FORMULATING FAMILY

NURSING CARE PLAN

Jenny Beth E. Lapaz, RN, MAN
Eva Boje-Jugador, RN MAN
 FAMILY NURSING CARE PLAN (FNCP)

• Is the blueprint of the care that the nurse designs to

systematically minimize or eliminate the identified
health and family nursing problems through
explicitly
• formulated outcomes of care (goals and objectives) and
• deliberately chosen set of interventions, resources and
evaluation criteria, standards, methods and tools.
 FEATURES FNCP

1. The nursing care plan focuses on actions

which are designed to solve or minimize
existing problem. The plan is a blueprint for
action. The core of the plan are the approaches,
strategies, activities, methods and materials
which the nurse hopes will improve the
problem/ situation.
 FEATURES FNCP

2. The nursing care plan is a product of a deliberate

systematic process. The planning process is
characterized by logical analyses of data that are
put together to arrive at rational decisions. The
interventions the nurse decides to implement are
chosen from among alternatives after careful
analysis and weighing of available options.
 FEATURES FNCP

3. The nursing care plan, as with all plans, relates

to the future. It utilizes events in the past and
what is happening in the present to determine
patterns. It also projects the future scenario if
the current situation is not corrected.
 FEATURES FNCP

4. The nursing care plan is based upon

identified health and nursing problems. The
problems are the starting points for the plan,
and the foci of the objectives of care and
intervention measures.
 FEATURES FNCP

5. The nursing care plan is a means to an

end, not an end in itself. The goal in
planning is to deliver the most appropriate
care to the client by eliminating barriers to
family health development.
 FEATURES FNCP

6. Nursing care planning is a continuous

process, not a one-shot-deal. The results of
the evaluation of the plan’s effectiveness
trigger another cycle of the planning
process until the health and nursing
problems are eliminated.
 STEPS IN MAKING FAMILY NURSING CARE
PLAN

• The ASSESSMENT phase of the nursing process

generates the health and nursing problems
which become the bases for the development
of nursing care plan. The planning phase takes
off from there.
 FORMULATING A FAMILY CARE PLAN
INVOLVES THE FOLLOWING STEPS:

•The prioritized condition/s or problems

•The goals and objectives of nursing care
•the plan of interventions
•The plan of evaluating care
 PRIORITIZING HEALTH PROBLEMS

NATURE OF THE PROBLEM – categorized into

HEALTH DEFICIT, HEALTH THREAT &
FORSEEABLE CRISIS
Health Deficit 3
Health Threat 2
Foreseeable Crisis 1
 PRIORITIZING HEALTH PROBLEMS

MODIFIABILITY OF THE PROBLEM – refers to the

probability of success in minimizing, alleviating or
totally eradicating the problem through intervention
Easily Modifiable 2
Partially modifiable 1
Not modifiable 0
 PRIORITIZING HEALTH PROBLEMS

PREVENTIVE POTENTIAL – refers to the nature and

magnitude of future problems that can be minimized
or totally prevented if intervention is done on the
problem under consideration
High 3
Moderate 2
Low 1
 PRIORITIZING HEALTH PROBLEMS

SALIENCE – refers to the family’s perception and

evaluation of the problem in terms of seriousness and
urgency of attention needed.
A serious problem, immediate attention needed 2
A problem, but not needing immediate attention 1
Not a felt need/ problem 0
II. FORMULATION OF GOALS AND OBJECTIVES
OF NURSING CARE
GOALS OBJECTIVES
➢General statement of ➢More specific statements
the condition or state to of desired results or
be brought about by outcomes of care
specific courses of ➢Specify the criteria by
action which the degree of
effectiveness of care are to
➢Client outcomes be measured
➢Goals tell where the ➢Must be specific in order
family is going to facilitate its attainment
➢Milestones to reach the
destination
 III. SELECTION OF APPROPRIATE NURSING
INTERVENTIONS
• N must choose among set of alternatives
• N must specify the most effective or efficient method of N-F
contact
• Home visit
• Clinic conference
• Visit in the work, place, school
• Telephone call
• Group approach
• Mail
 CONT…
• N must specify the most effective or efficient
resources
• Teaching kits – visual aids, handouts, charts
• Human – other team members, community leaders
 HOW TO CHOOSE THE APPROPRIATE NURSING
INTERVENTION?

A. Analyze w/ the Family the Current Situation and Determine

Choices and Possibilities based on a Lived Experience of
Meanings and Concerns
B. Develop / Enhance Family’s Competencies as Thinker, Doer
and Feeler
C. Focus on Interventions to Help Perform the Health Tasks
D. Catalyze Behavior Change through Motivation and Support
 A. EXPLORATION W/ FAMILY
CHOICES/POSSIBILITIES BASED ON LIVED
EXPERIENCE OF MEANINGS AND CONCERNS

• N.I. is dependent upon lived meaning of the experiences

of family member w/ each other and the nurse
• FAMILY is the active participant in the applc’n of Nsg.
Process
• FAMILY & NURSE are participants in active, mutual,
dynamic interchange of realities, concerns and resources
• They both need to analyze & understand the current
health/illness situation
• Nurse must explore w/ the F the possibilities and
choices presented by current situation
• Meanings
• Concerns
• Social relations
• Resources
B. DEVELOPING/ENHANCING COGNITION, VOLITION
AND EMOTION

• Provides the family ways to be THINKER, DOER &

FEELER

• THINKER – N must be able to share info/knowledge;

must be accessible for ease and confidence in
understanding current situations and health/illness
DOER – N must enhance confidence to the F in
carrying out/initiating and sustaining change for
health promotion & maintenance, and accurate dse
mgt.

FEELER – N must help the F strengthen its affective

competencies in order to appropriately
acknowledge & understand emotions generated by
family life or health illness situations; so that these
emotions will be transformed into growth-promoting
actions
C. FOCUSING ON THE INTERVENTIONS TO HELP THE
FAMILY PERFORM THE HEALTH TASKS

1) Help the F recognize the problem.

- information-giving about the nature, magnitude,
cause of the problem
- help the F see the implications of the problem
- relate health needs to the goals of the family
- help the F recognize its capabilities/qualities
and resources
 CONT…

2) Guide the F on how to decide on appropriate health

actions to take.
- identify/explore the courses of action + resources
available
- discuss the consequences of each courses of action
- analyze together w/ the F the consequences of
inaction
 CONT…

3) Develop the F’s ability and commitment to provide

nursing care to its members.
- nsg care to sick, disabled, dependent member/s →
demonstration / practice sessions on procedures/tx,
techniques
= use of low-cost, available resources
4) Enhance the capability of the F to provide a home env’t
conducive to health maintenance and personal dev’t.
- env’t modification, manipulation, management to reduce
health threats/risks

5) Facilitate the F’s capability to utilize community

resources for health care.
- coordination, collaboration, team work
→ referral system
S ource:
Nursing Practice in the Community – Maglaya 4th Ed and 5th Ed
 REVIEW

•Process in making the

Family Nursing Care Plan
• 1. Assessment Phase – Happens on the first and succeeding home visits.
Making objective observation can be coupled with subjective statements by
each family member.
2. Identification of the Problem/s – Make a list of the problems sited.
Prioritization of the needs must be applied.
3. Formulation of Goals and Objectives – Referring on the problems, goals
and objectives must be measurable, attainable, realistic and time-oriented.
4. Plot Nursing Interventions – The objectives must be the guidelines in
making nursing interventions. Nursing interventions must be rational
enough.
5. Evaluate the outcomes – This stage will be the determining stage
whether the goals and objectives have been met or not. Nursing
interventions can be modified at this stage.
 EXAMPLE

• Case: This is a case of S. Family. S. Family is composed of 5

children and both parents were alive. Upon observation the
family practices improper hygiene in eating and waste disposal.
The 5 children have 2 to 3 years of age gaps, having the
youngest child to be 1 year old and the oldest to be 9 years old.

• Problem Identified: Improper Hygiene

Date Identified: January 5, 2012 7:00AM
Date Evaluated: January 5, 2012 1:00PM
P r o bl e m C u e s :

• Subjective data: “Dahil sa dami ng anak ko, minsan

ang dudungis na nila. Mabuti na lang nandyan ang
panganay ko na si Nene, siya yung nagbabantay sa
dalawang kapatid niya.”
P r o bl e m C u e s :

• Objective data: Nene, her nine-year-old daughter cuddles

her younger brother Jose who has flu at this time. She
manages to feed her other sibling with bare hands without
hand washing. The fingernails and toenails of these children
were not trimmed properly and filled with dirt. The other
two siblings came into the house sweating and their feet
were smudged with mud. Jose suddenly wet his shorts and
Nene must clean him up. The place wherein he peed was
not cleaned but left only. The pillow that was affected by the
urine was just placed outside for the sun to dry.
• Goal of Care: Within 3 hours of nursing
interventions, the family will be able to recognize the
current home environment and health practices. They
must be able to identify healthy practices and be
able to practice them habitually. These hygienic
measures are as follows: proper hand washing,
proper waste disposal and proper house cleaning.
• Objectives:
Within 3 hours of nursing interventions, the family will be
able to:
1. Recognize the need for proper hand washing before and
after meals as well as after using the toilet
2. Enumerate factors that promote in unhygienic practices
3. be knowledgeable in ways on how to maintain hygiene
4. Accept the importance of proper hygiene in the activities
of daily living
5. Exhibit the desire to change the current unhygienic
practices
• Interventions & Rationale:

1. Check if the family is aware of their health practices. This will help
the nurse to know the severity of the health problem.

2. Demonstrate the proper hand washing. The nurse must perform

the proper hand washing technique so that the family will be able to
see the proper technique. A return demonstration will be necessary
so that the nurse can assess if the family members can absorb the
lesson.
• Interventions & Rationale:

3. Emphasize the importance of proper hygiene in preventing health

problems. This step will enable the family members to know the
consequences if health practices were not observed in their family.

4. Listen to the concerns of the family regarding the hindrance to

practice such hygienic practices. This will be a way of keeping in
touch with the family and facilitate them to be able to find concrete
ways to achieve the goal of observing hygienic practices.
• Tools:
1. Home Visits
2. Diagram of path of infection, steps in correct hand
washing
3. Demonstration
4. Hand washing supplies
5. Time and Effort for the family members as well as to
the nurse
• Evaluation:
After 3 hours of nursing interventions, the goal was
met. The parents were able to demonstrate proper
hand washing. The siblings who were five years old
and above were able to wash their hands with
assistance from their parents. Lunch was served and
the children filed for a line in washing their hands
before and after the meal