Chapter 7: Community Health Planning, Implementation, and Evaluation Flashcards
Health planning for and with the community is an essential component of community health nursing practice
Health planning varies at the different aggregate levels
Introduction
Individual or family
Group level
Community
Health planning varies at the different aggregate levels
goal is to focus on direct care needs or self-care responsibilities
Individual or family
primary goal may be health education
Group level
health planning involves population disease prevention or environmental hazard control
Community –
Not new
Lillian Wald’s work exemplified concept with poor immigrants; when focusing on indiv/fam - nurses must remember that these clients member of larger pop group/community; influenced by community and environment around them
The community as client
Improve aggregate health and apply the nursing process
Apply to larger aggregate within systems framework
Nursing process steps and listing within boxes what each step does
Assessment - Going through community what dealing with; health and conditions directly impacted by environment and community - true if indiv or if group of indivs - impacted by environment and things going on in community; gathering info
Planning - goals and objectives; work with info have to try to develop what goal/obj might be but work with clients/aggregates to make sure what they think need/want; establishing goals and objectives
Interventions - based on goals and objectives; needs be convo with client/aggregate so on same pg so still follow through
Eval - look over how effective intervention
Health planning model
First step in model
First Establish a professional relationship - good communication skills essential to making a good first impression
Then Meet with group leaders to clarify mutual expectations and available meeting times
Do data collection to Determine sociodemographic characteristics: distribution age, sex, race
Gather information from a variety of sources and will interview a key informant(s) (formal/informal leader in community who provides data informed from personal knowledge and experience with community)
Consider both positive and negative factors - working well and not well for community
Complete literature review where Compare the aggregate with the “norm”
Research potential problems
Identify health problems and needs
Then Prioritize the health problems and needs to create an effective plan
Assessment
Assess needs of clients and obtain input; interventions not successful unless client has input in determination of need, priority, and appropriateness of intervention
Expressed needs
Normative needs
Perceived needs
Relative needs
4 types of needs to assess
Demand for services and the market behavior of the targeted population
Expressed needs
Lack, deficit, or inadequacy as determined by expert health professionals
Normative needs
Population’s wants and preferences
Perceived needs
Gap showing health disparities between the advantaged and disadvantaged populations
Relative needs
The aggregate’s preferences
Number of individuals in the aggregate affected by the health problem
Severity of the health need or problem
Availability of potential solutions to the problem
Practical considerations such as individual skills, time limitations, and available resources
Refine the priorities by applying a framework such as Maslow’s hierarchy of needs or Leavell and Clark’s levels of prevention - basic needs have to take priority
Factors when determining priorities include:
The nurse is responsible for advocating for client empowerment throughout the health planning model process: assessment, planning, implementation, and evaluation steps of the process; essential component of health planning is to have strong level of community involvement
Successful health programs rely on empowering citizens to make decisions about individual and community health
Empowering citizens causes power to shift from health providers to community members in addressing health priorities
Community involvement is essential
Plan interventions for each level of prevention
Determine the intervention levels
Plan interventions for each system level
Validate the practicality of the planned interventions according to available resources
Coordinate the planned interventions with the aggregate’s input to maximize participation
Planning
Subsystem, aggregate system, and/or suprasystem
Determine the intervention levels
Primary, secondary, or tertiary levels of prevention
Plan interventions for each system level
Personal, aggregate, and suprasystem
Validate the practicality of the planned interventions according to available resources
Also in planning phase
Develop mutual goals and objectives
Goals - where the nurse wants to be
Objectives - steps needed to get there
Development of goals and obj
Measurable objectives are the specific measures used to determine whether the nurse is successful in achieving the goal
Objectives are instructions about what the nurse wants the population to be able to do – use verbs and include specific conditions (how well or how many)
Used to measure outcome – describes observable behavior rather than knowledge
May also be referred to as behavioral objectives or outcomes
Objectives - steps needed to get there
Often the most enjoyable stage for the nurse and the clients
Implementation should follow the initial plan
Prepare for unexpected problems
If the intervention is not able to be completed, analyze the reasons for failure
Should include a range of strategies
Interventions
Imp component for determining success/failure of a project and understanding the factors that contributed to its success/failure
Include the participant’s verbal or written feedback and the nurse’s detailed analysis
Reflect on each previous stage to determine the plan’s strengths and weaknesses (process or formative)
Reflect on whether or not the desired outcomes were achieved (product or summative)
Communicate follow-up recommendations
Evaluation
Each step of nursing process imp in health planning projects
Project failure often from probs in 1+ steps of nursing process; have people cont on in absence
Aggregate assessments must be thorough
The nurse must complete careful planning and set goals that the nurse and the aggregate accept
Interventions must include aggregate participation and must meet the mutual goals
Evaluation must include process and product evaluation and aggregate input
Importance of each step in the nursing process
