Family Nursing

Care Plan 
Saravon L. Casauay, MSN
Is defined as a guide or framework of
nursing care designed to provide ways
in solving health related problems
of the family as a whole.
CHARACTERISTICS OF FNCP
 Focuses on action to minimize or solve
existing problems.
 A productof deliberate systematic process –
data analysis.
 Relates to the future; projects future scenario.
 Basedupon the identified health and nursing
problems – problems are starting points.
 It is a means to an end, not an end to itself-
deliver the most appropriate care by
eliminating barriers to family health
development.
 A continuous process- must be evaluated for
its effectiveness.
DESIRABLE QUALITIES OF FNCP

 It should be based on clear, explicit definition

of the problems.
 A good plan is realistic.
 Prepared jointly with the family.
IMPORTANCE OF PLANNING CARE

 Individualizes patient care.

 Setpriorities by providing information about the
client and nature of problems.
 Promotes systematic communication involved in
care.
 Continuityof care is facilitated, prevents gaps
and duplication of care.
 Coordinates care to other health team members
STEPS IN DEVELOPING
FAMILY NURSING CARE
PLAN
1. Prioritization of problems
2. Setting the goals and objectives
3. Planning interventions
4. Evaluation of care
1. PRIORITIZATION OF PROBLEMS

 Known as the scale for ranking family health

problems according to priorities.
 Has four criteria for setting priorities.

I. Nature of the problem

A. HEALTH DEFICIT – instances of failure in
health maintenance.
B. Health threat – conditions that are conducive
to disease, accident or failure to realize one’s
potential.

C. Foreseeable crisis – anticipated periods of

unusual demand on the individual or family in
terms of adjustment/family resources.
2. MODIFIABILITY OF THE PROBLEM - the
probability of success in minimizing, alleviating or
totally eradicating the problem through intervention.

3. PREVENTIVE POTENTIAL – the nature and

magnitude of future problems that can be minimized
or totally prevented if the
Intervention is done on the problem.

4. SALIENCE – the family’s perception and

evaluation of the problem in terms of
seriousness and urgency of attention needed.
SCALE FOR RANKING FAMILY HEALTH
PROBLEMS ACCORDING TO PRIORITIES
CRITERIA WEIGHT
1.Nature of the 1
problem
presented
Scale : health
deficit
3

Health threat
2
Foreseeable
crisis 1
MODIFIABILITY OF THE PROBLEM

CRITERIA WEIGHT
2. Modifiability 2
of the problem

Scale :
easy 2
modifiable
Partially
modifiable 1
Not modifiable 0
3. PREVENTIVE POTENTIAL

CRITERIA WEIGHT
Scale : 1
High 3

Moderate 2

Low 1
4.SALIENCE
Criteria Weight
Scale : 1
A condition
needing
immediate 2
attention

A condition not
needing a 1
immediate
attention

Not perceived as
a problem 0
SCORING

 Decide on a score for each criteria

 Dividethe score by the highest possible score
and multiply by the weight : score/highest
score x weight
 Sum up the scores for all criteria. The highest
score is 5, equivalent to the total weight.
FACTORS AFFECTING
PRIORITY - SETTING
 Greater weight on health deficit
=needs more immediate attention and felt by the
patient over a health threat.

 Foreseeable crisis
= lowest score due to culture linked factors that
provide our client with adequate support to cope.
FACTORS IN DETERMINING THE
MODIFIABILITY OF THE PROBLEM
 Current knowledge, technology and
interventions to manage the problem
 Resources
of the family – physical, financial
and manpower
 Resources
of the community- facilities and
community support
FACTORS IN AFFECTING THE SCORING
OF PREVENTIVE POTENTIAL
 Gravity/severity of the patient.
= disease progression, extent, damage on the
patient/family.
= the more severe, the lower is the preventive potential.

 Current management
= appropriateness of intervention instituted.
= Exposure to any high risk group.
SALIENCE OF THE PROBLEM
 Perception of the patient/family on the
problem
 Family’s concerns and felt needs
II. FORMULATION OF GOALS AND
OBJECTIVES OF NURSING CARE
GOALS OBJECTIVES

General statement of the  More specific statements of

condition to be brought desired results or outcomes of
care
about by specific courses
 Specify the criteria by which
of action the degree of effectiveness of
Client outcomes care are to be measured
Goals tell where the  Must be specific in order to
family is going facilitate its attainment
GOALS

 Must be set together with the family

 Family must be able to recognize and accept
the presence of existing health needs and
problems
 Nursemust ascertain the family’s knowledge
and acceptance of the problems and the desire
to make actions to resolve them
 BARRIERS TO GOAL SETTING
 Failure of the family to perceive the existence of the problem.
 Family is too busy with other concerns.
 Familydoes not see the existence of a problem as serious
enough to necessitate attention.
 Familymay perceive the problem and the need to take action,
but they don’t want to do something on the situation.
 Failure
between the nurse and the family to establish a
working relationship.
REASONS FOR NOT DOING ANY
ACTIONS?
 A. Fear of consequences
 B. Respect for tradition
 C.
Failure to perceive the benefits of action
proposed
 D.
Failure to relate the proposed action to the
family’s goals
TIME SPAN OF OBJECTIVES

 Short term/immediate objectives

 Intermediate objectives
 Long term objectives
SELECTION OF APPROPRIATE NURSING
INTERVENTIONS

 Thenurse must specify the most effective

method of the nurse and family contact.

 Thenurse must specify the most effective

resources.
HOW TO CHOOSE THE APPROPRIATE NURSING
INTERVENTION?

 Analyze with the family the current situation

and determine choices and possibilities.
 Develop family’s competencies as thinker,
doer and feeler.
 Focus on interventions to help perform the
health tasks.
 Catalyzebehavior change through motivation
and support.
A.EXPLORATION WITH FAMILY CHOICES/POSSIBILITIES
BASED ON LIVED EXPERIENCE OF MEANINGS AND CONCERNS

 Nurse interaction is dependent upon lived meaning

of the experiences of the family members with each
other and the nurse
 Family is the active participant in the application
of the nursing process
 Family and nurse are participants in the active,
mutual, dynamic interchange of realities, concerns
and resources
 Theyboth need to analyze and understand the
current health situation.
 Nurse must explore with the family the
possibilities and choices presented by the
current situation.
MEANINGS, CONCERNS, SOCIAL
RELATIONS, RESOURCES
B.DEVELOP/ENHANCE COGNITION,
VOLITION AND EMOTION
 Provides
the family ways to be THINKER, DOER
AND FEELER
Thinker- the nurse must be able to share information,
knowledge.

Doer- the nurse must enhance confidence to the family in

carrying out and sustaining change for health promotion
and maintenance, and accurate disease management.
Feeler- the nurse must help the family
strengthen its affective competencies in order to
appropriately acknowledge and understand
emotions generated by family life or health
illness situations.
C. FOCUSING ON THE INTERVENTIONS TO HELP
THE FAMILY PERFORM THE HEALTH TASKS

1. Help the family recognize the problem

2. Guide the family on how to decide on appropriate
health actions to take.

3. Develop the family’s ability and commitment to

provide nursing care to its members.
CONTRACTING

 Maximizes opportunities to develop the ability

and commitment of the family to provide
nursing care to its members.
 Thenurse creates a situation in order that the
family learns to achieve a specific health related
behaviour through steps and conditions.
 Uses positive reinforcement
4. Enhance the capability of the family to
provide a home environment conducive to
health maintenance and personal development.

5. Facilitate the family’s capability to utilize

community resources for health care.
D. CATALIZING BEHAVIOR CHANGE
THROUGH MOTIVATION AND SUPPORT
 Thereshould be an environment that nurtures
change
 Thereshould be support from both parties in order
to make a change
 Motivation and support
 Enhance the family’s knowledge and willingness to
prevent, control health problems.
 Makes the family skillful, emotionally stable, and
creative in handling the issues surrounding them
 MOTIVATION
Refers to any information or experience that
leads the family to desire and agree to undergo
the behavior change or proposed measure and
takes the initial action to bring about a change.
 SUPPORT
 Refersto any experience or information that
maintains, restores or enhances the
capabilities or resources of the family to
sustain these actions and complete the change
process.
DEVELOPING THE EVALUATION PLAN
 Specifies how the nurse will determine
changes in health status, condition, or
situation and achievement of the outcome of
care.
 Itincludes criteria, evaluation methods/ tools
and sources of evaluation data.
CASE ILLUSTRATION ON PRIORITY SETTING

Malnutrition

Criteria Computation Actual Score Justification

1. Nature of 3/3 x 1 1 It is a health
the problem deficit that
requires
immediate
management
to eliminate
untoward
consequences
2. Modifiability of 2/2 x2 2 The problem is
the problem easily modifiable
since the nurse
resources are
available; she
can help the
family on
effective
budgeting of
money and
scheduling of
time ; she can
develop the skills
of other
members to
achieve good
nutrition – proper
food selection
and preparation
and feeding
practices
3. 3/3 x 1 1 Susceptibilit
Preventive y to other
potential diseases and
infections
can be
prevented if
malnutrition
is
eliminated;
normal
growth and
developmen
t can thus be
achieved
4. 0/2 x 1 0 It is not a
Salience felt
of the problem
problem

Total 4
score
Unsanitary waste disposal
Criteria Computatio Actual justificatio
n score n
1. Nature of 2/3 x 1 2/3 It is a
the problem health
threat
2. 2/2x 1 2 Resources
Modifiabilit are
y of the available
problem and
intervention
s are
feasible
3. 3/3 x 1 1 Occurrence
Preventive of parasitism
potential and other
communicabl
e diseases
can be
reduced or
minimized
4. Salience of No data No data
the problem available available
Total score 3 2/3
Improper refuse disposal
Criteria Computation Actual score Justification

1. Nature of 2/3 2/3 It is a health

the problem threat

2. 2/2 x2 2 Resources
Modifiability are available
of the and
problem interventions
are feasible
3. Preventive 3/3 x 1 1 Communicabl
potential e diseases
are
transferred
by insects
and rodents
can be
prevented
4. Salience of No data No data
the problem available available
Total score 3 2/3
 SAMPLE FAMILY NURSING CARE PLAN
FAMILY FAMILY GOAL OF OBJECTIVES NURSING RATIONALE METHOD OF RESOURCES EVALUATION
HEALTH NURSING CARE OF CARE INTERVENTI FAMILY REQUIRED
PROBLEM PROBLEM ON CONTACT
PRESENCE Inability to After nursing After hours Provide It can Home visit Low cost Goals
OF HEALTH provide a intervention of home visit information increase the resources to partially met
THREATS home the family of safety awareness improve and
environment will think of The family need or about injury modify The stairs
conducive to necessary will know injury hazards. facilities in without
health action to the prevention . home and handle can
maintenance reduce importance It can environment cause
and personal potential of a safe Discuss mobilize accident in
development hazards into environment about them to Time and the family
due to : Lack the home free from supervision utilize effort of
of environment hazards and for the preventive student,
knowledge accident young one’s measures community
on dangerous and health nurse
construction The family improvement and the
materials will be of the family
that can aware and facility
cause knowledgeab
damage le of the
hazards in
their home
including its
preventive
measures
 SAMPLE FAMILY NURSING CARE PLAN
FAMILY FAMILY GOALS OF OBJECTIVES NURSING RATIONALE METHOD OF RESOURCES EVALUATIO
HEALTH NURSING CARE OF CARE INTERVENTI FAMILY REQUIRED N
PROBLEM PROBLEM ON CONTACT
Presence of Inability to After 2 hours After nursing Discuss with To avoid Home visit Materials After nursing
insects and provide a of intervention, the family in disease. resources intervention
pests home intervention the family cleaning the the family
environment the family will be able kitchen Visuals aids makes
conducive to will decide to: before and about the actions to
health on the after using effects on avoid
maintenance appropriate To make it. the presence disease and
and personal action to action from of insects ways on
development prevent the home Discuss with and pests. improving
due to: diseases and sanitation. the family to their home
maintain a always cover
Lack of healthy To improve the food to
knowledge family their home. prevent from This will
on the flies and enhance the
possible Will consult other family’s
cause of our the nurse insects. knowledge
health after for about their
through guidance Discuss with health
pests and the family to nutrition
insects. always clean
Lack of the home
awareness in environment
the
environment To control
. the insects
and pests.
THANK YOU. 