NURSE FAMILY CONTACT

Criteria for Selecting the Type of Nurse-Family

Contact:
1. EFFECTIVITY/EFFECTIVENESS-determining whether goals
and objectives were attained.
Question answered: “Did we produce the expected result? Or Did
we attain our objectives?”
2. EFFICIENCY- is the relationship of resources used to attain the
desired outcomes.
Question answered: “Are the outcomes of family nursing care
worth the nurse’s time, effort and other resources?
3. APPROPRIATENESS – suitability of the goals/objectives and
intervention to the identified family health needs.
Question Answered: “Are our goals/objectives and interventions
correct in relation to the family health needs we need to address?”
4. ADEQUACY- means the degree of sufficiency of goals or
objectives and interventions in attaining the desired change in the
family.
Question Answered: “ Were our interventions enough to bring
about the desired change in the family?
 TYPES OF FAMILY-
ADVANTAGES DISADVANTAGES
NURSE CONTACT
1. HOME VISIT- is a ▪ Allows first hand • Expensive in terms of
professional, purposeful assessment of the home time, effort and
situation: family
interaction that takes logistics.
dynamics,
place in the family’s environmental factors
residence. affecting health and • Safety of the Nurse is
resources w/in the at risk
home.
▪ The nurse is able to seek • Inability to control
out previously the environment
unidentified needs.
(distraction is
prominent)
TYPES OF FAMILY-
ADVANTAGES DISADVANTAGES
NURSE CONTACT
▪ It gives the nurse an opportunity
to adapt interventions according
to family resources.
▪ Teaching is made easier by the
familiar environment

▪ It promotes family participation

and focuses on the family as a unit.
▪ The personalized nature of a home
visit give the family a sense of
confidence
 PHASES OF HOME VISIT:
➢PREVISIT PHASE- a plan for the home visit is formulated
Principles in Planning Home Visit:
1. Home visit should have a purpose
- To have more accurate assessment the family’s living conditions and adapt interventions
accordingly.
-To educate the family(health promotion, disease prevention, control of health problems)
-To prevent the spread of infection among family members and within the community.
-To provide supplemental interventions & guide them how to give care in the future
-To provide the family greater access to health resources in the community, providing
information and making referrals when necessary.
Cont….Principles in Planning Home Visit:
2. Use the information about the family collected from all sources
3. Focuses on identified family needs, particularly RECOGNIZED
needs by the family requiring IMMEDIATE attention
4. Client & the family should actively participate in planning for
CONTINUING care.
5. The plan should be PRACTICAL & ADAPTABLE
• Nurse must check the contents of her Nursing bag (PHN bag) &
other articles needed prior to home visit
• “BUDDY SYSTEM” is suggested
• SPOT MAP of the family’s house is identified (assists colleagues in
determining whereabouts of the nurse
➢IN-HOME PHASE – Nurse seeks permission to enter & lasts
until he/she leaves the family’s home.
Consists of:
• Initiation – nurse acknowledges the family with a greeting and introduces
himself/herself and the agency she represents.
• Implementation – application of the nursing process (Assessment; Provision of
direct Nursing care as needed and evaluation.
• Termination – summarizing with the family the events during the home visit and
setting a subsequent home visit or another type of nurse -family contact.
➢POST VISIT PHASE – the nurse has returned to the facility
- documentation of the events that
transpired during the visit.
- a referral may be made
TYPES OF FAMILY-NURSE
ADVANTAGES DISADVANTAGES
CONTACT
2. CLINIC VISIT – ▪ The family takes the • Obvious hardship
private clinic, initiative of visiting a for the family
professional health
barangay health
worker, usually
center, ambulatory indicating the family’s
clinic during outreach readiness to
programs. participate in the
healthcare process.
▪ Empowerment & Self-
Help
TYPES OF FAMILY-NURSE
ADVANTAGES DISADVANTAGES
CONTACT
3. Group ▪ Develops • Attendance is a must
Conference- cooperation, and requires
leadership, self- motivation and
resources include
reliance, and or availability of the
Telephone that community target family
provides easy access awareness among members.
between the health members • The nurse may not be
worker and family ▪ Requires immediate able to reach the
access to data families in need of
required from the great help.
target family
 TYPES OF FAMILY-
ADVANTAGES DISADVANTAGES
NURSE CONTACT
4. WRITTEN ▪ Less time ▪ A one-way
COMMUNICATION- consuming method;
used to give specific
▪ Places • The family may
information to families
via Pamphlets, a letter responsibility for feel less confident
or a note with action on the to discuss family
instructions thru family health concerns
reminders & other
learning materials. E-
mail may also be used.
 TYPES OF FAMILY-
ADVANTAGES DISADVANTAGES
NURSE CONTACT
5. School Visit – ▪ Work out interventions
working with the to help children and
adolescents on specific
family and school
health risks, hazards or
authorities adjustment problems.
6. JOB SITE VISIT –
working with ▪ Identify Accurate
employer/supervisor on assessment of health
what can be done to
risks/hazards
improve health and
safety of workers.
 ❖ THE NURSING BAG (PHN
BAG)
• A tool used by the nurse during home/community health visits
to be able to provide care SAFELY and EFFICIENTLY.

• A receptacle for items needed for nursing care which would

usually not be available in the home

• Serves as a reminder of the need for hand hygiene and other

measures to prevent the spread of infection.
 PRINCIPLES OF BAG TECHNIQUE
❑Helps the nurse in INFECTION CONTROL
❑Allows the nurse to give care EFFICIENTLY
❑Should not take away the nurse’s focus on the
patient and the family-it is simply a tool for
PROVIDING CARE
❑May be performed in different ways
 ❖ DEMONSTRATION ON PROPER BAG
TECHNIQUE
• 1. Upon arrival at the client’s house, place the bag on the tableto any flat
surface lined with plastic lining, clean side out (folded part touching the table.
Put the strap underneath the bag.
• 2. Ask for a basin of water and a glass of water if faucet is not available. Place
this outside of the work area.
• 3. Open bag, take the linen(1st towel)/ plastic lining and spread over the work
area with the lining, clean side out.
• 4. Take out hand towel, soap dish and apron and place them at one corner of
the work area (within the confines of the linen/plastic lining).
• 5. Do hand washing. Wipe dry with towel. Leave the plastic wrapper of the
towel in the bag.
• 6. Put on apron right side out and wrong side with crease
touching the body, place the neck strap to the head. Neatly tie
the straps at the back.
• 7. Put out things needed for Nursing care (e.g. thermometer,
cotton ball, paper waste container and place at one corner of
the work area.
• 8. Place paper waste container outside of the work area.
• 9. Close the bag.
• 10. Proceed to the specific nursing care treatment.
• 11. After completing nursing care, wash, clean, dry and disinfect
the things used.
• 12. Do hand washing again.
• 13. Open the bag and put back all articles in their proper places.
• 14. remove apron folding away from the body, with soiled sides
folded inwards.
• 15. Fold the linen/plastic lining, clean, place it in the bag and
close the bag
• 16. Make post visit conference on matters relevant to health
care, taking anecdotal notes preparatory for final reporting.
• 17. Make appointment for the next visit (either home/clinic)
taking note of the DATE, TIME and PURPOSE.
 • IMPLEMENTING THE NURSING
CARE PLAN
•Implementation-is the step when the family/nurse execute
the plan of action. Determined by the mutually agreed upon
goals and objectives and the selected courses of action.
• It involves providing nursing care & helping family members do
what is necessary to meet health needs and problems then
referring them to another health agency.
• Meeting the challenges of the implementation phase is the
essence of family nursing practice
• The nurse must engage in full awareness of being in this “lived
experience of caring with the family.
 • CATEGORIES OF NURSING INTERVENTION
1)SUPPLEMENTAL INTERVENTIONS –are actions the nurse
perform on behalf of the family when it is unable to do
things for itself.
2)FACILITATIVE INTERVENTIONS- Refer to actions that
remove barriers to appropriate health action
3)DEVELOPMENTAL INTERVENTIONS- aim to improve the
capacity of the family to provide for its own health needs
❑3 MAJOR METHODS/POSSIBILITIES IN EXPERT CARING
1. Competency-based teaching- directed towards developing the
family’s ability to perform the health task. Includes:
a. COGNITIVE(Knowledge)
b. PSYCHOMOTOR (Skills)
c. AFFECTIVE (emotions, feelings, values)
➢3 Learning Principles
A. Learning is an Intellectual & Emotional Process
- awareness towards the family’s reaction to
change
• 6 General Methods & Techniques that help the family handle the
affective/emotional components of teaching-learning situation:
1. Provide information to shape attitudes
2. Providing Experiential Learning activities
3. Providing examples/models to shape attitudes
4. Providing Opportunities for small group discussion to
shape attitudes
5. Role-playing exercises
6. Explore the benefits of the power of Silence
B. Learning is facilitated when experiences have meaning
to the learner.
-Focus and relate learning experiences to the family’s
meanings, aspirations and best choices among options available in
the family situation.
c. Learning is an individual matter: Ensure mastery of
competencies for sustained actions
-letting the families learn at their own speed, providing
enough time to practice the behavior & using a variety of teaching
methods.
2. Maximizing Caring Possibilities for Personal & Professional
development
- Focuses on effective family-centered Nursing care
- Philosophy of caring (nurse shares her expertise &
emotional/psychological strength) and commitment are
ingredients of effective nursing practice.
-use of Motivational Theories (Rosenstock’s Principles)
3. Expertise through reflective Practice
o Reflection-in-action - to think what one is doing while one is
doing it.
oReflection-on-action – reviewing or re-evaluating one’s action
 DATA VALIDATION AND PLAN MODIFICATION
• The nurse continually collects data through various assessment
methods in determining changes in the individual client/patients
condition and/or family and home situation.
• The plan of care is tentative, flexible and open to modification or
complete revision depending upon the current situation, heath needs
and problems as well as priorities of the family.
 EVALUATION/EVALUATING THE FNCP (Family
Nursing Care Plan)
• FORMATIVE Evaluation- is judgment made about effectiveness of nursing
interventions as they are implemented
• SUMMATIVE Evaluation- determining the end results of family nursing care and
usually involves measuring outcomes/degree to which goals have been achieved
• ASPECTS OF EVALUATION:
1. EFFECTIVITY/EFFECTIVENESS-determining whether goals and objectives
were attained.
Question answered: “Did we produce the expected result? Or Did we attain our
objectives?”
2. EFFICIENCY- is the relationship of resources used to attain the desired
outcomes.
Question answered: “Are the outcomes of family nursing care worth the nurse’s
time, effort and other resources?
3. APPROPRIATENESS – suitability of the goals/objectives and intervention to the
identified family health needs.
Question Answered: “Are our goals/objectives and interventions correct in relation to
the family health needs we need to address?”
4. ADEQUACY- means the degree of sufficiency of goals or objectives and
interventions in attaining the desired change in the family.
Question Answered: “ Were our interventions enough to bring about the desired
change in the family?

• EVALUATION process can be initiated at the planning stage where Objectives and
criteria are specified
• METHODS AND SOURCES OF EVALUATION DATA
1. Objectives and Criteria- SMART (Specific, Measurable,
Attainable, Realistic, Time-bounded)
2. Outcomes- it easily pinpoints nursing interventions that are
effective and those that are not.
- It is a matter of policy/preference
3. Indicators- performance measure must be valid,
reliable, objective, sensitive, specific, cost-effective and
timely
➢ DESIGNING & IMPLEMENTING THE EVALUATION PLAN
objective-criteria for evaluation-evaluation
tool
• STEPS IN EVALUATION:
1. Decide on what to evaluate
2. Design the evaluation plan
3. Collect relevant data
4. Analyze data
5. Make decisions
6. Report/Give feedback
 RECORDS IN FAMILY HEALTH NURSING
PRACTICE
• FHSIS –Field Health Service Information System
- is the official recording and reporting system of the DOH & is used by the
NSCB to generate health statistics.
- essential tool in monitoring the health status of the population at
different levels.
It is a basis for: a. Priority setting by local governments
b. Planning & decision making at different levels
c. Monitoring & evaluating health program
implementation.
• FHSIS MANUAL OF OPERATIONS (DOH-IMS, 2011)
RECORDING TOOLS:
1. Individual Treatment Record (ITR)
-building block of the FHSIS
-contains the date, name, address of patient, presenting
symptoms or complaint of the patient on consultation and
Diagnosis (if available), treatment and date of treatment.
- maintained at the facility on all patients seen
2. Target Client Lists (TCLs)
- second building block of the FHSIS
TCLs Purposes:
a. To plan and carry out patient care and service
delivery
b. To facilitate monitoring and supervision of service
delivery activities
c. To report services delivered, thus reducing the
need to refer back to the ITRs to accomplish
reporting
d. To provide a clinic-level database that can be
accessed for further studies
• TCLs maintained in RHUs & Health Centers:
a. Prenatal care
b. Postpartum Care
c. Under 1-year old children
d. Family Planning
e. Sick Children
f. National Tuberculosis Program TB Register
g. National Leprosy Control Program Central
Registration Form
3. SUMMARY TABLE – accomplished by the midwife
- a 12-column table in which the columns correspond to the
12 months of the year
- updated on a monthly basis
- a source of data for any survey/research
- kept by at the BHS and has 2 components:
▪ Health Program Accomplishment – provides the midwife w/a
tool for assessment of accomplishments and a ready source for
reports
▪ Morbidity Diseases- gives information on the monthly trend
of diseases and serves as a source for the 10 leading causes of
morbidity in the municipality
 4. Monthly Consolidation Table(MCT)
- accomplished based on the summary table
- serves as the source document for the Quarterly
Form and the Output Table of the RHU/health
center
• REPORTING FORMS
1. Monthly Forms – regularly prepared by the midwife & submitted to
the nurse then uses the data to prepare the quarterly forms:
a. Program report (M1)-indicators categorized as maternal
care, child care, family planning and disease control.
b. Morbidity Report (M2)- list of all cases of disease by age
and sex
2. Quarterly Forms – prepared by the nurse
- one quarterly form for the municipality
- Consolidation is done by the Municipal/City Health
Officer
-Forms submitted:
a. Program Report (Q1) contains 3-month total of indicators
categorized as maternal care, family planning, child care, dental
health and disease control.
b. Morbidity Report (Q2) a 3-month consolidation of
morbidity report (M2)
3. Annual Forms
a. A-BHS- a report by the midwife that contains
demographic, environmental and natality data.
b. Annual Form 1 (A-1) prepared by the nurse, and is the
report of the RHU/ Health Center; contains demographic and
environmental data and data on natality and mortality for the
entire year.
c. Annual Form 2 (A-2)-prepared by the nurse
-yearly morbidity report by age and sex
d. Annual Form 3 (A-3) – Yearly report of all deaths
(mortality) by age and sex
• Disease Registries
- A list of persons diagnosed w/ a specific type of disease in
a defined population
- data collected serves as a basis for monitoring, decision
making and program management
• DOH REGISTRIES:
• HIV/AIDS
• CHRONIC NONCOMMUNICABLE DISEASES
• CANCER; DM; COPD; STROKE
• RENAL DISEASE CONTROL PROGRAM
• PHILIPPINE RENAL DISEASE REGISTRY (NKTI)
• Census Data – a periodic governmental enumeration of the
population
➢Batasang Pambansa Blg. 72 provides for a national census of
population and other related data in the Philippines every 10
years
➢Philippine Statistical System (PSS) provides statistical information
and services to the public
➢NSCB (National Statistical Coordination Board)is the policy-
making and coordinating body of the PSS
➢NSO (National Statistics Office) is the PSS arm that generates
general purpose statistics: population, employment, prices and
family income/expenditures
• 2 ways of obtaining CENSUS DATA:
1. De Jure assignment- based on the legally
established place of residence of the people
- NSO/PSA conducts this type of method
2. De facto- is actual physical location of the people
• GRAPHS FOR PRESENTING COMMUNITY DATA:
➢ Bar graph- compare values across different categories
➢Line graph- trends in data over time & age
➢Pie chart- percentage ditribution
➢Scatter plot/diagram- shows correlation between 2 variables