Community & Public Health Nursing

Community Health Nursing

• Encompasses caring for individual clients in a community setting.
• Considers social justice and equity.
• Ensures vulnerable individuals have easy access to healthcare.
• Utilizes nursing, social sciences, and public health knowledge to promote health, prevent disease, and protect populations.

Public Health Nursing Focus

• Public health nurses concentrate on the health of populations.
• Strive to prevent disease and disability, often in collaboration with community groups.
• Involves working with community members, assessing community needs, and implementing public health functions.

Factors Increasing Life Expectancy

• Improved sanitation and other public health activities
• The control of infectious diseases through immunizations and sanitation.

Nurse Entrepreneurs

• Nurse Entrepreneurs receive private funding.
• Community health nursing roles are generally provincially or federally funded.

Population Health Measurement

• Measured through health status indicators.
• This includes health outcomes as measured by social determinants of health

Essential Components of "Health for All" Goal

• Basic needs
• Belonging and engagement
• Healthy living
• A functioning health system.

Primary Health Care Definition

• Essential care universally accessible to individuals and families within a community.
• Also includes promotion of self reliance that occurs at a cost that the community can afford.

Community Health Nurse Focus

• Focused on community-oriented and systemic perspectives.
• Also focused on entire at risk population and applying nursing processes to them.
• Understands the entire community context, and identifies which groups are at the highest risk for problems.

Advocacy

• Provides a voice for client concerns.
• Achieved through active participation in community action groups.

Interprofessional Collaboration

• Effectively fulfilled by attending meetings at various health agencies.
• It requires effective implementation.
• Broader than recreation.
• Considers individual concerns less important than aggregate priorities.

Resource Allocation Decisions

• Best determined by choosing what best serves the needs of the aggregate (entire community)
• Needs of the larger population outweigh individual needs.

Public health nurse focus

• Assesses the services and effectiveness of the school health clinic.
• A population-focused approach considers all children receiving care, to assess services' effectiveness in improving the health of the school population.

Prevention Levels

• Primary prevention: involves influenza vaccinations.
• Secondary prevention: involves infant car seat safety screening programs.
• Primary prevention activities to seek to prevent the occurrence of disease

Health Promotion and Thinking

• Upstream thinking: Involves a macroscopic, big-picture population focus.
• Downstream thinking: Involves a microscopic, individual curative focus.

Study of Nursing History

• Allows one to understand that history is a director for current and future community health nursing practice.
• Provides direction to guide nursing strategies.

Early Hospitals

• Religious orders established hospitals in the Middle Ages to care for the aged, disabled, orphaned, sick, and neglected.
• Historically, people were responsible for their own healthcare services.

Industrial Revolution Impact

• The Industrial Revolution shifted earlier caregiving approaches as families, friends, and neighbours became inadequate to meet increasing demands.
• Also urbanization demanded transportation, communication, and increased mobility.

Florence Nightingale

• Revolutionized healthcare by establishing the discipline of nursing.
• Her work led to the development of modern nursing practices and standards of care.

Eunice Dyke

• Pioneer decentralizing public health nursing in 1914.
• Previously, public health nurses specialized in areas like tuberculosis care.

Early Visiting Nurses' Success

• They provided economical care to families by seeing more families.
• Provided care irrespective of the clients location at home, work, or school.

Kathleen Russell

• Instrumental in establishing the first integrated basic degree nursing program in Canada in 1920.
• It involved public health nursing education.

Lillian Wald's Argument

• Convinced the Metropolitan Life Insurance Company to establish the first community health nursing program in 1909.
• Argued that it would be more economical for the company to employ nurses instead of paying higher taxes to the city.
• Keeping workers healthier increases their productivity.

CHNAC's Achievement

• Published the national standards of practice for CHNs in 2003.
• Established the term "community health nursing".
• Also defined minimum scope of practice for CHNs.

Romanow Report

• Identified home care as the most rapidly growing area of community health care in 2002.

Early PHNs Job

• Involved in tuberculosis education, prevention, and treatment

Nurse Practitioner Programs

• The nurse practitioner model educational program was short-lived mostly caused by lots of primary care doctors

Manitoba in 1917

• First province in Canada to establish a public health nursing service.

Community health

• Public health in Canada takes a population health approach to protecting and promoting health and preventing disease to all Canadians.

Public health education

• Public health nurses in Canada are required to have Baccalaureate degree.

Public Health Competencies

• Skill in developing policy and planning programs to improve health is a core competency for PHNs.
• Divided into core public health competencies

Community Health Nurse Responsibilities

• Work with community members, public health partners, and stakeholders.
• Involve collaborative partnerships as essential to a community health nurse

Preventative action

• Health and hygiene (hand washing)
• Preventing communicable disease: primary prevention.
• Tracing Sexual health in potential health risks with sexually transmitted disease clients: This is secondary prevention activity.
• Reducing or preventing serious illnesses relates to mental health concerns

Parish nurses

• Found in faith congregations.
• Affiliated mostly with diverse types of religion

Home health care

• Differs from other types of providing healthcare.
• Differs in that home healthcare practices in the client’s environment

Levels of comprehension

• By working with clients to help them identify their strengths, the pastoral care aspects of practice are enhanced.

Hospice Care

• Delivery of palliative care: for comforts to very ill and dying.

Public Health Nurse

• Enlists high school role models.
• This is high level of action to prevent, for junior high school kids sports or scholarship abuse against drug abuse
• They partner with community for programs. Also address the illegal usage and effects of the drugs and alcohol to educate children.
• Preventation is secondary if using screening which isn’t appropriate for setting here

Upstream Thinking

• Use a big, macro picture focusing on bigger populations.
• While downstream thinking is a microscope focusing on the individuals current curative functions

The Ottawa Charter on Health Promo

• Focuses on definition of health, incorporated into daily activities.
• Consists of helping reach a complete state of physical, social and mental wellbeing.

What does Health promo focus on?

• Enabling increased determinants of health
• Improving all health resources for better outcome

Epps framework supported

• Canadian framework for health, through community and policy focus.
• Through active community action, strengthened services and organized policy

Starting of Application

• Population health has starting point, focusing determinants of health

Behavior

• Contemplation stage, changing is different.
• In planning action the thinking about changing and the next 6 months.
• Lack of readiness

Canadian Community Health Nursing Standards

CHN’s roll is advocate creating public policy and supporter of influence policy

• Includes immunization and baby safety

Community Mobilization Framework

• Identify social planning and help communities of change process by themselves.

Best improved idea about community health

• Implementing help towards decisions of health

Canada Population Health Promotion

• Focuses on the determinants/foundational concepts of health.
• In contrast to individual health promotion
• The USA has foundation concepts of health

Ethical Categories

• Nightingale pledge, nurse follows ethics. First code of ethics. LYSTRA GREETER 1893.

Ethical Dilemma

• When nurses go to supervisors
• Ethically CNH must account for decisions cannot rely on anyone else

Ethical Action

• The appreciation best, for family needs.
• That family makes the informed choice to take no action

Ethical Dilemma

• A CHN has personal belief against the clinic
• Nurse refers clients and assists with service. If he for she needs additional support

The CHN

• Focuses on duties ethics in deonthological and obligations

Community Ethics

• Utilitarianism : stress from the whole families needs.

1. CHNS care of the community and inter community consider tradition and interactions.
2. The principle of beneficence includes doing good for the ill of families and non maleficence that all are caring and equal.

Interventions in Health

• Includes all action synchronization and values
• Principles can be conflicting in health care, ethical principles.

What Is Home Care?

• Care is applied providing clients in a setting/home type
• The location, setting will matter as a aspect

Nurses with community health nurses care must have

1. Open attitude for welcome difference

Nurses must have skill to:

1. Intergrade cultural awareness
2. Skill for techniques considerations in terms of body touches and facial and language expressions

Safe environment entails

1. Understanding others' health and beliefs

When there is overt racism

1. Superiority over each other occurs.

While health statement practices

1. Can differ but it can be the same in which they should be as they are and don’t change

Community

1. Has no care.
2. Must seek assistance first from client

In Canada's health

• Involves the influences biology and what lifestyle could have better health

Community Health Nurses

1. Must work for a good and effective environment

Evidence Based Practices in Healthcare Settings

• First need to formulate a clinical answer to a clinical question
• The needs to access is the challenging element for the action

Ethical Codes - What They Include:

• Client experience values

Improve research

1. Increased source and knowledge in the community.

What is the best way

1. Form the question to why so, there is a problem why to resolve it with data available and evidence found.

Multiperspective Evidence

• Nursing practice, people, mileau

Implementation

1. Is best in which the health education is needed

Evaluation

1. What is the best thing to measure which has effectiveness and goals

• This stage of nursing includes evaluating the intervention, identifying objectives and the measurement of the effects.

Community/Environment

1. Is in order to maintain ethical framework

Program Planning

• The ultimate goal is that to ensure high comparable effectiveness.

Program Planning

• A comprehensive goal ensures equitable, suitable and effective care available.

Assessment for Nursing Client Concern

• Assesses the future goals for the needed care needed.

Community Health Nursing Needs

• Should recognize the prestige to have a helpful altercations.

Managed Community needs- to ensure it the area has

1. Care for the client for what we are needed

A healthy community contains

1. All residents and no issues are seen

A community partnership

1. Has health action and improvement

Health Programs

• Should be planned to reduce the needs for financial services.

Best way to help someone?

1. Have them talk about the situation first.

Community Health

• Is based off community health assessments.

Community health nursing focuses on individual care within a community context, emphasizing social justice and healthcare access for vulnerable populations. Public health nursing targets population health, disease prevention, and community collaboration. Factors such as sanitation and immunization have increased life expectancy.