Community Health Nursing Introduction PDF

Community Health Nursing SANDRA CHISHOLM-FORD  Objectives Define the concepts of community, community health, public health, and population of aggregate; Compare and contrast Community Health Nursing and Public Health Nursing; Examine national and international historic...

Community Health Nursing SANDRA CHISHOLM-FORD  Objectives Define the concepts of community, community health, public health, and population of aggregate; Compare and contrast Community Health Nursing and Public Health Nursing; Examine national and international historical development of community health nursing, Examine the role of health organizations – community, state, national, and international. Explain the effect of the Sustainable Development Goals and Vision 2030 on health care delivery in Jamaica; Discuss the essential public health functions; Identify aggregates in the community with specific health needs; Discuss the laws and regulations related to community health nursing practice in Jamaica  Community Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. WHO (1948)  Community Health  “Community health is a multi-sector and multi- disciplinary collaborative enterprise that uses public health science, evidence-based strategies, and other approaches to engage and work with communities, in a culturally appropriate manner, to optimize the health and quality of life of all persons who live, work, or are otherwise active in a defined community or communities” (Goodman et al, 2014)  Community-based nursing Minor acute and chronic care that is comprehensive, coordinated, and delivered where people work, live, or attend school. (Illness Care) An extension of illness care provided to clients and their families outside the acute care setting.  Aim of Community Based Care To manage acute and chronic health conditions in the community, and the practice is family-centered illness care. Individual needs are met, however, little attention is paid to family dynamics, environmental health, health education, and health promotion  Community-oriented nursing Healthcare provided to either individuals, families, and groups in the community, or to the community as a whole. Its’ primary focus is the health care either of the community or populations (as in public health nursing )or of individuals, families, and groups in a community.  Community health nursing The systematic delivery of nursing care to individuals, families, and communities aimed at promoting, preserving, protecting, and maintaining health. This type of care is directed at individuals, families, or communities and contributes to the health of the population as a whole. (Harkness & Demarco, 2012).  Public Health All organized measures (whether public or private) to prevent disease, promote health, and prolong life among the population as a whole.  Public health nursing Population-based nursing practice which is a fusion of nursing and public health within the context of preventing disease and disability. It involves promoting and protecting the health of the entire community (Harkness & Demarco, 2012).  Health Promotion “The science and art of helping people change their lifestyle to move toward a state of optimal health” (American Journal of Health Promotion, 1989) “The process of enabling people to increase control over, and to improve, their health” (WHO,2014)  Population of aggregate A sub population or a subgroup of a population. The aggregate concept is used in public health to target interventions to these specific groups within a community  Public Health A scientific discipline that includes the study of epidemiology, statistics, and assessment.  Levels of prevention A three level model of intervention based on the stages of disease, designed to stop or reverse the disease process as early as possible, preventing further damage  Primary Health Care Services Both primary care and public health services that are designed to meet the basic needs of people in communities at an affordable cost  Primary prevention Primary prevention include interventions that seeks to promote health and prevent disease from developing. It focuses on two main areas: 1. Health promotion 2. Illness prevention/Risk factor modification  Secondary Health Care Services Services designed to detect and treat disease in the early acute stage It is geared towards health maintenance for patients experiencing health problems  Secondary Prevention Secondary prevention is aimed at identifying disease in its early stage; in order to facilitate the treatment of early onset health problems that if they remain untreated will result in complication and disability. The two areas of focus in this level are: Screening/Early diagnosis Prompt treatment  Tertiary Prevention Tertiary prevention is employed after the disease has already caused illness or injury. The aim is to facilitate the client’s optimal level of functioning despite the illness or injury.  Tertiary Health Care Services Services designed to limit the progression of disease or disability  Tertiary Prevention Includes: Preventing further loss of function in the affected area(s) Preventing loss of function to the unaffected area(s) Restoring functions Monitoring Health Status Promoting Adjustment Providing end of life care Characteristics of Public health Nursing It is a specialty field of nursing Its practice combines public health with nursing It is population focused. It emphasizes on wellness and other than disease or illness It involves inter-disciplinary collaboration It promotes client’s responsibility and self-care  Characteristics of Public Health Nursing Focuses on the health needs of an entire population, including inequities and the unique needs of sub-populations; Assesses population health using a comprehensive, systematic approach Utilizes the multiple determinants of health Emphasizes primary prevention Facilitates interventions at all levels— individuals, families, communities, and the systems that impact their health.  History of Public Health Nursing Early societies practiced public health measures such as: burying wastes away from water supplies developing sewage systems, draining marshes to control communicable disease. Sick persons were cared for at home by their family and community.  History of Public Health Nursing Caregivers were usually women who: cultivated healing herbs, applied poultices, applied heat and cold, immobilized fractures, delivered babies, attended the dead  Four Stages of Community Health Nursing 1. The early home care stage 2. The district nursing stage 3. The public health nursing stage 4. The community health nursing stage  Early Home Care Stage (Before Mid 1800s) For many centuries female family members and friends attended the sick at home. The focus of this care was to reduce suffering and promote healing. The early roots of home care nursing began with religious and charitable groups. Care provided by lay women resulted in high infant and maternal mortality rates  District Nursing (Mid 1800s to 1900) Interventions by Florence Nightingale resulted in the formal organization of visiting nursing or district nursing. District nurses primarily care for the sick and instructed family members on personal hygiene, diet and wholesome living to their patients.  Nightingale referred to them as “health nurse”. District nurses focused almost exclusively on the care of individuals by recording temperatures and pulse rates and gave simple treatments to the sick poor under the immediate direction of a physician. Public Health Nursing Training (1900- 1970) District nursing had broadened its focus to include the health and welfare of the general public, not just the poor Specialized programs such as infant welfare, antenatal and family planning and gave nurses an opportunity for more independent work, and helped to improve nursing education Community Health Nursing (1970 to present) Community health nursing was the broader term referring to all nurses practicing in the community regardless of their educational preparation  Sustainable Development Goals 1. No Poverty - End poverty in all its forms everywhere 2. Zero Hunger - End hunger, achieve food security and improved nutrition and promote sustainable agriculture 3. Good Health and Well-being - Ensure healthy lives and promote well-being for all at all ages 4.Quality Education - Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all  Sustainable Development Goals 5. Gender Equality - Achieve gender equality and empower all women and girls 6. Clean Water and Sanitation - Ensure availability and sustainable management of water and sanitation for all 7. Affordable and Clean Energy - Ensure access to affordable, reliable, sustainable and modern energy for all 8. Decent Work and Economic Growth - Promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all  Sustainable Development Goals 9. Industry, Innovation and Infrastructure - Build resilient infrastructure, promote inclusive and sustainable industrialization and foster innovation 10. Reduced Inequalities - Reduce income inequality within and among countries 11. Sustainable Cities and Communities - Make cities and human settlements inclusive, safe, resilient and sustainable  Sustainable Development Goals 12. Responsible Consumption and Production - Ensure sustainable consumption and production patterns 13. Climate Action - Take urgent action to combat climate change and its impacts by regulating emissions and promoting developments in renewable energy 14. Life Below Water - Conserve and sustainably use the oceans, seas and marine resources for sustainable development  Sustainable Development Goals 15. Life on Land - Protect, restore and promote sustainable use of terrestrial ecosystems, sustainably manage forests, combat desertification, and halt and reverse land degradation and halt biodiversity loss 16. Peace, Justice and Strong Institutions - Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels 17. Partnerships for the Goals - Strengthen the means of implementation and revitalize the global partnership for sustainable development  Vision 2030 Goal 1: Jamaicans are empowered to achieve their fullest potential Goal 2: The Jamaican society is secure, cohesive and just Goal 3: Jamaica’s economy is prosperous Goal 4: Jamaica has a healthy natural environment  Principles of Public Health Focus on the aggregate Promote prevention Encourage community organization Practice the ethical theory of the greater good Model leadership in health Use epidemiologic knowledge and methods (Harkness & Demarco, 2012).  Dimensions of Health There are seven dimensions of health and each dimension impacts our ability to thrive.  Although many are healthier in some areas than others, research suggests that improving health in one dimension can have a positive effect on other dimensions as well.  Dimensions of health Physical - the ability to open our minds to new ideas and experiences that can be applied to personal decisions, group interaction and community betterment.  Dimensions of health Social - the ability to relate to and connect with other people in our world. Our ability to establish and maintain positive relationships with family, friends and co-workers contributes to our Social Wellness.  Dimensions of health Intellectual - The ability to open our minds to new ideas and experiences that can be applied to personal decisions, group interaction and community betterment. The desire to learn new concepts, improve skills and seek challenges in pursuit of lifelong learning contributes to our Intellectual Wellness.  Dimensions of health Emotional - The ability to understand ourselves and cope with the challenges life can bring. The ability to acknowledge and share feelings of anger, fear, sadness or stress; hope, love, joy and happiness in a productive manner contributes to our Emotional Wellness  Dimensions of health Spiritual - The ability to establish peace and harmony in our lives. The ability to develop congruency between values and actions and to realize a common purpose that binds creation together contributes to our Spiritual Wellness.  Dimensions of health Occupational - the ability to get personal fulfillment from our jobs or our chosen career fields while still maintaining balance in our lives. Our desire to contribute in our careers to make a positive impact on the organizations we work in and to society as a whole leads to Occupational Wellness.  Dimensions of health Environmental - the ability to recognize our own responsibility for the quality of the air, the water and the land that surrounds us. The ability to make a positive impact on the quality of our environment, be it our homes, our communities or our planet contributes to our Environmental Wellness.  Health promotion Health promotion is geared at making people healthier by reducing their chance of developing certain health condition. This is achieved through three methods: 1. Education 2. Political Activism 3. Immunization  Risk factor modification Smoking Obesity Hypertension Safety precautions  Essential Public Health functions Monitoring, analysis, evaluation of health status to solve health problems Public health surveillance Health promotion and social participation Policy formulation & analysis that support individual and community effort Laws & regulations enactment, monitoring and enforcement Equitable access to care  Essential Public Health functions Human resource development( Assure a competent workforce ) Quality assurance - Evaluate effectiveness, accessibility, and quality of personal and population-based health services Research for new insights and innovative solutions to health problems Disaster management and mitigation  Aggregate Population with common characteristics and common concerns A group of people who share one or more personal or environmental characteristics  Populations of aggregate Children Women Pregnant & lactating women Men Elderly  Special needs of children Immunization Proper nutrition Protection from abuse  Components of community health practice Promotion of health Prevention of health problems Treatment of disorders Rehabilitation Evaluation  Settings for community nursing practice Facilities – There are five Types of health care facilities in the community nursing practice Standard of care for each setting – This is determined by the services offered. Highest standard of care is expected from all facilities offering service Services provided at each setting Role & functions of staff at each facility Factors affecting community based care & community health nursing practice  Public health laws & regulations in Jamaica An act to make provision for promoting the public health and for preventing the spread of communicable and epidemic diseases Cover the areas of health and safety Was first passed February 21, 1985 Last amended in 1996  Immunization Regulation 1986  Parents of children under seven years of age must see to it that these children are immunized.  Parents must ensure that their children are immunized within one year of their birth with further immunization being done whenever this becomes due. Under normal circumstances, any breach of these rules is a criminal offence and parents are liable to a fine and in default of payment, imprisonment  Immunization Regulation 1986 Children entering school must show immunization certificate It is an offence to admit a child of less than seven years to school unless the parent produces a certificate proving that the child has been immunized. Any one who authorizes the admission of a child under this age who is not immunized, is guilty of an offence and is liable to a fine and in default of payment, imprisonment.  Immunization Regulation 1986 Child care and protection act An Act to Provide for the care and protection of children and young persons and for connected matters. Passed on March 26, 2004 last amended in 2009  The Public Health (Tobacco Control) Regulations, 2013  This is the primary piece of legislation governing tobacco control in Jamaica.  The law establishes smoke free places and large graphic health warnings on tobacco product packaging, among other things.  The regulations were amended by the Public Health (Tobacco Control) (Amendment) Regulations, 2014.  Reference Anderson, E. T. McFarlane, J. (2008). Community as partner. Philadelphia: Lippincott Williams & Wilkins Clarke, M.J. (2002). Community Health Nursing (Caring for population) 4th Ed. New Jersey: Prentice & Hall Green, Lawrence W.; Mckenzie, James,F. (2002) Encyclopedia of Public Health Stanhope, M. & Lancaster, J., (2002). Foundation of Community Health Nursing. Missouri: Mosby  Ministry of Justice(1986). Public Health Act. Retrieved fromhttp://moj.gov.jm/sites/default/files/laws/ Public%20Health%20Act.pdf WHO (2014). Public Health. Retrieved from http://www.who.int/trade/glossary/story076/e n/ WHO (2014). Health Promotion. Retrieved from http://www.who.int/topics/health_promotion/e n/