mmunity health nurses for practicing community health nurses. Martin and Scheet state that prior to the development of this classification system in the early 1970s, Visiting Nurse Associations throughout the country had no systematic scheme for patient problems.
The developed system, now used by VNAs throughout the country, classifies patient problems into four categories:
(1) environmental problems; (2) psychosocial problems;
(3) physiological problems; and (4) health-related behaviors. Each type of problem falling into each category is listed along with signs and symptoms related to identifying the entire scope of the existing problem situation.
An excellent example of the work of a visiting nurse using the Omaha Problem Classification Scheme is provided by Martin and Sheet (1994) in the case of a nurse (Jan Smith) working with a Vietnamese patient (Dhun Ziong) who had been exposed to Hepatitis B just prior to the delivery of her second child.
The nurse's case write-up is presented in Table 1. As can
Case Write-up Using Omaha VNA Classification System
DOMAIN CLIENT DATA
-----------------------------------------------------------------
Environmental Dhun exposed to confirmed case of Hepatitis B. Renting small, two-rom basement apartment. Apartment is crowded and cold. House needs repairs, especially furnace. PROBLEMS/SIGNS/SYMPTOMS: Sanitation: potential/family. Residence: deficit/family; inadequate heating/cooling; cluttered living space
Psychosocial Moved to United States 8 months ago without extended family. Has church sponsor. Fluent in Vietnamese; little English. PROBLEMS/SIGNS/SYMPTOMS: Communication with community resources; impairment/family. Unfamiliar with options/procedures for obtaining services; language barrier.
Mother held newborn, Bo, for part of visit. Handled adequat...