NCM 104 - FIRST LEVEL ASSESSMENT

gathering and analysis on what condition on problem exists on its

health condition or related with maintaining wellness. While in the
OBJECTIVE: second-level assessment, this an explanation about the family’s
After 30 minutes of video lecture, the students will be able to learn the problem related to maintaining wellness or providing a home
processes in doing family health assessment using the critical thinking environment --- have maintenance and personal development
approach
STEPS IN FAMILY NURSING ASSESSMENT
FAMILY HEALTH ASSESSMENT Nursing Assessment includes:
In the family health nursing practice, this involves a set of actions by
which the status of a family as client, its ability to maintain itself as a system
and functioning unit, and its ability to maintain wellness, prevent, control or
resolve problems in order to achieve health and well-being among its
members.
Data about the present status of the family are compared against
norms and standards, personal, social and environmental health, system,
integrity and ability to resolve system’s problem. This norms or standards are
derived from values, beliefs, principles, rules or expectations, NURSING DIAGNOSIS - is the end result of two major types of nursing
assessment in family nursing practice based on the FRAMEWORK
The REASONS why the nurse conduct family health assessment are the ff:
REASONS: 1. DATA COLLECTION - one of the major steps in nursing assessment
1. Recognize need to use data based on evidence based practice ● FRAMEWORK - is use as organized and comprehensive approach to
2. Ensure accuracy and reliability of data assessment that includes First Level and Second Level Assessment.
3. Check of inconsistencies But before doing data collection, the nurse must remember to
4. Complete the missing information in the family health record important things in order to ensure effective and efficient data
collection in the family nursing practice.
In doing the family health assessment, the relies on the framework data I. To identify the types and kinds of data that are needed
collection II. Or the methods of data gathering and necessary tools to
collect subs data
FRAMEWORK FOR DATA COLLECTION:
DATA COLLECTION
A. FIRST LEVEL ASSESSMENT - is a process whereby existing and potential A. FIRST LEVEL ASSESSMENT
health conditions or problems of the family are determined a. Family structure, characteristics and dynamics
b. Socio-economic and cultural characteristics
In FIRST LEVEL ASSESSMENT, the categories or nature of health problem or c. Home and environment
conditions: d. Health status of each family member
1. WELLNESS STATES - stated as potential or readiness - a clinical e. Values and practices on health promotion / maintenance
judgement about a client in transition from a specific level of and disease prevention
wellness or capability to a higher level (NANDA, 2001) B. SECOND LEVEL ASSESSMENT - data includes those that specify or
describe the family’s realities, perceptions about and attitudes
● WELLNESS POTENTIAL - is a nursing judgement on related to the assumption or performance of family health tasks on
wellness state or condition based on clients performance, each health condition or problem identified during the first level
current competencies or clinical data but NO explicit assessment
expression of client desire
✓ METHODS/SOURCES (1ST LEVEL ASSESSMENT)
● READINESS FOR ENHANCED WELLNESS STATE - is a ● Health status / condition of family / household members
nursing judgement on wellness state or condition based 1. Health assessment
on clients current competencies or performance, clinical 2. Laboratory / diagnostic test / result
data and Explicit expression of desire to a higher level of 3. Records / reports
state or function in a specific area on health promotion ● Home and environment
and maintenance 1. Observation/ocular survey / PE
2. Interview
2. HEALTH THREATS - conditions that are conducive to disease and 3. Laboratory / diagnostic test / result
accident or may result to failure to maintain wellness or realize 4. Records/ reports
health potential
Observation - sensory capacity such as sense of sight, hearing smell and touch
3. HEALTH DEFICITS - instances of failure in health maintenance that PE - can be done by use of IPPA- Inspection, Palpation, Percussion, Auscultation
includes: as well as measuring of specific body parts and reviewing the body systems
a. Illness states, regardless of whether it is diagnose or Interview - this is used to determine the current health status as well as
undiagnosed by medical practitioner or physician significant past health history
b. Failure to thrive/develop according to normal rate Records review - this we gather relevant information through viewing existing
c. Disability - whether congenital or arising from illness records and reports , it is pertinent to health
Laboratory and Diagnostic test - through performing laboratory test and
4. STRESS POINTS / FORESEEABLE CRISIS - anticipated periods of diagnostic procedure or test for integrity or function, health defect on any
unusual demand on the individual or family in terms of adjustment problem
or family resources
✓ METHODS/SOURCES (2ND LEVEL ASSESSMENT)
B. SECOND-LEVEL ASSESSMENT - defines the nature or type of nursing ● In depth interview on realities / perceptions about attitudes towards
problems that the family encounter in performing the health atss with assumption / performance of health task
respect to a given health condition or problem and the etiology or barriers ● Observation: the nurse must vigilant enough and relate verbal and
to the family’s assumption of the health tasks non verbal cues
- These are data;s which specify or describe the family’s realities,
perceptions about and attitudes related to the assumption or TYPES OF DATA
performance of family health tasks on each health condition or A. FAMILY STRUCTURE, CHARACTERISTICS AND DYNAMICS
problem identified during the first level assessment ● Members of the household and relationship to the lead of
- This two-level assessment specificies the hierarchy of two sets of the family
data and barrier analysis, for the first level, it will depth reflect of data ● Demographic data
● Palace of residence or each members
 NCM 104 - FIRST LEVEL ASSESSMENT
● Types of family structure (matriarchal, patriarchal,
nuclear, extended)
● Dominant family ,e,bers in terms of decision making
● General family relationships or dynamics

B. SOCIO-ECONOMIC AND CULTURAL CHARACTERISTICS

● Income and expenses
○ Occupation and place or work of each
members
○ Adequacy to meet basic needs
○ Who makes decision about family expenditures
● Educational attainment of each members
● Athnic background and religious affiliation
● Significant other and roles they play in the family
● Relationship of the family to a larger community

C. HOME AND ENVIRONMENT

● Housing
○ Adequacy of living space
○ Sleeping arrangement
○ Presence of breeding or resting site of vectors
of diseases
○ Presence of accident hazards
○ Food storage and cooking facilities
○ Water supply
○ Garbage disposal
○ Drainage system
● Kind of neighborhood
● Social and health facilities available
● Communication and transportation facilities available

D. HEALTH STATUS OF EACH FAMILY MEMBERS

● Medical history indicating current / past significant
illness or beliefs and practices conductive to health and
illness, nutritional assessment, developmental
assessment of infants, toddlers and pre schooler
(MMDST), risk factors assessment, physical assessment
(diagnoses/ undiagnosed disease, results of laboratory /
diagnostic screening procedure)