COMMUNITY

NURSING
 GROUP B

1. DEFFY ANJANI TINIDI (I1B020039)

2. DIAN NOVITA SARI (I1B020035)
3. FUZNA DAHLIA MUDZAKIROH (I1J020010)
4. JONATHAN PUJI HADI SASONO (I1J020009)
5. NURMAYA FAUZTINA FAUZANI (I1B020019)
6. YUSMITA PUJI LESTARI (I1B020013)
7. MUTIARA ROMADHON (I1B020040)
8. RESTY DESYANI FITRI (I1B020058)
 Community

Community is a group of people who have value and interest which is a

special group with clear geography boundaries, with institutionalizing
norms and value. (Sumijatun et. al, 2006)

Example : the pregnant group, toddler group, etc.

A. DEFINITION OF COMMUNITY
NURSING

• Community nursing is a practice to improve public health by

using knowledge from nursing science, social science and
public health sciences. Another definition of community
nursing is a form of professional service based on nursing
knowledge and tips aimed primarily at high-risk groups to
improve community health status by emphasizing efforts to
improve health, prevent disease and not neglect curative and
rehabilitative.
 B. COMMUNITY NURSING
OBJECTIVES

1. Health promotion
Health promotion in the goal of community nursing means an
effort to help people make their lifestyle optimally healthy.
Optimal health is defined as a balance of physical, emotional,
social, spiritual and intellectual health. Health promotion is not
just changing lifestyle, but maintaining and increasing healthy
behavior is a goal that will be achieved as well.
2. Health protection
Health protection is an effort to protect community groups against exposure to a
disease.

3. Disease prevention and cure

Disease prevention is an effort to prevent disease from occurring in groups at
risk, while healing is an effort made on groups of people who have been affected
by the disease. The healing effort aims to heal the sick and prevent complications.
 C . TA R G E T S O F C O M M U N I T Y
NURSING

The target of community nursing is individuals, families and high-

risk groups (families or residents in slum areas, isolated areas,
inaccessible areas including groups of infants, toddlers and
pregnant women).
 D. COMMUNITY NURSING
MODEL

1. Self-care model according to Dorothy Orem

a. Four Central Concepts in the Philosophy of Nursing
1) Human.
Orem (1971, in Marriner, 2001), views humans as a complete unit that has biological, social
functions, has initiative, and is able to carry out self-care activities to maintain life, health and
community welfare. The ability of the community to do self-care (independently) reflects the strength
of the existing community, and this is very dependent on the level of maturity or experience, level of
knowledge, and the health of the community.
2) Health.
This model views that community health can be achieved when the community is able to meet its self-
care needs. If the community is unable to meet their needs, there will be a self-care deficit. The following
are self-care needs that must be met by the community.
b. Orem's model explains that there are three types of self-care needs (independent)
1) Universal self care is needed by all humans, such as air, water, food, elimination, activity
and rest, as well as social interactions. When these needs are met, the community will be
able to achieve the health it desires.
2) Developmental self care, is a need that includes the life process to become more mature.
For example, recently the mass media often broadcast incidents of clashes between
citizens or between community groups. The causes vary widely from the trivial to the
most basic. Think about it, what could it be? In fact what happens is the inability of the
community to develop, when there is a slight change, the community immediately flares
up. Indeed, when the need for universal self-care (independent), as above can be met,
especially the ability to foster good social interaction, the community will be more
mature in dealing with problems.
3) Health deviation self care, is the community's need to survive because of a disease or
trauma that can interfere with the structural, physiological and psychological functions of
humans. This change will result in the community needing help to stay alive.
c. Nursing Well, for more details, this model will discuss three nursing
systems that nurses can use to help communities meet their disruptive
needs, as described above. Self-care (independent) is a community
reaction to demands to fulfill self-care needs in an effort to achieve
health.
d. Nursing system type
1) Wholly Compensatory Nursing System
Community nurses take all self-care activities to meet the total needs of the
community.
2) Partly Compensatory Nursing System
Community and community nurses together fulfill self-care needs. The nurse
identifies the needs, abilities, and weaknesses that exist in the community. For needs
that cannot be met by the community, the nurse takes nursing actions, and if the
community is capable, the nurse continues to provide motivation so that this ability
can be maintained or increased.
3) Supportive Educative System
In this situation the community is able to fulfill self-care needs, but it must be with the
guidance and support of nurses in making decisions, controlling behavior, gaining
knowledge and skills.
e. Environment
Environment can be interpreted as a place, situation or things that
interact with individuals, either actively or passively. The
environment and individuals will both think, analyze and make
conclusions during interactions. The nature of the environment
which may be in the form of the environment, such as the presence
of other individuals can affect one's internal environment.
2. Health Care System Model according to Betty Neuman
The second model to be discussed is the health care system model (Neuman,
1972, in Anderson & McFarlane, 2000).

a. Human
b. Health
c. Environment
d. Nursing
3. Community as partner nursing model according to Anderson & Mc Farlane

The community as partner model was developed based on the Neuman model with a
human totality approach to describe existing health problems. This model also emphasizes
primary health care (PHC) as a philosophy that underlies the community to actively
participate in improving health, preventing and overcoming problems through community
empowerment and partnerships. You need to know that there are three main approaches to
primary health care (PHC), namely providing basic health services with appropriate
technology, forging cross-sectoral cooperation, and increasing community participation.
Therefore, this model focuses very much on partnerships, through partnership the
community will feel that their health problems are also their responsibility.
4. Roles and functions of community nurses
a. Case manager If, acting as a manager, the nurse must be able to
manage services in coordination with the community or family, health
service providers or existing social services.
As a community nurse case manager must be able to function to perform the
following actions.
1) Identifying community needs for health services. This is important to do so that the
health services provided are in accordance with the needs of the community.
2) Develop a community nursing care plan. This plan is made based on the results of the
community needs assessment for health services.
3) Coordinating the activities of the multidisciplinary health team so that the services
provided can be optimal and right on target.
4) Assess the quality of nursing services and health services that have been provided. As
a manager, this is important to improve subsequent management.
b. Nursing care implementer
One of the important roles of nurses is to provide direct services to the community according to
the needs of the community or family.
As administrators of nursing care, nurses can function to:
1) conduct a comprehensive assessment;
2) define community nursing problems;
3) developing nursing plans taking into account the needs and potential of the community;
4) perform direct nursing actions including independent actions (such as performing wound
care, practicing deep breathing and effective coughing, practicing range of motion exercises
/ rom, etc.), as well as collaborative actions (such as administering TB drugs and so on);
5) evaluate nursing actions that have been given;
6) document all nursing actions.
c. Educators
If they act as educators, nurses must be able to provide health information and teach the community or
family about health efforts that the community can do.
Following are the functions that community nurses can carry out in carrying out their role as educators.
Family And Community Nursing 69
1) Identifying learning needs, namely what the community wants to know, this can be known when the
nurse conducts a community assessment.
2) Choose learning methods (lectures, discussions, or demonstrations), and materials that suit your needs.
3) Develop a health education plan.
4) Carry out health education.
5) Train the community / group / family on skills that must be possessed according to their needs.
6) Encourage families to practice skills that have been taught by nurses.
7) Documenting health education activities.
d. Advocate
The role of an advocate can be carried out by nurses by supporting quality and
competent nursing services. The attitude of nurses who always try to improve their
competence so that the quality of the community nursing care provided is
maintained is an example of implementing the role of advocate.
e. Counselors
Nurse counselors need special skills, namely the nurse is a person who understands
(expert) in their field of expertise, can be trusted to help the community or family
and develop constructive coping in problem solving. The nurse can also provide
various solutions in order to define better ways of solving the problem.
f. Role Model
If we remember Topic 1, community nursing service is sustainable and
sustainable, of course this requires nurses to be able to interact well with the
community. In interaction, there is a process of transforming nurse behavior
that can be learned by the community or family. This process is really what
the nurse is doing as a role model (example).
g. Case Finder
The next role that community nurses can play is to involve themselves in
tracing cases in the community or in the family, to further study what the
community needs. Of course, these cases may require intervention from
other professions or more complex health services, so what community
nurses do is refer clients immediately.
h. Reformer
You have certainly heard the term reformer (change agent). This role helps
the community to make changes towards a healthier life. What nurses do as
reformers are as follows.
1) Identifying the strengths and barriers to change. This is important to do
because a change is something new that needs support.
2) Helping disbursement and motivating to change.
3) Help the community internalize change.
 PARADIGM OF COMMUNITY NURSING

According to Logan & Dawkins (1987) there are 4 main components in nursing
community’s health. They are human, nursing, health, and environment. As practical target,
client of nursing can be distinguished into :

1. Individual as client

Role of nurse in individuals is basically to fulfill the basic needs which includes the need
of biology, social, psychology, and spiritual because there is physical and mental
weaknesses, knowledge limitations, lack of will to patient/client self-reliance.
2. Family as client

There are several reasons why family are include in focus of nursing, they are :

1) Family is prime unit in society and institution that concern people lives
2) Family is a group that create, prevent, repair, or neglect health problems in their own
group.
3) Health problem in a family are interrelated. A disease that suffered by one member of
family will affect the whole of family.

3. Society as client

Health in community health nursing is defined as the ability to carry out roles and functions
effectively.
THE SCOPE OF COMMUNITY HEALTH
NURSING

1. Preventive Efforts
2. Promotive Efforts
3. Curative Efforts
4. Rehabilitative Efforts
5. Resocialitative Efforts
 BASIC PRINCIPLES OF COMMUNITY
NURSING

In public health care, several principles must be considered, they are:

a. Benefit
All actions in nursing care should give a great benefit to the community. Intervention or
implementation that is carried out must provide the maximum benefit for the community, means
that there is a balance between benefits and losses (Mubarak, 2005).
b. Cooperation
Cooperation with clients for a long time and sustainable, and also doing collaboration across
programs and sectors (Riyadi, 2007).
c. Directly
Nursing care is given directly to assess and intervene, clients and their environment including the
social, economic and physical environment have the main goal of improving health (Riyadi, 2007).
d. Justice
Actions taken are tailored to the ability or capacity of the community itself. In
the sense of making efforts or actions according to the ability or capacity of the
community (Mubarak, 2005).

e. Autonomy
Clients or communities are given the freedom to choose or implement some of
the best alternatives in solving existing health problems (Mubarak, 2005).
 References

http://bppsdmk.kemkes.go.id/pusdiksdmk/wp-content/uploads/2017/08/
Keperawatan-Keluarga-dan-Komunitas-Komprehensif.pdf

https://www.academia.edu/31113993/BAB_II_LANDASAN_TEORI_2_1_
Keperawatan_Komunitas_2_1_1_Pengertian_Keperawatan_Komunitas
THANK
YOU