FAMILY NURSING PROCESS

is a systematic approach to providing family-centered care that helps families meet their health
needs. A step-by-step way to care for families, understanding that their health is connected to
the health of individuals and the community. It focuses on the family as a whole, considering
their strengths, needs and challenges.

The process involves:

A. PHASE 1: ASSESSMENT- Family Health Assessment

B. PHASE 2: DIAGNOSING- Family Nursing Diagnosis

C. PHASE 3: PLANNING- Formulating Family Nursing Care Plan

D. PHASE 4: IMPLEMENTATION- Implementing Family Nursing Care Plan

E. PHASE 5: EVALUATION- Evaluation of Family Nursing Care Plan

A1. FAMILY HEALTH ASSESSMENT

This is the foundation of the family nursing process.

It involves collecting, organizing, validating and documenting comprehensive

information about the family’s health status, function, identifying strengths and needs
and potential health risks.

TOOLS FOR ASSESSMENT

i. Initial Data Base

1. Family structure characteristics and dynamics- include the composition

and demographic data of the members of the family; their relationship
to the head of place of residence; type of family; family interaction/
communication and decision-making patterns and dynamics.

2. Socio-economic and cultural characteristics- includes the occupation,

place of work, income of each working member, educational attainment
of each family member; ethnic background and religious affiliations,
significant others and other role they play in the family’s life and the
relationship of the family to the larger community.

3. Home environment- includes information on housing and sanitation

facilities; kind of neighborhood and availability of social health
communication and transportation facilities in the community

4. Health status of each family member- includes current and past

significant illness; beliefs/ practices conducive to health and illness;
nutritional and developmental status; physical assessment findings
 5. Values, habits, practices on health Promotion, maintenance and
disease prevention- includes use of preventive services; adequacy of
rest/ sleep, exercise, relaxation activities, stress management or other
healthy lifestyle activities

ii. Typology of Nursing Problems in Family Nursing Practice

1. CAT I- presence of:

a. HEALTH THREATS- refers to conditions which predispose to

diseases, accident or result in failure to realize one’s health
potentials. Ex., obesity, unimmunized 1-year old, Joe is training
to become a professional skate-boarder

b. DEFICITS- it can be an illness state; disability or failure to

develop at a normal rate. Ex., alterations in perception

c. STRESS POINTS/ FORESEEABLE CRISIS- refers to anticipated

periods of unusual demands of the family in terms of
adjustment or family resources. Ex., pregnancy, retirement from
work.

d. WELLNESS CONDITION- refers to a nursing judgement based on

client’s performance, current competencies or performance or
explicit expression of desire to achieve a higher level of state or
function in a specific area of health promotion and
maintenance.

2. Inability to recognize the presence of the condition or problem

3. Inability to make decisions with respect to appropriate health actions

4. Inability to provide adequate nursing care to the sick, disabled,

dependent or vulnerable at-risk family member.

5. Inability to provide a home environment conducive to health

maintenance and personal development.

6. Failure to utilize community resources for health care.

iii. Family Health Task

Eight Family Tasks (Duvall & Niller)

1. Physical maintenance- provides food shelter, clothing, and health care to

its members being certain that a family has ample resources to provide

2. Socialization of Family– involves preparation of children to live in the

community and interact with people outside the family.
 3. Allocation of Resources- determines which family needs will be met and
their order of priority.

4. Maintenance of Order– task includes opening an effective means of

communication between family members, integrating family values and
enforcing common regulations for all family members.

5. Division of Labor – who will fulfill certain roles e.g., family provider, home
manager, children’s caregiver

6. Reproduction, Recruitment, and Release of family member

7. Placement of members into larger society –consists of selecting

community activities such as church, school, politics that correlate with
the family beliefs and values

8. Maintenance of motivation and morale– created when members serve

as support people to each other

iv. Family Coping Index- its purpose is to provide a basis for estimating the nursing
needs of a particular family.

A2. FAMILY DATA ANALYSIS

This is done by comparing findings with accepted standards for individual family
members and for the family unit.

Nurse correlates findings in the different data categories and checks for significant gaps
in information or the need for more details related to a finding

B. FAMILY NURSING DIAGNOSIS

This is an evaluation of current or potential health issues within a family that is
determined through nursing assessment. This provides a framework for identifying
needs, documenting clinical judgement, providing holistic view and selecting
interventions that helps nurses determine the plan of care.

Nurses interpret, analyze and synthesize all the data gathered, determine the family’s
strengths, risks and problems, framing nursing diagnoses and collaborative problem
statements. The goal of stating a family nursing diagnosis is to identify and address the
family’s health care needs to improve their outcomes.

This examines how family interactions, relationships and behaviors influenced the
health of the individuals in the family unit. This diagnosis takes into account factors such
as communication, coping strategies and support networks to address health concerns
 together. For instance, it may identify issues like “Ineffective Family Coping” or “Risk for
caregiver Role Strain” to guide nursing intervention that strengthen family health and
well-being.

C. FORMULATING FAMILY NURSING CARE PLAN

It involves determining how to prevent, reduce or resolve the identified family health
problem; how to support their strengths and how to implements nursing interventions
in an organized and goal-directed manner.

Nurses must set priorities, establish goals/ objectives in collaboration with the
family as the client; select appropriate family nursing strategies or
interventions; consult with other health professionals and communicate to relevant
health care providers.

D. IMPLEMENTING FAMILY NURSING CARE PLAN

It involves carrying out the nursing interventions outlined in a plan of care.

Nurses reassess the client to update the database; determine need for nursing assistance;
perform or delegate planned nursing interventions; communicate what nursing actions
were implemented; document care and their responses to care; collaborate with client and
collect data related to desired outcomes.

i. Categories of Intervention
1. Promotive

2. Preventive

3. Curative

4. Rehabilitative

ii. Tools of Public Health Nurse

1. PHN bag and contents- a nursing bag or home visit bag is an essential and
indispensable equipment used by public health nurses and other healthcare
professionals during home visits and community health interventions. The bag
contains essential medical supplies, equipment, and documentation materials
necessary to provide comprehensive and efficient care in various community
settings. It plays a crucial role in infection control, ensuring that nurses can deliver
safe and effective care while minimizing the risk of cross-contamination.
2. CONTENTS OF PHN BAG

a. Paper lining- Provides a clean surface for organizing and preparing supplies,
minimizing the risk of contamination from surfaces in the patient’s
environment.

b. Extra paper for making waste bag- Enables nurses to create disposable
waste bags for proper disposal of used supplies and biohazardous materials,
promoting infection control and environmental safety.

c. Plastic/linen lining- Acts as a barrier between supplies and potentially

contaminated surfaces, maintaining the cleanliness and integrity of the
contents of the nurse bag.

d. Apron- Protects the nurse’s clothing from spills, splashes, and soiling
during patient care activities, ensuring personal hygiene and
professionalism.

e. Hand towel- Allows nurses to dry their hands after handwashing or using
hand sanitizers, promoting proper hand hygiene and reducing the risk of
infection transmission.

f. Soap in a soap dish- Provides a means for handwashing with soap and
water, a critical component of infection control and preventing the spread of
pathogens.

g. Thermometers (oral and rectal)- Essential for measuring body temperature

accurately, aiding in the assessment and monitoring of patient’s health
status, and detecting signs of fever or hypothermia.

h. 2 pairs of scissors (surgical and bandage)- Facilitate the safe and precise
cutting of medical materials such as dressings, bandages, and tapes
during wound care and other procedures.

i. 2 pairs of forceps (curved and straight)- Assist in handling sterile supplies

and instruments safely, reducing the risk of contamination and ensuring
aseptic technique during procedures

j. Disposable syringes with needles (g. 23 & 25)- Used for administering
medications, vaccines, or other injectable treatments, allowing for
precise dosage delivery and minimizing the risk of needlestick injuries.

k. Sterile gauze 4x4 - Provides a sterile covering for wounds or incisions,

promoting wound healing and preventing infection by protecting the area
from contamination.

l. Cotton balls- Used for wound cleaning, applying topical medications, or

removing debris, providing a gentle and absorbent material for
various patient care needs.
 m. Micropore plaster- Offers a hypoallergenic adhesive tape for securing
dressings or medical devices, providing gentle adhesion without causing
skin irritation.

n. Tape measure- Allows for accurate measurements of various body parts,

aiding in assessments such as growth monitoring, wound size evaluation
and proper placement of medical devices.

o. 1 pair of sterile gloves- Provide a protective barrier for the nurse’s hands
during invasive procedures or when handling potentially infectious
materials, reducing the risk of cross-contamination.

p. Baby’s scale- Enables accurate measurement of infant weight, essential for

monitoring growth and assessing nutritional status during well-child visits or
postnatal care.

q. Solutions of: BETADINE, 70 %ALCOHOL, HYDROGEN PEROXIDE- Various

solutions serve different purposes such as wound cleansing, disinfection,
sterilization, or diagnostic testing, supporting comprehensive patient
care and treatment protocols.

r. BP apparatus and stethoscope are carried separately and are never placed
in the bag.

3. The bag technique is a tool by which the nurse, during the visit, will be able to
perform a nursing procedure with ease and agility, to save time and effort to render
effective nursing care to clients. It is a systematic approach used by nurses,
particularly those working in home health care and community settings, to prevent
the spread of infections and ensure the safe, efficient delivery of care. It involves the
careful organization, use, and maintenance of a nursing bag that contains all the
necessary medical supplies and equipment needed for patient care.

iii. Types of Family Nurse Contact

1. Clinic consultation- It develops the family's initiative in providing for
health needs of its members.

2. HOME VISIT- It provides an opportunity to do first hand appraisal of the

home situation

3. Group conference- It allows sharing of experience among people with

similar health problems
E. EVALUATION OF FAMILY NURSING CARE PLAN
It involves measuring the degree to which goals/ desired outcomes have been achieved
and identifying factors that positively or negatively influence goal achievement.

Nurses’ judges whether the goals have been met or not; relate nursing actions to client
outcomes; make decision about problem status; review and modify the care plan as
indicated or terminate nursing care.

This final step of the nursing process is vital to a positive patient outcome. Whenever a
healthcare provider intervenes or implements care, they must evaluate to ensure the
desired outcome has been met.