Nursing Process Applied to Community Health Nursing Learning objectives: Describe the components of the nursing process planning, implementing and evaluation as applicable to CHNsg. Validation Assessment and Diagnosis Validation

Learning Objectives Discuss methods the CHN uses to interact with the community Identify the four phases of developing a plan to meet the health needs of a community Identify actions taken when implementing health promotion activities Describe the process of evaluating community health interventions

Methods Used to Interact with the Community Communication: Open honest sharing Explain who you are and why you are there Encourage group members to talk about themselves Nurse and group discuss relationship and expectations and division of roles Interaction must be reciprocal ( a two-way sharing) do not talk all the time or listen all the time Remember that there is a period of testing before trust can be established Remember team work is essential!

Planning Definition: A logical, decision-making process to design an orderly, detailed program of action to accomplish specific goals and objectives Planning is based on assessment Then diagnosis is done and validated based on the findings of the assessment

Phases of Planning Setting Priorities Ranking by importance clients’ needs Immediate, intermediate, long-range Establishing Goals broad statements of desired end results Establishing Objectives specific statements of desired outcomes stated in behavioural terms that can be measured and include target dates Planned actions Specific methods and actions by nurse, client and other people of accomplishing objectives Outcome measurement Judging the effectiveness of meeting objectives : how and when were they met? If not met why not? Progress notes are NOT the same as outcome measurement

Rules in Setting Objectives Each objective should state a single idea Each objective should state one behaviour that can be measured To facilitate planning objectives CHN involves other people Involve clients in every step of planning

Implementation (action phase) Definition: Putting the plan into action and doing all the activities included in the plan Collaborative implementation by nurse, other professionals or clients. Nurse is a catalyst and facilitator Ultimate goal is to help people to help themselves toward their optimal level of health

Actions Involved in Implementation The nurse applies theories ( for e.g. Change theory( to the actions performed The nurse facilitates an environment that helps in carrying out the plan for e.g. (quiet room) The nurse prepares the clients for the services to be received. Following clients’ validation the plan is carried out or modified The nurse and team document the progress of the implementation by process evaluation (measuring the achievement of planned actions on an ongoing basis)

Evaluation Purpose of evaluation: To determine whether planned actions met clients’ needs (effectiveness) Criteria steps necessary to achieve the goals Evaluation requires judgment skills: comparing real outcomes with expected outcomes When actual client behaviour matches desired behaviour, then the goal is met If not examine causes ( inadequate data collection, incorrect diagnosis, unrealistic plan, ineffective implementation

Types of Evaluation Structure –Process evaluation Outcomes evaluation Structure: tools and resources in health care environment that are beyond one’s control (physical and organisational structure) Process criteria: How care is given ( Are policies and procedures followed? Documentation?) Outcomes evaluation

Characteristics of Nursing Process Applied to Community as a Client Deliberative Adaptable Cyclic Client –focused Interactive Need oriented