It is more than making a medical or nursing diagnosis relevant to the community. It means learning about the area where people in the community live, other families in the area, especially community leaders, their lifestyles, and their resources. All this information can be obtained through:-

• Conducting formal and informal meetings with community people, leaders and organized groups which may include Panchayat members, school teachers, women’s groups, youth clubs/groups, youth researchers etc.
• Visit the community to observe the physical environment, biological environment and psychosocial environment.
• Informal conversation with people
• Going through records (Going through records) ).
• Formal community/sample surveys (through formal community or sample surveys).
• Talking to health and allied health personnel working in the community.

Various dimensions (outcomes) are seen about the community, the three basic dimensions of which are as follows

1.Place or space

2.People or person (People or Person)

3.Function

1.Place or space:

This includes the following components.

• Geographical area:
  Size, census, blocks, climate, name of area, location, etc.
• Geographical boundaries:
  In our country, geographical and administrative boundaries have a significant impact on the administration of a community, so it is necessary to mention the electoral situation and local administration of the community. is.
• Means of transport, foot, bullock cart, bus, boat, train, air etc.
• Physical environment: land use pattern, housing conditions etc.

2.People or person (People or Person):

• It includes the demography and characteristics of the community.
• It is a fact that without people, a community has no meaning.
• Therefore, the demographic setup should be properly identified to identify the community.
• The handling of population composition is described more.

3.Function (Function):

It includes the main functionaries of the community, which may differ in urban and rural communities in our country.

It also implies the following….

• Maintenance of social control
• Employment/unemployment/ partial / seasonal employment status of the community.
• Socialization of new members
• Socialization of new members
• Production, distribution system consumption of goods and services
• Adaptation of ongoing and expected changes
• Provisions of mutual aid, cooperation
• Description of functions related to caste or religion etc. (Description of functions related to caste or religion etc.).

Explain community health nursing, process and community assessment (Define Community Health Nursing, Process and Community Assessment ) :

Introduction:

• Community health nursing is a synthesis of nursing and public health practice that is applied to promote and protect the health of a population.
• The community health nursing process is a process that determines the health status of a client. It is a systematic way to develop a plan to identify health problems, initiate the process of implementing the plan, and evaluate the plan’s suitability in solving the problem. Which is as follows…
• Which has 5 phases…

1.Community assessment (Community Assessment)

2.Community nursing diagnosis (Community Nursing Diagnosis)

3.Planning

4.Implementation

5.Evaluation

1.Community assessment:

Definition ( Definition ) :

Community assessment is a process that assesses the health status of local people, identification of main risk factors and causes of health Describes.

Or

Community assessment is a process that systematically collects data using quantitative and qualitative methods to understand the health of a specific community and analyzes that data.

Describe benefits of community assessment:

Benefits of community assessment:

Benefits of community assessment:

1. 1. Increase our understanding of the needs of people in the community.

1. 1. Get opportunities to share needs.

1. 1. Increased Community engagement

1. 1. Identify the strengths and weaknesses of the community.

1. 1. Raise awareness among community members.

1. 1. Data Use to inform strategic planning and priority setting.

Tools of community assessment

• • Survey

• • Asset inventory

• • Community mapping

• • Daily activity schedule 

• • Seasonal calendar

• • Panel discussion etc…

Explain steps of community assessment :

Steps of community assessment :

1. Define the scope
2. Collect data
3. Determine major findings
4. Set priorities
5. Create action plan

Components of community assessment ( Component of community assessment) :

• People (People)
• Health and social services (Health and social services)
• Economics (Economic)
• Communication
• Physical environment
• Safety and transport
• Politics and government
• Recreation
• Education

To describe the method of data collection:

To discuss community health nursing assessment.

Data collection and interpretation:

Data collection is necessary to obtain useful information about the community and its health data collection includes data of the community and data generation in its health data collection The details that can be collected from the information include:-

A. Geographical information
B. Demographic information
C. Environmental information

A. Geographical information:

• Getting preparing a map of the area, locating important institutions of public importance Demographical information:

• Name of the locality or area (लोकालिती तथा एरिया नु Name),
• Physical structure, boundaries,
• Important roads, streets, buildings,
• Important landmarks,
• Seasonal variation and months.

• Getting preparing a map of the area, locating important institutions of public importance.

• Specific vulnerable groups: infants, toddlers, expecting and lactating mothers and disease risk group

C. Environmental information:

• Physical environment: Housing, water supply, sanitation (Physical environment: Housing, water supply, sanitation).
• Social environment: social organization, school’s, temples etc (Social environment: Social organization, schools, temples etc). community organization (voluntary welfare organizations), leadership structure (Community organization: Voluntary welfare organization, leadership structure).
• Environmental communication:- Official and non-official channel, common meeting place, important communications events of communication (fairs, festivals)
• Media of communication:-radio, TV, cinema, newspapers etc
• Environmental resources:- economic resources (occupation, family income), institutional resources, human resources (doctors, engineers, teacher), natural resources (land, water soil) etc).(Environmental Resources: Economic Resources (Occupation, Family, Income), Institutional Resources, Human Resources (Doctors, Engineers, Teachers)Natural Resources (Land, Water, Soil) etc…)

2.Community nursing diagnosis:

• Community Nursing diagnosis is the second step of the nursing process. In which the actual or potential problem of the community is identified through assessment and a nursing diagnosis is made. Then, care is provided keeping it in mind.

• Nursing diagnosis is the second step of the nursing process. In which the nurse interprets the collected data using critical thinking and identifies the problem.
• Diagnosis is the clinical act of identifying a problem.
• Nursing diagnosis is a clinical judgment of the actual and potential health response of the individual, family, and community.
• Nursing diagnosis is the reasoning process or clinical act of identifying a problem.
• Nursing diagnosis provides a link between assessment and planning.
• A list of nursing diagnoses has been provided by the North American Nursing Diagnosis Association (NANDA) and these NANDA nursing diagnoses are used throughout.

Write purpose of nursing diagnosis

• Identify the client’s health status and actual and potential problems.
• Identify nursing priorities.
• Analyze the collected data.
• Provide direction for planned nursing interventions.
• Identify the client’s normal level of function.

Write down statement of nursing diagnosis

Problem/ Diagnostic label

In a nursing diagnosis, the patient’s actual or potential problem or diagnostic label is first written. This problem is written in a few words. This nursing diagnosis is taken from the list given by NANDA (North American Nursing Diagnosis Association). For example: Knowledge deficit, Anxiety, Ineffective airway clearance, Fluid volume deficit

Etiology

Etiology is the second statement of a nursing diagnosis. In which one or more causes of the problem are identified and written. Etiology gives direction to treat the problem. A problem may be seen in two patients but the etiology of both patients is not necessarily the same. This problem as well as the etiology is written with ‘related to’. For example Anxiety related to hospitalization, Anxiety related disease condition. In which Anxiety is a problem or diagnostic label that is the same in both patients. Also, the etiology of hospitalization and disease condition is different for each patient.

Defining characteristic

Defining characteristic shows how the problem in the patient is identified. It can be subjective or objective data. This defining characteristic is written as ‘as evidenced by’ or ‘manifested’. For example, Altered body temperature related to inflammatory condition as evidenced by increasing body temperature, Acute pain related to surgical process manifestd by facial expression.

3.Planning

Planning is the third step of the nursing process. In which an entire framework is created for which activities are to be carried out. That is, in this framework, what activities are to be done, when to do them, where to do them, how to do them, who will do these activities, etc. are planned.

• Planning is a kind of selected and carried out action series to achieve a goal.
• Planning is a planned careframe for providing nursing care.

Purpose of planning (Purpose of Planning)

• To provide direction to client care activities.
• To reduce uncertainty
• To enhance continuity of care.
• To minimize impulsive and arbitrary decisions

Write down elements of planning

1) Prioritizing nursing diagnosis
2) Determining goal and expected outcomes
3) Select nursing
interventions
4) Developing nursing care plan

1) Prioritizing nursing diagnosis

When planning, first prioritize nursing diagnoses. That is, give first priority to nursing diagnoses that require immediate care. This priority is set according to Maslow’s hierarchy of needs. Give first priority to ineffective airway clearance. Give less priority to nursing diagnoses like knowledge deficit.

2) Determining goal and expected outcomes

After setting the priority of the nursing diagnosis, determine the goal of that diagnosis and determine the expected outcome. So that we know whether the nursing care provided is going in the right way or not. For example, to set a goal such as relieving breathing difficulties in a patient with breathing difficulties.

3) Select nursing interventions

After determining the goals and expected outcomes, select specific interventions according to the nursing diagnosis. So that the set goals can be achieved. For example, providing Fowler’s position in a patient with breathing difficulty, providing oxygen supplementation if necessary.

4) Developing nursing care plan

After setting the priority of nursing diagnosis, determining the goal and expected outcome, and selecting specific nursing interventions, develop a nursing care plan. Which provides a framework for providing nursing care.

Goal and expected outcome

• A goal is a statement of the expected outcome of a nursing intervention.
• A goal is a specific, measurable, achievable, relevant, and time-bound objective.
• It provides direction, motivation, and focus.

Write down purpose of goal of goal)

• To evaluate the effectiveness of nursing interventions
• To evaluate the client’s progress
• To evaluate whether changes are needed in nursing interventions

Write down types of goal

There are mainly two types of goals. :

1) Short term goal
2) Long term goal

1) Short term goal (शोर्ट टेर्म गोल)

Short term goals are determined for a short time duration. Short term goals are to be achieved within a week. Short term goals are mainly set for immediate nursing care. For example, if a patient has breathing problems, your short term goal would be to relieve the patient from breathing difficulties.

2) Long term goal

Long term goals are determined for a long duration. Long term goals are to be achieved from a week to a month. Long term goals are also applied after discharge. Such as the patient not getting any kind of infection after discharge.

Expected outcome

• Expected outcome is a type of prediction. Which predicts the result of the action taken.
• The prediction of what kind of changes are seen in the health of a patient after nursing care is provided is known as the expected outcome.

Write down principles for formulating the outcome

• Expected outcome should be realistic.
• Expected outcome should be patient-centered.
• Expected outcome should be problem-oriented.
• Expected outcome should be measurable and observable.
• Expected outcome should be clear and concise.
• The expected outcome should be time limited.

4.Implementation:

• Implementation is the fourth step of the nursing process.
• In implementation, planned activities are converted into action.
• In implementation, planned activities and procedures are performed and documented.
• A nursing intervention is a type of action that is performed by a nurse to bring a patient out of the current health status and to achieve the expected outcome.

Write down purpose of implementation

• To provide therapeutic nursing care
• To provide technical nursing care
• To help the patient achieve optimal levels of health

Write activities of implementation

• Reassess the Community People :

The condition of the community people can change at any time, so reassess the patient’s condition even after interacting with them.

• Set priority :

As the conditions of the community people change, priorities also keep changing. Therefore, based on the reassessment, set priorities and then implement nursing interventions.

• Organize resources:

Arrange the necessary equipment, articles, environment and health care personnel to provide nursing care.

• Perform nursing interventions:

To implement or perform the planned nursing interventions according to the patient’s priorities.

• Documentation:

After implementing the plan Document everything in the patient’s health record as soon as possible. Record as per the institution’s policy.

Write nursing skill required during implementation

To successfully implement a nursing care plan, the nurse must have the following skills:

• Cognitive skill:

Nurses need to have cognitive skills to identify patient needs and anticipate nursing knowledge. Cognitive skills include skills such as problem solving, decision making, and teaching.

• Interpersonal skills:

Nurses need to have the skills to develop interpersonal as well as intrapersonal relationships because they also need other health care personnel to achieve goals. Apart from this, it is also necessary to have good communication skills.

• Technical skill:

To perform procedures and use equipment and machines, a nurse must have technical skills such as administering injections, calculating doses, and handling machines such as ventilators, phototherapy machines, infusion pumps, etc.

• Psychomotor skill:

While providing nursing care, nurses need to have integration between cognitive and motor activities. For example, when giving an intramuscular injection, the nurse needs to have knowledge of anatomy and physiology as well as the motor skills to administer the injection.

5.Evaluation:

• Evaluation is the last, or fifth, step of the nursing process.
• Evaluation is a process in which the progress of the community towards the expected outcome and the effectiveness of nursing care are determined.
• Evaluation is a type of judgment that judges how effective nursing care was in achieving the set goal.
• This step determines the effectiveness and success of the entire nursing process.
• Evaluation also helps in making decisions about whether to continue, modify, or repeat the process.
• When documenting the evaluation phase, any one of the following possible conclusions is written.
• The goal was met (This sentence is written when both goals have been achieved and the desired outcome is observed. (This sentence is written when the short-term goal is achieved but the long-term goal is not achieved.)
• The goal was partially met (This sentence is written when the short-term goal is achieved but the long-term goal is not achieved)

Write purpose of evaluation (Write purpose of evaluation)

• To check effectiveness
• To monitor implementation
• To monitor the quality of nursing care
• To bring about improvements in the care plan
• To identify errors in the care plan
• Client and health care team Assess member collaboration
• Improve decision-making

Write activities during evaluation phase

• Review of Patient Goals and Outcome Criteria
• Data Collection
• Goal Measurement
• Documentation
• Revision and Modification of Nursing Care Plan

Nursing care plan :

A nursing care plan is a structure that clearly explains the problem, reason, and the process of evaluating the proper treatment, action and lastly the patient’s disease. A nursing care plan is a plan that promotes quality care and provides convenient services to patients. individual care, continuity care, communication, evaluation….

characteristics of nursing care plan ( Characteristics of Nursing Care Plan ) :

• Nursing care plan should be written by a qualified nurse.
• Nursing care plan should be the most effective because it comes into contact with the patient first and then comes into contact with the nurses, because it has to collect information related to the patient first from the patient, so it can be said to come into contact with the patient first.
• Nursing care plan should be for all care of the patient.
• Nursing care plan should contain all the information of the patient.

Component of nursing care plan (v) (Components of nursing care plan) :

Components of nursing care plan (PRONE):

1.problem (P : Problems)

2.Reason (R : Reason)

3.Objectives (O : Objectives)

4.Nursing intervention (N : Nursing Interventions)

5.Evaluation (E : Evaluation)

1.problem (P : Problems):

• A problem is an unsatisfactory state that is difficult to change into a future desire state. It is identified in the phase of Nursing diagnosis.
• It is a situation faced by the patient in which the nurse can help, which shows the performance of the nurse through her professional function.

2.Reason (R : Reason):

Reason can be the cause, event, sign and symptoms of the disease or condition that the patient presents during observation when he comes for a visit/interview, which helps the nurse to formulate his objectives and list nursing interventions.

3.Objectives (O : Objectives ):

This is a small statement of intended results/outcome of an action program which is the intended results/outcome of the action program which is helpful for the nurse to evaluate the patient to know the progress of the patient…

whose objectives are as follows Can….

• -Related to the problem statement
• -client centered
• -clear and concise
• -observable and measurable
• -Time limited
• -Realistic

4.Nursing intervention (N : Nursing Interventions):

• There are specific approaches that help assist the client in accordance with his objectives.
• The etiological component is necessary for the nursing diagnostic statement.
• Gathering information during the assessment.
• The nurse should maintain interaction with the patient and his family members.

5.Evaluation (E : Evaluation):

Evaluation means to evaluate or to make an estimate or as a last phase To find the value of the effect of the care provided in the nursing process, there is a process that is used to know whether the care has been provided and whether the effect of that care has been achieved or not.

Explain functions of community nursing care:

Review prepared nursing care plan and assess identified objectives.

Provide comprehensive nursing care to individuals, families, and communities.

Prepare a working environment to provide effective community health nursing care.

Supervise care provided by the health team and other members.

Recording and reporting of the care provided.

Providing nursing care in the community without discrimination and with proper distribution. While providing care, give priority to high risk groups.

Utilizing the most available resources in the community.

Using affordable and acceptable techniques while providing care.

Working as a team leader with health team members.

In the community Coordinate with other health agencies and provide care.

Enlist the types of community nursing care services provided:

➤ According to need of community:

-Care of pregnant women’s

-Postnatal care

-Neonatal care

-Immunization

-Family planning services

-Health education

-Prevention of communicable and noncommunicable diseases.

-Recording and reporting.

-Recording and reporting.

-treatment of minor ailments .

-bring community awareness of various govt. scheme.

e.g.-BSBY, MNDY, JSSY etc.

-emergency services during accidents and trauma .

Nurse’s role:

• A nurse should be a content expert, counsellor, health educator so that she can implement community health nursing care.
• Health problems should be selected according to type.
• Participate the community for the solution of the problem.
• Know the characteristics of the process of social changes.

Explain methods of intervention (Explain method of intervention) :

Individual or family health nursing process can be implemented by a nurse but a single community health nurse is never considered as an implementation method in community health nursing process.

Small interacting groups :
-formal group
-Informal group

Lay advisor :
These act as opinion leaders. They hold high positions in the community. Village panch or sarpanch, religious persons, ward members etc.; Works as a health assistant.

Mass media (Mass Media) :
Tv, radio, video, newspaper, mobile, internet.

Health policies and public health law (Health Policies and Public Health Law):
MTP PFA, PCPNDT, RTI

Evaluation of nursing care services given ( Evaluation of Nursing Care Services Given ) :

• Evaluation is the assessment of the effects of some organized activity or program.
• The evaluation of community health nursing process mainly includes two aspects.
• -evaluation of the nurse’s performance (Evaluation of the Nurses Performance).
• -evaluation of the behavioural changes in the community (Evaluation of the of the Behavioral Changes in the Community).