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Handout Revised)

Handout Revised)

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Published by: Ritamaria on Oct 23, 2011
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COMMUNITY HEALTH NURSING (Handout)
Community Health Nursing:SAFE AND QUALITY CARE, HEALTH EDUCATION, AND COMMUNICATION,COLLABORATION AND TEAMWORK The 3 Broad Concepts
1. What is a
community 
?
a group of people with common characteristics or interests living togetherwithin a territory or geographical boundary
place where people under usual conditions are found
 The community is the object or focus of care in CHN, with the family as theunit of service.
LEVELS of CLIENTELE
: Individual, Family, Population Group, and Community
FOCUS in CHN: Health Promotion and Disease PreventionFACTS of CHNF
ocus: promotion and preservation of health
A
rea of Content: skills and knowledge relevant to both nursing and public health
C
lients: general populations (individuals, families, communities)
T
ime: continual, not limited to episodic care
S
cope: comprehensive and general, not limited to a particular age or diagnostic group
Concepts on Community Health Nursing:
Community as a CLIENT
Composed of different levels of clientele: Individual, family, population group,and community
Community as a SETTING for CHN PRACTICE
School Health Nursing- School
Occupational Health Nursing- Workplace
Public Health Nursing-Home2. What Is
Health
?
A state of complete physical, mental, and social well-being and not merely theabsence of disease and infirmity (WHO, 1995).
Health Illness ContinuumWhat influences OLOF?B
ehavioral (culture, habits, mores, ethnic customs)
S
ocio-economic (employment, education, housing)
P
olitical (safety, oppression, people, empowerment)
H
ereditary (genetic endowment, familial, racial)
H
ealth Care Delivery System (promotive, preventive, curative, rehabilitative)
E
nvironment (air, food, water, wastes, noise, radiation, pollution, congestion)
3. What is
Nursing?
 
 The diagnosis and treatment of human responses to actual or potential healthproblems (ANA, 1980).
Nursing, together with public health, is one of the helping professions in the healthcare system which operates at three levels of clientele – individuals, families orgroups, and communities
It operates within the realm of health care both independently and interdependently.
 The objective of nursing is to assist clients to achieve, maintain, or recover a highlevel of functioning.
Assisting sick individuals to become healthy and healthy individuals achieve optimumwellness
(Henderson)
 
COMMUNITY HEALTH NURSINGFOCUS
: Health Promotion and Disease Prevention
 
 
HEALTH EDUCATION (IEC)General Steps: Create and Heighten awareness, Motivation, Decision-makingCharacteristics of CHN:
it is a developmental service – development of health capability of people
> enabling service – self-reliance> health education and community organizing – transfer of technology 
it is community-based – applied in the three fields of CHN practice>
catchments – point of responsibility or accountability> place of residence – determinant for catchment area
it is population-focused – “the greatest good for the greatest number”
> Community diagnosis> Vital statistics> Priority setting
it is a promotive-preventive service adheres to Primary Health Care
It is a generalist practice deals with all casesThe ULTIMATE GOAL of CHN
Promotion of the client’s wellness or OLOF through teaching and delivery of care based onthe worth and dignity of man (Shetland)
The PRIMARY FOCUS of CHN
Health promotion wherein health teaching is the primary responsibility of the communityhealth nurse, who is a generalist in terms of practice
Principles of CHNE – ducation as primary toolM – ade available to all regardless of race, creed and socio-economic statusP – eople’s initiativeO – rganizing for health, with the family as the unit of serviceW – orks as a member of the health team (PHN)E – xisting active organizationsR – ecording and reportingM – onitoring and evaluationE – xisting indigenous resourcesN – eeds recognized by clientelesT – raining and development as opportunities for continuing staff educationprogramsOther Principles in CHN:
1.The patient in CHN is the community with the family as the unit of service2.Active not a passive recipient of care3.CHN practice is affected by any changes in society and environment4.Multi-sectoral effort is the key to goal achievement5.CHN is a part of health care system and the larger human services system
HIGHLIGHTS in CHN Concepts
CHN is based on the recognized needs of communities, families, groups, andsindividuals.
CHN is a unique blend of nursing and public health practice, and is oftentimes usedinterchangeably with the term “Public Health Nursing”.
Philosophy of Public Health
Health and longevity as birthrightsLongevity – average lifespan or life expectancy
OBJECTIVE OF PUBLIC HEALTH:3 P’s:P
romote health
P
revent Disease
P
rolong Life
Basic Competencies Needed by the Public Health Nurse
 Teaching
Management
 
Critical Thinking
Physical Caregiving
Application of the Nursing Process
Application of the Epidemiological Process
Documentation
Functions of the PHN
Manager
Health Care Provider
Researcher
Community Organizer
 Trainer
Role Model**If MHO cannot function- PHN takes charge 
In the care of the families:
Provision of primary health care services
Developmental/Utilization of family nursing care plan in the provision of care
In the care of the communities:
 
Community organizing mobilization, community development and peopleempowerment
Case finding and epidemiological investigation
Program planning, implementation and evaluation
Influencing executive and legislative individuals or bodies concerning health anddevelopment
Responsibilities of CHN:
be a part in developing an overall health plan, its implementation andevaluation for communities
provide quality nursing services
maintain coordination/linkages
conduct researches relevant to CHN services
provide opportunities for professional growth and continuing education for
 personal growth thru
staff development
The National Health Situation
Population:
12
th
in the world (Aug 2007)
88.6 M
Median Age: 21 yo (YOUNG)
Life Expectancy: F: 72.8; M:67.5
Dependency Ratio: 69 per 100
CBR: 23.1 per 1000 pop’n.
CDR: 4.8 per 1000 pop’n.
IMR: 26 per 1000 LB
MMR: 2 per 1000 LBHealth IndicesA.LEADING CAUSES OF MORBIDITY (2007)1.Acute Lower RTI and Pneumonia2.Bronchitis/ Bronchiolitis3.Acute Watery Diarrhea4.Influenza5.Hypertension6.TB Respiratory7.Chicken Pox8.Heart Diseases9.Malaria10.Dengue FeverB.Leading Causes of Mortality1.Heart Diseases2.Vascular System Diseases

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