COMMUNITY HEALTH NURSING DIAGNOSIS
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Overall health and well-being are greatly impacted by the communities in which patients live and work. Access to care is influenced by economic, social, and political issues. Depending on the needs of the individual and the population, it may be a major factor in determining physical, emotional, and mental health as well as morbidity and mortality.
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COMMUNITY HEALTH NURSING DIAGNOSIS
- 1. COMMUNITY HEALTH NURSING DIAGNOSIS Individual, Family, and Community Diagnoses
- 3. INTRODUCTION • Creating nursing diagnoses requires the application of detailed assessment skills, critical thinking, and decision making. The formulation of nursing diagnoses is related to competency in diagnostic reasoning.
- 5. DEFINITIONS A diagnosis is a that synthesizes (brings together) assessment It is a label that situation (or state) and implies an etiology (reason) and gives evidence to support the inference.
- 6. NANDA-I • The North American Nursing Diagnosis Association (NANDA) defines nursing diagnosis as a clinical judgment about individual, community or family responses to community to actual or potential health problems or life processes.
- 7. FAMILY A family nursing diagnosis is an extension of a diagnosis to the family system and/or subsystems is the outcome of family assessment. It includes or potential health problems. Diagnoses statement: Single diagnosis (no etiology included BUT adding family member who had problems)
- 8. COMMUNITY A community diagnosis in that it is focused on an aggregate or a community (rather than an individual). It requires a multidisciplinary action to address or treat, multiple determinants must considered when planning interventions. Outcomes of action may not be visible for long time
- 9. WELLNESS DIAGNOSIS Characteristics: • Sometimes called positive or health oriented diagnoses. • Focus is on an individual, family, community or aggregate. • There is usually a desire for a higher level of wellness. • Sometimes an effective program or status is present and there is a desire to improve the functioning. • Usually require multidisciplinary action to address or enhance. • Multiple determinants must be considered when planning interventions. • Outcomes/ actions may not be visible in the short term. • Focus is on existing or potential individual/family/community strengths.
- 10. WELLNESS DIAGNOSIS: Nurse’s Role in Wellness Diagnoses: • The role of the nurse is basically to facilitate healthy responses in order to reach a higher level of health oriented goals. There is a progression from one level of wellness to a higher level of wellness. For example, the nurse can help clients to complete transitions, to achieve higher levels of wellness or to attain wellness status. • Health promotion plays a significant role.
- 11. COMMUNITY DIAGNOSIS IN NANDA -I • Commonly located at Domain 1 (Health promotion), but could be at other Domains • Commonly labelled as : - Deficient community health (D1, C2) - Readiness for enhanced health management (D1, C2) (NANDA International, Inc. Nursing Diagnoses: Definitions & Classification 2015–2017, Tenth Edition)
- 12. DEFICIENT COMMUNITY HEALTH •Definition Presence of one or more health problems or factors that deter wellness or increase the risk of health problems experienced by an aggregate.
- 13. DEFICIENT COMMUNITY HEALTH Defining Characteristics ■ Health problem experienced by aggregates or populations ■ Program unavailable to eliminate health problem(s) of an aggregate or population ■ Program unavailable to enhance wellness of an aggregate or population ■ Program unavailable to prevent health problem(s) of an aggregate or population • Program unavailable to reduce health problem(s) of an aggregate or population • ■ Risk of hospitalization experienced by aggregates or population • ■ Risk of physiological states experienced by aggregates or populations • ■ Risk of psychological states experienced by aggregates or population
- 14. DEFICIENT COMMUNITY HEALTH Related Factors ■ Inadequate consumer satisfaction with program ■ Inadequate program budget ■ Inadequate program evaluation plan ■ Inadequate program outcome data ■ Inadequate social support for program • Insufficient access to healthcare provider • ■ Insufficient community experts • ■ Insufficient resources (e.g., financial, social, knowledge) • ■ Program incompletely addresses health problem
- 15. READINESS FOR ENHANCED HEALTH MANAGEMENT •Definition A pattern of regulating and integrating into daily living a therapeutic regimen for the treatment of illness and its sequelae, which can be strengthened.
- 16. READINESS FOR ENHANCED HEALTH MANAGEMENT Defining Characteristics ■ Expresses desire to enhance choices of daily living for meeting goals ■ Expresses desire to enhance management of illness ■ Expresses desire to enhance management of prescribed regimens • Expresses desire to enhance management of risk factors • ■ Expresses desire to enhance management of symptoms ■ Expresses desire to enhance immunization/vaccination status
- 17. COMMUNITY 4 PARTS OF COMMUNITY DIAGNOSIS; 1. a description of the problem, response, or state (risk, concern, issue, potential or actual), 2. a statement of the aggregate, population, community, or focus (boundaries). THIS DIFFERS FROM THE NURSING DIAGNOSIS, the focus is added 3. an identification of factors etiologically related to the problem ( factors), and 4. those signs and symptoms (manifestations) that are characteristic of the problem. EXAMPLE: deficient community health among children aged 0-5 y.o in the area of Village A related to Insufficient access to healthcare provider as evidenced by Health problem experienced by children (malnutrition, etc), Program unavailable to eliminate health problem(s) of an aggregate or population (Ex: no health education)
- 18. COMMUNITY HEALTH NURSING : PLANNING
- 19. PLANNING Prioritize the community- health conditions and problems Define objectives and goals Develop the intervention plan Define persons, time, place, method, tools
- 20. CRITERIA TO ESTABLISH PRIORITIES OF CHN NURSING DIAGNOSES • Appropriateness to the community health nursing role • Prevalence of the risk in the community • Severity of the risk • Potential for risk reduction • The level of the community's interest in reduction of the risk • Availability of appropriate resources (personnel, money, equipment, space, time, etc.). Muecke, M. A. (1984). Community health diagnosis in nursing. Public Health Nursing,1(1), 31.
- 21. DEFINE OBJECTIVES AND GOALS • Formulate expected outcomes : c - onditions to be observed to show problem is prevented, controlled, resolved or eliminated knowledge, behavior, status (signs & symptoms) • Individuals / families/ community responses or behaviors • Specific, measurable, community centered
- 22. DEVELOP INTERVENTION PLAN Categories of the intervention scheme: Primary preventions • Health teaching, guidance and counseling (assistance with decision making and problem solving) Secondary preventions • Treatments and procedures (decreasing and alleviating sign and symptoms) Tertiary preventions • Case management (coordination, advocacy and referral) Independent or collaborative intervention
- 23. REFERENCES: Freidman, M.M., Bowden, V.R., & Jones, E.G. (2003). Family nursing: Research, theory, and practice. (5th ed.). New Jersey: Prentice Hall. Muecke, M. A. (1984). Community health diagnosis in nursing. Public Health Nursing,1(1), 31. Sparks, S.M., & Taylor, C.M. (2001). Nursing diagnosis reference manual. (5th ed.). Pennsylvania: Springhouse. Stammler, L.L. & Yiu, L. (Eds.). (2008). Community health nursing: A Canadian perspective. (2nd.ed.). Toronto: Pearson. Stolte, K.M. (1996). Wellness: Nursing diagnosis for health promotion. Philadelphia: J.B. Lippincott. Vollman, A.R., Anderson, E.T. & McFarlane, J. (2004). Canadian community as partner: Theory and practice in nursing. Philadelphia: Lippincott Williams & Wilkins.