Family Assessment Guideline
Each student will perform a family assessment on a family in their community. The family is to be chosen during the community rotation.
After completion of the Family Assessment each student is to determine one family nursing diagnosis and develop a care plan for this diagnosis.
Use the following outline and table to gather and record your data.
1. Family profile
a. Personal characteristics of each of the identified family members
1) Initials
2) Age
3) Sex
4) Marital status
5) Ethnic orientation
6) Religious orientation
7) Educational level
8) Language
9) Occupational history (type of job, duration)
10) Interest, hobbies, recreational activities
b. Current health orientation
1) What each family member considers to be healthy about him/herself
2) What health goals each family member has
c. Family characteristics
1) Type of family form
2) Family structure
a) Role structure (Include the roles of each family member, satisfaction with the role, presence of role strain, role flexibility
b) Value systems (Include what the family values are regarding education, work, health, and religion, and presence of conflicts of value in this family system)
c) Communication pattern (Include whether the communication between family members is clear, open and specific, whether emotions are expressed, and whether there are areas not open for discussion)
d) Power structure (Include how decisions are made in this family, especially regarding health issues, household matters, and raising children. Also include who makes the decisions)
2. Biophysical considerations
a. Water
1) Identify the family’s source of water supply
2) Identify the family patterns of fluid intake
3) Identify whether there are any difficulties in meeting fluid requirements for any of the family members and how is this managed
b. Food
1) Usual family dietary pattern
2) Appropriateness of dietary pattern based on food groups
3) Dietary modifications necessary for any of the family members due to cultural, religious, or medical reasons for any of the family members
4) How food is prepared and by whom (Identify whether the food budget for the family is adequate)
5) Family members’ weight gain/loss patterns
c. Elimination
1) Address family members’ bodily hygiene (i.e., adequacy, problems with elimination)
d. Activity and rest
1) Family members’ activity patterns: Address means of ambulation (safety concerns), level of activity (home, work, leisure), regular exercise programs
2) Family members’ sleep/rest patterns: Address circadian rhythms, time and duration of sleep, use of supportive aids (sedatives, alcohol) or devices (reading, music)
3) Activities the family engages in as a group
4) Acceptable and accessible resources for this family to meet recreational, cultural, transportation, child care, and respite care needs
3. Safety Assessment
a. Describe the family members’ personal safety practices
b. Address social habits (i.e., level of use by family members of drugs, alcohol, tobacco, coffee/tea/cola)
c. Family related to accident prevention and protection, protection from acts of violence, and protection from communicable disease
4. Health Practices Assessment
a. Health resources used (e.g., medical, dental, vision and hearing, screening and immunization programs, and counseling)
b. Personal health practices by family members (e.g., stress/anxiety management, meditation, relaxation techniques, breast self-exam, and well-child checkups, etc.)
c. Adequacy of family members’ mental health (Address affect/mood, thought processes, sensorium and reasoning, locus of control, and suicidal or homicidal ideation)
5. Developmental Assessment
a. Identify what developmental stage of the family life cycle this family is at (Ericson for pediatrics and Duvall for obstetrics)
b. Identify conditions that promote or prevent normal development for family members (i.e., life events, poor health, education)
6. Current Health Assessment
a. Family’s perception of current sources of stress or concern
b. Coping mechanisms
c. Concurrent stresses (life events) in the family system as a result of the current stresses, concerns, or other health deviations (Address psychological, physiological, and financial changes)
d. Family perception of the health situation
1) Family’s own perception of its strength to engage in self-care.
2) Identified area of health for enhancement and development in this family system (health promotion, health maintenance)
3) Family’s receptiveness to engage in health promotion / maintenance activities
Family Assessment Data
Family Profile
Initials
Gender/
Age
Marital status
Ethnic orientation
Religious orientation
Educational level
Language
Occupational history
Hobbies, Recreation
Current Health Status
Family Characteristics
Family form
Role structure
Communication pattern
Power structure
Value system
Biophysical Considerations
Water
Food
Elimination
Activity pattern
Rest
Family Practices and Developmental Stage
Safety practices
Health practices
Developmental stage
Current Health Assessment
(narrative format)
Family Nursing Diagnosis
Family Plan of Care
Nursing
Diagnosis
Family Goals and
Desired Outcomes with projected Date:
Planned Interventions
with Rationales
Family Responsibilities
Nurse Responsibilities
#1
#2
#3
#1
#2
#3
#1
#2
#3
Describe how you plan to evaluate the effectiveness of each intervention.
#1
#2.
#3
Identify Strengths and Weaknesses of the Family that may help or hinder implementation of the plan of care. (Identify at least 3 strengths and weaknesses.)
#1.
#2
#3.
Clinical Evaluation Tool (CET) 2017
Clinical Evaluation Tool (CET) 2017
Research Topics – Criteria
Ratings
Pts
This criterion is linked to a Learning OutcomeProfessional Role
view longer description
threshold: 1 pts
Satisfactory- Consistently provides safe, skilled client care; accountable for practice; maintains confidentiality; organized and functions as a client advocate
2 pts
Needs Improvement- Acknowledges limitations through self-reflection and analysis to improve consistent assumption of a professional role
1 pts
Unsatisfactory- Does not acknowledge limitations; failed to provide safe, skilled care. Or, arrived late to clinical not assuming responsibility for actions; demonstrated unprofessional behavior at clinical site
0 pts
—
This criterion is linked to a Learning OutcomeCritical Thinking
view longer description
threshold: 1 pts
Satisfactory- Utilizes best practice standards to provide safe, effective care; Adheres to nursing process and demonstrates appropriate problem solving strategies; Draws accurate conclusion
2 pts
Needs Improvement-Acknowledges limitations through self-reflection and analysis to improve critical thinking for clinical decisions; identifies resources and processes to assist in drawing accurate conclusions in the future
1 pts
Unsatisfactory- Does not acknowledge limitations; failed to provide safe, skilled care through assessment data analysis and nursing process. Demonstrated faulty clinical decisions placing clients/peers/ staff’s safety at risk.
0 pts
—
This criterion is linked to a Learning OutcomeCollaboration/ Communication
view longer description
threshold: 1 pts
Satisfactory- Consistently provides unbiased, therapeutic communication with clients/ families/staff. Respectful at all times; Verbal, nonverbal, and written communication accurate, clear, age appropriate; Provides health promotion education
2 pts
Needs Improvement- Acknowledges limitations through self-reflection and analysis to improve communication and collaboration skills. Needs more than normal assistance with patient/client health promotion education and communication processes
1 pts
Unsatisfactory- Does not acknowledge limitations; failed to provide clear appropriate communication with staff/ client/families; Demonstrated inaccurate verbal/nonverbal/ written communication. Failed to teach client/family as instructed
0 pts
—
Total Points: 0
