COURSE TITLE:

COMMUNITY HEALTH
NURSING (NCM 113)
COURSE CODE: NCM 113
THEORY: 2 UNITS (36HRS)
COURSE DESCRIPTION :
 This course deals with concepts, principles,theories and
techniques in the care of population groups, and
communities, utilizing community organizing strategies
toward :
1. Health Promotion
2. Disease Prevention
3. Restoration and Maintenance
4. Rehabilitation and Community Development

 The learners are expected to provide safe appropriate

and Holistic Nursing care to clients utilizing the
community Health Nursing Process.
 COURSE OBJECTIVES:
 AT THE END OF THE COURSE, THE STUDENT WILL BE ABLE
TO:
1. Apply concepts and principles of community health
development in the care of communities and population
groups.
2. Utilizing the Nursing Process in the care of communities
and population group.
3. Ensure a well-organized recording and reporting system.
4. Share leadership /relate effectively with others in work
situations related to nursing and health.
 COURSE OUTCOME:
1. Apply knowledge of physical, social, natural and health
sciences, and humanities in the practice of nursing.
2. Provide safe, appropriate and holistic care to individuals,
families, population groups and communities utilizing
nursing process.
3. Apply guidelines and principles of evidence-based practice
in the delivery of care.
4. Practice nursing in accordance with existing laws, legal,
ethical and moral principles.
5. Communicate effectively in speaking, writing and
presenting using culturally –appropriate language.
6. Document to include reporting up-to-date client care
accurately and comprehensively.
 7. Work effectively in collaboration with inter-, intra-, and multi-disciplinary
and multi-cultural teams
8. Practice beginning management and leadership skills in the delivery of
client care using a system approach.
9. Conduct research with an experienced researcher.
10. Engage in lifelong learning with a passion to keep current with national
and global developments in general, and nursing and health developments in
particular.
11. Demonstrate responsible citizenship and pride of being a Filipino.
12. Apply techno-intelligent care systems and processes in health care
delivery.
13. Adopt the nursing core values in the practice of the profession.
14. Apply entrepreneurial skills in the delivery of nursing care.
COMMUNITY HEALTH NURSING
There are 2 Broad fields of Nursing in terms of setting or
place of practice:
1. Hospital Nursing
2. Community Health Nursing –more broader because it
involves many sectors in the community
HEALTH

“A state of complete physical, mental and social well being,

not merely the absence of disease or infirmity”
WHO
 The modern concept of health refers to optimum level of
individuals, families, and Communities.
 Several factors in the Eco-system affects the level of
functioning:
1. Political 5.Environmental Influences
2. Behavioral 6. Socio-Economic Influence
3. Heridetary
4. Health Care Delivery System
OPTIMUM LEVEL OF FUNCTIONING
(OLOF)
PUBLIC HEALTH
 “ The science and art of preventing disease, prolonging
life, and promoting health and efficiency through
organized community effort” .

Dr.C.E. Winslow
 “ Special field of Nursing that combines the skills of
nursing,public health and some phases of social assistance
and functions as part of the total public health programme
for the promotion of health, the improvement of the
conditions in the social and physical
environment,rehabilitation of illness and disability.”
WHO
Community Health Nursing

 CHN is a field of nursing practice where services are delivered

outside of purely curative institutions but in community
settings( home,places of work,health centers,and clinics).
 The scope of services covers the whole range of health
promotive,preventive,curative and rehabilitative(restore the
health of the patient through therapeutic means) nursing services.
 A unique blend of nursing and public health practice woven
into a human service that properly developed and applied has
a tremendous impact on human well being. Its responsibilities
extend to the care and supervision of individuals and families
in their homes, in places of work,in schools and clinics.It is
one of the basic services of health departments.
 A service rendered by a professional nurse with the
community ,groups, families, and individuals at home,in
health centersin clinics,in school,in places of work fro the
promotion of health,prevention of illness, care of the sick at
home and rehabilitation.”
Dr. Ruth B. Freeman
 is a learned practice discipline with the ultimate goal of
contributing as individuals and in collaboration with others to
the promotion of the client’s optimum level of functioning
through teaching and delivery of care” .
Jacobson
 The ultimate objective of care is achieving the highest possible
level of community by developing and enhancing the
capabilites of individuals, families,various population groups
and the community as a whole.
• In the past Community health nurse is referred to in the past
by such titles as “Visiting Nurse”,Lady Health Visitor”,and
Community Health Nurse.
• In the late 1960’s the term used was changed to “Community
Health Nursing” and Community Health Nurse due to the
leaders of the health profession decided to shift and expand
its orientation from disease to health, cure to health
promotion and disease prevention and from Hospital to
Community.
PHILOSOPHY

 Defined as a system of beliefs that provides a basis for a

guide action. A philosophy provides direction and
described the whats,the why’s, and hours of activities
within a profession
 According to Dr.Margaret Shettland, the philosophy of
Community Health Nursing is based on the worth and
dignity of man.
 Community Health Nursing is guided by the following
beliefs:
H-umanistic values of the nursing profession upheld
U-nique and distinct component of health care
M-ultiple factors of health considered
A-ctive participation of clients encouraged
N-urse considers availability of resources
I-nterdependent among health team members practiced
S-cientific and up-to-date
T-ask of CHN vary with time and place
I-ndependence of health and development regarded
Basic Principles which guide the practice
of CHN:
 Integral part of the community health service system,which in turn
is part of the larger socioeconomic development system of a given
community.It interacts,collaborates and coordinates with the other
human service system operating in the community that are
concerned with health and health-related problems.
 A general practioner nurse is a general practioner of nursing.The
services she provided encompasses practically al fields of clinical
nursing specialties.
 The community is the patient/client in CHN
 Basic purpose of CHN is to improve community health through
selective application of nursing and public health measures within
the framework of the total health care system
 The goal of improving community health is realized through
multidiciplinary effort.The nurse shares the responsibility of
delivering the health services in the community with other
workers in the health team and works with them in the spirit of
teamwork.
 The basis for the professional practice of nursing and of CHN is the
applicaiton of the problem-solving method referred as the nursing
process.The use of this facilitates the delivery of
planned,systematic,effective and efficient care to
client’s/patient.
 Family is the basic unit of care in CHN. An individual is viewed as a
member of a family which,in turn,part of a community.Even
though sometimes the focus of care is in the individual but it is
viewed in the context of the family.
 The community health nurse works with and not for the individual
client,family,group or community. The latter are active
partners,not passive recipients o of care and they have the primary
responsibility for their health.The nurse involves the patient in all
phases of planning,organization,implementation,management and
evaluation of their care.
 Two very important roles of a community health nurse are those of
a health teacher and change agent.Health education is a major
nursing interventions measure in CHN practice.
 CHN is affected by changes in society in general and by changes
and developments in the health and related fields in particular.It is
part of and functions within the framework of the community.Any
changes in the system affects the practice of CHN.
 Features/Role of CHN
 There are seven major functions of a community health nurse, those
are mentioned in the following:
 Clinician or Health Care Provider - utilized the nursing process in the
care of the client in the home setting through home visits and in
public health care facilities: conducts referral of patients to
appropriate levels of care when necessary.
 Health Educator – utilizes teaching skills to improve the health
knowledge,skills and attitude of the individual,family and the
community and conducts health information campaigns to various
groups for the purpose of health promotion and disease prevention
 Advocate- work to ensure that members of a particular community are
treated fairly and adequately in all health care matters
 Managerial/Supervisor- monitors and supervises the performance of
midwives and other auxilliary health workers; also initiates the
formulation of staff development and training programs for
midwives and other auxiliary health workers as part of their training
function as supervisors.
 Collaborator and collaborator- establishes linkages and
collaborative relationships with other health
professionals,government agencies,the private sector,non-
government organizations and people’s organizations to address
health problems
 Leader and Change Agent- Influences people to participate in the
overall process of communtiy development.
 Researcher – participates in the conduct of research and utilizes
research findings in practice
 Community Health Nursing vs.
Hospital Nursing
Hospital
Setting/place Hospital setting
Type of Patient Patient-sick people maybe
limited to one group of
patients(maternity
cases,depending on clinical
area of practice)
Scope of Concern Mostly curative and
rehabilitative
CHN
Outside hospital(Home,clinic,
School,health centers)
Varied patients.From healthy to sick to
recovering from diseaseor terminally ill or
dying
total care,whole range of services(health
promotion,disease prevention,curative
care,rehabilitative care,developement of
self reliance,capabilities in health care.
 HOSPITAL CHN
Priority Concern Comfort and care during Promotion and
illness,recovery from maintenance of
disease health ,prevention of
disease
Unit Focus of Care Individual patient Family,population
groups,whole community

Ultimate Goal Maximum comfort,patient Effective coping and self

independence(self reliance for families and
care),recovery from whole community in
disease,peaceful/dignifie health care
d death for terminal cases
HEALTH NURSING PROCESS
 Theoretical Models / Approaches

 1. Health Belief Model (HBM)

 2. Milio’s Framework for Prevention
 3. Nola Pender’s Health Promotion
 4. Lawrence Green’s PRECEDE-PROCEED MODEL
 (PRECEDE = Predisposing, Reinforcing, Enabling, 
 Constructs in  Educational Diagnosis and Evaluation)
 5. (PROCEED= Policy, Regulatory and Organizational Constructs in
Educational and Environmental Development)