19175765 Developing a Family Nursing Care Plan

8/3/2019 19175765 Developing a Family Nursing Care Plan

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DEVELOPING A FAMILY NURSING CARE PLANGroup 2 MAN_2008 AUL


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F N C P : definedBlueprint of the care that the N designs to systematically minimize or eliminatethe identified health and family nsg problems through explicitly formulated outcomes of care and deliberately chosen sets of interventions, resources and evaluation criteria, standards, methods and tools.


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CHARACTERISTICS OF FNCPFocuses on action to solve/minimize existing problems A product of deliberate systematic process data analyses Relates to the future; projects future scenario Basedupon the identified health and nursing problems problems are starting points


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ContIt is a means to an end, not an end in itself deliver the most appropriate care to the ct by eliminating barriers to family health development A continuous process must be evaluated for its effectiveness


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DESIRABLE QUALITIES OF FNCP It should be based on clear, explicit definition of the problems. = Must be based on comprehensive analysis of the problem A good plan is realistic


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Cont Prepared jointly with the family. = N works with the family; not works for the family = N involves family in determining the health needs & problems, priorities, appropriate actions, implementation and evaluation of outcomes A means of communication (within the profession and other professions)


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IMPORTANCE OF PLANNING CAREIndividualizes patient care. Sets priorities by providing information abt the ct;his nature of problems. Promotes systematic communication involved in care. Continuity of care is facilitated, prevents gaps and duplication of care. Coordinates care to other health team members.


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THE ASSESSMENT PHASE OF THE NURSING PROCESS GENERATES THE HEALTH AND NURSING PROBLEMS WHICH IS THE BASIS OF DEVELOPING THE FNCP.


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STEPSI.

PRIORITIZATION OF PROBLEMS SETTING THE GOALS AND OBJECTIVES PLANNING INTERVENTIONS EVALUATION OF CARE

III.

V.

VII.


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Prioritizing the Health Problems c) Nature of the problem d) Modifiability e) Preventive potential f) Salience

Development of Evaluation Plan Criteria Standards Methods / tools

Selection of Appropriate Nursing Interventions Formulation of Goals and Objectives of Nursing Care

Consider alternatives Decide on appropriate measures Determine methods of nurse-family contact Specify resources


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I. PRIORITIZATION OF PROBLEMS

Devised by Maglaya and Bailon Known as SCALE FOR RANKING FAMILY HEALTH PROBLEMSACCORDING TO PRIORITIES Has four (4) criteria for setting priorities


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SCALE FOR RANKING FAMILY HEALTH PROBLEMS ACCORDING TO PRIORITIESFOUR CRITERIA: 1) NATURE OF THE PROBLEM a) health threat b) health deficit c) foreseeable crisis


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2) MODIFIABILITY OF THE PROBLEM - the probability of success in minimizing, alleviating or totally eradicating the problem through intervention 3) PREVENTIVE POTENTIAL - the nature and magnitude of future problems that can be minimized or totally prevented if intervention is done on the problem under consideration 4) SALIENCE - the familys perception and evaluation of the problem in terms of seriousness and urgency of attention needed


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SCALE FOR RANKING FAMILY HEALTH PROBLEMS ACCDG TO PRIORITIESWeight 1) Nature of the Problem scale: Health Deficit Health Threat ForeseeableCrisis 2) Modifiability of the Problem scale: Easily Modifiable Partially modifiable Low 3) Preventive Potential scale: High Moderate Low Serious px, imm. AttnPx, not needing imm. Attn Criteria 1 3 2 1 2 2 1 0 1 3 2 1 1 2 1

4) Salience scale:


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Scoring1)

2)

3)

Decide on a score for each criteria Divide the score by the highest possible score and multiply by the weight : score/highest score x weight Sum up the scores for all criteria. The highest score is 5, equivalent to the total weight.


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Fxs Affecting Priority - Setting

Greater weight on Health Deficit = needs more immediate attn and felt by the ptover a health threat Foreseeable crisis = lowest score d/t culture-linked variab

les/factors that provide our ct with adequate support to cope


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Fxs in Determining the Modifiability of the Problem

Current knowledge, tech. and interventions to manage the problem Resources of the family physical, financial, manpower Resources of the N S, K, time Resources of the community facilities and community org/support


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Fxs Affecting the Scoring of Preventive Potential

Gravity / severity of the px = dse progression, extent, damage on the pt/fam = the more severe or advanced, the lower is the preventive potential

Duration of the px = length of time the px has been existing Current management= appropriateness of intervention instituted Exposure to any high risk group


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SALIENCE OF THE PROBLEM

Perception of the pt/fam of the problem Familys concerns and felt needs


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II. FORMULATION OF GOALS AND OBJECTIVES OF NURSING CAREGOALS General statement of the condition or state to be brought about by specificcourses of action Client outcomes Goals tell where the family is going OBJECTIVESMore specific statements of desired results or outcomes of care Specify the criteria by which the degree of effectiveness of care are to be measured Must be specific in order to facilitate its attainment Milestones to reach the destination


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GOALS Must be set together with the family Family must be able to recognize and acceptthe presence of existing health needs and problems. Nurse must ascertain the familys knowledge and acceptance of the problems and the desire to make actions toresolve them.


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BARRIERS TO GOAL-SETTING1) Failure of the family to perceive the existence of the problem. = family mayfeel satisfied with the existing situation 2) Family is too busy with other concerns or preoccupations at the moment.


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Cont3) Family does not see the existence of a problem as serious enough to necessitate attention 4) Family may perceive the problem and the need to take action, butthey face to do something about the situation.


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Reasons for Not Doing Any Action1) Fear of consequence of doing action = social stigma / financial reasons 2) Respect for tradition 3) Failure to perceive the benefits of action proposed = previous experience 4) Failure to relate the proposed action to the familys goals


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Cont BARRIERS TO GOAL-SETTING5) Failure between the nurse and the family to establish a working relationship.= TRUST AND CONFIDENCE


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TIME SPAN OF OBJECTIVES1) Short Term / Immediate Objectives - immediate attn; results: can be observed in a period of short time 2) Medium Term / Intermediate Objectives - required toattain long term objectives 3) Long Term or Ultimate Objectives - several N-F contact + more resources - takes time to see the result


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III. SELECTION OF APPROPRIATE NURSING INTERVENTIONS N must choose among set of alternatives N must specify the most effective or efficient method of N-F contact Home visit Clinic conference Visit in the work, place, school Telephone call Gup approach Mail


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Cont N must specify the most effective or efficient resources Teaching kits visual aids, handouts, charts Human other team members, communityleaders


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HOW TO CHOOSE THE APPROPRIATE NURSING INTERVENTION?A. Analyze w/ the Family the Current Situation and Determine Choices and Possibilities based on a Lived Experience of Meanings and Concerns Develop / Enhance Familys Competencies as Thinker, Doer and Feeler Focus on Interventions to Help Perform the Health Tasks Catalyze Behavior Change through Motivation and Support

B. C. D.


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A. EXPLORATION W/ FAMILY CHOICES/POSSIBILITIES BASED ON LIVED EXPERIENCE OF MEANINGS AND CONCERNS

N.I. is dependent upon lived meaning of the experiences of family member w/ eachother and the nurse FAMILY is the active participant in the applcn of Nsg. Process FAMILY & NURSE are participants in active, mutual, dynamic interchange of realities, concerns and resources


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They both need to analyze & understand the current health/illness situation Nurse must explore w/ the F the possibilities and choices presented by current situation Meanings Concerns Social relations Resources


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B. DEVELOPING/ENHANCING COGNITION, VOLITION AND EMOTION

Provides the family ways to be THINKER, DOER & FEELER THINKER N must be able toshare info/knowledge; must be accessible for ease and confidence in understanding current situations and health/illness


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DOER N must enhance confidence to the F in carrying out/initiating and sustaining change for health promotion & maintenance, and accurate dse mgt. FEELER N musthelp the F strengthen its affective competencies in order to appropriately acknowledge & understand emotions generated by family life or health illness situations; so that these emotions will be transformed into growth-promoting actions


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C. FOCUSING ON THE INTERVENTIONS TO HELP THE FAMILY PERFORM THE HEALTH TASKS

1) Help the F recognize the px. - information-giving about the nature, magnitude, cause of the px - help the F see the implications of the px - relate health needs to the goals of the family - help the F recognize its capabilities/qualitiesand resources


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Cont2) Guide the F on how to decide on appropriate health actions to take. - identify/explore the courses of action + resources available - discuss the consequencesof each courses of action - analyze together w/ the F the consequences of inaction


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Cont3) Develop the Fs ability and commitment to provide nursing care to its members.- nsg care to sick, disabled, dependent member/s demonstration / practice sessions on procedures/tx, techniques = use of low-cost, available resources


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CONTRACTING Maximizes opportunities to develop the ability & commitment of the family to provide nsg care to its members N creates a situation in order that the ct learns to achieve a specific health-related behaviour through steps and conditions or elements jointly identified by both parties Uses positive reinforcement


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4) Enhance the capability of the F to provide a home envt conducive to health maintenance and personal devt. - envt modification, manipulation, management to reduce health threats/risks 5) Facilitate the Fs capability to utilize community resources for health care. - coordination, collaboration, team work referral system


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D. CATALYZING BEHAVIOR CHANGE THROUGH MOTIVATION & SUPPORT There should be an envt that nurtures change There should be support from both parties in order to make a change MOTIVATION & SUPPORT Enhance the Fs knowledge andwillingness to prevent, control health pxs Makes the F skillful, emotionally stable and creative handling the stresses/issues surrounding them


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MOTIVATION: described Any experience or information that leads the family to desire and agree to undergo the behavior change or proposed measure and takes the initial action to bringabout a change


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SUPPORT: described Any experience or information that maintains, restores or enhances the capabilities or resources of the family to sustain these actions and complete the changeprocess feelings of security and in control of the px (family)


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DEVELOPING THE EVALUATION PLAN Specifies how the N will determine achievement of the outcomes of care Criteria,standards, evaluation methods and sources of data


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19175765 Developing a Family Nursing Care Plan

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