Care Plan Examples for Community Health Nursing

Nursing Care Plan - Community Health Nursing


Community is a social group who live in a place, interacting with each other, know each other and have the same interests. Communities are groups of people who live in the same location with the same under the rule, the area or the same location where they live, the social groups that have the same interest.

Health care is a specialized field of nursing which is a combination of science nursing, public health sciences and social sciences are an integral part of the health care provided to individuals, families, groups and communities either healthy or sick comprehensively through promotive, preventive , curative and rehabilitative and resocialization, involving the active participation of the community. Active participation with community health teams are expected to know the health problems faced and solved the problem.

Public health targets are individuals, families / groups and communities, with a focus on primary health efforts, secondary and tertiary. Therefore, public education about the health and social development will help the community in encouraging the spirit to care for themselves, independent living and self-determination in creating optimal health status.

Public participation is required in the individual case. Community as the subject and object of society is able to recognize expected, took the decision to maintain good health. Most of the primary health care goals of society are expected to be able to independently maintain and improve the health status of the community.


Assessment 

Community profile assessment framework (modified)

This assessment is the result of a modification of some previous theories about the community assessment.

Data collection

The data collection is intended to obtain information about health problems in the community to determine which actions should be taken to resolve the issue concerning the physical, psychological, social, economic, spiritual and environmental factors that influence.

Data collection can be done in the following way:

1. Interview or anamnesis

The interview is a mutual communication activities in the form of questions and answers between the nurse with the patient or the patient's family, the community on matters relating to the patient's health problems. Interviews should be conducted with a friendly, open, use simple language and easily understood by the patient or the patient's family, and subsequent interviews or anamnesis recorded in the format of the nursing process.

2. Observations

Observations conducted in community nursing covers aspects of physical, psychological, behavioral and attitude in order to nursing diagnosis. Observations were made using the five senses and the results are recorded in the format of the nursing process.

3. Physical examination

In one community nursing where nursing care is provided nursing care family, the physical examination were performed in an effort to help nursing diagnosis by means of inspection, percussion, auscultation and palpation.



Data processing

Once the data is obtained, the next activity is the processing of data in the following way:

• Classification of the data or categories of data.
• Calculation of percentage of coverage.
• Tabulation of data.
• Interpretation of the data.

Data analysis

Data analysis is the ability to associate the data with the cognitive abilities possessed that can be known about the gaps or problems faced by the community if it's a problem of health, or nursing problems.

1. Determination of the problem or the formulation of health problems

Based on the analysis of the data can be known health and nursing problems faced by the community, and can be formulated hereinafter intervention. However, the problem has been formulated not to be overcome at once. Therefore we need a priority issue.

2. Priority issues

In determining priority public health issues and nursing need to consider various factors such as the criteria are:

• Public attention.
• Prevalence.
• The severity of the problem.
• Possible problems to be overcome.
• Availability of community resources.
• Political aspects.

Selection or screening community health problems, according to the format Mueke (1988) have screening criteria, among others:

• In accordance with the role of community nurses.
• The amount at risk.
• The magnitude of the risk.
• The possibilities for health education.
• The public interest.
• Possibility to overcome.
• In accordance with the government program.
• A resource.
• Time resources.
• Funding resources.
• Equipment resources.
• Human resources.

Nursing Diagnosis

Nursing diagnosis is the individual's response to health problems whether actual or potential. The actual problem is a problem that is obtained at the time of assessment, while the potential problems are problems that may arise later. So the nursing diagnosis is a statement that is clear, concise and definite about the status and health problems that can be addressed by nursing actions. Thus nursing diagnosis is determined based on problems found. Nursing diagnosis will give an overview of public health issues and the status of both the real (actual), and which may occur.


Nursing Care Plan

Planning nursing is nursing action plans to be implemented to address the problems within their nursing diagnosis has been determined with the aim of fulfilling the needs of the client. So public health nursing care plan is based on pre-defined nursing diagnoses and nursing plan drawn up should include the formulation of objectives, plans nursing actions to be performed and the criteria for assessing the results of the achievement of objectives.

The steps in the planning of public health nursing are as follows:

• Identify alternative nursing actions.
• Set techniques and procedures to be used.
• Involve community participation in planning through village community consultation activities, or mini workshops.
• Consider the community resources and facilities available.
• Actions to be implemented must be able to meet the requirement, which was felt by the public.
• Leads to the objectives to be achieved.
• Action must be realistic.
• Arranged sequentially.

References :

(Mubarak, 2005).
(Elisabeth, 2007).
(Riyadi, 2007).

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The Role of Public Health Nurses

Many roles can be performed by Public Health Nurses are:

1. As a service provider (Care provider)

Provide nursing care through reviewing the existing nursing problems, nursing action plan, implement and evaluate nursing care actions, which have been given to individuals, families, groups and communities.


2. As an educator and consultant (Nurse Educator and Counselor)

Provide health education to individuals, families, groups and communities both in the home, community health centers, and in society as organized in order to instill healthy behavior, resulting in a change of behavior as expected in achieving optimal health status.

Counseling is the process of helping the client to recognize and cope with psychological distress or social issues to establish good interpersonal relationships and to increase one's progress. In it are given emotional support and intellectual.

The teaching process has four components: assessment, planning, implementation and evaluation. This is consistent with the nursing process in the assessment phase of a nurse assess patient's learning needs and readiness to learn. During the planning nurses make specific goals and teaching strategies. During the implementation of the nurse implement teaching strategies and for evaluation of the nurse assess the results that have been obtained


3. As a role model (Role Models)

Public health nurses should be able to give a good example in the field of health to individuals, families, groups and the public about how healthy the way of life that can be imitated and emulated by the public.


4. As defenders (Client Advocate)

Defense can be given to an individual, group or community level. At the family level, nurses can perform its functions through social services in the community. A client advocate is an advocate of the rights of clients. Defense including an increase in what is best for clients, ensuring client needs are met and to protect the rights of clients (Mubarak, 2005).

The task of the nurse as a client advocate is responsible for assisting clients and families in interpreting information from a variety of service providers to provide information and other things necessary to take approval (Informed Concent) on nursing actions given to him. Another task is to preserve and protect the rights of the client, because the client must be sick and hospitalized will interact with many health workers.


5. As a case manager (Case Manager)

Public health nurses are expected to manage a variety of health services and community health centers in accordance with the burden of the duties and responsibilities imposed upon him.


6. As collaborators

The role of the nurse as a collaborator can be implemented by means of cooperation with other healthcare teams, both with doctors, nutritionists, radiologists, and others in relation to help speed up the healing process of collaboration or cooperation measures client is a decision-making process with others on the stage of the nursing process . This action plays a very important to plan the actions that will be implemented (Mubarak, 2005).


7. As planners further action (Discharge Planner)

Discharge planning can be provided to a client who has been undergoing treatment at a medical institution or hospital. This plan can be provided to clients who have experienced improved health conditions.


8. As identifiers health problems (Case Finder)

Implement monitoring of the changes that occur in individuals, families, groups and communities on issues of health and nursing as well as the resulting impact on health status through home visits, meetings, observation and data collection.


9. As a health services coordinator (Coordinator of Services)

The role of the nurse as a coordinator among others, direct, plan and organize health services provided to clients. Service of all members of the health team, because the client receives the services of many professionals.


10. As the carrier changes or reformer and leader (Change Agent and Leader)

Agents for Change is a person or group who initiate change or help others to make a change in him or in the system. Torney Marriner describes that the carrier change is that identifying the problem, assessing client's motivation and ability to change, suggesting alternatives, explore the possibility of alternative outcomes, reviewing resources, demonstrate the role of help, build and maintain relationship help, help during the phase of the change process and guiding clients through these phases.

Improvement and change is an essential component of treatment. By using the nursing process, the nurse helps clients to plan, implement and maintain such a change: knowledge, skills, feelings and behaviors that can improve health.


11. As an identifier and community service providers (Community Care Provider And Researcher)

This role is included in the process of nursing care services to the community which includes assessment, planning, implementation and evaluation of health problems and solving the given problem. Search action or identifying other health problems are also part of the role of community nurses.


Source : (Mubarak, 2005)

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