Community Health Nursing PDF

Community Health Nursing Community: It is defined as 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. By this definition, geopolitical entities, such as the cit...

Community Health Nursing Community: It is defined as 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. By this definition, geopolitical entities, such as the city of Baghdad, a college of nursing, and a religious congregation can be considered communities. A geopolitical community is one characterized by geographic and jurisdictional boundaries, such as a city. Health It is the state of balance between illness and wellness. It ranges between optimum and potential levels. Population Health: It can be defined as the attainment of the greatest possible biologic, psychological, and social well-being of the population as an entity and of its individual members. The health of population is defined and determined by the perceptions, norms, and values of its members. Characteristics of Healthy Communities 1. Foster dialogue among residents to develop a shared vision for the community. 2. Promote community leadership that fosters collaboration and partnerships. 3. Engage in action based on a shared vision of the community. 4. Embrace diversity among residents. 5. Assess both needs and assets. 6. Links residents to community resources, and 7. Foster a sense of responsibility and cohesion among residents. 1 Nursing: It is a scientific discipline in which a professional nurses can deliver a comprehensive nursing care “preventive, curative, rehabilitative” to individual, family, group and community who share common needs and problems. Aggregates: They are subpopulations within the larger population who possess some common characteristics, often related to high risk for specific health problems. School-age children, persons with human immunodeficiency virus (HIV) infection, pregnant adolescents, the older adults are examples of aggregates. Community Health Nursing (CHN): It is a branch of nursing science which is concerned with the delivery of comprehensive nursing care to individuals, family, group, and community as a whole to meet their needs and solve their problems through the application of nursing process to maintain wellness and prevent illness. Nursing Process and Epidemiology Community health uses the nursing process and epidemiology interchangeably and in an integrative approach. Both share commons with regard to the process through which (assessment, planning, intervention, and evaluation) are employed. The Mission of Community Health Nursing The primary mission of community health nursing is improving the overall health of the population through health promotion, illness prevention, and protection of the public from a wide variety of biological, behavioral, social, and environmental threats. 2 Health promotion and illness prevention in the population may be achieved through interventions directed at the total population or at the individuals, families, and groups that constitute its members. Attributes of Community Health Nursing 1. Population Consciousness Awareness of factors that impinge on the health of populations as well as that of individuals. 2. Orientation to Health Emphasis on health promotion and disease prevention rather than cure of illness. Although community health nurses frequently help clients resolve existing health problems, their major goal is to promote clients’ highest level of physical, emotional, and social well-being. 3. Autonomy (Self-direction) Greater control over health care decisions by both nurse and client than in other settings. 4. Creativity Use of innovative approaches to health promotion and resolution of health problems. 5. Continuity Provision of care on a continuing, comprehensive basis rather than a short-term, episodic basis. 6. Collaboration Interaction between nurse and client as equals; greater opportunity for collaboration with other segments of society. 3 7. Intimacy Practicing in community setting, however, the nurse can get a more accurate picture of the factors that affect clients’ health. The CH Nurse may also become more intimately aware of everyday details of an individual client’s normal life and environment (e.g. the CH Nurse might discover evidence of spouse abuse that might not be uncovered in other health care settings. 8. Variability Community health nurses deal with diverse clients at different levels (individual, family, or population group) and ethnic backgrounds in a wide variety of settings. This variability necessitates a broad knowledge base and providing an exciting area of practice. Roles and Functions of Community Health Nurse Client-Oriented Role 1. Caregiver It involves applying the principles of epidemiology and the nursing process to the care of clients at any level “individual, family, group, or community”. Some functions entailed in this role are assessing clients needs, deriv- ing nursing diagnoses, and planning appropriate nursing intervention. 2. Educator In this role, the community health nurse provides clients and others with information and insights that allow them to make informed deci- sions on health matters. Community health nurses often provide educational services to individ- uals, families, and groups. 4 3. Counselor Counseling is the process of helping the client to choose viable solutions to health problems. In education, one is presenting facts and developing attitudes and skills. In counseling, one is not telling people what to do, but helping them to employ the problem-solving process and decide on the most appropriate course of action. In the role of counselor, CH nurses explain the problem-solving process and guide clients through each step. Referral Resources Referral is the process of directing clients to resources required to meet their needs. These resources may be other agencies that can provide necessary services or source of Information, equipment, or supplies that the client needs and the CH nurse can not supply. 4. Role Model It is someone who consciously or unconsciously demonstrates behavior to others who will perform a similar role. CH nurses serve as role models for a variety of people with whom they come in contact. The CH nurses’ role as a model is not confined solely to influencing the health-related behavior of clients. The nurse also serves as a role model for other health care professionals. 5. Case Manager A case manager is a health professional who coordinates and directs the selection and use of health care services to meet client needs, maximize resources utilization, and minimize the expense of care. Delivery-Oriented Roles They are roles designed to enhance the operation of health care delivery system, resulting in better care for clients. 5 6. Coordinator/Care Manager Coordination is the process of organizing and integrating services to best meet client needs in the most efficient manner possible. Unlike the case manager, the coordinator does not plan the care to be carried out by other health care professionals, but organizes that care to meet clients’ needs as effectively as possible. The functions of CH nurses in this role are: first determining who is providing care to the client. Second one is to communicate with other providers regarding the particulars of the client situation and needs. A simple example of coordinating services for an individual client might involve arranging for appointments in a prenatal clinic and a child health clinic on the same day, when both services are provided at the same location. 7. Collaborator The CH nurse engages in joint decision making regarding action to be taken to resolve client health problems. Collaboration should always take place between nurses and client or a significant other. This may also include other providers. The functions of CH nurse in this role include communication (conveying to other team members his or her perceptions of client needs, factors influencing these needs, and ideas for problem solving. And joint decision making (participation in joint problem-solving efforts, using the problem- solving process with the health care team to identify and evaluate alternative solutions to client problems and to select an appropriate alternative. 6 8. Liaison A liaison provides a connection, relationship, or intercommunication. The liaison role might involve continued communication between client and other providers via the nurse Population-Oriented Roles Are those roles directed toward promoting, maintaining, and restoring the health of the population. 9. Case Finder Case finding involves identifying individual cases or occurrences of specific diseases or other health-related conditions requiring services. In this role, the CH nurses explore the factors contributing to the development of a communicable disease in a specific person. E.g., investigation of cases of food poisoning may uncover unsanitary practices in a local restaurant or contamination of food supplies during processing, leading to the modifications that will prevent illness in others. 10. Leader CH nurse functions in this role include identifying the need for action and leadership, assessing the leadership needs of followers, and selecting and executing a style of leadership appropriate to both the followers and the situation. 11. Change Agent A change agent is one who initiates and brings about change. CH nurses may serve as change agent working with individuals, families, groups, and communities or in health care delivery (e.g. change may be required in the dietary patterns of individual clients or families. Or there may be a need to alter the way a community deals with homeless. 7 12. Community Mobilizer Community mobilization is defined as “a process by which community groups identify common goals and mobilize assets to implement strategies that address local concerns”. The functions of CH nurse in this role include assisting communities to identify health issues of concern and to collect data related to the issue, mobilizing members to action, and assisting with coalition development within the community. 13. Policy Advocate Is a person or group of people who work for and argue on behalf of policy formation or changes in policy that influence the health of population groups. Policy advocate may occur at institutional, community, state, national, or international levels. CH nurse role include determining the need for policy formation or change, developing policy goals, analyzing factors influencing the policy situation, identifying key decision makers involved in policy formation, and assisting in the formulation of proposed policies. 14. Social Marketer Social marketing is the application of commercial marketing technologies to the analysis, planning, execution, and evaluation of programs designed to influence the voluntary behavior of target audiences to improve their personal welfare or that of their society. The functions of CH nurse in this role include identifying a needed change in societal behavior, analyzing behavioral motivations and perceived benefits and barriers to action, identifying particular target markets for interventions, developing and testing strategies to promote the desired change, implementing those strategies to promote the desired change and evaluating their effectiveness. 8 14. Researcher A researcher explore phenomena observed in the world with the intent of understanding , explaining, and ultimately controlling them. The role of CH nurse related to research include critically reviewing relevant researchable problems, designing and conducting research studies, collecting data, and disseminating research findings 9