Community Based Nursing

Care in Rural Settings

NUR337
Lecture 2
Nancy Stephens

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 Lecture Overview
 Review of the principles of community health
nursing
 Applications of the principles of community health
nursing in a rural setting

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 Nursing in the Community
 The health of individuals and their families is greatly
influenced by their community, and nurse can make
a significant contribution by working with the
community.
 Healthy community address concerns through
collaboration between and among citizens, health
care providers, business and governmental and
private agencies.

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 Community Concepts
 A community is a group of individuals with shared
characteristics or interest who interact with each other.
 A community is a system that includes:
 children and families,
 health and social services.
 the physical environment,
 educational facilities,
 safety and transportation resources,
 political and governmental agencies,

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 Community Health Nursing
 Community health nursing focuses on promoting
and maintaining the health of individuals, families
and groups in the community settings.
 Community health nursing is a combination of
nursing and public health.

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 Community Health Nursing
 Community nurses collaborate with other discipline
to assess, plan, implement, and evaluate care that
emphasizes personal responsibility for health and
self care by community members.
 Community health nursing empowers communities
by enabling community members to gain the
knowledge and skills needed to fulfill their own
needs.

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 Community Health Nursing
 Traditionally , the roles and functions of community
health nurses included:
 Caregiver,
 Advocate,
 Case manager
 Counselor,
 Educator,
 Epidemiologist,
 Group process leader,
 Health planner and manager.

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 Demography
 Demography is the study of population
characteristics.
 Demographic characteristics include age, gender,
race/ ethnicity, socioeconomic status and
education.
 Individuals, families, and communities may have
demographic characteristics that affect their health
risks
 Risk is an increased probability of developing a
disease, injury or illness.

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 Demography
 Age is one of the most important risk factors for
disease prevention and certain health conditions.
 Gender, race, socio economic status also plays
important role in disease progression.

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 Epidemiology
 Epidemiology is the science of population health
applied to the detection of morbidity and mortality
in a population
 Epidemiologic process identifies the distribution
and causes of disease or injury across a population
 It also serves as an important component in
developing health programs.

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 Incidence
 Incidence measures the occurrence of new events
in a population during a period of time.

# of new events in a population

___________________________
Total at risk population
within a time periodx100

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 Prevalence
 Prevalence measures existing events in a population
during a period of time

# of existing events in a population

____________________________
Total at risk population
within a time periodx100

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 Epidemiologic triangle
 Three factors fm the epidemiologic triangle and
their relationship alter the risk of acquiring a
disease or condition
These are:
 Agent
 Host
 Environment

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 Levels of Prevention
Community health programs are based on three
classic levels of prevention:

 Primary prevention focuses on health promotion

and prevention of disease or injury.
 Secondary prevention focuses on screening and
early diagnosis of disease.
 Tertiary prevention focuses on optimizing function
for children with a disability or chronic disease.

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 Community Nursing Process
 In community nursing, the focus of the nursing
process shifts from the individual and family to the
community or target population.
 The stages of the process are similar whether the
client is one person or a population
 Only the type of interventions and indicators of
wellness and illness differ.

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 Community Nursing Process
 Assessment is focused on collecting subjective and
objective information about the target population in
order to diagnose problems based on community
needs.
 Planning involves the development of community
centered goals.
 During intervention stage the nurse works with the
community to implement a program that enables
member to reach their goals.
 Finally , the nurse and community members evaluate
whether or not the goals were met.

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 Community Nursing Process
 Community nursing is collaborative and the nurse is
one member of a community team that includes
other health professionals, educators, politicians,
religious leaders, members of public and voluntary
organizations and consumers.

 The role of nurse depends on the scope of the

project, the target population and the expertise of
team members.

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Community Need Assessment
 The assessment phase of the community nursing
process is called a community needs assessment.
 Assessment involves the collection of subjective
and objective information about a community.
 Subjective information indicates what community
members say are their most important needs.
Through interview, questionnaire etc
 Objective information is collected by observation of
nurse or through written sources.

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 Community Health Diagnosis
 It is a statement of an actual or potential health
problem in the community.
 It helps to identify the physical, social, cultural
and psychological issues that develop during
certain diseases, and conditions.
 It is used to address widespread illnesses and
conditions and also helps to stop the spread of
illness or conditions.

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 Community Planning in a
Rural Setting
 How can the nurse collaborates with community
members in developing a plan that address the needs
and problems of a rural population?

 What will be some of the barriers to having the

community develop their own plan?
 What are some advantages to having the community
develop their own plan?
 How would you get community members to prioritize
their needs?

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 Community Planning in a
Rural Setting (cont)
 The nurse needs to maximize the use of community
resources to make sure the problems are addressed
based on their
 severity,
 the felt needs of the community,
 the ability of the community and the nurse to bring
about change

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 Community Planning in a
Rural Setting
 Once the problems are prioritized, the nurse works
with community members to develop at least one
goal for each problem
 Goals are outcomes that give direction to
interventions and provide a measure of the change.

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 Community intervention in a
Rural Setting
 During program implementation the nurse and
community members carry out the intervention.
 E.g. “within 1 year we will build 3 latrines.”

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 Evaluation in a Rural Setting
 The nurse and community conduct a systematic
evaluation to determine that goals and programs
objectives were met.
 How can this be done?
 Who should provide the feed-back?

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 Questions??

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