Community Health Nursing

Standards of Practice:
Where do Public Health Nurses (PHN) practice?
What standards of professional practice guide their work?
How is excellence achieved? Spotlight
on
PUBLIC
HEALTH
NURSING
CHNC Standards and Competencies Committee
May 2021
 CHNC:
the national voice of community health
nurses. Our goal is to advance community
health nursing across Canada and improve the
health of Canadians.

https://www.chnc.ca/en/standards-of-practice
At the end of this session, participants will
be able to competently and independently:

 Recognize the unique practice settings and public health

nursing (PHN)
 Discriminate the CHNC standards of practice
 Consider how the CHNC standards contribute to PUBLIC
excellence in community health nursing practice settings HEALTH
 Explore examples of PHN competencies in practice NURSING
Canadian Community Health Nursing
Professional Practice Model and
Standards of Practice
 Canadian
Community
Health
Nursing
Professional
Practice
Model

Client as center
COMMUNITY HEALTH NURSING Specialties of CHN practice
Public Health (PHN)
• focus on promoting, protecting and preserving the health of
populations
• links the health & illness experiences of individuals, families, and
communities to population health promotion practice All Include:
Nurses
promoting health
Home Health (HHN) of individuals,
families, groups,
• focus on prevention, health restoration, maintenance & palliation populations,
• focus on individuals, designated caregivers, and their families communities and
systems

RN in Primary Care/Family Practice Nurses

• focus on preventative health screening, health education,
comprehensive assessment, treatment of minor acute illness,
chronic disease management, case management, system
navigation, therapeutic intervention (wound care, immunization)
and medication review with individuals and families
CHNC Standards of Practice:
Where do they fit?

Provincial standards
CHNC standards
HH, PH and FP competencies
What are the CHNC standards
of practice?
1. Health Promotion
2. Prevention and Health Protection
3. Health Maintenance, Restoration
and Palliation A vision
for
4. Professional Relationships excellence
in
5. Capacity Building communit
y health
6. Health Equity nursing
practice
7. Evidenced Informed Practice
8. Professional Responsibility and
accountability
Canadian Community Health Nursing
Standards of Practice, 2019

#4 Professional #1 Health Promotion #7 Evidence

Relationships Informed
Practices
#2 Prevention and
Standards
#5 Capacity Health Protection
promoting health #8 Professional
Building Responsibility

#6 Health Equity #3 Health Maintenance,

Restoration and Palliation

Standards #4,5,6,7 8 help achieve #1,2 & 3

Community Health Nurses and System
Determinants of Health
Government Support

Community Organizations
Delivery Structure and Process
Management Practice
Professional Relationships & Partnerships

Community Health Nurses and Nursing Practice

Code of Ethics
Community Health Nurse
Community Health Nursing Standards
Discipline Specific Competencies
Professional Regulatory Standards
Theoretical Foundational concepts
Values and Principles
CHN Standards of Practice:
Why do they matter?
Inspire
excellence
Strengthen
education Foundation for
and professional certification
development

Set criteria and

Support human
expectations
resource
for safe
management
and ethical care
Define the scope
and
depth practice
 Unique Characteristics of
Community Health Nursing
CHNs promote, protect & …wherever people live,
preserve the health of work, learn, worship &
individuals, families, play….
groups, communities &
populations…

Combine
specialized
nursing, social
View health as a Work at a high and public
resource & focus on …in a continuous versus
level of health science
capacities episodic process
autonomy with
experiential
knowledge
Marshal resources to Have a unique Build partnerships
support health by understanding of the based on primary
coordinating care & plan influence of the health care
nursing services, environmental context principles, caring &
programs & policies of health empowerment
What are the CHNC standards
of practice?
1. Health Promotion
2. Prevention and Health Protection
3. Health Maintenance, Restoration
and Palliation A vision
for
4. Professional Relationships excellence
in
5. Capacity Building communit
y health
6. Health Equity nursing
practice
7. Evidenced Informed Practice
8. Professional Responsibility and
accountability
Public Health Nursing
Public health nursing utilizes knowledge from
public health, nursing, social and environmental
sciences, and research, integrating these with the
concepts of primary health care, disease and injury
prevention, community participation, community
development, the social determinants of health,
and health equity in order to promote, protect, and
maintain the health of the population
The essential functions of public health are health
promotion, disease and injury prevention, health
protection, health surveillance, population health
assessment, and emergency preparedness and
response (Stamler, Yiu, Dosani, Etowa & van
Daalen-Smith, 2020).
Standard 1: (8 indicators)
Health Promotion The five Ottawa
Charter health
 Community health nurses integrate health promotion
strategies:
promotion into practice 1. build healthy
public policy,
“Health promotion is the process of enabling 2. create
supportive
people to increase control over, and to improve, environments,
their health.” 3. strengthen
community
 actions,
Involves the individuals, families, groups, 4. develop
communities, population and systems personal
skills and
5. reorient
health
services.
PHN- Health Promotion Examples

• PHNs work with a

community to advocate
for a smoke-free town or
municipality.
Standard 2: (9 indicators)
Prevention and Health
Protection
Socioecological
 model focuses
Community health nurses use the socio- on sustainable
ecological model to integrate prevention and solutions

health protection activities into practice.

 These actions are implemented in accordance
with government legislation and nursing
standards to minimize the occurrence of disease
or injuries and their consequences.
PHN: Prevention & Health
Protection Examples
• PHNs work with a
parent’s organization
and the police to
promote proper
installation of car
seats through the
media and conduct
several clinics to
provide one-on-one
assessment and
teaching.
Standard 3: (6 indicators)
Health Maintenance,
Focus is on
Restoration and Palliation maintaining
maximum
function,
 Community health nurses integrate health improving
health, and
maintenance, restoration and palliation into supporting
their practice life
transitions
including
acute,
chronic, or
terminal
illness, and
end of life
PHN: Health Maintenance, Restoration
& Palliation Examples
• PHNs provide
directly
observed
therapy (DOT)
for people with
TB in their
living
arrangement
 Standard 4: (12 indicators)
Professional Relationships
 Community health nurses work with others to Relational
establish, build and nurture professional and Participative
therapeutic relationships. These relationships
include optimizing participation, and self-
determination of the client.
 PHN-Professional
Relationships Examples

• PHNs establish a
therapeutic working
relationship with
multigenerational
families, and families
that have young children
to have healthy family
outcomes.
• PHNs establish
interprofessional
relationships (e.g., key
informants,
stakeholders, political,
clergy, etc.)
Standard 5: (17 indicators)
Capacity Building
 Community health nurses partner with the client Partnership
to promote capacity. The focus is to recognize is key!
barriers to health and to mobilize and build on
Work with to
existing strengths. build
capacity and
efficacy
PHN- Capacity Building Examples
• A PHN works as a
partner with a Health
Action Team in a high
school to mobilize
students, parents,
teachers,
administration, and
community partners to
identify the school
community’s strengths
and needs, and
prioritize, plan,
implement, evaluate the
growing vaping
behaviour among youth.
Standard 6: (15 indicators)
Health Equity
 Community health nurses recognize the impacts
of the determinants of health and incorporate
actions into their practice such as advocating for
healthy public policy. The focus is to advance
health equity at an individual and societal level.
 Definition of Health Equity
 All people (individuals, groups, and communities) have a
fair and equitable chance to reach to reach their full
health potential and are not disadvantaged by social,
economic, attitudinal, policy, and environmental
conditions.
PHN- Health Equity Examples
• PHNs identify that their
smoking cessation
messaging is not
culturally safe nor
considerate of the
Indigenous realities and
culture. Acknowledging
the recommendations
from the Truth and
Reconciliation
Committee, the PHN with
other colleagues include
Indigenous peoples to
begin a community
consultation process.
Standard 7: (6 indicators)
Evidence Informed Practice

 Community health nurses use best evidence to

CHN
guide nursing practice and support clients in Practice is
making informed decisions. Evidence
Based
 PHN- Evidence Informed Practice
Examples

• PHNs are developing a

new program for
school age children
related to physical
literacy. They decide to
complete a rapid
review to find the best
evidence to guide their
planning.
 Standard 8: (14 indicators)
Professional Responsibility and
Accountability
 Community health nurses demonstrate
Accountability
professional responsibility and accountability as Responsibility
a fundamental component of their autonomous Professionalism
Competencies
practice. Transparency
PHN- Professional Responsibility and
Accountability Examples
• A PHN is assigned to
work in a needle
exchange program
based on harm
reduction. He has
difficulty accepting
the tenets of harm
reduction and uses
reflective practice
personally and with
his supervisor to
understand and
change his
assumptions.
Canadian Community Health Nursing
Standards of Practice, 2019

#4 Professional #1 Health Promotion #7 Evidence

Relationships Informed
Practices
#2 Prevention and
Standards
#5 Capacity Health Protection
promoting health #8 Professional
Building Responsibility

#6 Health Equity #3 Health Maintenance,

Restoration and Palliation

Standards #4,5,6,7 8 help achieve #1,2 & 3

 Get your copy of the
Professional Practice Model &
Standards of Practice

 Community Health Nurses of Canada website:

https://www.chnc.ca/

 The standards are available on the CHNC website:

https://www.chnc.ca/en/store
 Consider Membership to
CHNC
 Join Community Health Nurses from across Canada
and enjoy the many benefits of membership.
https://www.chnc.ca/en/member-benefits

 Support your professional association and this

important work!
QUESTIONS
info@CHNC.ca
 References

 Community Health Nurses of Canada (CHNC). (2019). The

Canadian Community Health Nursing Professional Practice
Model & Standards of Practice. Retrieved from
https://www.chnc.ca/en/standards-of-practice
 Stamler, L.L., Yiu, L., Dosani, A., Etowa, J., & van Daalen
Smith, C. (Eds.). (2020). Community Health Nursing: A
Canadian Perspective, 5th Edition. Toronto Ontario: Pearson.