Community Health Nursing: An Overview

 Community

  • a group of people with common characteristics or interests living together within a territory or geographical boundary
  • place where people under usual conditions are found
  • Derived from a latin word “comunicas” which means a group of people.
Health
  • OLOF (Optimum Level of Functioning)
  • Health-illness continuum
  • High-level wellness
  • Agent-host-environment
  • Health belief
  • Evolutionary-based
  • Health promotion
  • WHO definition
Community Health
  • Part of paramedical and medical intervention/approach which is concerned on the health of the whole population

 Aims:

  1. Health promotion
  2. Disease prevention
  3. Management of factors affecting health
Nursing
  • Both profession & a vocation. Assisting sick individuals to become healthy and healthy individuals achieve optimum wellness
Community Health Nursing
  • “The utilization of the nursing process in the different levels of clientele-individuals, families, population groups and communities, concerned with the promotion of health, prevention of disease and disability and rehabilitation.” ( Maglaya, et al)
  • Goal: “To raise the level of citizenry by helping communities and families to cope with the discontinuities in and threats to health in such a way as to maximize their potential for high-level wellness” ( Nisce, et al)
  • Special field of nursing that combines the skills of nursing, public health and some phases of social assistance and functions as part of the total public health program for the promotion of health, the improvement of the conditions in the social and physical environment, rehabilitation of illness and disability ( WHO Expert Committee of Nursing)
  • A learned practice discipline with the ultimate goal of contributing as individuals and in collaboration with others to the promotion of the client’s optimum level of functioning thru’ teaching and delivery of care (Jacobson)
  • A service rendered by a professional nurse to IFCs, population groups in health centers, clinics, schools , workplace for the promotion of health, prevention of illness, care of the sick at home and rehabilitation (DR. Ruth B. Freeman)
Public Health
  • “Public Health is directed towards assisting every citizen to realize his birth rights and longevity.”“The science and art of preventing disease, prolonging life and efficiency through organized community effort for:
  1. The sanitation of the environment
  2. The control of communicable infections
  3. The education of the individual in personal hygiene
  4. The organization of medical and nursing services for the early diagnosis and preventive treatment of disease
  5. The development of a social machinery to ensure every one a standard of living, adequate for maintenance of health to enable every citizen to realize his birth right of health and longevity (Dr. C.E Winslow)
Mission of CHN
  • Health Promotion
  • Health Protection
  • Health Balance
  • Disease prevention
  • Social Justice
Philosophy of CHN
  • “The philosophy of CHN is based on the worth and dignity on the worth and dignity of man.”(Dr. M. Shetland)
Basic Principles of CHN
  1. The community is the patient in CHN, the family is the unit of care and there are four levels of clientele: individual, family, population group (those who share common characteristics, developmental stages and common exposure to health problems – e.g. children, elderly), and the community.
  2. In CHN, the client is considered as an ACTIVE partner NOT PASSIVE recipient of care
  3. CHN practice is affected by developments in health technology, in particular, changes in society, in general
  4. The goal of CHN is achieved through multi-sectoral efforts
  5. CHN is a part of health care system and the larger human services system.
Roles of the PUBLIC HEALTH NURSE
  • Clinician, who is a health care provider, taking care of the sick people at home or in the RHU
  • Health Educator, who aims towards health promotion and illness prevention through dissemination of correct information; educating people
  • Facilitator, who establishes multi-sectoral linkages by referral system
  • Supervisor, who monitors and supervises the performance of midwives
  • Health Advocator, who speaks on behalf of the client
  • Advocator, who act on behalf of the client
  • Collaborator, who working with other health team member

*In the event that the Municipal Health Officer (MHO) is unable to perform his duties/functions or is not available, the Public Health Nurse will take charge of the MHO’s responsibilities.

Other Specific Responsibilities of a Nurse, spelled by the implementing rules and Regulations of RA 7164 (Philippine Nursing Act of 1991) includes:
  • Supervision and care of women during pregnancy, labor and puerperium
  • Performance of internal examination and delivery of babies
  • Suturing lacerations in the absence of a physician
  • Provision of first aid measures and emergency care
  • Recommending herbal and symptomatic meds…etc.
In the care of the families:
  • Provision of primary health care services
  • Developmental/Utilization of family nursing care plan in the provision of care
In the care of the communities:
  • Community organizing mobilization, community development and people empowerment
  • Case finding and epidemiological investigation
  • Program planning, implementation and evaluation
  • Influencing executive and legislative individuals or bodies concerning health and development
Responsibilities of CHN
  • be a part in developing an overall health plan, its implementation and evaluation for communities
  • provide quality nursing services to the three levels of clientele
  • maintain coordination/linkages with other health team members, NGO/government agencies in the provision of public health services
  • conduct researches relevant to CHN services to improve provision of health care
  • provide opportunities for professional growth and continuing education for staff development
Standards in CHN
  1. Theory
    • Applies theoretical concepts as basis for decisions in practice
  2. Data Collection
    • Gathers comprehensive, accurate data systematically
  3. Diagnosis
    • Analyzes collected data to determine the needs/ health problems of IFC
  4. Planning
    • At each level of prevention, develops plans that specify nursing actions unique to needs of clients
  5. Intervention
    • Guided by the plan, intervenes to promote, maintain or restore health, prevent illness and institute rehabilitation
  6. Evaluation
    • Evaluates responses of clients to interventions to note progress toward goal achievement, revise data base, diagnoses and plan
  7. Quality Assurance and Professional Development
    • Participates in peer review and other means of evaluation to assure quality of nursing practice
    • Assumes professional development
    • Contributes to development of others
  8. Interdisciplinary Collaboration
    • Collaborates with other members of the health team, professionals and community representatives in assessing, planning, implementing and evaluating programs for community health
  9. Research
    • Indulges in research to contribute to theory and practice in community health nursing

Reference:
Community Health Nursing
Ms. Adel Morong R.N., M.S.N.