Community Health Clinical Family Assessment Project Assignment

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Community Health Clinical Family Assessment Project Guide


Family Assessment Project Guide

*** Add all Health Assessment Tools to Appendix for full credit – 20 clinical hours

I. Introduction to this family
Member Age Sex Designate husband, wife, etc.** In Introduction introduce the family, identify chronic or long-term illness for one family member and specify present status of the illness.

II. Setting

A. Neighborhood

• Perform a brief windshield survey of selected family’s neighborhood.
• Give a brief overview of the neighborhood. (How does it look?)
• Identify positive and negative aspects of this neighborhood:
• Identify if establishments and resources are close by for the family (Post office, grocery, church, drugstore, community center, etc.)
 How does the family utilize these resources?

**List recommendations for any negative aspects identified.

B. Home Assessment Check List (hint: relate how chronic illness has affected)
• Include in appendix
• Include the pertinent findings and analysis AEB (as evidenced by)
• A list of recommendations

III. Family Function

This section’s purpose is to guide the nurse in the collection of data that will result in a synthesis of family function as described by strengths and weaknesses, functional and dysfunctional behaviors.

A. Genogram – Add Genogram to Appendix and create a key or legend).

Stanhope & Lancaster (2016) p. 611. See Video in Module 3 for Instructions.

• Include 3 generations (i.e., self, siblings, parents, aunts, uncles, grandparents, children of client, children of siblings, etc.)

• Identify risk factors, predominant family patterns, family relationships, and boundaries, strengths / weaknesses & significant hereditary conditions.

B. Psychosocial & Developmental – may use this format in paper assignment

1. Developmental Tasks – Individual family members – developmental tasks met? [Erikson=s]
*ED= Educational level

Name Age ED* Developmental Tasks Evidence of met/not met




• Address effect of individual development on family health

2. Social/Leisure: List social support, hobbies, recreational activities.

• Address how social/leisure needs are being met along with any recommendations.

3. List Financial Resources:
• Address income adequacy, effectiveness of management and expenses – housing, food, healthcare/medications, insurance) along with any recommendations

4. Family Development – Add Family Apgar with Score to Appendix

a. Family communication:

• Address how effective the patterns, power and boundaries are related to family functioning.
• Also include the tone of the family communication with any recommendations.
b. Family stage of development – Stanhope & Lancaster (2016) pp. 606-607/Table 27-1.
• Identify the stage that this family is presently in and include the specific tasks.
• Justify your assessment and evidence of tasks being met/not met. Include recommendations.
c. Extent of emotional support for family members:
• Complete a Family Apgar and document the Family Apgar score. Include both in Appendix
• Summarize the meaning of the findings and recommendations.
d. List internal and external Coping strategies utilized by the family
• Include at least two defense mechanisms used Stanhope & Lancaster (2016) p. 627 Table 28-1.
• Identify the effectiveness to reduce stress. Also, include any recommendations.

May use completed chart of family roles in family assessment paper, if desired.

e. Family roles:

Formal Role Role model Performed by Adequacy

f. Informal Family Roles:

Member initials AEB (or example)















For ex. family roles and Informal roles
• Identify role overload and use of informal roles that are not promoting growth for the family with any recommendations.

IV. Health Assessment

• Briefly describe the family’s perception of their health status.
• Identify the family’s cultural beliefs and influences on health, use of home remedies, folk remedies, self care practices.
• Identify the family’s source/s of health care and any barriers to obtaining health care.
• Discuss the cost of illness (economic, time, emotional) on the individual and the family as a whole.

B. Health Promotion Activities (Complete Health Promotion Checklist – Add to Appendix).

• Report any pertinent findings along with any recommendations.
C. History and Review of Systems – Add to Appendix

• Complete the history form and ROS on 1 adult family member with chronic illness. Include any hazards r/t occupation (if any), immunizations, meds, drug interactions etc].

• Summarize pertinent findings along with recommendations.

D. Activities of Daily Living – Add to Appendix

• Form found in Stanhope & Lancaster (2016) Appendix E-1 p. 1048.
• Complete the assessment guide and add to the Appendix.

• Report the score, identify implications along with any recommendations.
E. Family Nutrition – Add Nutrition Checklist and Nutritional Assessment Tool to Appendix

• Complete the Nutrition checklist and family nutritional assessment tool –
Stanhope & Lancaster (2016) p.146.
• Report the nutritional score.

• Summarize below pertinent findings r/t nutritional assessment including conclusions & recommendations for change.

F. Medication Assessment – Add to Appendix

• Complete medication forms on 1 adult family member’s medications (member with a chronic illness) and include in appendix.
• No more than 10 medications. Medications Forms found in next page.
• Summarize medication risks/recommendations for change, include any safety issues.

G. Spiritual Assessment – Using information gathered from Module 4 Spiritual assessment.
• Briefly summarize your analysis…add impact of family’s religion/spirituality/faith influences, if any on health, health behaviors, and family dynamics.

Medication Assessment

Patient #1 Name:

Disease states:

Acute illnesses requiring medications

Drug allergies:

 Drug
How long client has taken
Exp. Date Strength/Directions

Self-med practices
Side/adverse effects

Assessment of client’s understanding of this medication:

 Drug
How long client has taken
Exp. Date Strength/Directions

Self-med practices
Side/adverse effects

Assessment of client’s understanding of this medication:

Medication Assessment

 Drug
How long client has taken
Exp. Date Strength/Directions

Self-med practices
Side/adverse effects

Assessment of client=s understanding of this medication:

 Drug
How long client has taken
Exp. Date Strength/Directions

Self-med practices
Side/adverse effects

Assessment of client’s understanding of this medication:

Medication Assessment

Client #2 Name:

Disease states:

Acute illnesses requiring medications

Drug allergies:

 Drug
How long client has taken
Exp. Date Strength/Directions

Self-med practices
Side effects/ adverse effects

Assessment of client’s understanding of this medication:

 Drug
How long client has taken
Exp. Date Strength/Directions

Self-med practices
Side/adverse effects

Assessment of client’s understanding of this medication:

Medication Assessment

 Drug
How long client has taken
Exp. Date Strength/Directions

Self-med practices
Side/adverse effects

Assessment of client’s understanding of this medication:

 Drug
How long client has taken
Exp. Date Strength/Directions

Self-med practices
Side/adverse effects

Assessment of client’s understanding of this medication:

**May use Table for paper assignment. Insert Table under level one heading- Remove this heading prior to adding document.

V. Comprehensive Family Nursing Diagnoses:
Identify all dx that apply to this family; prioritize all dx; give rationale for how top 5 were prioritized.

Family Assessment Project

Family Diagnoses (list all & prioritize)
Rationale for Top 5 DX











**May use Table for paper assignment. Insert Table under level one heading- Remove this heading prior to adding document.

VI. Local Referrals/Community Resources:
Complete the chart below. Include a copy of any pamphlet / handout in appendix. The Rationale should include how this community resource applies to the family, which family diagnosis it addresses, and the cost involved.

Family Assessment Project SAMPLE APA FORMAT

Family Assessment

Your Name


My family is a family of 4. Husband has diabetes and lost his job over 4 months. The wife works part time. They are raising  a granddaughter who has a baby.

The living in a middle class neighborhood in Houston Texas


                                                             Family Assessment Project

Paragraph one is the introduction to the paper.  It should begin with something that will grab the reader’s attention and provide a citation to support your opening sentence.  According to McGuinness and McElroy (2016), xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx. Next, support that opening sentence with discussion or explanation  4-6 sentences, which will make up the body of the introductory paragraph.  The last sentence of the introduction should highlight areas to be covered in the paper (the purpose statement).      

                                                                    Setting   Paragraphs at least 4 sentences long! No Quotes!


Use as many headings as necessary to organize your paper. Short papers may only have first-level headings. Longer papers may require more organizational detail with subtopics. See your APA Manual, page 62, for instructions on formatting multiple levels of headings (APA, 2010).

Home Assessment

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                                                          Family Function  

Genogram    5-6 sentences


Cite Genogram within your text and add as Appendix B and so on………..

Psychosocial and Developmental       (Note level 3 headings are lowercase with a period.)

Developmental tasks.     (May use Table of tasks in project guide)  

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Financial resources.


            Family communication.

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Family developmental stage.

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            Emotional Support.

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Coping strategies.

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Family roles.

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                                                             Health Assessment

Health Promotion

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Activities of Daily Living

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Family Nutrition



Medication Assessment                                            


Spiritual Assessment


Family Nursing Diagnosis 

          Complete table and Insert Page 9 of project guide


                                                    Community Resources

                    Complete table and Insert page 10 of project guide




Most papers should end with a short paragraph that summarizes key points of the paper. See rubric for required content for summary.  Do not add new material not covered in the paper.  No matter how much space is left on the page, the reference page has its own page. Sdufhgfghufhdifvhdifgdfibghdfibhfdibhfgiobhfgobhfogbhfihbfiysafcydsfcaydfcyafcyfcydfcayfcysdfcysdfcysufudsfsdugudgd.


**Note proper spacing – double space between headings and sentences

Proof-read your paper prior to submission!




References (centered – not bold)

American —————————————————————————————–

McGuinness, ————————————————————————- 48(1), 33-38. doi:10.3928/02793695-20091204-05

You next reference…….

Must have at least 3 current/scholarly sources from Professional Journals -required for this assignment.

 See below

Each Tool is added to the Appendix and has its own page and label!  DO not clump tools together.  Add an Appendix Label and title only if the tool does not already have one.

(Add Appendix Label  A)                      Appendix A                             B.B.  (Client’s initials)

Home Assessment Checklist  

General Household

  1. Is there good lighting available, especially around stairwells?
  2. Are there handrails (which can be easily grasped) on both sides of the staircases, designed to indicate when top and bottom steps have been reached
  3. Are top and bottom steps painted in easily seen colors? Are nonskid treads used?
  4. Are the edges of rugs tacked down? (Suggest the use of “wall-to-wall carpeting).
  5. Is a telephone present? Does the telephone have a dial that is easily readable? Are emergency numbers written in large print and kept near the telephone?
  6. Are electrical cords, footstools, and other low-lying objects kept out of walkways?
  7. Are electrical cords in good condition?
  8. Is furniture arranged to allow for free movement in heavily traveled areas?
  9. Is furniture sturdy enough to give support?
  10. Is furniture designed to accommodate easy transfers on and off?
  11. Is the temperature of the home within a comfortable range?
  12. If fireplaces or other heating devices are present, do they have protective screens?
  13. Are smoke detectors present (especially in the kitchen and bedroom)?
  14. Are rapidly closing doors eliminated?
  15. Are there alternative exits from the house? List them
  16. Are basements and attics easy to get to, well lighted, and well ventilated?
  17. Are slippers and shoes in good repair? Do they fit properly and have nonskid soles?
  18. Are there loose extension cords, small sliding rugs, and slippery linoleum tiles present? (Suggest the use of rubber-backed, nonskid rugs and nonskid floor wax).
  19. Is the cooking stove gas or electric?
  20. Are there large easily readable dials present on the stove or other appliances, with the “on” and “off” positions clearly marked?
  21. Are refrigerators in good working order? Are refrigerators placed on 18-inch platforms to avoid bending over?
  22. Are spaces for food storage adequate? Are shelves at eye level and easily reachable?
  23. Is a sturdy stepladder present for reaching?
  24. Are electrical circuits overloaded with too many appliances?
  25. Are electrical appliances disconnected when not in use?
  26. Are sharp objects (such as carving knives) kept in special holders?
  27. Are cleaning fluids, polishes, bleaches, detergents, and all poisons stored separately and clearly marked?
  28. Are kitchen chairs sturdy, with arm rests with high backs?
  29. Is the stove free from flammable objects?
  30. Are potholders available for removing pots and pans from the stove?
  31. Is baking soda available in case of fire and easily accessible?


  1. Are there grab bars in the bath, in the shower, and around the toilet?
  2. Are toilet seats high enough to get on and off of without difficulty?
  3. Can the bathroom door be easily closed to ensure privacy? Do doors lock? (If so, is a key readily available?)
  4. Are the bathroom doorways wide enough for easy wheelchair and walker access?
  5. Are there nonskid rubber mats in the bath, in the shower, and on the floor?
  6. Is there good lighting in the area of the medicine cabinet? Where is the medicine cabinet located (best in a well-lit non-humid area)?
  7. Are internal and external medications stored separately? And safely (especially important with young grandchildren present in the house)?
  8. Do medication containers have childproof tops? Are they labeled in large print? Is a magnifying glass present for reading medication instructions?
  9. Have all outdated medications been discarded?
  10. Do you notice any medication (both prescription and over-the-counter) that could cause adverse side effects or drug-drug interactions that the client is unaware of?
  11. Can the water temperature be easily regulated?
  12. Are electrical cores, outlets, and appliances a safe distance from the tub?
  13. Are razor blades kept in a safe place?
  1. Is a first aid kit available? Where is it kept?


  1. Is there adequate lighting from the bedside to the bathroom?
  2. Are lights easily accessible? (If not, suggest keeping a flashlight by the bedside or using a flashlight for entry into dark rooms if light switch is not within easy reach).
  3. Are beds in good repair?
  4. Are beds at the proper height to allow for easy transfer on and off without difficulty?
  5. Do bedroom rugs have nonskid rubber backings?

From Tideikssar R; Ritter Department of Geriatrics and Adult Development: New York. 1983. The Mount Sinai Medical Center

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