NCM 213

COMMUNITY HEALTH
NURSING 2
Care of Population Groups and
Community
 HOUSE RULES
• Attendance is a must
• We are encourage to wear decent attire and observe proper decorum
• 40 minutes total session
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using the same link
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 Lesson 1
• Define community health nursing;
• Philosophy and Principles of CHN
• Features of CHN;
• Concept of the community;
• Types and components of communities;
• Factors affecting the health of the community; and
• Nurse’s roles and activities.
COMMUNITY DIAGNOSIS
COMMUNITY DIAGNOSIS
• process used to determine the health status of
the community and the factors responsible for
it.
• is called as community assessment or
situational analysis
 Types of Community
Diagnosis
1. COMPREHENSIVE
•Aims to obtain general information about the
community or a certain population group
2. PROBLEM-ORIENTED
•Type of assessment that responds to a particular
need.
 Elements of Comprehensive
Community Diagnosis
• Demographic Variables
• Socio-Economic and Cultural Variables
• Health And Illness Patterns
• Health Resources
• Political/Leadership Patterns
 Schemes in Stating Community
Diagnosis ( NANDA)
Shuster and Goeppinger (2004)
•Three Part Statement
• The health risk or specific problem to which the community is
exposed
• The specific aggregate or community with whom the nurse will
be working to deal with the risk or problem
• Related factors that influence how the community will respond
to the health risk or problem
 Risk of maternal complications
leading to maternal mortality among
pregnant women in Tomas
Monteverde Agdao related to cost
and inaccesibility of skilled birth
attendance and the community
member’s perception that skilled
birth and facility based delivery are
not necessary during childbirth.
 OMAHA SYSTEM

• Applications for Community Health Nursing

• This is the oldest of the nursing classifications and
was developed in the 1970’s by Karen Martin
• It was designed for nurses in community and public
health services.
 OMAHA SYSTEM
• is a research-based, comprehensive practice and
documentation standardized taxonomy designed
to describe client care.
• Components:
• Problem Classification Scheme ( Client Assessment )
• Intervention Scheme ( Care Plan and services )
• Problem Rating Scale for Outcomes (client
change/evaluation)
PROBLEM CLASSIFICATION
SCHEME
• Provides a structure, terms, and system of cues and
clues for a standardized assessment of individuals,
families, and communities.
 PROBLEM CLASSIFICATION
SCHEME
• Consist of 4 domains
• Environmental
• Psychosocial
• Physiological
• Health related behaviors
• It includes 40 problems or diagnoses
• Modifiers for the diagnoses identify the problem as either
individual or family problem and as either a health
promotion, potential, or actual problem
• There are also s/s specific to each problem
The OHAMA System : Domains and problems of the problem
classification Scheme
 Intervention Scheme
( Care Plan and Services)
Describe and communicate multidisciplinary practice,
practice to prevent illness, improve/restore health,
decrease deterioration, and/or provide comfort before
death.
Four ( 4 ) Intervention Categories
•Teaching Guidance, and Counselling
•Treatments and Procedures
•Case Management
•Surveillance
Identified Problem are classified in 4
levels
1. The first and most general level of classification is
composed of 4 domains ( environmental, psychosocial,
physiological, health related behaviors )
2. The second level consists of problems or areas of
concern under the four domains
3. The third level , the problem or area of concern is
classified according to two sets of qualifiers ( 1. the area
of concern is categorized into health promotion , potential
problem, ,or actual problem. 2. The level of clientele
( individual, family, community)

4. The fourth and most specific level is made up of

clusters of signs and symptoms that describe actual
problems.
 Planning Community Health
Interventions

PRIORITY SETTING
•This step provides the nurse and the health team with a
logical means of establishing priority among the identified
health concerns
 Criteria in Deciding Community
Health Concern for Interventions

• Significance of the problem

• Community Awareness
• Ability to reduce risk
• Cost of reducing risk
• Ability to identify the target population
• Availability of resources
1. Significance of the Problem
•Is based on the number of people in the community
affected by the problem or condition.
•Disease condition /Potential problem
2. Community Awareness
•Related to the priority that the community gives to the
health concern
3. Ability to reduce risk
•Is related to the availability of expertise among the health
team and the community itself.
4. Cost of reducing risk
•The nurse has to consider economic, social, and ethical
requisites and consequences of planned action
4. Ability to identify the target population
•Matter of availability of data sources such as FHSIS,
census, survey reports, and /or case finding or screening
tools
5. Availability of Resources
•To intervene in the reduction of risk entails
technological, financial, and other material resources of
the community, nurse ,and the health agency.
 CRITERION
1. From a scale of 1 to 10, 1 being the lowest, the
members give each criterion a weight based on their
perception of its degree of importance in solving the
problem. “ How important is significance of the
problem to it’s solution”
2. From a scale of 1 to 10, 1 being the lowest, each
member rates the criteria in terms of the likelihood of
the group being able to influence or change the
situation. “ Can the group influence the significance
of this problem”
3. Collate the weights (from step 1 ) and ratings ( from step 2 ) made by the
members of the group
4. Compute the total priority score of the problem by multiplying collated weight
and rating of each criterion.
5. The priority score of the problem is calculated by adding the products obtained in
step 4.

“ How important is the criterion in solving the problem?”

“ Can the group influence the situation in relation to the criteria”
Criterion Nurse 1 Midwife BHW Mrs. Mr. Average
Miranda Peralta

Significance of 8 10 7 10 6 8
the Problem

Community 8 8 5 5 6 6
awareness

Ability to 10 10 10 10 10 10
reduce risk

Cos of reducing 8 8 8 8 8 8
risk

Ability to 4 5 6 5 6 5
identify target
population

Availability of 8 8 6 5 8 7
Resources
 Nature of the problem

• Health status problems – may be described in terms of

increased or decreased morbidity, mortality or fertility.
• Health resource problems – they may be described in
terms of lack of or absence of manpower, money,
materials, or institutions necessary to solve the problem.
• Health-related problems – may be described in terms of
existence of social, economic, environmental, and
political factors that aggravate the illness-producing
situations in the community.
 Steps in Prioritizing Problem

• Score each problem according to each criteria

• Divide the score by the highest possible score
• Multiply the answer by the weight of the criteria
• Add the final score for each criterion to get the
total score for the problem. The highest possible
score is 10, while the lowest possible score is 1
• The problem with the highest total score is given
high priority by the nurse.
 Formulating Goals and
Objectives
GOALS
•Broad and not constrained by time and resources, states the
ultimate desired end point of all activities, directed towards
solving health status problems
OBJECTIVES
•Stated in specific, measurable terms, client –centered, and
outcome-focused, concerned with resolutions of the health
problems itself. An adequate statement of objective specifies
both the criteria as well as the standards of evaluation
 Formulating Goals and Objectives
Problem: Risk of maternal complications leading to materna mortality
in Brgy. Bagong Silang
Goal: To reduce maternal mortality rate from 132/100,000 live births to
80/100,000 live births by the year 2015
Objectives: At the end of the year, the community of Brgy. Bagong
Silang will:
1.Demostrate the abiltiy to organize groups to participate in the cy
health process from assessment to evaluation
2.Increase the proportion of facilty-based births from 10% to 15 %
3.Lower the proportion of untrained HILOT attended births from 20%
to 10%
4.Reduce the prevalence of Nutritionally at risk pregnant women by
20%
5.Reduce the prevance of anemia among pregnant women by 20%
 Deciding on Community
Interventions
• The process of developing the plan, the group takes
into consideration the demographic,
psychological,social, cultural, and economic
characteristics of the target population on one hand
and the available health resources on the other
hand.
 Implementing the Community
Health Interventions
• Entails coordination of the plan with the
community and the other members of the health
team.
Thank You for
Listening
 PROJECT PROPOSAL
A. Project Title
(state the main point/purpose for which the
funds are sought)

B. Project Identification

C. Type of Project
 Indicate the specific project (Type of toilet-
Water sealed)
. Location
- State the name of the barangay or municipality
where the project will be implemented
E. Implementing-Community health Organization
- Write the name/ acronym of the requesting group
and its address: include contact person (preferably
the president of an org)
F. Estimated project cost
- Total Request Amount
- Total Community Counterpart
Write the amount representing the community
counterpart
G. Participatory/ Assisting Agencies
- enumerate the GO, NGO agencies that will be
providing assistance
H. Beneficiaries
- Community residents who will benefit from the
project. Indicate the estimated number and
description of the beneficiaries
I. Project Objectives
 State the general objectives
 What is/are the goal(s) of the project?