Community Health Nursing Definition & Concepts PDF

Definition of Community Community. Seen as a group or collection of locally-based individuals, interacting in social units and sharing common interests, characteristics, values, and or goals. A. Allender – “A collection of...

Definition of Community Community. Seen as a group or collection of locally-based individuals, interacting in social units and sharing common interests, characteristics, values, and or goals. A. Allender – “A collection of people who interact with one another and whose common interests or characteristics form the basis for sense of unity or belonging.” B. Lundy and Janes. A group of people who share something in common and interact with one another, who may exhibit a commitment with one another and may share geographic boundary.” C. Clark. A group of people who share common interests, who interact with each other, and who function collectively within a defined social structure to address common concerns.” D. Shuster and Goeppinger. “A locality- based entity. Composed of systems of formal organizations reflecting society’s institutions, informal groups and aggregates. Maurer and Smith further addressed the concept of community and identified Four defining attributes: 1. people 2. place 3. interaction 4. common characteristics, interests, or goals. 2 types of community Geo-political communities are defined or formed by both natural and man-made boundaries and include barangays, municipalities, cities, provinces, regions, and nations. May also be called Territorial communities. Phenomenological communities refer to relational , interactive groups, in which the place or setting is more abstract , and people share a group perspective or identity based on culture, values, history,  Definition of Health  WHO – “ a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”  In the mid 1980”S WHO expanded the definition of health. Thus health is “the extent to which an individual or group is able, on one hand, to realize aspirations and satisfy needs, and on the other hand to change or cope with the environment , Health is, therefore, seen as a resource for everyday life, not the objective of living: it is a positive concept emphasizing social and personal resources, and physical capacities (WHO,1986)   Murray – “ a state of well-being in which the person is able to use purposeful, adaptive responses and processes physically, mentally, emotionally, spiritually, socially.”  Pender – actualization of inherent and acquired human potential through goal- directed behavior, competent self-care and satisfying relationship with others.”  Roy – “ The individuals total well-being the regular patterns of people and their environment that result in maintaining wholeness and human integrity”  Greiner – State of physical, mental,spiritual, and social functioning that realizes a person”s potential and is experienced within a developmental context” Health as a Human right As stated by Dr. Ghebreyesus, WHO Director-General “ the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion ,Political belief, economic, or social condition (WHO ,2017)  Models of Health 1. Clinical Model Health is the absence of signs and symptoms of disease and illness 2. Role Performance Model – The society is preoccupied with expectations on how one should perform at work, within the family and society. Failure to fulfil these roles means illness. 3. Adaptive Model – Health is dynamic state. An individual is considered to be healthy if he/she was able to adjust positively to social, mental, and physiological changes. Illness exist when the person failed to cope. 4. Eudemonistic Model – an elevated level of wellness suggests optimal health and illness is reflected by a lack of vitality. This model highlights the interactions between physical , social , psychological, and spiritual facets of life. Modern concept of health  Refersto optimum level of functioning of individual , family, community optimum level of health (OLOF) is influenced by the Ecosystem  Ecosystem Factors: Socio-economic status Hereditary factor Health care delivery system Activities and behavior Political factors Environmental factors Determinants of health Income and social status Education Physical Environment Employment and working conditions Social support networks Culture Genetics Personal behavior Health services Gender  Indicators of Health and Illness  National epidemiology center of the department of health, the national statistics Office , and the local health centers/offices/departments provide mortality, morbidity and other health status-related data  Local health centers/offices/departments are responsible for collecting morbidity and mortality data forwarding the information to the higher level health facility. Mortality illustrate health status of a community and/or population because changes in mortality reflect a number of social, economic, health service and related trends.  Community health nurses should participate in investigative efforts to determine what is precipitating the increased disease rate and work to remedy the identified threats or risks What is NURSING?  Assisting sick individuals to become healthy and healthy individuals achieve optimum wellness.  Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings.  Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles. (ICN, 2002)  Community health nurses have a level of autonomous function, meaning they can make independent decisions within their scope of practice. Some key aspects of their autonomous function include:Assessment and Diagnosis: They independently assess the health needs of individuals, families, and communities, identifying risk factors and health problems.Planning and Implementation: They develop and implement care plans or interventions to address identified health needs. This includes health education, preventive care, and managing chronic conditions.Health Promotion and Disease Prevention: Community health nurses engage in activities like Definition and focus of public health and community health Dr Charles Edward Winslow defines Public Health as the “the science and art of preventing disease, prolonging life, promoting health and efficiency through organized community effort for: A. sanitation of the environment, B. control of communicable diseases, C. education of individuals in personal hygiene , D. organization of medical and nursing services for the early diagnosis and preventive treatment of disease, E. development of the social machinery to ensure everyone a standard of living adequate for the maintenance of health, so organizing these benefits as to enable every citizen to realize his birth right of health and longevity.”   WHO define Public Health as “the art and science of preventing disease, prolonging life and promoting health through the organized efforts of society” (Acheson, 1988; WHO)  A key phrase in the definition of public health is “ through organized community effort” The term public health connotes organized,legislated and tax-supported efforts that serve all people through health departments or related governmental agencies. exxxx 3 Primary functions of public health  1. Assessment. Regular collection, analysis, and information sharing about health conditions, risks, and resources in a community.  2. Policy development. Use of information gathered during assessment to develop local and state health policies and to direct resources toward those policies  3. Assurance. Focuses on the availability of necessary health services throughout the community. It includes maintaining the ability of both public health agencies and private providers to manage day-to-day operations and having the capacity to respond to critical situations and emergencies. Public health efforts focus on Prevention of population health at the national and local level Promotion National level – concentrates on providing support and advisory support Local level - provide direct services to communities through two avenues 1. Environmental health services, which protect the public from hazards such as polluted air and water and tainted food. 2. Personal health care services such as immunization and family planning services, well infant and maternal care, treatment- prevalent health conditions, both communicable and non communicable.  Public health efforts are multidisciplinary because they require people with many different skills. Community health nurse work with a diverse team of public health professionals , including health officers, midwives and sanitation inspectors. 9 Essential Public health functions  1. Health situation monitoring and analysis.  2. Epidemiological surveillance/disease prevention and control.  3. Development policies and planning in public health.  4. Strategic management of health systems and services for population health gain.  5. Regulation and enforcement to protect public health.  6. Human resources development and planning in public health.  7. Health promotion, social participation, and empowerment.  8. Ensuring the quality the personal and population-based health services.  9. Research development, and implementation of innovative public health solutions. Community Health  The WHO defines community health as the environmental, social, and economic resources to sustain emotional and physical well-being among people in ways that advance their aspirations and satisfy their needs in their unique environment. Primary health care....  Community health refers to the health status of the members of the community, to the problems affecting their health and to the totality of the health care provided for the community. (WHO,1971)  Community health covers a wide range of healthcare interventions, including health promotion, disease prevention, and treatment. It also involves management and administration of care.  AIMS Health promotion Disease prevention Management of factors that affects health 3 levels of prevention  1. primary prevention – prevention of problems before they occur Example; Immunization  2. Secondary prevention – early detection and intervention. Example: screening for STDs, Breast examination , mammography  3. tertiary prevention – Correction and prevention of deterioration of a disease state; Example : health teaching on insulin administration in the home Definition and Focus of Community health nursing. Public health Nursing and community based nursing Public Health Nursing WHO  Public Health Nursing a special field 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 condition in the social and physical environment, rehabilitation of illness and disability. Ruth B. Freeman  a service rendered by a professional nurse with communities, groups, families, individuals at home, in health centers, in clinics, in schools, in places of work for the promotion of health, prevention of illness, care of the sick at home and rehabilitation Jacobson  it encompasses “nursing practice in a wide variety of community services and consumer advocate areas, and in a variety of roles, at times including independent practice. community nursing is certainly not confined to public health nursing agencies Lillian Wald  The term, public health nursing became associated with “public” or government agencies and in turn with the care of the poor people. Community Health Nursing Janet Henrich and Ruth Freeman –  Community Health Nursing as “ an area of human services directed toward developing and enhancing the health capabilities of people-either singly, as individuals, or collectively as groups and communities Ruth B. Freeman  Community health nursing -service rendered by a professional nurse with communities, groups, families, individuals at home, in health centers, in clinics, in schools, in places of work for health promotion, disease prevention, care of the sick at home and rehabilitation Margaret Jacobson Community health nursing is learned practice discipline with the ultimate goal of contributing, as individuals and in collaboration with others to the promotion of the patients, optimum level of functioning through teaching and delivery of care. Dr. Araceli Maglaya, et al.  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. Nisce, Reyala, et al  To raise the level of health of the citizenry by helping communities and families cope with the discontinuities in and threats to health in such a way as to maximize the potential for high-level wellness  Community Health Nursing “ the synthesis of nursing practice and public health practice applied tp promoting and preserving health of the populations (ANA,1980)  Encompasses subspecialties that include public health nursing, school nuring, occupational health nursing and other developing field of practice such as home health, hospice care and independent nurse practice Community based nursing  Refersto the application of the nursing process in caring for individuals, families, and groups where they live, work or go to school, or as they move through the health care system. Standard of public Health nursing practice Standard of care  Standards 1. Assessment.The public health nurse collects comprehensive data pertinent to the health status of population.  Standard 2. Population Diagnosis and Priorities The health nurse analyses the assessment data to determine the population diagnoses and priorities.  Standard 3. Outcomes Identification The public health nurse identifies expected outcomes for a plan that is based on population diagnoses and priorities. Standard 4.. Planning The public health nurse develops a plan that reflects best practices by identifying strategies, action plans and alternatives to attain expected outcomes. Standard 5. Implementation The public health nurse implements the identified plan by partnering with others. Implementation The public nurse implements the identified plan by partnering with others A. Coordination The public health nurse coordinates programs, services, and other activities to implement the identified plan. B. Health Education and Health Promotion The public health nurse employs multiple strategies to promote health, prevent disease, and ensure a safe environment for populations.  C. Consultation The public health nurse provides consultation to various community groups and officials to facilitate the implementation of programs and services D. Regulatory Activities. Revised Feb 28 2008 The public health nurse identifies, interprets, and implements public health laws, regulations, and policies. Standard 6 Evaluation The public health nurse evaluates the health status of the population Standard of professional performance  Standard 7. Quality of Practice. The public health nurse systematically enhances the quality and effectiveness of nursing practice.  Standard 8. Education. The public health nurse attains knowledge and competency that reflects current nursing and public health practice.  Standard 9. Professional practice evaluation. The public health nurse evaluates one’s own nursing practice in relation to professional practice standards and guidelines, relevant, stattutes, rules, and regulations.  Standard 10. Collegiality and professional relationship. The public health nurse establishes collegial partnerships while interacting with representtives of the population, organizations, and health and human services professionals and contributes to the professional development of peers, students, colleague, and other.  Standard 11. Collaboration. The public health nurse collaborates with the representatives of the population, organizations, and health and human services professionals and contributes to the professional development of peers, students, colleague, and other.  Standard 12. Ethics. The public health nurse integrates ethical provisions in all areas of practice.  Standard 13. Research. The public health nurse integrates research findings in practice.  Standard 14. Resource utilization population. The public health nurse considers factors related to safety, effectiveness, cost and impact, on practice and in the planning and delivery of nursing and public health programs, policies, and services.  Standard 15. Leadership. The public health nurse provides ledership in nursing and public health Evolution of Public Health Nursing in the Philippines  1912 Fajardo Act (Act NO. 2156) created Sanitary Divisions. THe President of the Sanitary Division (forerunners of the present Municipal Health Officers) took charge of two or three municipalities. Where there were no physicians available, male nurses were assigned to perform duties of the President, Sanitary Division.  Philippine General Hospital, then under the Bureau of Health sent four nurses to Cebu to take care of mother and their babies. The St. Paul’s Hospital School of Nursing in Intramuros, also assigned two nurses to do home visiting in Manila and gave nursing care to mothers and newborn babies from the outpatient obstetrical service of the Philippine General Hospital. 1914  School nursing was rendered by a nurse employed by the Bureau of Health in Tacloban, Leyte.  Reorganization Act No. 2462 created the Office of General Inspection. Office of District Nursing was organized under this office. Headed by Dr. Rosario Pastor a lady physician and a nurse.  This office was created due to increasing demands for nurses to work outside the hospital, and the need for direction, supervision and guidance of public health nurses.  Two graduate Filipino nurses, Mrs. Casilang Eustquio and Mrs. Matilde Azurin a two graduate Filipino nurses were employed for Maternal and Child Health and Sanitation in Manila under an American nurse, Mrs. G.D. Schudder. health care delivery system  A health care delivery system is the totality of “societal services and activities designed to protect or restore the health of individuals, families, groups, and communities (Banta,1986 in Cookfair, 1996:66). It includes both government and non-government health facilities The World Health Organization is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of health. Vision A world in which everyone can live healthy, productive lives Putting people first Placing health at the center of the global agenda Engaging countries and strengthening partnerships MDG  The Millennium Development Goals (MDGs) commit the international community to an expanded vision of poverty reduction and pro-poor growth, one that vigorously places human development at the centre of social and economic progress in all countries.