School of School of Nursing, NICH, Karachi Nat, NICH, Karachi

Community Health Nursing

3rd Year General Nursing

Compiled by: Dileep Kumar

2012

Ph: 0345-3092967 e m a i l dileepkumar.duhs@gmail.com

UNIT # I HOME CARE Mr. DILEEP KUMAR (Post R.N BSN, Dip: in CHN, DIT, (MSN)) N/ Instructor School of Nursing NICH, Karachi Introduction Nurses play an integral role in the delivery of quality care in the home. Home health nurses are committed to the provision of accessible, responsive and timely care which allows people to stay in their homes with safety and dignity (Community Health Nurses of Canada, 2010). The provision of home care allows peoples of all ages the opportunity to recover or manage their health care issues and age at home surrounded by family, friends and their community to which they can continue to make a meaningful contribution. Home care services help people with a ill-health or with acute, chronic, palliative or rehabilitative health care needs to independently live in their community and co -ordinate and manage an admission to facility care when living in the community is not a possible alternative. Definitions

Home care is care that allows a person with special needs stay in their home. It might be for people, who are getting older, are chronically ill, recovering from surgery or disabled. Home Care is health care or supportive care provided in the patient's home by healthcare professionals. Home nursing care is the promotion of health, assessment, provision of care and treatment of health conditions by supportive, preventive, therapeutic, palliative and rehabilitative means in order to attain or maintain optimal function (Havens 2003). Home health nursing is a specialized area of nursing practice in which the nurse provides care in the client s home, school or workplace

Services within home care Services within home care include; 1. Nursing 2. personal support/homemaker 3. therapy (including physiotherapy, occupational therapy, speech language pathology, social work, nutrition/dietetics) 4. medical supplies and equipment in the home 5. Home care is delivered by service provider agencies that have met high standards of excellence identified through a rigorous competitive process A home health nurse is a community health nurse who:

combines knowledge from primary health care (including the determinants of health), nursing science and social sciences focuses on prevention, health restoration, maintenance or palliation focuses on clients, their designated caregivers and their families integrates health promotion, teaching and counseling in clinical care and treatment initiates, manages and evaluates the resources needed for the client to reach optimal well -being and function provides care in a home care clinic, the clients home, school or workplace To order and interpret diagnostic tests, communicate diagnoses, prescribe pharmaceuticals and perform specific procedures, are beginning to practice within home care as well.

Elements of home health nursing The elements of home health nursing that are central to practice are:

Assessment, Monitoring and Clinical Decision Making Care Planning and Care Coordination Health Maintenance, Restoration & Palliation Teaching and Education Communication Relationships Building capacity

Home Care Nurse Role The home care nurse roles are; 1. advanced assessment and evaluation skills 2. effective communication skills
3. sound judgment

4.

effective documentation skills

5. Flexibility 6. critical /creative thinking and self-direction 7. Competency in technology and the maturity to work confidently and autonomously.

Foundations of home health nursing The foundations of home health nursing include:

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1. health promotion 2. illness prevention 3. health protection Job duties for a home health nurse

Job duties for a home health nurse vary based on an individual client's needs.

Medical tasks completed by the nurse can include administering medication, tube feedings, ventilator monitoring and suction of the airway. Some clients may require some light housekeeping duties and assistance with activities of daily living as well. Other home health services could include medical or psychological assessment, wound care, medication teaching, pain management, disease education and management, physical therapy, speech therapy, or occupational therapy.

Advantages

One-on-one care is a major benefit for both the nurse and the client. The client will receive more specialized attention to medical needs because the nurse will spend the entire shift focused on one person. The nurse will also become extremely familiar with the client, enabling her to familiarize herself with the client's medical history and current medical needs.

Disadvantages

In an emergency situation, no other nurses or physicians are present to help in the home care setting. The nurse is the sole provider for all medical care and must alert 911 to obtain medical assistance for the client. No one is there to relieve the nurse for breaks or lunches, which mean the nurse, can work up to 12 hours straight with no breaks.

UNIT # II MATERNAL AND CHILD HEALTH SERVICES Mr. DILEEP KUMAR (Post R.N BSN, Dip: in CHN, DIT, (MSN)) N/ Instructor School of Nursing NICH, Karachi Maternal and Child Health refers to the promotive, preventive, curative, and rehabilitative health care of mothers and children It includes the subareas of maternal health, child health, family planning, school health and health aspects the adolescents, handicapped children and care for children in special settings. Objectives of MCH To reduce maternal, infant, and childhood mortality and morbidity. To promote reproductive health
To promote physical and psychological development of children and adolescent The mother and child should be considered and treated as one unit for providing health

services because of the following reasons

o

During antenatal period the fetus is part of the mother. During this period, it obtains all necessary supplies of nutrients and oxygen from the mothers blood.

o Health of the child is elaborately linked to the mothers health

o o o

Certain diseases inflicting mother during pregnancy can have the harmful effect on the health of the fetus Even after birth, the child is dependent for its feeding upon the mother, at least in the first year of life The mental and social development of the child is also dependent on the mother. Mother is the earliest teacher of the child. The death of mother causes a maternal deprivation syndrome in the child.

Policy Guidelines for implementation of MCH Program

Effective use should be made of existing resources and infrastructures available in the community The services should be delivered as close to the homes of beneficiaries as possible Services for mothers and children should be delivered, in an integrated (incorporated) manner Child survival programs should serve as sugarcoating for delivery of the family planning programs which in general are not popular Voluntary agencies working in the area should be involved in providing MCH services

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Following are the responsibilities of 1. Registration of pregnant women

Responsibilities/ Services of Nurse in Maternal & Child Health

2. Provides antenatal, natal and postnatal care to mother

3. Provide family planning services 4. Provide immunization service 5. Provide education about the breast feeding and hygienic care of children
6. Early detection of complications such as Anemia, APH, PPH, Fever, Prolonged/ obstructed

labor and apply professional approach 7. Maintain the record of statistics such as: CBR, MR, MMR etc at the clinic 8. Provides T.B.A (Trained birth attendant) training 9. Provides referral services