NCM 113 HANDOUT implementation to determine its

Prepared by: MELISSA D. SARMIENTO, RN, RM, MSN effectiveness in achieving the goals

PLANNING & IMPLEMENTING COMMUNITY HEALTH ESSENTIAL STEPS IN PLANNING PROCESS

NURSING SERVICES  Prioritizing the identified nursing
problems/diagnoses
PLANNING  Based on the nature of the problem,
 Determining the approach to be used in modifiability, preventive potential and salience
assisting the client/community toward optimal  Developing goals/Outcome statements
wellness  identifying expected outcomes and discussing
 Deciding what actions will be used to help: them with the client when possible
 Solve, lessen or minimize the effects of  Planning nursing actions
identified problems  Writing the nursing orders
 Prevent potential problems  Nursing behaviors that will help the client
achieved the identified outcomes
HEALTH PLANNING  Documentation of the Nursing Care Plan
 A plan is a map, a preparation or an agreement  Recording the diagnoses, nursing strategies and
 defines where one wants to go, how to get expected outcomes in an organized nursing
there and the timetable for the journey care plan
 A process to produce health by creating an
actionable link between needs and resources PLANNING NURSING ACTION
 Determining the actions or activities which will
PLANNING CYCLE achieve the expected outcome
 Surveying the environment  examine the second element of the nursing
– identify current state of the issue diagnosis statement
 Setting directions  Proceed to how these are recognized by the
- involves setting goals and objectives and nurse, states by “as evidenced by” determine
establishing the standards to compare nursing actions or interventions which would
 Problems & Challenges eliminate the factors or minimize their effects
– involves identifying and quantifying the
shortfalls between what is and what ought to GUIDELINES IN FORMULATING NURSING
be INTERVENTIONS
 Range of solutions  Put safety first!
– involves identifying the range of solutions to  Individualize the nursing actions for each
each identified problem or challenge; assessing client/community
each possible solution in terms of feasibility,  Base nursing actions on scientific rationale
cost and effectiveness  State nursing actions clearly and specific
 Best solutions  Make the nursing actions realistic
- involves a choice of solution or sets of solutions  Do not let nursing actions interfere with other
that should be implemented to address the therapies
problems or challenges identified  Whenever possible, involve the
 Implementation client/community in planning nursing actions
- involves implementation of the chosen  Strive to help the client/community understand
solutions how nursing actions will result in achievement
- begins with the development of an of a goal
implementation plan
 Evaluation IMPLEMENTATION
- involves evaluation of the results of
  All the previous phases are integrated during  Assesses and describes the selection of the
this phase target population, selection of specific activities
 Continue to assess, validate concerns, modify to achieve the objectives and the manner of
the plan and identify priorities as needed implementation
 Structure, resources or input
 Refer to manpower, funds, buildings, facilities,
COMPONENTS OF PROGRAM IMPLEMENTATION equipment, supplies, the time expended or
 Coordinating the health programs spent an supporting organizational structure
 Monitoring health programs  Outcome/Output Evaluation
 Supervising the program staff  An appraisal of the outcomes or end-results of
care and of accomplishments
EVALUATION, RECORDING AND REPORTING OF
COMMUNITY HEALTH NURSING SERVICES SPECIFIC OUTCOMES OF NURSING CARE
 Change in health status of the client
EVALUATION  Change in pattern of communication,
 Is the final on-going phase of the nursing interaction and relationships and improved
process that tries to find out if both the patient assumption of expected roles and functions
responses and the extent to which the expected  Prevention of unwanted results or negative
outcomes have been achieved outcomes
 Change in the quality of the environment
PURPOSES OF EVALUATION  Change in health behavior or lifestyle
 Assess or appraise the status of the  Change in the level of competence
client/community  Patient satisfaction or dissatisfaction with the
 Determine the client’s/community’s progress nursing care received
toward achievement of the stated
goals/expected outcomes METHODS & TOOLS OF EVALUATION
 Judge the effectiveness of the nursing orders ,  Direct Observation
strategies and care plan  most valid method of determining change
 Tools to be used: clock or watch, weighing
CRITERIA FOR EVALUATION scale, tape measure, thermometer,
 The criteria for evaluation are the goals and sphygmomanometer, stethoscope, checklist or
expected outcomes in terms of the exact client rating scale
behaviors as identified during the planning  Records & Reports Review
process.  Important sources of primary and secondary
data: x-ray, laboratory test results, individual
TYPES OF EVALUATION patient’s record or family health and service
 Quantitative records
- involves measurable or quantifiable variables in  Verbal Reports, Interview or questionnaire
terms of numbers, amount or quantity of  the client/patient or key members of the family,
resources expended, services provided and through verbal reporting can provide primary
outcomes or results that have been realized data related to attitudinal and behavioral
 Qualitative changes
- evaluation that deals with the quality or  Simulation Exercises
character of the person, service, activity,  Used to test:
program or resource being evaluated - Cognitive skills
- Psychomotor skills
ASPECTS/ITEMS OF EVALUATION - Attitudinal changes
 Process Evaluation
 - To assess the nurse’s general competence and
her KSA related to the delivery of nursing
services

DEVELOPING THE EVALUATION PLAN

 Don’t over promise!
 It must be measurable.

RECORDING AND REPORTING

 HEALTH RECORDS
 A written document about a target client,
whether an individual, family, group or the
whole community which relates an event
pertinent to health and health care services
 HEALTH REPORTS
 Is an account or summary of the services
rendered to the clients and rationalizes the
continued existence of the program
 Field Health Services Information System
 A network information source developed by the
DOH
 Intended to address the short-term data needs
of the DOH staff with managerial or supervising
functions in the DOH facilities and in each of the
program areas
 Aims to monitor the national health service
delivery system

COMPONENTS OF FHSIS
 Individual Treatment/Family Treatment Record
 Most basic or fundamental record which must
be kept in the facility
 Fundamental building block or foundation of
FHSIS
 Target/Client Lists
 2nd building block of FHSIS
 It is the eligible population to whom the health
services will be rendered
 Summary Table
 A form with 12-month column retained at the
BHS facility where the midwife makes a monthly
report for all relevant data
 The Monthly Consolidation Table (MCT)
 Essential form in the FHSIS where the RHU
nurse records the reported data per indicator as
submitted by each midwife or BHS.