So Family Nursing Care Plan is considered as the blueprint of the care of the nurse designed to systematically minimize or eliminate the identifying health or family nursing problems. So since this is a plan, still, we will be following the process of APPI. So we're done and ready on the assessment part. We're done with the diagnosis part, which is the...
first level and secondary level of assessment. Here is now the third step of the nursing process, which is your planning. For the planning, these are the different features of a nursing care plan. Focus of action is to minimize or eliminate the existing problem.
The core of the plan is approaches, strategies, activities, methods, and materials. Deliberate and systematic process. Projects the future and the current situation.
is not corrected and is based upon the identified health and nursing problem. You also need to take note that all plants should follow the principle of SMART. What is SMART? It has to be simple, measurable, attainable, realistic, and right down. Okay?
So that's the same thing kung paano kayo gumawa ng inyong MCT. Okay, goals and objectives. Now, the features of a nursing care plan, okay, includes also problems starting with the points for the plan to focus on the objectives of the care interventions. Nursing care plan means to an end and not the end of itself. The goal of planning is to deliver the most appropriate care and a nursing care plan should be continuous.
Continuous means to say... that you have to continuously evaluate this every now and then. Now, what are the desirable qualities of a nursing care plan?
These are the qualities that we want to see in an NCP. It should be based on a clear, explicit definition of the problem. Is the problem really existing? Where should you base the problem?
On the identified data. So you need to make an initial dicta base based on your diagnosis. It should be realistic. Nursing care plan is prepared jointly with the family. When you say realistic, I saw this in the board exam.
Okay, for tuberculosis to be continuously monitored, each family should have an x-ray machine and food. Is that realistic? No.
Of course not. Right? So that's what I call realistic, okay? Though, x-ray is one diagnostic test for tuberculosis, but it's not realistic that per house there should be an x-ray machine. Because not all of them know how to operate.
At the same time, continuous exposure with x-ray is also bad for your health. Clear? Yes, because that is a tension. Nursing care is prepared jointly with the family.
Meaning, once we identify the information, Okay, from the family, and when you start to identify a problem, you have to go back to the family and ask, Ma'am, I did this yesterday. I read all the data that we have. And this is the data I got.
So do you think this is a problem? Then when you say, it's not really. Then you start giving health education. Until they realize that there is an existence of a problem.
Once they know that there is an existence of a problem, then you will be working together to create a plan. Why do you need to involve the family? Because whose problem it is?
So who should be the one to make the solution? It's them. So it means, even though, as a nurse, you identify that there is already an existence of the problem, still, you will not prioritize...
You will not prioritize fixing the problem for them. Why? Because our goal is for them to become independent.
We don't want them to be dependent on outside resources. Like for example, ayuda. Ayuda is the worst form of organizational health.
Or what we call mobilization of health. It's the worst form. Why?
because it teaches people to become dependent to the person or organization giving the help How about if they don't give? Will they be able to live? No. That's why it's the worst form of help. It's okay during emergency and disaster situations.
Example, they were hit. They were hit and the house was damaged. Help them until they can get back to their homes. But the 3 years of help is still a problem. Okay?
Next, nursing care plan is most useful in written form. Written form. You need to have an NCP, you need to have handwriting too. Okay?
But I'm just a typewriter. There. I wish I could edit NCP. For example, the NCP, that's not his duty. He used it.
He didn't even edit the content for the sake of having a translation. He thought that his CI wouldn't read it. And the thing is, his CI reads.
What did the data show here in your patient? It's like this. He didn't edit it.
He did a lot of things. In case press, yes. The bank used case press before. They edited the property and sent the name. He thought he wouldn't know.
CI. You're zero. You have your own things to do.
You're lazy to interview. During duty, you're just fighting. A leader assigned but he doesn't want to follow.
You are the leader, okay. I am the leader, okay. You are the one who will interview, you are the partner, you will do this.
Why me? A leader assigned but he doesn't want to follow. Right? A good leader knows how to delegate.
That's why a leader really doesn't know how to do anything. That's why when a leader is assigned, he doesn't expect to do anything. Because a leader will delegate.
And we'll supervise the delegation. The problem is, when you sign, there are still groups. Who is the most timid, the most nonchalant in the group?
The most shy and slow? They will call the leader. In their fight, if they do it wrong, they do it.
There are those. Importance of planning, individualizes care to clients, it helps setting priorities by providing information about the client, it promotes systematic communication among those involved, continuity of care, and facilitates the coordination of care by making known to other people and members. So that is the importance of planning care.
Other ones, steps in developing... Family nursing care plan, number one, prioritizes the limitations of the problem. So after assessment, you prioritize which problem should be prioritized. In terms of prioritization, okay, what are we doing here? Computation.
So using the four criteria, look at the four criteria. Nature of? Modifiability of the problem. Preventive potential and salience. Salience is the perception of the Family, is that correct?
Yes, perception of the family. What is the nature of the problem if you identify it with its wellness? That is it, threat or foreseeable crisis.
The modifiability, if you modify it according to? Not modifiable, partially modifiable, and fully modifiable. Then you have the preventive potential, what is this?
What are the levels of this one? Low, preventable. Moderately preventable and highly preventable.
Yes, it corresponds to different scores. Each criteria corresponds an actual weight. That's nature of the problem, one.
Modifiability of the problem, two. Preventive potential, one. Salience, one.
Making modifiability of the problem has the highest number and is the most important criteria. Let's go again. Yes. Why?
Because if the problem is non-modifiable, what can we do about it? Example, his inborn disease. He was born with cerebral palsy.
Can you do something to change it? No. Because the condition is non-modifiable.
We are giving him a low score in terms of modifiability because we can do what we were born with. Okay? You cannot change the course of life simply because you want to. Especially if it is already decided.
Decided by whom? Of course, by the higher. Higher being. Depende na lang kung sino pinaniwalaan mo. Higher being.
Kung ang higher being mo yung EP's, parang problema doon. Because you're entitled to your own being. Clear? Yes. The goals and objectives should be created, okay, based on the prioritized problems.
Then the plan of intervention should be near and the plan for evaluating here. Okay? So I have discussed it already.
The prioritization of health problem in one of my videos does just get a rundown of this, the process of ranking the identified health problem based on the scale for ranking health conditions. With regards to this one, it uses four criteria as I have mentioned earlier. The nature of the problem, modifiability of the problem, preventive potential, and the series.
So nature of the problem is the wellness, dependency, threat, and foreseeable crisis. Not modifiable, partially modifiable, and fully modifiable, low, moderate, and highly preventable. That's what? Not perceived by the family, perceived but not considered immediate interventions, perceived by the family, and provided immediate interventions.
Isn't it? Yes. That seems coarse.
Zero, one, two. Dito naman ay, one, two, three. 0, 1, 2, then it goes 1, 2, 3, 3. Am I right? Yes.
Very basic. There are a lot of those in the exams. There are a lot of those in the exams.
Identification of the nature of the problem, there are a lot of those in the exams. So review your major. Okay? Nature of the problem, we discussed that earlier. So the biggest weight is given to the wellness state because of the premium of client's effort and the same weight is assigned.
to the health deficit because it senses the clinical emergency of the condition. Now, if you're going to choose between the wellness condition and the health deficit, you would prioritize the health deficit. Why?
Because it's an actual problem. Of course, foreseeable crisis is the least priority because it has the lowest weight. So, modifiability of the problem, the probability of success, enhancing the wellness state. Okay, modifiability of the problem uses different factors in order to identify kung siya ba ay full and not modifiable, partially or fully modifiable. If none of the factors were met, ibig sabihin walang resources si family, walang resources si nurse, walang resources si community, bago yung sakit.
Ang tawag doon is zero factor that is not modifiable. During the early stage of COVID-19, Okay, considered po siyang partially modifiable lang. Actually, during the first few months or weeks, non-modifiable siya.
Kasi nga, bago yung sakit. Walang bakuna. Nag-develop pa lang ng test.
So, wala kayo resources in terms. Okay, though may resources tayo ng health worker, but the health worker are blanks. Ipig sabihin, wala silang ka-IDA niya kung ano ang gagawin.
Partially modifiable lang. Here. But if you have community health resources, if you have a health center, if the health center is available, if you have a knowledge because the illness is not too bad, if the nurse is not sick, if the family is not sick because there is no one to take care of them, there is no one to take care of them, so it's still partially modifiable.
It means that if there is no one to make this factor, it's not modifiable. At least one factor is missing if the rest are present, that's partially modifiable. All are men.
that's fully modified clear my resources yeah my resources are we clear yes objective okay preventive potential the actual score is one the nature and magnitude of the future problems that can be minimized or totally prevented. Example here. is the gravity, severity, duration, current, management, and exposure to any risk or vulnerable. Ibig sabihin ito, if one of the factors repress it, and the rest are none, low preventable.
Okay? Pag sobrang lala ng condition, malabang low preventable. Hindi siya pwedeng highly preventable.
Okay? Duration of the problem, pag sobrang tagal na, chronic na siya. It's not highly preventable, partially or low preventable.
Actually, it depends on your assumption because in the actual setting, you will need... They make a justification. Bakit siya partially? Bakit siya fully?
Bakit siya low? Bakit siya monitoring? Bakit siya hiding? Then you would present these factors.
Then, singleness is the perception of the family. This is different from social concern. Social concern is the perception of the community. While singleness is the perception of the family.
This includes The ranking, okay, wellness, deficit, health threat, 3-3-2-1, actual rate is 1. Modifiability, not partially and easily modifiable, 2-1-0, actual rate is 2. Okay, so preventive potential, high, moderate, and low, 3-2-1, actual rate is 1. Condition problems leading to immediate attention, a condition or problem not leading to immediate attention, and not perceived, that's 2-1-0. respectively with an actual weight of one because this is the video okay scoring of criteria this is how you're going to do it determine the score per criterion then divide the score by the highest possible score then the category multiplying by the weighting criterion can get the sum of all the scores the drop over quality nursing problems the thing is the rank over school of each nursing problem and the nursing problem with the highest number is the first priority problem. It means, when you're visiting the family, you will need to identify at least 10 problems.
Those 10 problems should be created with a computation. After computation, you arrange them from highest to lowest. Whichever disease has the highest number, that is the priority problem that you will make in the city. So that is what you will do in the area once you go for duty. So, hello to the community.
What are we doing? We are going to pass this on to the people who are not here. I opened it in the last few days because it's going to be my cousin's wedding. It's not for a long time.
Okay, so next week na kayo. Next week na kayo, di ba? Good na pala. We're going to PEC though.
We do vital signs to the forces. Okay, next. Example tayo, nature of the problem.
Okay? So for example, itikagamitin natin. O, dito na tayo. O, going three days, stopping calls. So my one-year-old, six-month child, no medications are given and no consultations done by the family.
Ano ang ating problem? Bigyan na isa. Tapping?
Calls. Ano ang nature of the problem? Ano?
Deficit. Very good. Ano pang-preg? Can you handle it?
Yes. Caffeine-pulsed transmissibility is one of them. Health threat. What else?
What other problems are there? No medication. No medication taken. No?
And no consultation. If it's a civilian, they just go to the health center. Is it? That is your health threat.
Related to what? What secondary problem? On going 3 days staff, they are not allowed to check up. Why are they not allowed to check up? There are several reasons.
It's possible that they don't recognize the problem because they just sat down. So if that's the problem, what is your first level of assessment? Top end calls as a health deficit.
Secondary level of assessment, inability of the family to recognize the problem due to... What? Lack of knowledge. Kasi, come in codes lang naman. Clear?
Yes. There is presence of health threat. Okay, ano yung health threat natin dito? Non-consultation as a health threat. Yun ang first level niya.
Yes, anong secondary level niya? Pain you're due? Utilize.
Sir, pwede ba ako magpaloan ng more than one secondary level of assessment? Yes. Depende sa kung ano ang dahilan ng main problem nila. Are we clear? For example, yung main problem nila, hindi na-recognize kasi may lack of knowledge.
Okay? Then, hindi sila makapagbigay ng decision kasi may lack of knowledge. So, in the same way, I'm... The lack of knowledge. So what is the focus of your goal?
Improvement of knowledge. So what is the focus of your intervention? Health education. Health education. So basically, the first level of assessment is the actual problem that you see in the family.
Now, look for the reason why you have this problem. That is the secondary level of assessment. There is also the inability, In each of the inability, there are specific reasons.
What is the reason? Lack of time, lack of resources, lack of knowledge. That is the big reason. For example, Man consultation of couples as a health threat.
First level of assessment. Clear? Yes.
Secondary level of assessment is, Inability to recognize the problem. Due to, because, It's just a lump of... Lack of knowledge.
So what's your goal? The goal is to improve. Okay, the goal is at the end of the nursing intervention, the family will be able to improve knowledge regarding the disease-caught in colds.
Your objective? Specifically all. That's your objective.
Number one. Okay? The description of cut and calls. Number two, the trans-piscidity of cut and calls.
So, i-enumerate mo yun sa isa. At yung objective na yun, yun na din ang magiging criteria before evaluation. If all the objectives were met, the goal is met.
Where? If one or more of the goals or objectives were not met and some were met, partially met. If no goals were met, that is what is in the evaluation.
Clear? Okay, the format, I'll be sending a video for that. Okay, because there's a final activity that I have to do.
Members of the family with a history of tuberculosis. So if we're going to compete, let's compete. Let's compete. Three days. For example, Okay, tap and pause as in...
Health threat, I mean health deficit. So what's the acting score? What's the nature of the problem?
Health deficit. You're wrong. What's the score?
Three. So I'll put three there. So the acting score is three over the highest score of the particular criteria, which is three times the actual weight. What's the nature of the problem?
One. So three divided by three times one equals to? One. So you put this here in 1. Now, the justification you put, why is it a health threat? It is a health threat because Kaplan-Coltz is an actual illness or disease.
Clear? Okay? Non-compliance or non-consultation, okay, non-consultation as a health threat is an example of health threat because Without consultation, patient may suffer from possible complications.
Making a non-consultation as a risk factor. Clear? Yes. So please bear with me because we are not here for two days.
That's why I'm trying to rush up everything. Modifiability, check that. All the factors were met.
There are available resources, available knowledge. Available resources to family, available resources to community. So what is my interpretation of the modifiability? 2. 2 over 2 times? 1. 1. Accurate.
Yes, because of the project app, so in the end, they identified the problem but not requiring immediate attention. What's the score? 2-1-0.
the final score, all the patients that you identified, you do the computation, whichever problem has the highest number, that is your priority problem. For example, the CI said, among the top 10 of the list of problems, after computation, the highest score you will identify is the highest score is the one you did of FNCV. For example, out of the 10 problems, the top 2 problems you did of FNCV. And that is your requirement. Clear?
Yes. Okay? So we're okay with that? So combination of goals and objectives I'll just open it and then I'll ask you to go ahead Okay?
So combination of goals and objectives The difference is that goal is general While objective is specific Okay? Example is After nursing intervention, the family will be able to take care of a disabled child competently. So we said to take care. Caring is fake, right?
Yes, there are many things that you can do with caring. But in general, because the phrase take care is general. How will it be objective?
It's just a specification. Okay? So the goal must be jointly.
Done with the family, with the family, establish a mutual acceptability. Okay? And nurse must assert the family's knowledge and acceptance of the problem.
So the barriers in setting goals are the following. Failure of the family to perceive the existence of the problem. The family may realize the existence of the problem or condition of the problem, but it's too busy at the moment. Okay?
They can't decide or provide nursing care. sometimes the family perceives the existence of the problem but does not see it as a problem. And number four, the family may perceive the presence of the problem and they need to take action but refuses to face and do something about it. And a big barrier to collaborative goal setting between the nurse and the family is failure to develop a working relationship. Okay, because the family is reluctant to change.
So our purpose is to provide direction for value nursing intervention, provide time span for the plan, serve a criteria for evaluation, enable clients, nurse intervene when the problem has been resolved, and help motivate the nurse and the client by providing a sense of achievement. So for the formulation of goals and objectives, objectives are stated in an outcome of care. Examples are the following. At the end of the nursing intervention, the family will be able to feed the mentally retarded child.
So taking care in terms of feeding. Taking care in terms of education. Taking care in terms of applying measures. to prevent infection so that is your objectives if you said if our general is to provide nursing care objective nothing is the specific nursing here so that's how you're going to set your objectives okay any questions so again where is your intermediate okay And your long-term, that's your immediate, intermediate, and ultimate.
So short-term is your immediate, medium is your intermediate, and ultimate is your long-term objectives. So examples of objectives, the SIG member will take drugs accurately as to those frequency duration. and drug combination.
Major term is all members have medical checkup, laboratory supervision to diagnose malaria, and long term, all members will carry out mosquito vector control measures. That is considered long term because the problem that we're trying to solve will not be resolved immediately. So that is your objectives.
Example of your objectives. Do you have any questions? Okay. As for the evaluation, okay, for the evaluation, um, you will just use the category.
Okay? So this is the last part of our discussion. Next part is the implementation.
In the implementation, Okay, there are two categories of implementation. The anticipatory interventions and the compensatory interventions. Pag sinabi natin anticipatory interventions, these are measures pertaining to the health promotion, taken to lower and reduce the risk, this action taken before the occurrence of the condition.
So example, pag sinabi natin anticipatory, things that you need to do bago ka siya magkasakit. So it's more on preventive and promotive aspects of the care. Examples of your anticipatory are the following. Promoting healthy lifestyle, removing accident hazards, immunizing elderly, ensuring the safety of water supply, proper garbage disposal, and community health education.
So anything that would promote health and prevent disease is anticipatory by nature. From the word itself. anticipate meaning you look to the future okay what will be the possible problem that can be prevented and the last one compensatory are measures that are taken with particular unwanted adversarial outcome related to health was not prevented.
Nagkasakit ka na. The objective of compensatory intervention measures is to effectively cope with undesirable health situation so example of this Okay, compensatory interventions are the following. Treatment, diagnosed disease, rehabilitation of post-troub patient, measures to hold and uphold stuff on epidemic, and organizing support system, okay, organizing support system.
So vaccination during epidemic is one. So vaccination or immunization in general is anti-symptomatic. But vaccination during an actual epidemic is an example of confidence attack.
Because the problem is already existing. Ayaw mo lang siyang lumalang. Pero kung walang pandemic, tas tuloy-tuloy ang bakuna, ang tawa doon anti-symptomatic.
Because the problem is still non-existing. Clear? Any question?
Clarification, violent reaction. Voila. Okay? So that would be...