables the identification of the major risk interventions that are needed.

Is a way of using information to plan healthcare and public health programs in the future.

Purpose of Community Health Needs AssessmentEnable the health practitioners,

NGO’s, civic societies and policy-makers to identify the member to identify the health needs of the population.

To identify priority health needsDevelop community

particapation and involvement.

Steps of Community Health Needs AssessmentProfiling- collection of relevant

data or information.Deciding the major health issues.Planning public health and health

care programImplementing the planned

activities.Evaluation of health outcomes.

Components of CHNAHealth Status- is the standing or

condition of the population as indicated by the morbidity, mortality and fertility rates. (MMR).

Factors Contributes to the Disproportionate Burden of Diseases Experience by Marginalized Communities

Mortality data. Describes pattern of death in relation to age, gender and causes of death. basic measure of epidemiology –

study of disease in population. collected nationally, regionally and

locally from death certificate.

Cont.Indicates deaths from diseases, accidents,

suicides and homicides and the general health of the population in terms of life expectancy.

• Morbidity data. Information of types of illness and disability, their incidence and prevalence.

• Behavioral Measures. Indicators of health (smoking proven causes ill health)

• Quality of life measures. Physical assessment, psychological wellbeing.

Cont.Use of service information. Health Inequalities.

Health ResourcesAre assets, means, strengths and

skills that are contributory to the promotion of health and well-being that exist within communities to meet the needs of individuals, families or social groups

Resources of Health Informal families delivers the greatest part of

all care services in the community. - burden of care primarily falls to women and

can have significant effects on their health status.

- government, private or voluntary systems of care supplements the family or fill in where no family network exist.

Formal. Educational resources, agencies including health services and sectors that have an impact on health

-political, religious organizations that provides economic assistance and health and social care.

Kinds of resources in a CommunityKnowledge and skills in caring for

and promoting health.Health careers (family and

friends)Social support networks;

community-based organizationsResources (money, shops, food,

transport)The ability to cope in often very

difficult circumstances (supportive interpersonal relationship

Health Action Potential. Is a complex activity and should be undertaken where the more local people are involved in action planning, the more likely that the plans will be accepted and implemented.

Collaboration with other organizations and agencies as partners in health planning

Action Planning StagesPreparation stage.Agreeing to the aims set by the

groupDescribing the objectives of the

program or project.Detailing the activities needed to

meet the objectivesEvaluation of the outcomes.

Community DiagnosisIs the statement of the client’s

current health status and concerns which were obtained from the assessment data and are can be minimized or resolved through nursing interventions..

Clinical judgement about individual, family or community.

Types of Nursing ProblemsActual – currently or presently

experienced or perceived by client. And validated with the presence of signs and symptoms

Risk/high risk. Potential of developing in the future due to the presence of certain risk factors. And may develop into full blown illness or disorder.

Types of Nursing ProblemsPossible. Problem that may exist

but needs addition data. Will alert the nurse to undertake further data collection and observation.

Syndrome. Combination or group of actual or high-risk nursing diagnosis that all relate to serious event or situation

Community DiagnosisIs a statement of the health and

health-related problems of the community or which have a high risk of developing and the possible causes or causative organisms and the contributory factors.

The end result of data collection and analysis

Types of Community DiagnosisComprehensive. Aims to obtain

general information about community like demographic variables, socio-economic/cultural, health and illness pattern, health resources, political/leadership pattern.

Problem oriented or Focused diagnosis. Responds to a particular problem or need.

Steps of Conducting Community Diagnosis

Determine the objective Define the study population Determine the data to be gathered Collect the data Develop the instrument Actual data gathering Data collation Data presentation Data analysis Problem identification Health status- mortality, morbidity, fertility Health resources-money, manpower, materials,

institution Health related-environment, culture, economic political Prioritization of health problems.

Prioritizing Health ProblemsHealth problem- is a situation

where there is a demonstrated health need combined with actual or potential resources to apply immediate measures and a commitment to act on the part of the provider or the client.

Nature or Categories of Health ProblemsHealth Threat. Conditions that are

conducive to disease, accident or failure to realize one’s potential. E.g., hereditary history of diseases, accident hazards, unhealthy lifestyle, etc.

Health deficit. When there is gap between actual and achievable health status which may be due to failures in health maintenance. E.g. Repeated infections, miscarriage, illness, disability, transient (aphasia, paralysis because of CVA)

Nature or Categories of Health ProblemsForeseeable crisis. Anticipated

periods of unusual demand on the individual or family in terms of adjustment/family resources. e.g. Marriage, pregnancy, divorce, separation, loss of job and death.

Magnitude of problem.Refers to the percentage of the

population that has been affected

Modifiability of the ProblemRefers to the probability of

success in minimizing, alleviating or totally eradicating through intervention.

Preventive PotentialRefers to the nature and

magnitude of future problems that can be minimized or totally prevented if intervention is done on the problem under consideration

Salience or Social ConcernRefers to community’s perception

and evaluation of the problem in terms of seriousness and urgency of attention needed; it is the degree of seriousness or importance of the problem as perceived by the community

DemographyIs the science of vital and social statistics like

marriages, births, deaths of the population.It is the statistical study of the population

specifically with references to size, destiny and distribution,

Demographic data includes demographic features (population, population density, sources of power, communication services and land use); physical infrastructure (roadworks, transportation and water supply); Social features ( health status (leading cause of mortality/morbidity; % of malnourish children, health facilities and services, toilet facilities, garbage collection and disposal and education)

Sources of Demograhic DataSurveys: a. Census

De Jure- consist of data from place of origin.De facto- registration where it happened or the person is registered in the place where he/she was located or staying when the census was taken.

b. Survey

Sources of Demograhic DataContinuing Population Registers –

computers monitor birth records.Other records and registration

system.

Sources of Data on HealthVital Registration Recordsa. RA 3753 (Civil Registry Law)

registration of births, deaths to local registrars (city health officer or municipal treasurer)

b. Problems: underregistration and de facto registration; unreported birth –unreported death.

Sources of Data on HealthWeekly reports from feild health

personnel based on RA3573Population censusIndividual census.Individual health records/family

recordsPublications

ReferencesFundamentals of Nursing

Concepts, Process and Practice by Kozier & Erb’s

Nursing Assistant A Nursing Approach by Hegner