Community Health Nursing Practice PDF
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This document presents an overview of community health nursing, highlighting its principles, components, and practice settings. The text includes concepts like policy development and service provision within different community contexts, such as health centers and home visits.
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The Community Health Nursing 2. P olicy development ommunity Health Nursing (CHN) is oneofthefields C...
The Community Health Nursing 2. P olicy development ommunity Health Nursing (CHN) is oneofthefields C gathered information as a basis of local & of nursing. The term is used interchangeably with s tate health policies public health nursing in the Philippine s ettings. It 3. Assurance indicates s imilarities yet presents distinctive Ability of public health agencies & private ideologies, visions and philosophies utilized in the providers to m anage health c oncerns & practice. You were introduced with this term in the respond to c ritical s ituations & c ourse CHN 1 which is pre-requisite of this c ourse emergencies CHN 2. Experts defines CHN in different perspective. Settings for CHN services heAmericanNursesAssociation(inFamorca,et.al., T ou were given an opportunity to explore the Y 2013) defines c ommunity health nursing as a “ c ommunity during the exposure CHN 1 c ourse . I s ynthesisofnursingpracticeandpublichealthpractice believeyouhavem eta c ommunityhealthnursefrom applied to promoting and preserving the health which, in the Philippines and other developing populations”.Theunderlinedwordsfocusontheuseof c ountries is usually employed by a public health nursing knowledge in providing service to society. agency which c ould either be a government, heemphasisonthisc ourseCHN2,isthec ommunity T s emi-governmentorprivateinstitutions.Sheisusually as a c lient or the general public. Therefore, public assigned in a c ommunity, usually a town, c ity or health nursing will be highlighted on the following m unicipality with s patial boundaries. The nurse discussions. Publichealthnursingisdefinedas“field implements varied roles in practice s ettings and of professionalpracticeinnursingandinpublichealth provide range of s ervices with the goal of promoting in which technical nursing , interpersonal, analytical the health of the different level of clientele. and organizational s kills are applied to public as they he nurse’s work base is usually a health c enter T affect the c ommunity ( Freeman, in Famorca et.al., where s he provides s ervices to c lients and patients 2013). It is an organized , legislative and tax-support like pre-natal c heck-up, well-baby or general c linicfor efforts that s erved all people through health s ick c ases.Inadditiontoc linic/healthc enters ervices, department and other related government the nurses deliver services in the following venues : organizations. Thepurposeofwhichistoimprovethe health of the public. . c 1 lients/patients’ homes 2. s chools pecifically, Public health nursingdealsisanchored S 3. industrialestablishmentorplaceofworkss uch on the following activities : as factories p reventing disease 4. others ettingwheres ervicesisneededs uchas pr olonging life m arket or rice fields where accidents m ay promoting health & efficiency through occur. organized community effort The core public health functions are as follows : 1. A ssessment regular c ollection, analysis & information s haring on health c onditions, risk & resources of the community 1 Level of Clientele forthec hildreninadayc arec enterwiththepurposeof alleviating hunger and m alnutrition among pre-school s a s tudent nurse, you are going to portray varied A c hildren. rolesinpractices ettingsandproviderangeofs ervices with the goal of promoting the health of the different hethree(3)c haracteristicsbasictopositivec oncept T level of c lientele. Thefollowingarethes pecificc lients of health are as follows : of the nurse : 1. R eflects c oncerns for the individual as a 1. INDIVIDUAL totalpersonratherthanasm erelythes um s pecific c lients/patients in various of various part; c onditions of health & illness 2. place health in the c ontext of the from healthy/well to the dying environment; all ages from birth to senescence 3. equates health w/ productive & c reative 2. FAMILY living. 2orm oreindividualjoinedorrelatedbyties of blood, marriage or adoption HEALTH AS A SOCIAL PHENOMENON w/ respective familial roles & m aintain a c ommon culture ou have s een in your the c ommunity during your Y 3. G ROUP/AGGREGATES previous c ommunity exposure that health affects These are the population with c ommon primarily the physical well-being of people in the unique health needs s ociety.Thes ocial,economic,political,intellectualand E.g. child bearing women, infants s piritual development of the c ommunity and the c ountry m ay affectthepeople’sliferegardlessoftheir G roupthatareatriskofdevelopingorhave health c ondition. An example of which is economic developed certain health problems globalization and privatization of hospital & health facilitiesthatdisruptedthehealthofthepeoples inceit E.g. pre-diabetic clients c auses the increase of m edical expenses which 4. C OMMUNITY prohibit the society to avail regular health services. Share c ommon interest, needs, ethnic or c ultural ties HEALTH AS A BASIC HUMAN RIGHTS E.g. squatters community of Metro Manila ealth accessibility and equality are essential human H rights. It is a reflection of s ociety’s c ommitment to P lace w/ s patial boundaries, physical & equityandjustice.Healths houldprevailovereconomic environmental c haracteristics w/ natural & andpoliticalc oncerns.Anexampleisthec ommitment m an-made resources of the Philippine government in c reating an interim E.g.Barangay, vilage/barrio, town, province, agenciess uchastheInter-AgencyTaskForce (IATF) to alleviate the people’s c ondition or eradicate the Concept of Health as a Community Perspective COVID 19 . Health s hould not be discriminatory and s hould not be limited to groups regardless of their incethefirstprofessionalc ourseinnursinginlevel1, S race, religion, gender, age and s ocio-economic you were introduced withvariousdefinitionsofhealth c onditions. as an evolving c oncept. The W orld Health O rganization (WHO) defines health as “ a s tate of c omplete physical, m ental and s ocial well-being and HEALTH AS A PERSONAL & SOCIAL RESPONSIBILITY not m erely the absence of disease or infirmity”. It ealth is a c ollective effort to ensure that everyone H describes health in s ocial dimensions rather that gets every health c are due to them. Being a m edical terms. Social health pertains to c ommunity responsible m ember of s ociety, one s hould c onsider vitality and is a result of positive interaction among thewelfareofothersbesidesourselves.Theindividual groups withinthec ommunitywithemphasisonhealth is responsible to one’s s tate of health, to family & promotionandillnessprevention.Anexampleofwhich s ociety.Meanwhile,thegovernmentrepresentedbythe isac ommunitygroupsthats ponsorafeedingprogram 2 epartment of Health ( DOH) ensurestheaccessto D 1. Income & social status public health s ervices & establish health c are the greater gap between the richest & the programs to regulates activities of the Filipinos. An poorestpeople,thegreaterthedifferencein example is that the people s hould refrain from health indulging himself to reckless and inconsiderate 2. Education habits/vicess incethec ostofhealthc areisbecoming low education levels are linked w/ poor expensive everyday health , m ore s tress & lower s elf-confidence here are various c onditions that affect the health of T 3. Physical environment the community as a whole. These are as s afe water, c lean air, healthy workplaces, follows : PLSS s afe houses, c ommunities and roadsm ay c ontribute to good health 1. P eople 4. Employment & working conditions demographic profile of the population c onducive working c onditions lead to a affects health healthier employee population variable : s ize, density, 5. Social support networks c omposition, rate of growth or decline, families, friends & c ommunities s upport is c ultural c haracteristics, m obility, s ocial linked to better health c lass & educational levelS D C ROGD CC M SC EL 6. Culture g. A population c omposing of bigger Customs, traditions & beliefs of family & working groups ( ages 21- 45 years old) c ommunity may affect health hasthehighprobabilityachievingeconomic 7. Genetics development inheritance plays part in determining 2. Location lifespan, healthiness & likelihood of natural & man-made variables developing diseases geographic features, climate, flora & fauna 8. Personal behavior & coping skills c ommunity boundaries whether it is urban Good nutrition, indulging to physical or rural, the quality of air, soil & water activities, c essation of s moking & alcohol g.Environmentc onditionsofpeoplelivingin drinking connotes better health outcome the rural areas is better thatthatofpeople 9. Genetics living in as lumc ongestedareaintherural inheritance plays part in determining c ommunity. lifespan, healthiness & likelihood of 3. Social System developing diseases patterneds eriesofinterrelationshipexisting 10.Personal behavior & coping skills between individuals, groups and institutions Good nutrition, indulging to physical pertains to the family, economic, activities, c essation of s moking & alcohol educational level, c ommunication, political drinking connotes better health outcome and legal s ystem, religion, recreational, 11.Health services health system equitable & accessible health s ervices g. A c ommunity with recreational facilities c ontributes to health promotion & disease s uch as basketball c ourt or playgroundfor prevention c hildren m ore likely for the population to 12.Gender exhibit good health m en & women experience disease at Determinants of Health and Diseases different stages in life he attainment of c ommunity’s health s tatus is T affected by numerous factors. Specifically, the following are the determinants of health with c orresponding explanation on how they affect the health.. There are examples given in each factor. 3 Philosophical and Theoretical Framework of 4. C HNbelievesintheprimacyofhealthasa Community Health Nursing Practice goal and as an essential element that ommunity health nursingutilizespractice-basedand C affects the quality of life of individuals, evidenced-based s trategies and approaches in its families, groups and communities. practice. The philosophy and theoretical framework 5. The goal of nursing c are is independence guidestoandbasesforawell-directed,purposive,and and s elf-reliance in health c are for the s ystematic engagementofac ommunityhealthnurse. different levels of c lientele. The nurses in In order to understand fully these c oncepts, the the c ommunity believes in the c apacity of definitions of each term is established. thepeopletoc hangeforthebetterprovided that they will be given the proper hilosophy focuses on the natureofhumanlife and P information, motivation and assistance. reality (McEwen,W illis,2019).Itisas etofs ystemof 6. CHN as field of nursing recognizes the beliefs that provides basis and guide for action. relationship of non-health problems to healthproblems,andtheroleofnon-health heoretical framework refers to the basic s tructure T interventions in the s olution of health of ideas, beliefs and principles being followed in the problems. An example of this is the practiceofaprofession(Bailon-Reyes,2006). CHNis occurrence of poverty that m ay lead to the totality of its philosophy and theories to m aintain m alnutritionduetoinabilityofthefamiliesto the high standard of practice. s ecure nutritious food and inaccessible In this lesson, we will be discussing about the information due to infrastructure problems. philosophicalandtheoreticalbasesofCHNpractice.In 7. The c ommunity health nurse works with, ordertoengageyourselfinthediscussion,youneedto not for, the different c lientele. She/he use your imagination about the role of a c onsiders the people as active participant c ommunity/public health nurse. fordecisionm akingandc areprocess,and not as a passive recipient of care. ailon-Reyes ( 2006) provides the discussion of the B 8. Nursinggoalsands tandardsofc ares hould philosophical beliefs thatguidethepracticeofCHN. c onsider c onstraints imposed by c lients, These are as follows: health agency and c ommunity resources. 1. N ursing is uniqueanddistinctc omponents Basically, c oncerns of nurses in the ofhealthc are.Thenurseinthec ommunity EFFICIENT c ommunity pertains toresources.Theuse s hares its discrete roles and functions to of indigenous resources in the c ommunity otherm embersofthehealthteaminc aring particularly in the rural areas is one of the for the different levels of c lientele c ompetencies of community health nurses. particularly, the individual c lients/patients, 9. CHN practice is not a body or s et of the families, aggregates and the c ommunity. s ame repeating tasks. The c ontent, The uniqueness ofCHNaimstoachievea approach and priorities in practice of a better heath outcome of the clients. c ommunity health nurse isbasedonc lient 2. CHN is interdependence among health needs and s etting where health s ervices professions. CHN deals with the are being delivered. m ulti-facetedhealthproblemsofthec lients. 10.Nurseshavetheresponsibilitytokeeptheir She/heworksc ollaborativelywithm embers knowledgeands killsc urrentanduptodate ofthehealthteamandm ulti-sectoralteams accordingtodevelopmentinnursing,health in the s pirit of team work using team andrelateds ciences.Nurses houldbelife- approach to provide quality health services. long learner where they s hould attend 3. As a s pecial filed of nursing, CHN s hares s eminars and c onferences on trends and the humanistic beliefs and values of the issuesc onfrontingthenursingpracticeand nursing profession. The nurses in the the community. c ommunitybelievesinthedignityofhuman beings and respects the rights of every individual clients and families. 4 Thefollowingares omefeaturesandc haracteristicsof xpert caringin nursing practice : e 1. E xpert c aringisbothanartandas cience. Nursing as an art reflects the innate c reativity of the nursewhileperformingthe nursing interventions. Meanwhile, s cience-based nursing practice utilizes a m ethodological and logicalapproachinthe c are of c lients. An example is the use of nursing process. 2. Expertc aringdemonstratesthehumanistic aspects of c are that form the c ore of ommunity health nursing utilizes the c oncept and C nursing philosophy which are universally principlesofnursingandpublichealthinpractice.The accepted as basic element ofgoodquality proposed theoretical framework (Figure1)defines c are. A nurseemploysthepersonaltouch, the following : OBJECTIVE: PREVENTION human kindness, c ourtesy, respect, 1. T he level of clienteleofthecommunity c ompassion, empathy and the TLC ( health nurse tender, loving, care). angels of mercy”. The c are focused on the needs of the 3. Expert c aring in nursing is c omprehensive individual, family, groups and the in s cope. The c are of the c lients 2. T he objectives of care encompass health promotion, preventive, The practice of CHN focuses on c urative and rehabilitative nursing actions. prevention. 4. Expert c aring is individualized.Itc onsiders 3. T he methodology of practice theuniquenessofthec lientsinthepractice The nursing process is utilized inthec are of nursing care. of four level of clientele. 5. Expert c aring provides holistic c are. 4. Priorities for care Nursing focuses on the totality of c lients’ The c ommunity health nurse utilized the needs based on physical, psycho-social risk approach to identify the priorities of and spiritual dimensions. c are. It pertains to delivering the c are to 6. Expert c aring demonstrates s killful those at greater risk of developing the m inistration inpractice.Thenurseisadept disease or other health problems and demonstrate dexterity in the 5. Approach to health care delivery performanceofnursingandrelatedm edical The c ommunity health nurse is part ofthe procedures. health team with s pecific roles and 7. Expert c aring involves a m utual, dynamic functionsintheachievementofthegoalfor and active interchange of m eaning, c ommunity health development. c oncerns, perceptions, emotions, biases, knowledge and s kills between the c lients/patients and the nurse. Expert Caring in CHN 8. Expert c aring is efficient. The nurse is expected to provide a quality c aretoc lient hes cienceofnursinghasgrownanddevelopedover T despite of the limitations in resources. the years. You have learned from the theoretical 9. Expertc aringfocusesonnursingc oncerns foundationofnursingduringyourfirst-yearlevelinthe and responsibilities asaprofession,onits’ BSN program that caring is the c ore of the nursing independent functions and put primacy in practice. Expert nursing c are provided by a theperformanceofnursingc areratherthan professionalnurseisac ombinationofthec ompetence just the implementation of m edical plan of and c haracter that pertains to c ompassion, human c are. kindness, concern and empathy. 5 10.Expertc aringincludesm aintenanceofhigh 3. P articipates in the implementation of the s tandard of acre and delivery of quality m unicipal health plan. nursing services to the public at all times. 4. Implements the nursing care plan. 11.Expert c aring realizes the c ollaborative 5. Monitors and evaluatestheimplementation effort with other m embers of the health of the nursing service plan. team and to other intra/intersectoral teams. 6. Initiates c hanges for the improvement of 12.Expert c aring appreciates the importance s ervices. of leading an exemplary personal and 7. Manages the RHU in the absence of the family life, practicing what one preaches Rural health physician (RHP). andprovidingarolem odelofhealthfulliving B.Training to the community. midwives, students, TRAINEES 1. P articipates in m eeting the training needs he m entioned features and c haracteristics of expert T of m idwives, s tudent affiliates and other c aringisimportantfortherealizationofthec ommunity trainees. health nurse’s roles and functions in the c are of the 2. Prioritizes the needs of the Rural health different level of clientele. m idwives (RHM)thatc anbeaddressedby training. Different Fields of Community Health Nursing in the 3. Conducts a s taff education program or Philippines c aching sessions. 4. Evaluates effects of trainings on work In the Philippine s etting, m ajority of c ommunityhealth performance. nurses works in the health c enters as publichealth C.Supervision EVALUATES and MAINTAINS nurses, industrial c ompanies as occupational health nurses and school nurses. . F 1 ormulates the supervisory plans for RHM. 2. Implements the supervisory plan. he law as a basis of the role and functions is T 3. Monitors and evaluates the m idwives’ embodiedinRepublicAct973otherwiseknownasthe performance in the implementation of Philippine Nursing law. Likewise, it is defined by the public health programs. different professional organizations s uch as the 4. Maintains records and reports. Philippine Nurses O rganization (PNS), Inc., O ccupational Health Nurses Association of the D.Provision of health and nursing care Philippines (OHNAP) and the National League of PhilippineGovernmentNurses (NLPGN)andagencies 1. Identifiesthehealthneedsandproblemsof s uch as the Department ofHealthandDepartmentof individual, families and communities. Education (DepED). 2. Formulates the nursing/ health care plan. IDENTIFY, FORMULATE, COORDINATE,3. Coordinates with individual, groups and IMPLEMENTATION, EVALUATION agencies for resource assistance in Public Health Nursing (PHN) implementing the health care plan. 4. Implements the health care plan. The PHN , together with otherm embersofthehealth 5. Evaluates the nursing interventions and team, are the implementers of the local government other c omponents of c are provided to the unit’s m andate in promoting and protecting thehealth individual, families and communities. of their constituents. E.Health Education pecifically, the following are the functions and S activities of the PHN : medications, preparation, organizer, . Identifies the client’s needs for education. 1 MONITOR implementation, improvement, 2. Conducts health education activities. A. M anagement absence of physician. 3. Assesses the effects of health education 1. Plansandorganizesthenursingunitofthe activities on the capabilities of the clients. RHU/BHC. 2. Participates in the preparation of the m unicipal health plan. 6 F.Coordination REFERRAL 1. Identifies person, groups, organizations, other agencies and c ommunities whose resources are available within and outside thec ommunityandwhichc anbetappedin the implementation of individual, families and community health care. 2. Refers to other health personnel, health facility or government agency. O ccupational Health Nursing (OHN) The duties and responsibilities of O HN are grouped ccording to the following : CPPEA a urative/palliative c preventive educative administrative functions The major areas of concerns includes the following : mergency and palliative care e family planning nutrition counseling immunizations environmental sanitation disaster preparedness and control work safety orientation of the new employees dissemination of health information School Nursing his field of CHN practiceaimstopromotethehealth T ofthes choolpersonnelandpupils/students.Majorityof the role of s chool nurses focus on health advocacy, health promotion, disease prevention and early detection of disease. Specifically, the school nurse performs the following : 1. h ealthandnutritionassessment,s creeningand c ase-findings 2. treatmentofc ommonailmentsandattendingto emergency cases 3. c ounseling and health education 4. perform nursing procedures 5. s upervision of health and s afety of s chool personnel 6. referrals and follows of pupils/students and personnel seeking health services to the clinic. 7
