Data Gathering Methods

Method Interviews with: Description Interviews are conducted one-on-one or with a small group (the smaller the better so that everyone has a chance to contribute fully). Interviews can be used throughout the data gathering process, but they are perhaps most useful during the performance analysis stage, when you are trying to determine what the real performance deficiency is. Although the process is time-consuming, it is useful because you can gather specific information and ask follow-up questions to get more detail on items of particular interest. 1. Tips Write down your questions before the interview and give them to the person(s) being interviewed, if possible Decide beforehand how you want to document the information you gather Consider videotaping the interview so that you have a record to refer to later Put the persons being interviewed at ease by telling them the purpose of the interview and how you will use what they tell you When appropriate, assure them that what they say will be kept confidential

Management Exemplars Workers

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Panels of Experts

Panels of experts are used to get the collective observations and opinions of the best of the breed. They are particularly useful when there is not one correct solution or procedure (e.g., conducting a goal analysis).

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Make sure that each participant is truly an expert Let participants know well in advance what you expect of them and give them time to prepare Focus the discussion on the topic at hand and keep participants on track Document your panel just as well as you documented interviews

Observations

Direct observation of work performance is an excellent means of gathering data. Observations are usually done in conjunction with another data gathering method that is used to fill in the gaps and answer questions.

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Make sure to arrange your observations well in advance and get permission from management Let workers know why you are observing them If possible, have an expert with you who can tell you what to look for Videotaping observation sessions works well if it is permitted

Surveys

Formal Informal

Surveys are used when you want to gather data from a large number of people and when it is impractical to meet them all face to face. Surveys can be both formal (where the results are subject to statistical reliability and validity) and informal (where results are anecdotal). In the developingworld reproductive health context, there are relatively few commercially designed instruments. Although PRIME might be able to design some generic survey instruments, the unique problems and country differences might limit their

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Decide up-front if you need to base your conclusions on statistically valid and reliable data. If so, consult an expert to help determine your sample group, method of data collection and how you will compute your results It is best to use commercially designed instruments, if they are available. They save development time, and they have been tested to ensure they work

usefulness. Clearly, it is expensive to design a survey for one performance improvement effort, so while we include surveys in this table, we are not optimistic about their applicability (except on a small, informal basis). Reviews of Performance Data Almost all organizations maintain records. They may include data about time and attendance, rates of production, and cost of goods sold. A review of some of these records can provide valuable information to substantiate the performance deficiencies under consideration and lead to potential causes. In the contexts in which PRIME II operates, one of the challenges will be to determine which data are relevant and whether the quality of the data is adequate.

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If you must design your own survey, make sure you try it out on a sample group from the target population

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Make sure you understand how the data were collected and what the data mean Make sure that the data you have are current. Outdated data can be more harmful than no data at all It is important that you comply with any restrictions your client puts on your use of their data. Unauthorized use of confidential data can be illegal and harmful to the organization

Nursing Assessment in Family Nursing Practice Nursing Assessment first major phase of the nursing process. - involves a set of actions by which the nurse measures the status of the family as a client, its ability to maintain itself as a system and functioning unit, its ability to maintain wellness, prevent, control or resolve problems in order to achieve health and well-being among its members. Nursing Assessment includes: Data collection Data analysis or interpretation Problem definition or nursing diagnosis end result of two major types of nursingassessment in family health nursingpractice.First Level Assessment is a process whereby existing and potentialhealth conditions or problems of the familyare determined.

Category of Health conditions/Problems: Wellness state/s Health Threats Health deficits

Stress points or foreseeable crisissituationsSecond Level Assessment- the nature or type of nursing problems thatthe family encounters in performing thehealth tasks with respect to a given healthcondition or problem, and the etiology or barriers to the familys assumption of the tasks. Steps in Family Nursing Assessment 1.Data Collection gathering of five typesof data which will generate the categoriesof health conditions or problems of the family. a.) family structure, characteristics &dynamics include the composition and demographic data of the members of the family/household, their relationship to the head and place of residence; the type of, and family interaction/communication and decision-making patterns and dynamics. b.) socio-economic & culturalcharacteristics include occupation, placeof work, and income of each workingmember; educational attainment of eachfamily member; ethnic background andreligious affiliation; significant others andthe other role(s) they play in the familyslife; and, the relationship of the family tothe larger community. c.) home and environment includeinformation on housing and sanitationfacilities; kind of neighborhood andavailability of social, health,communication and transportationfacilities in the community. d.)health status of each member includes current and past significantillness; beliefs and practices conducive tohealth and illness; nutritional anddevelopmental status; physicalassessment findings and significantresults of laboratory/diagnostictests/screening procedures. e.) values and practices on healthpromotion/maintenance & diseaseprevention include use of preventiveservices; adequacy of rest/sleep, exercise,relaxation activities, stress managementor other healthy lifestyle activities, and immunization status of at-risk family members. Data Gathering Methods & Tools a.)Observation method of data collection through the use of sensory capacities sight, hearing, smell and touch. Data gathered through this method have the advantage of beingsubjected to validation and reliabilitytesting by other observers. b.) Physical Examination done through inspection, palpation, percussion ,auscultation, measurement of specific body parts and reviewing the bodysystems. c.) Interview completing the health history of each family member. The health historydetermines current health status based onsignificant past health history. The second type of interview is collectingdata by personally asking significant family members or relatives questions regardinghealth, family life experiences and homeenvironment to generate data on whatwellness condition and health problems existin the family.Productivity of the interview processdepends upon the use of effectivecommunication techniques to elicit theneeded responses. Second level assessment can beadequately done for each wellness state,health threat, health deficit or crisissituation by going through the followingprocedures:

Determine if the family recognizesthe existence of the condition or problem. If the family does notrecognize the presence of the condition or problem, explore thereasons why. If the family recognizes the presenceof the condition or problem,determine if something has beendone to maintain the wellness stateor resolve the problem. If the familyhas not done anything about it,determine the reasons why. If thefamily has done something about theproblem or condition, determine if the solution is effective. Determine if the family encountersother problems in implementinginterventions for the wellnessstate/potential, health threat, healthdeficit or crisis. What are theseproblems? Determine how all the other members are affected by thewellness state/potential, health threatdeficit or stress point. d.) Record Review reviewing existingrecords and reports pertinent to the client.( individual clinical records of the familymembers; laboratory & diagnostic reports;immunization records; reports about thehome & environmental conditions. e.) Laboratory/Diagnostic Tests performinglaboratory tests, diagnostic procedures or other tests of integrity and functionscarried out by the nurse herself and/or other health workers. 2. Data Analysis- sort data- cluster/group related date- distinguish relevant from irrelevant dataidentify patterns- compare patterns with norms or standards- interpret results- make inferences/draw conclusions

3. Nursing Diagnoses: Family NursingProblems * A wellness condition is a nursing judgment related with the clients capabilityfor wellness. Ahealthconditionorproblemisasituation which interferes with thepromotion and/or maintenance of healthand recovery from illness or injury. NURSING DIAGNOSIS in the FAMILYNURSING PRACTICE - the familysfailure to perform adequately specifichealth tasks to enhance the wellnessstate or manage the health problem. TYPOLOGY OF NURSING PROBLEMS INFAMILYNURSINGPRACTICEclassification system of family nursingproblems.FIRST- LEVEL ASSESSMENT I. PRESENCE OF WELLNESS CONDITION stated as Potential or Readiness II. PRESENCE OF HEALTH THREATS conditions that are conducive to disease andaccident, or may result to failure to maintainwellness or realize health potential.III. PRESENCE OF HEALTH DEFICITS instances of failure in health maintenance.IV. PRESENCE OF

STRESSPOINTS/FORESEEABLE CRISIS SITUATIONS anticipated periods of unusual demand onthe individual or family in terms of adjustment/family resources. SECOND-LEVEL ASSESSMENT I. Inability to recognize the presence of thecondition or problem. II. II. Inability to make decisions with respect totaking appropriate health action. III. III. Inability to provide adequate nursing careto the sick, disabled, dependent or vulnerable/at-risk member of the family. IV. Inability to provide a home environmentconducive to health maintenance andpersonal development. IV. Failure to utilize community resources for health care.

DEVELOPING THE NURSING CARE PLANTHE FAMILY CARE PLAN is the blueprint of the care that the nurse designs tosystematically minimize or eliminate theidentified health and family nursingproblems through explicitly formulatedoutcomes of care ( goals and objectives) anddeliberately chosen of interventions,resources and evaluation criteria, standards,methods and tools. DESIRABLE QUALITIES OF A NURSINGCARE PLAN1.It should be based on clear, explicitdefinition of the problems. A goodnursing plan is based on acomprehensive analysis of the problemsituation.2.A good plan is realistic.3.The nursing care plan is prepared jointlywith the family. The nurse involves thefamily in determining health needs andproblems, in establishing priorities, inselecting appropriate courses of action,implementing them and evaluatingoutcomes.4.The nursing care plan is most useful inwritten form.THE IMPORTANCE OF PLANNING CARE1.They individualize care to clients.2.The nursing care plan helps in settingpriorities by providing information aboutthe client as well as the nature of hisproblems. 3.The nursing care plan promotessystematic communication among thoseinvolved in the health care effort.4.Continuity of care is facilitated throughthe use of nursing care plans. Gaps andduplications in the services provided areminimized, if not totally eliminated.5.Nursing care plans, facilitate thecoordination of care by making known toother members of the health team whatthe nurse is doing.STEPS IN DEVELOPING A FAMILY NURSINGCARE PLAN1.The prioritized condition/s or problemsbased on: nature of condition or problem modifiability preventive potential salience2.The goals and objectives of nursing care. Expected Outcomes: conditions to be observed to showproblem is prevented, controlled,resolved or eliminated.

Client response/s or behavior > Specific, Measurable, Client-centered Statements/Competencies3.The plan of interventions. Decide on: Measures to help family eliminate:. barriers to performance of health tasks. underlying cause/s of non-performance of health tasks Family-centered alternatives torecognize/detect, monitor, control or manage health condition or problems Determine Methods of Nurse-FamilyContact Specify Resources Needed4.The plan for evaluating. Criteria/Outcomes Based onObjectives of Care Methods/Tools COMMUNITY DIAGNOSISTYPES OF COMMUNITY DIAGNOSIS1.COMPREHENSIVE COMMUNITYDIAGNOSIS aims to obtain a generalinformation about the community.A.Demographic VariablesB.Socio-Economic and CulturalVariablesC.Health and Illness PatternsD.Health resourcesE.Political/Leadership Patterns2.PROBLEM-ORIENTED COMMUNITYDIAGNOSIS type of assessment thatresponds to a particular need.PROCESS OF COMMUNITY DIAGNOSIS: Collecting Organizing Synthesizing Analyzing and interpreting health data STEPS IN CONDUCTING COMMUNITYDIAGNOSIS1.DETERMINING THE OBJECTIVES thenurse decides on the depth and scope of the data she needs to gather.2.DEFINING THE STUDY POPULATION the nurse identifies the population groupto be included in the study.3.DETERMINING THE DATA TO BECOLLECTED the objectives will guidethe nurse in identifying the specific datashe will collect, and will also decide onthe sources of these data.4.COLLECTING THE DATA the nursedecides on the specific methodsdepending on the type of data to begenerated.5.DEVELOPING THE INSTRUMENT instruments/tools facilitate the nursesdata-gathering activities.Most common instruments: survey questionnaire

interview guide observation checklist 6.ACTUAL DATA GATHERING the nursesupervises the data collectors bychecking the filled-up instruments interms of completeness, accuracy andreliability of the information collected.7.DATA COLLATION the nurse is nowready to put together all the information.8.DATA PRESENTATIONwilldependlargely on the type of data obtained.(descriptive & numerical data)9.DATA ANALYSIS aims to establishtrends and patterns in terms of healthneeds and problems of the community.10.IDENTIFYING THE COMMUNITY HEALTHNURSING PROBLEMS Health status problems increasedor decreased morbidity, mortality,fertility or reduced capability for wellness. Health resources problems lack of or absence of manpower, money,materials or institutions necessary tosolve health problems. Health-related problems existenceof social, economic, environmentaland political factors that aggravate the illness-inducing situations in thecommunity.11.PRIORITY-SETTING prioritize whichhealth problems can be attended toconsidering the resources available atthe moment. Nature of the condition/problempresented problems classified by thenurse as health status, health resourcesor health-related problems. Magnitude of the problem refers to theseverity of the problem which can bemeasured in terms of the proportion of the population affected by the problem. Modifiability of the problem probabilityof reducing, controlling or eradicatingthe problem. Preventive potential probability of controlling or reducing the effects posedby the problem. Social concern perception of thepopulation or the community as they areaffected by the problem and their readiness to act on the problem. WHAT IS PLANNING?PLANNING is a process that entailsformulation of steps to be undertaken in thefuture in order to achieve a desired end. Concepts of Planning:. Planning is futuristic.. Planning is change-oriented.. Planning is a continuous and dynamicprocess.. Planning is flexible.. Planning is a systematic process.THE PLANNING CYCLE:1.Situational Analysis -

gather health data tabulate, analyze and interpret data identify health problems set priority2.Goal and Objective Setting define program goals and objectives assign priorities among objectives3.Strategy/Activity Setting Design CHN Program Ascertain resources Analyze constraints and limitations5.Evaluation determines outcomes specify criteria and standards

Genograms and ecomaps are visual tools used by a variety of professionals to help assess family situations and dynamics. They are useful tools for medical professionals, social workers, counselors and therapists.

Identification

A genogram is a family tree depicted in graphic form to illustrate the relationships between family members with in-depth data. An ecomap encompasses more of an individual's relationships, extending into representing not just family members but other personal social relationships as well.

Function

To use an ecomap or genogram, some symbols are utilized to illustrate elements of relationships. For example, males are represented with squares and females with circles; biological children are connected by a solid line while adopted children are connected with a dashed line; and pregnancy is indicated by a triangle while miscarriage is shown as a triangle with an "X" through it. A divorce is indicated by two slashes, and separation by one slash line.

Significance

Genograms and ecomaps are helpful in identifying prevalent patterns of behavior or family issues such as divorce, alienation between siblings, suicides or alcoholism. Professionals working with individuals or +++families can use these tools to recognize family history and help the client understand patterns at work in their history

An environmental assessment is an opportunity to tour and observe the workplace to understand more about the setting employees work in and the physical factors at and nearby the worksite that support or hinder employee health and evaluate the physical and organizational work environment for health hazards and risks. The built environment includes all the physical parts of the worksite (e.g., building, open spaces, streets, and infrastructure) which can influence employee health. It considers such components as land use patterns, transportation systems, and design features.

Land use patterns refer to the spatial distribution of human activities Transportation systems refer to the physical infrastructure and services that provide the spatial links or connectivity among activities Design refers to the aesthetic, physical, and functional qualities of the built work environment, such as the design of buildings and streetscapes, and relates to both land use patterns and the transportation system4 An assessment of the physical work environment can identify a number of opportunities for employers to create access and opportunity for employees to practice healthy behaviors, such as physical activity, or discourage unhealthy behaviors, such as creating a tobacco free work environment. When conducting an environmental assessment of the workplace, it is important to recognize that there are numerous physical features that may be examined. The organization can decide how narrow or broad to make the assessment. To properly identify health risks and hazards from the work environment that may cause occupational disease or injury and institute prevention and control measures for these risks, employers can implement a system to collect, analyze, and interpret occupational disease and injury control information. This system involves collecting data from many sources including workplace inspections, measurement and evaluation of exposure, examination of workers, record keeping, and reporting of health effects and exposures for acute (when the time between exposure and disease or injury is short) or chronic conditions (e.g., resulting from repeated exposure). Direct observation of the work environment through a workplace inspection is an important source of data. Inspections can be conducted 1) on a regular and routine basis to identify hazards; 2) following an incident or accident resulting in injury to identify cause(s) and; 3) when someone at the workplace requests an inspection due to a suspicion of a health or safety hazard. Inspections can be performed by a variety of

individuals including workers; health and safety professionals; engineers; external agencies, such as regulatory agencies; insurance providers; corporate officials; or union representatives. Because of their familiarity with the worksite and work environment, workers are good sources of environmental health and safety risk information and may provide information not found in formal records (e.g., OSHA) or workers compensation claims. However, the information workers provide should not substitute for a professional evaluation of the workplace practices and the work environment by an industrial hygienist or ergonomist.5 The following questions may be helpful to consider when planning a worksite environmental assessment:

Is the workplace free of recognized health and safety hazards? Are there health and safety risks that may be anticipated and addressed based on knowledge or experience with similar worksites in the organization? What are the mechanisms for reporting and responding to perceived health and safety threats? How effective are these mechanisms? What are the mechanisms and channels for communicating about workplace health and safety? How effective are they? Examples of the types of physical factors supporting employee health that an environmental assessment can be used to observe include:

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Setting Overall site layout number of buildings (freestanding or connected), square footage (internal), acreage (external how big is the campus for things like walkability), traffic patterns Meeting and multipurpose rooms Grounds and Parking Lot Stairs/Elevators Appropriate noise level, lighting, ventilation, ergonomics, and safeguards for machines and equipment Communication about Health & Wellness Signs/Bulletin board postings about health and wellness Information kiosks Computer and intranet Fitness Environment On-site fitness center including types and condition of equipment Accessibility for bikes/other forms of transportation (e.g., bike racks) Outdoor physical activity options (e.g., walking paths, running trails) Nearby community fitness facilities Shower/Changing room facilities Occupational Health Clinic Staffing

Hours of operation o Facilities Nutritional Environment o Cafeteria hours and selections including price o Vending machine location(s) and selections including price o Break rooms/Eating areas o Nearby restaurants and food retailers Safety Environment o Review of Material Safety Data Sheets (MSDS) o Hazards Inventory including physical (e.g., noise, extreme heat or cold), ergonomic (e.g., repetitive motion), chemical (e.g., gases and vapors), biological (e.g., animals and plants), and psychosocial (work load; hours worked) hazards o Job specific safety training Safety Equipment (e.g., fire extinguishers, Automated External Defibrillators [AED]) o Availability and maintenance of personal protective equipment o Training in the use of personal protective or other safety equipment Community Resources (presence/absence of these in close proximity to the worksite) o Sidewalks o Hospitals/Pharmacies o Parks and recreational areas A final component of an environmental assessment includes direct observations of employees in their normal working environment going about their normal routines. These direct observations are important to understand: How employees operate within the physical and social environment. The team may observe issues that went unreported during interviews because employees are too close to their situations How workers interact with managers and each other Where the organizations social norms (e.g., acceptable standards of behavior) are generated and where social support networks exist The level of trust, confidence, and level of employee engagement in the organizational mission and work processes For worksites with established health promotion opportunities, the team can arrange to have the opportunity to see these programs in action6
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Research suggests that employees with the highest health risks are associated with high job demands, low job control and low social support in the work environment. Employee participation and empowerment appear to improve employee health.7 Key things to consider when conducting direct observations:

Vary observation days and times so that they are a more representative sample of employees (e.g., multiple shifts)

Explain to employees the purpose for observing and get their permission before doing so. Remember that employees may alter their normal routines in the presence of an observer Make a list prior to observing key health behaviors of interest such as posture at the workstation, physical intensity of the work, perceived stress levels, or interactions with coworkers and record observations