Overview of Community Health Nursing PDF

Community Health Nursing Overview of community health nursing Zagazig University -Faculty of Nursing -0- Community Health Nursing Overview of community health nursing Overview of community health nursing Outlines   The...

Community Health Nursing Overview of community health nursing Zagazig University -Faculty of Nursing -0- Community Health Nursing Overview of community health nursing Overview of community health nursing Outlines   The historical development of community health nursing  Definition of health, community health, and community health nursing  Aim of community health nursing  Factors affecting the health of any community  Factors influencing the development of community health nursing  Characteristics of community health nursing  Settings of community health nursing practice  Differentiate between hospital nurse and community nurse  Role of the community health nurse Learning objectives By the end of this lecture, the student will be able to:  Identify the historical development of community health nursing.  Define health, community health, and community health nursing  Identify aim of community health nursing.  List the factors affecting the health of any community.  Discuss the factors influencing the development of community health nursing.  Explain the characteristics of community health nursing.  List settings of community health nursing practice.  Differentiate between hospital nurse and community nurse  Discuss the role of the community health nurse. Zagazig University -Faculty of Nursing -1- Community Health Nursing Overview of community health nursing  Historical development of community health nursing: Community health nursing is a specialized form of registered nursing that combines nursing and public health principles. According to the American Public Health Association, the primary focus of public health nursing is improving the health of the community as a whole rather than just that of an individual or family. Public health nursing traces its roots to England, Florence Nightingale assisted in organizing district public health nursing. The specialty of community health nursing developed historically through four stages: 1. The early homecare stage (before the mid-1800s) emphasized care to the sick poor in their homes by various lay and religious orders. 2. The district nursing stage (mid-1800s) included voluntary home nursing care for the poor by specialists or "health nurses" who treated the sick and taught wholesome living to patients. 3. The public health nursing stage (1900-1970) was characterized by an increased concern for the health of the general public. 4. The community health nursing stage (1970 to the present) includes increased recognition of community health nursing as a specialty field, with focus on communities and populations.  Some definitions:  Health: A positive state of well-being that is felt physically, mentally, socially and spiritually. Or it is a positive quality of life which helps us to live life to its fullest.  Community: Group of people living in a certain locality such as a village, who have a village, who have common interests. They meet and react with one another. Zagazig University -Faculty of Nursing -2- Community Health Nursing Overview of community health nursing  Public Health: The science and act of preventing disease and prolonging life by using available resources in the community and involving the community members in efficiency.  Community health: The state of health of the members of the community, the problems affecting their health and the health care provided for the community.  Community Health Nursing: A field of nursing practice that blends knowledge and skills from both the nursing and the public health sciences and applies them to the promotion of optimal health for the total population.  Community Health Nurse: Registered nurse that work in conjunction with numerous Health District programs, such as case management, and many community partners. She provides home follow up care, immunizations for homebound patients, health education and referral of clients to appropriate agencies for assistance.  Aim of Community Health Nursing:  To promote health and efficiency.  Prevention and control diseases and disabilities.  Need based health care to prolong life.  Factors influencing the development of community health nursing:  Advanced technology.  Progress in causal thinking.  Changes in education.  The changing role of women.  The consumer movement.  Economic factors. Zagazig University -Faculty of Nursing -3- Community Health Nursing Overview of community health nursing 1. Advanced Technology Advanced technology has contributed in many ways to shaping the practice of community health nursing. For example, technologic innovation has greatly improved health care, nutrition, and lifestyle. 2. Progress in Causal Thinking Progress in the study of causality, particularly in epidemiology, has significantly affected the nature of community health nursing. The germ theory of disease causation was the first real breakthrough in control of communicable disease. A second advance in causal thinking was called attention to the interactions among a causative agent, a susceptible host, and the environment. 3. Changes in Education Changes in education, especially those in nursing education, have had an important influence on community health nursing practice. When people's understanding of their environment grows, an increased understanding of health usually is involved. Education has led to more responsibility. 4. Changing Role of Women The changing role of women has profoundly affected community health nursing, Women today have more education and consequently more influence than before. Although the diversity of career options and employment opportunities for women has been a positive factor, these gains have decreased the number of women entering nursing. 5. Consumer Movement and Changing Demographics The consumer movement also has affected the nature of community health nursing. Consumers have become more aggressive in demanding quality services and goods. Changing demographics, such as shifting patterns in migration, numbers of births and deaths and rabidly increasing population of elderly persons, affect community health nursing planning and programming efforts. Zagazig University -Faculty of Nursing -4- Community Health Nursing Overview of community health nursing 6. Economic forces Many economic forces have affected community health nursing practice. Unemployment and the rising cost of living, combined with mounting health care costs, having resulted in numerous people carrying little or no health insurance. With limited or no access to needed health services, these populations are especially vulnerable to health problems and further economic stress. Economic factors continue to play a significant role in shaping community health nursing practice.  Factors that affect the health of any community:  Physical factors  Social and cultural factors  Community organization  Individual behavior 1. Physical factors  Geography: A community health problem can be directly influenced by climate (humidity, temperature).  Environment: The quality of our environment is directly related to the quality of our stewardship over it (Water, soil, and air).  Community size: The larger the community the greater it's range of health problems and the greater its health resources.  Industrial development: Industrial development, like size, has either positive or negative effects on the health Status of a community. Zagazig University -Faculty of Nursing -5- Community Health Nursing Overview of community health nursing 2. Social and cultural factors:  Social factors: Are those that arise from the interaction of individuals or groups within the community, e.g. rural areas has health problems and low resources  Cultural Factors ''Beliefs, traditions, and prejudices'': The beliefs of those in a community about such specific health behaviors as exercise and smoking. The tradition of specific ethnic groups can influence the types of food, restaurants, and bars in community. Prejudices in one specific ethnic or racial group against another can result in acts of violence and crime e.g. black and white.  Religion: A number of religions have taken a position on health care e.g. address moral e.g. prevent AIDS.  Socio-Economic status (S.E. S): Segments of the community with the lowest socio-economic status also have the poorest health and the most difficulty in gaining access to health care. 3. Community organization: The way in which a community can organize its resources directly influences its ability to intervene and solve problems, including health problems. 4. Individual behavior: The behavior of the individual member of a community contributes to the health of the entire community.  Characteristics of community health nursing: Eight characteristics of community health nursing are particularly salient to the practice of this specialty: 1. It is a field of nursing. 2. It combines public health with nursing. 3. It is population focused. 4. It emphasizes prevention, health promotion, and wellness. 5. It promotes client responsibility and self-care. 6. It uses aggregate measurement and analysis. 7. It uses principles of organizational theory. 8. It involves inter professional collaboration. Zagazig University -Faculty of Nursing -6- Community Health Nursing Overview of community health nursing 1. Field of Nursing The two characteristics of any specialized nursing practice are knowledge and skills, and focus on a particular set of people receiving the service. These two characteristics are true for community health nursing. As a specialty field of nursing, community health nursing adds public health knowledge and skills that address the needs and problems of communities and focuses care on communities and vulnerable populations. 2. Combines Public Health with Nursing Community health nursing is grounded in both public health science and nursing science, which makes the nature of its practice unique. It has been recognized as a subspecialty of both fields. 3. Population Focused Community health nursing shares this essential feature: It is population focused, meaning that it is concerned for the health status of population groups and their environment. 4. Emphasizes Prevention, Health Promotion, and Wellness In community health nursing, the promotion of health and prevention of illness are of first-order priority. These include services to mothers and infants, prevention of environmental pollution, school health programs, and "workers' right-to-know" hazards in the workplace. Another distinguishing characteristic of community health nursing is its emphasis on positive health, or wellness. 5. Promotes Client Responsibility and Self-Care The goal of public health, "to increase quality and years of healthy life and eliminate health disparities" requires a partnership effort. The goals of public health cannot be realized without consumer participation. Independence and feelings of self-worth are closely related. By treating people as independent adults, with trust and respect, community health nurses help promote self-reliance and the ability to function independently. Zagazig University -Faculty of Nursing -7- Community Health Nursing Overview of community health nursing 6. Uses Aggregate Measurement and Analysis The need to collect and examine data on the entire population under study before making intervention decisions is fundamental to community health nursing in a public health practice. Analyses of health states, environmental factors, and health-related services are among the many foci of community health research and evaluation. 7. Uses Principles of Organizational Theory Community health nursing uses principles from organizational theory to provide effective administration of health care services. The organization and administration of such services that enables practitioners to ultimately address community needs. 8. Involves inter professional collaboration Community health nurses must work in cooperation with other team members, coordinating services and addressing the needs of population groups. This inter-professional collaboration among health care workers, other professionals, and clients is essential in establishing effective services and programs. Inter-professional collaboration is important in individualized practice, since nurses need to plan with the physician, social worker, physical therapist, teacher, or counselor and must keep them informed of the client's health status; however, it is a greater necessity when working with population groups.  Settings of community health nursing practice: These settings can be grouped into five categories: 1. Homes 2. Outpatient department (ambulatory service settings) in the health institutions 3. Occupational health setting (factories, cottage industries) 4. Social institutions (schools, Prisons, Orphanages) 5. The community at large Zagazig University -Faculty of Nursing -8-  Community Health Nursing Overview of community health nursing  Key Difference between Community Nurse and Hospital Nurse: Hospital Nurse Community Nurse Hospital health nurses are Community nurses are designated to a population-focused or oriented. specific region and also provide various skills according to the particular needs of the specific community. Unit of service has a single focus: Unit of service has a double focus: small the individual hospitalized patient group, family. The nurse is concerned with subgroups of people or subgroups in the or patients in a ward unit. community. Focused on treatment and care of Focused on promoting health, also maintain sick and on restoring the a degree of balance toward health, early detection of disease, and also measuring care individual’s balance towards (restorative, facilitation, and rehabilitation. health. Hospital nurses can communicate A community nurse is solely responsible for their findings to the physician for a patient’s care and may take independent decisions according to the patient’s managing the patient’s care. condition such as referral. Hospital nurses directly can contact A community nurse can work alone. the physician. Hospital nurses deliver health Community nurses deliver health services in services in hospital settings. the community (versus hospital) settings such as health centers, schools, homeless shelters, or senior centers. Hospital nurses usually follow up A community nurse usually follows up with with some specific hospitalized multiple patients every day and may often travel from one home to another. patients. A hospital nurse may care for a They have the opportunity to build long- definite patient once in the whole term relationships with the community patients and may visit several times in a life of that patient. week or month. Zagazig University -Faculty of Nursing -9- Community Health Nursing Overview of community health nursing  Roles of community health nurse:  Direct care provider  Educator  Counselor  Advocate  Manager  Researcher  Referral 1. Direct care provider This role involves the direct delivery of care, performing tasks or skills for which the nurse has been trained e.g. (client assessment, taking vital signs, giving medication, changing dressing, and inserting cannula or catheter). 2. Educator Health education is an important component of quality nursing care. It is the most significant role of community nurse, teaching individuals, families and groups about maintenance of health threats to health, and relevant lifestyle choices that affect health. Nurses should consider such factors as the client's developmental stage, learning readiness, language, educational level, and learning needs. Additionally, the nurse should evaluate learner's level of understanding accurately and reinforce accordingly. Various tools (written materials, visual aids, and models) and techniques (demonstration, observation, and repetition) should be incorporated in teaching plan. Zagazig University -Faculty of Nursing - 10 - Community Health Nursing Overview of community health nursing 3. Counselor The nurse here listens to clients and their families encourage them to explore issues and options, and enable them to manage their personal situation. Assistance with identification of problems and possible solutions and guidance through the problem-solving process. 4. Advocate A nurse advocate is one who acts on behalf of, intercedes, for the client. Frequently, clients particularly children, elderly people, and the disadvantaged are unable to obtain needed care and services within today's health care system. Advocates ensure that clients receive necessary care and services. In community settings, the nurse's role as an advocator is vital, because the nurse often work with vulnerable population. For example, the school nurse identifies a source of funding to pay for eyeglasses for the child whose parents cannot afford them. 5. Manager Nursing care in both hospital and community settings involves management of nurses time, limited resources, other personnel, and program organization and coordination, as well as the management of the clients care. The management role includes planning, organizing, coordinating, marketing, controlling and evaluating care and care delivery. 6. Collaborator Through interaction, discussion, and coordination, goals are set and a plan of care is formed to meet this goal. The nurse must work with other health providers to deliver the most comprehensive, effective, cost conscious care possible. For example, caring for stroke victim may involve collaboration between physician, nurse, physical therapist, occupational therapist, speech therapist, and possibly others in hospital and community settings. Zagazig University -Faculty of Nursing - 11 - Community Health Nursing Overview of community health nursing 7. Researcher Nurses must remain informed of developments that are relative to their individual practice. They should critically review research findings for merit and applicability to practice and determine care accordingly. 8. Referral Referral resources through:  Obtain information on community resources.  Determine the need for and appropriateness of referral.  Follow up on the referral. Zagazig University -Faculty of Nursing - 12 - Community Health Nursing Overview of community health nursing References McKenzie, J. (1994). An introduction to community health. P. 8. McEwen, M. (2002). Community based nursing: An introduction. (2nd ed). Elsevier science (USA). P.p.15-20. Mengistu, D., Misganaw, E. (2006). Community Health Nursing book, University of Gondar In collaboration with the Ethiopia Public Health Training Initiative, The Carter Center, the Ethiopia Ministry of Health, and the Ethiopia Ministry of Education. Mona, M. (2016). Major Difference Between Hospital Nurse and Community Nurse. Available at http://nursingexercise.com/hospital- nurse-community-nurse/ Stanhop. M. and Lancaster.J. (2000). community health nursing, (4th ed.). United States of America, on Hoffmann press company. Therithal info. (2018-2023). COMMUNITY HEALTH NURSING. Available at https://www.brainkart.com/article/Community-Health- Nursing_37848/ Warner, K.D. (2013). History and evolution of community health nursing. Available at https://www.researchgate.net/publication/305428662_History_and_evolut ion_of_community_health_nursing Zagazig University -Faculty of Nursing - 13 - Community Health Nursing Overview of community health nursing Quiz 1) Define health, community health, and community health nursing. 2) Enumerate factors affecting health. 3) Give an account on characteristics of community health nursing. 4) Apply the roles of community health nurse on any community health problem you select. Zagazig University -Faculty of Nursing - 14 -