Community health nursing (CHN) and public health nursing (PHN) are often used

interchangeably. However, they have specific meanings. Community health nursing (CHN) is
the use of systematic processes to deliver care to individuals, families, and community groups
with a focus on promoting, preserving, protecting and maintaining health. Public health nursing
(PHN) is the population-based practice, synthesis of nursing and public health within the context
of preventing disease, disability, promoting and protecting the health of the entire community.

U.S. Health trends, there are three majors changes in health care in the 21st century. These are

 Patient/client centered care. It is care that focuses on the client as a whole. Empower
the patients to take an active role in their own health care by encouraging them to
participate in decisions made. It includes the patient’s personal preferences, values,
family, cultural traditions. Reduce health disparities.
 Technology. Through the use of health information technology or IT providers
consumers government and insurers can all manage health information as well as or
track health statistics to obtain goals. For example, MyChart and Electronic Health
Records (ERS).
There are some benefits of health information technology, they are improved
coordination of care, support for evidence-based care, elimination of paperwork, reduced
error, expand access to affordable care, decreased health care costs, and improved
overall health outcomes.
 Personal responsibility for health. This is the belief that if person has a vested interest in
health they will do more to maintain it. As healthcare providers we need to encourage
active participation. When the client actively participates they make a commitment to
lifestyle change. When the patient takes responsibility for their own health, this may
increase utilization of health care services and decrease overall healthcare costs.
Education is the key to awareness and accountability.

Healthy people initiative in 2020 goals are attain high-quality, longer lives free of preventable
disease, disability, injury, and premature death. Also achieve health equity, eliminate disparities,
and improve the health of all groups. Create social and physical environment and promote good
health for all. Lastly, Promote quality of life, health development, and healthy behaviors across
all life stages.
Public health is describes as what society collectively does to ensure that conditions exist in
which people can be healthy. Patients today are experiencing shorter hospital stays which can
lend itself to the growing need for community based care.

There are several principles of public health. The principles are as follow a focus on the
aggregate, promote prevention, encourage community organization, practice the ethical theory
of the greater good, model leadership in health, and use of epidemiologic knowledge and
methods.

Public health nursing is a synthesis of nursing and public health within the context of preventing
disease and disability, promoting and protecting the health of the entire community. The eight
domains of public health nursing practice are as follows, first analytic assessment skills, policy
development and program planning skills, communication skills, cultural competency skills,
community dimensions of practice skills, basic public health science skills, financial planning
and management skills, and the last is leadership and system thinking skills.

Public health can do for your community, they can prevent epidemics & spread of disease,
protect against environmental hazards, prevents injuries, promotes & encourages healthy
behaviors, responds to disaster and assists communities in recovery, assure the quality and
accessibility of health services.

Challenges still exist in the 21st century for public health nurses. Engaging in evidence-based
practice, helping eliminate health disparities in underserved populations, demonstrating cultural
competence, planning for community change, contributing to a safe and healthy environment,
responding to emergencies, disasters and terrorism and responding to the global environment.

The community is derived of a group of people sharing common interests, needs, resources,
and environment; an interrelating and interacting group of people with shared needs and
interests. There are some types of community, they are:

 Geopolitical is categorized as a community living in a specific area which processes

geographical boundaries and governing structures (city, town, etc.)
 Phenomenological communities are members of community with common interests
beliefs and goals (homeless, church, neighborhood groups)
 Communities of solution are group of people formed to address common interests,
beliefs, or needs (response to a health threat)
 Aggregates, those who live or work within the geopolitical boundary.
The community assessment is a critical process for the future because the process may identify
a method to improve the health of at-risk clients. It includes examination of biological,
psychological, and sociocultural influences of the environment that surrounds a specific group of
people. The community assessment will assist in identifying vulnerable population as well as
underserved populations, unmet needs of a population and resources available.

There are common element of assessment and planning frameworks. Most assessment and
planning framework include steps or phase that reflects the following actions, some of which
may occur simultaneously. First, organize and plan. Engage the community. Develop a goal or
vision, conduct community health assessment. Prioritize health issues. Develop community
health improvement plan. Lastly, implement and monitor community health improvement plan.

Frameworks for community assessment. Framework provide direction for the assessment. The
epidemiologic approach is a means of studying health-related trends & populations for the
purpose of disease prevention and assessing the community through gathered information and
statistics. Community as partner framework, for those living within the community and the
aspects in which they are continuously interacting. Gordon’s functional health patterns utilizes
assessment as a form of evaluating and assessing behaviors that occur sequentially across
time. Developmental models & approaches are utilized to describe cultural change within the
community or aggregate over time.

The next steps are first, need to identify a community in which assessment will be performed.
Then you’ll go out in the community and perform a windshield survey. You want interview key
informants. You want to access resources for information. From there, you will develop a
nursing diagnosis for your community. You will implement a plan-teaching and then you will
evaluate outcomes.

Ways to collect data rate community assessment. They are internet, interviews, key informants,
windshield surveys, community guides, research publication/newspapers/surveys, and local
libraries/service organization & other local sources.