Family

Nursing Care
Plan
By: Judith J. Sugay, PhD, RN
Faculty, Institute of Nursing
Far Eastern University
Introduction
Insert Body Text Here
 Prioritize health problems

Learning Outcomes Establish goals

After completing this module the students
are expected to write a Family Nursing Care Develop objectives
Plan (FNCP), specifically
Write FNCP
Family Nursing Care Plan

Promotes systematic
communication in
settings where there
are several healthcare
workers providing care
to the family.
 Planning Phase
• Prioritized health condition
• Goals and Objectives
• Intervention
• Evaluation
Prioritization of Health
Problems
Subtitle / Description / Paragraph
Steps in Developing FNCP
1. Prioritized health condition/s or problems
✓ Rank the identified health problems into
priorities
✓ Tool: Scale for Ranking Health Conditions
and Problems according to Priorities
(Baylon and Maglaya, 1990).
✓ Aim: facilitate decision-making in determining the family nursing
problems that can be addressed by the nurse with the family.

facilitate decision-making in determining the family nursing

problems that can be addressed by the nurse with the family.
Criteria in Prioritizing Health Problems
1. Nature
✓ Wellness state/potential
✓ Health threat
✓ Health deficit
✓ Foreseeable Crisis
2. Modifiability
✓ The probability of success in enhancing
the wellness state, improving condition,
minimizing/eradicating the problem
through interventions.
Criteria in Prioritizing Health Problems
3. Preventive potential
✓ Wellness state/potential
✓ Health threat
✓ Health deficit
✓ Foreseeable Crisis
2. Modifiability
✓ The probability of success in enhancing
the wellness state, improving condition,
minimizing/eradicating the problem
through interventions.
 TABLE 1. SCALE RANKING HEALTH CONDITIONS AND
PROBLEMS ACCORDING TO PRIORITIES
Criteria Weight
1. Nature of the condition or problem
Scale**Wellness state 3
Health deficit 3 1
Health threat 2
Foreseeable crisis 1
1. Modifiability of the condition or problem
Scale** Easily modifiable 2 2
Partially modifiable 1
Not modifiable 0
1. Preventive potential
Scale** High 3 1
Moderate 2
Low 1
1. Salience
Scale** A condition or problem, 2 1
needing immediate attention
A condition or problem not 1
needing immediate attention
Not perceived as a problem or condition needing change 0
Scoring
1) Decide on a score for each of the criteria.
2) Divide the score by the highest possible score and multiply by the weight: (Score/Highest Score)x Weight
3) Sum up the scores for all the criteria. The highest score is 5 equivalent to the total weight.

❖ Developed by Salvacion G. Bailon and Araceli S. Maglaya. For details see article: “Tools and Guidelines for Nursing at the Family Level:. The Anphi Papers,
22(1):13,1997. Updated by A.S. Maglaya in 2003
❖ Figures (0,1,2,3) for the weights and scale values are arbitrary, dictated more by convenience in computation.
Factors Affecting Priority Setting
NATURE of GOAL
1. Wellness
✓ The client’s desire to function at a higher
level, go beyond maintaining health
✓ Problem: Readiness on enhanced
capability for breastfeeding of Mrs. Tiwala
✓ Goal:After two weeks on nursing
intervention, Mrs. Tiwala will breastfeed
more competently.
Factors Affecting Priority Setting
NATURE of GOAL
2. Health deficit
✓ Appropriate when the client’s situation or
health condition interferes with the
promotion and/or maintenance of health and
recovery from illness or injury.
✓ Problem: Readiness on enhanced capability
for breastfeeding of Mrs. Tiwala
✓ Goal:After one month of nursing intervention,
the family will be able to maintain the blood
sugar of Mrs. Garcia within normal level.
Factors Affecting Priority Setting
NATURE of GOAL
3. Preventive Potential
✓ Gravity of the problem
✓ Duration of the problem
✓ Current management
✓ Exposure to high risk group
4. Salience
✓ Family’s perception of the problem
✓ Felt need /readiness increases the score
Goals of Nursing Care
Nature of Goal
1. Wellness
✓ The client’s desire to function at a higher
level, go beyond maintaining health
✓ Problem: Readiness on enhanced
capability for breastfeeding of Mrs. Tiwala
✓ Goal:After two weeks on nursing
intervention, Mrs. Tiwala will breastfeed
more competently.
Nature of Goal
2. Health deficit
✓ Appropriate when the client’s situation or health
condition interferes with the promotion and/or
maintenance of health and recovery from illness
or injury.
✓ Problem:Diabetes Mellitus of Mr. Garcia as
Health deficit
✓ Goal: After one month of nursing intervention,
the family will be able to maintain the blood
sugar of Mrs. Garcia within normal level.
Nature of Goal
3 Health threat
✓ appropriate when the client’s situation or
health condition is conducive to disease or
may result to failure to maintain wellness.
✓ Problem: Presence of accident hazard,
particularly broken stairs in the hallway of Mr.
and Mrs. Juan Dela Cruz as Health threat.
✓ Goal:After one week of nursing intervention,
Mrs. & Mrs. Cruz will be able fix the stairs in
the hallway..
Nature of Goal
4. Foreseeable Crisis
✓ appropriate when the client has anticipated
periods of unusual demand on the individual
or family.
✓ Problem: Presence of Foreseeable crisis on
loss of job of Mr. Gomez
✓ Goal:After one week of nursing intervention,
the family will be able to decide on taking
alternative job for Mr. Gomez which is
appropriate to his skills and capabilities.
Objectives of Nursing
Care
Objectives of Nursing Care
• Short-term in nature and is usually attainable while the client is in the
direct care of an institution.
• Flows from an etiological clause.
• Describes an intended result of a particular action (Mager, 1984).
• Usually three to six objectives are necessary for each goal.
• Useful tools in the design, implementation, and evaluation of care.
 A. Performance

Characteristics of B. Condition
Objectives
C. Criterion
Characteristics of Objectives: Performance
• Any activity engaged in by the client
• Types:
a. Overt are those that can be directly seen or heard.
Verbs: recite, list, sort, verbalize, demonstrate, name, select, and state.

b. Covert performances are mental/invisible/cognitive but have a direct way of

being assessed.
Verbs: identify, solve, use, compare, and determine.
Characteristics of
Objectives: Condition

• Conditions may include

experiences that the client is
expected to have had before
completing the following which the
client will carry out the
performance:
a)Objective;
b)Resources; and
c) Environmental condition
Characteristics of
Objectives: Criterion
• The criterion is the standard by which a performance is evaluated.
Criteria within the objectives may be stated in four ways:
• Speed: Set a time limit that is reasonable, given the client’s
health state, as well as the nurse’s capabilities and limitations.
• Accuracy: Identify a specific degree of performance
quantitatively.
• Quality: Indicate the standard that is expected in terms of
given acceptable procedures.
• Criterion: referenced: Use a book, pamphlet, or other
resources . They also provide a measure for meeting the
objective.
 A. Cognitive

Domains of B. Affective
Objectives
C. Psychomotor
Domains of Objectives:
Cognitive
Levels of Cognitive Domain
• Cognitive Domains are associated Category Example

with changes in knowledge or Knowledge level: Recall, define, or identify specific

information.
After 30 minutes of teaching session, the client will be able to
state with accuracy the definition of Asthma.

intellectual abilities and skills. Comprehension level: Understand, or demonstrate

comprehension of what is being communicated by
After watching a 5 – minute video on nutrition following gastric
bypass surgery, the client will be able to give at least three
recognizing its translated form. examples of food choices that will be included in his diet.

• Learning in this domain involves Application level: Use ideas, principles, abstractions, or Upon completion of a cardiac rehabilitation program, the
theories patient will modify three exercise regimes that can fit his
acquiring information and lifestyle at home.

addressing the development of the Analysis level: Recognize and structure information After reading handouts provided by the nurse educator, the
family member will calculate the correct number of total grams
of carbohydrate included on daily average of the family’s diet.

learner’s intellectual abilities,

mental capacities, and thinking Synthesis level: Put together parts into unified whole Given a sample list of foods, the patient will create a menu to
include foods from the 3 basic food groups in the recommended
amount of daily intake.
processes (Eggen & Kauchak, 2012).
Evaluation level: Judge the value of something by applying After three teaching sessions, the learner will assess his
the appropriate criteria readiness to function independently in the home setting.
Domains of Objectives:
Levels of Affective Domain
Affective Category
Receiving level: Awareness of idea or
Example
During a group discussion session, the
fact patient will admit to any fears he may have
about needing to undergo repeat
angioplasty.

Responding level: to respond to an At the end of one-to-one instruction, the

• Learning in this domain involves

experience, and later on willingly child will verbalize feelings of confidence in
respond with satisfaction. managing their asthma using the peak-flow
tracking chart.

increasing internalization of Valuing level: Regard or accept the After attending a grief support group

commitment to feelings worth of a theory, idea, or event

demonstrating commitment to an
experience that is perceived as
meeting, the patient will complete a
journal entry reflecting her feelings about
the experience.
expressed as emotions, having value.

interest, beliefs, attitudes, Organization level: Organize, classify,

and prioritize values by integrating a
After 45 – minute group discussion session,
the patient will be able to explain the
new value into general set of values. reasons for anxiety about self-care
values, and appreciations. management responsibilities.

Characterization level: Display Following a series of teaching sessions, the

adherence to a total philosophy, learner will display consistent interest in
showing firm commitment into the maintaining good handwashing technique
values system. to control the spread of infection to the
members of the family.
Domains of Objectives:
Levels of Psychomotor Domain
Psychomotor Category
Perception level: Awareness on cues or
objects associated with some tasks
Example
After a 20-minute teaching session
on aspiration precautions, the
performed. family caregiver will describe the
best position to place the patient
in during mealtimes to prevent
choking.
Set level: Exhibit readiness to take certain Following a demonstration of how
kind of action and express willingness to to do proper wound care, the
take action patient will express willingness to
practice changing the dressing on
his leg using the correct procedural
steps.

• Learning in this domain

Guided level: Exert effort via overt After watching a 15-minute video
actions under the guidance of an on the procedure for self-
instructor/mentor examination of the breast, the
patient will perform the exam on a

involves acquiring fine and Mechanism level: repeatedly perform

steps of a desired skill with a certain
degree of confidence
model with 100% accuracy.
After a 20 minute teaching session, the patient
will demonstrate the proper use of crutches
while repeatedly applying the correct three-

gross motor abilities such as Complex overt response level:

Automatically perform a complex motor
point gait technique.
After 20-minute teaching session, the patient
will demonstrate the correct use of crutches

walking, handwriting, or act with independence and a high degree

skill
while accurately performing different tasks
such as going up stairs, or using the toilet.

performing a procedure Adaptation level: Modify or adapt a

motor process to suit the individual or
various situations, indicating mastery of
highly developed movements.
After reading handouts on healthy food
choices, the patient will replace unhealthy food
items with healthy alternatives.

Origination level: Create new motor acts, After simulation training, the parents will
such as novel ways of manipulating respond correctly to a series of scenarios that
objects or materials, as a result of demonstrate skill in recognizing respiratory
understanding a skill and developed distress in their child with asthma.
ability to perform skills.
 Guidelines in Writing
Specific SMART Objectives
Be specific of what has to be achieved
Measurable
Relate it to the goal
Attainable
Quantify/Qualify the objectives
Realistic
Time bound Realistic objectives

Indicate when the objectives will be

achieved
Writing a Nursing Care Plan
Family Nursing Care Plan

• A written guide that organizes

about client’s care into a
meaningful whole.
• The tool for documenting and
communicating the client’s
nursing diagnoses, expected
outcomes, nursing orders,
strategies, and evaluation.
Purposes of Family
Nursing Care Plan

• Care plans provide direction for

individualized care of the client
• For continuity of care
• Helps to teach proper documentation
• Serves as guide for assigning staff to
care for the client
• Care plans serve as guide for
reimbursement of health insurance
Guidelines for Writing a
Family Nursing Care Plan

• Indicate the date and sign the plan

• Use category headings. Example: Nursing
diagnoses, Goals, Nursing Intervention and
Evaluation
• Be specific.
• Refer to procedure books or other sources of
information rather than including all the
steps on a written plan.
Guidelines for Writing a
Family Nursing Care Plan

• Ensure that the NCP incorporates

preventive and health maintenance aspects
as well as restorative ones.
• Ensure that the plan and contains
interventions for ongoing assessment of
the client.
• Ensure that the plan and contains
interventions for ongoing assessment of
the client.
Guidelines for Writing a
Family Nursing Care Plan
• Include collaborative and coordination
activities in the plan
• Ensure that the plan and contains
interventions for ongoing assessment of
the client.
• Include plans for the client’s discharge
and home care needs
 Format in Writing a
Family Nursing Care
Plan

• Head of the Family: _____________________

• Name of the Client: _____________________
• Address: ______________________
• Family Number: ______________________

Health Problem Family Analysis Goal & Objectives Interventions Rationale Evaluation
and Cues Nursing
Problem
Note: Refer to
the Module for
sample activities.
 Thank you!

jsugay@[Link]