COMMUNITY

HEALTH
NURSING
REPORT BY: ERA C. MARTIREZ, RM, RN
 COMMUNITY HEALTH NURSING- One of the two major
fields of nursing in the Philippines; the other one is HOSPITAL
NURSING
 Public Health Nursing
 Occupational Health Nursing
 School Nursing
COMMUNITY HEALTH NURSING IS CHARACTERIZED BY:

1. Promotion of health and prevention of disease are the goals of professional practice
2. Community health nursing is comprehensive, general, continual and not episodic
3. There are different levels of clientele- individuals, families and population groups,
and the practitioner recognizes the primacy of the population as a whole
4. The nurse and the client have greater control in making decisions related to
healthcare and they collaborate as equals
5. The nurse recognizes the impact of different factors on health and has a greater
awareness of his/ her clients’ situation
 WHO ARE THE CLIENTS OF THE COMMUNITY HEALTH NURSE?
1. INDIVIDUAL
○ Considered as entry point to working with families and communities
○ The CHN deals with individuals – sick or well- on a daily basis

NURSING PROBLEMS THAT MAY ARISE ON THE INDIVIDUAL LEVEL:

● Inadequate knowledge about the disease/health condition (nature, severity, complications, prognosis, and
management)
● Inadequate knowledge about child development
● Inability to provide self-care due to physical or mental limitations
● Ineffective coping related to stress, anxiety, or depression
● Risk for injury related to falls, seizures, or other health conditions
2. FAMILY

● Basic unit of the community, shaped by what surrounds it

● A collection of people who are integrated, interacting, and interdependent, tied by blood
relations, marriages, or adoption.
● Two or more people who usually live in the same household, share a common emotional bond,
and perform a certain interrelated task (Spradley & Allender)
● Has a boundary wherein a other people can recognize the people who belong and do not
 Second-Level Assessment
I. Inability to recognize the presence of the condition or problem due to:
A. Lack of or inadequate knowledge
B. Denial about its existence or severity as a result of fear of consequences of diagnosis of problem,
specifically:
1. Social-stigma, loss of respect of peer/significant others
2. Economic/cost implications
3. Physical consequences
4. Emotional/psychological issues/concerns
C. Attitude/Philosophy in life, which hinders recognition/acceptance of a problem
D. Lack of/inadequate knowledge/insight as to alternative courses of action open to them
E. Inability to decide which action to take from among a list of alternatives
F. Conflicting opinions among family members/significant others regarding action to take.
G. Lack of/inadequate knowledge of community resources for care
H. Fear of consequences of action, specifically:
5. Social consequences
6. Economic consequences
7. Physical consequences
8. Emotional/psychological consequences
I. Negative attitude towards the health condition or problem-by negative attitude is meant one that interferes
with rational decision-making.
J. In accessibility of appropriate resources for care, specifically:
1. Physical Inaccessibility
2. Costs constraints or economic/financial inaccessibility
K. Lack of trust/confidence in the health personnel/agency
L. Misconceptions or erroneous information about proposed course(s) of action
III. Inability to provide adequate nursing care to the sick, disabled, dependent or vulnerable/at risk member
of the family due to:
A. Lack of/inadequate knowledge about the disease/health condition (nature, severity, complications,
prognosis and management)
B. Lack of/inadequate knowledge about child development and care
C. Lack of/inadequate knowledge of the nature or extent of nursing care needed
D. Lack of the necessary facilities, equipment and supplies of care
E. Lack of/inadequate knowledge or skill in carrying out the necessary intervention or treatment/procedure
of care (i.e. complex therapeutic regimen or healthy lifestyle program).
F. Inadequate family resources of care specifically:
1. Absence of responsible member
2. Financial constraints
3. Limitation of luck/lack of physical resources
G. Significant persons unexpressed feelings (e.g. hostility/anger, guilt, fear/anxiety, despair, rejection)
which his/her capacities to provide care.
H. Philosophy in life which negates/hinder caring for the sick, disabled, dependent, vulnerable/at risk
member
I. Member’s preoccupation with on concerns/interests
J. Prolonged disease or disabilities, which exhaust supportive capacity of family members.
K. Altered role performance
IV. Failure to utilize community resources for health care due to:
A. Lack of/inadequate knowledge of community resources for health care
B. Failure to perceive the benefits of health care/services
C. Lack of trust/confidence in the agency/personnel
D. Previous unpleasant experience with health worker
E. Fear of consequences of action (preventive, diagnostic, therapeutic, rehabilitative) specifically :
1. Physical/psychological consequences
2. Financial consequences
3. Social consequences
F. Unavailability of required care/services
G. Inaccessibility of required services due to:
1. Cost constrains
2. Physical inaccessibility
H. Lack of or inadequate family resources, specifically
1.Manpower resources
2.Financial resources, cost of medicines prescribe
I. Feeling of alienation to/lack of support from the community, e.g. stigma due to mental illness, AIDS,
etc.
J. Negative attitude/ philosophy in life which hinders effective/maximum utilization of community
resources for health care
3. POPULATION GROUP
○ A group of people who share a common characteristic, developmental stage, or common exposure to
particular environmental factors
○ Population aggregates with developmental needs, and those who are vulnerable (Allender and
Spradley, 2001)
○ Usual targets of social services and health programs
 There are several population groups that are considered vulnerable:

 Racial and ethnic minorities

 The economically disadvantaged
 The uninsured
 Low-income children
 The elderly
 The homeless
 Those with chronic health conditions, including severe mental illness
 Rural residents
 Children
 Immigrants and refugees
 LGBTQI persons
 Women
These groups may experience greater risk factors, worse access
to care, and increased morbidity and mortality compared with
the general population. It is important to address the needs and
challenges that vulnerable populations face in order to promote
equity and improve health outcomes.
4. COMMUNITY
 Each one is unique due to it’s functions (sociocultural, political, economic, and environmental
context
 Vary also because of community dynamics, citizen participation, power, decision-making structures,
and community collaboration efforts.

PROBLEMS THAT MAY ARISE IN THE COMMUNITY LEVEL

o Ineffective community coping related to insufficient resources for problem-solving, inadequate

community resources (emergency services, transportation), or lack of social support services
o Higher rates of illness due to environmental factors such as pollution, poor sanitation, or inadequate
housing
o Lack of access to healthcare services due to geographic or financial barriers
Identifying the health needs and resources of clients, including individuals, families, and communities, is
an important step in providing appropriate healthcare services. Health needs assessment (HNA) is a
systematic method of identifying unmet health and healthcare needs of a population and making changes
to meet these unmet needs

The following are some steps that can be taken to initiate appropriate action based on the
assessment:

Step 1: Clearly define the objectives of the needs assessment to ensure that the assessment is focused and
relevant

Step 2: Identify target audiences and stakeholders: Identify the target audiences and stakeholders who
will be involved in the assessment process

Step 3: Be realistic about the resources and capacity available to conduct the assessment

Step 4: Collect and analyze data to identify the health needs and resources of the clients
• Step 5: Prioritize needs: Prioritize the identified needs based on their urgency and importance

• Step 6: Develop an action plan: Develop an action plan to address the identified needs

• Step 7: Implement and evaluate the action plan: Implement the action plan and evaluate its
effectiveness in meeting the identified needs
.
Overall, the goal of a needs assessment is to develop strategies to address the health needs and
identified issues of the community, and to improve health, commissioning of healthcare, and other
service planning, policy making, and priority setting
 IMPORTANCE OF
COMMUNITY HEALTH
NURSING TO POPULATION
GROUPS
 Promoting healthful physical environment: Community/public health nurses promote a healthful
physical environment that supports health and well-being

 Preventing disease: By definition, community-oriented nursing has the goal of preserving,

protecting, or maintaining health and preventing disease to promote the quality of life

 Assessing and monitoring population health: Community health nurses assess and monitor
population health to investigate, diagnose, and address health hazards and root causes of health
problems

 Providing education: Community health nurses provide education to individuals and communities to
promote health and prevent disease
 Addressing health disparities: Community health programs address disparities by ensuring equitable
access to health resources, such as healthcare providers and health insurance

 Partnering with communities: Community-based nurses work in partnership with communities to address
an array of health-related needs ranging from population-level diabetes management to community-wide
sexual risk reduction

 Enhancing engagement and performance: Community-based interventions, such as INSIGHTS into

Children’s Temperament, have been shown to improve the behavior of children both with and without
attention-deficit/hyperactivity disorder (ADHD) and to enhance engagement and performance
In summary, community health nursing can assist population
groups to maintain health by promoting a healthful physical
environment, preventing disease, assessing and monitoring
population health, providing education, addressing health
disparities, partnering with communities, and enhancing
engagement and performance.
 COMMUNITY
DEVELOPMENT AND
ORGANIZATION
 PROGRAM PLANNING

Identifying a community problem, developing a

program to address it, and evaluation of the program
success or failure
STEPS IN PROGRAM PLANNING

1 2
COMMUNITY IDENTIFYING
ASSESSMENT NEEDS

4
3 DEVELOP AN
SETTING GOALS INTERVENTION
AND OBJECTIVES (EVIDENCE-BASED
PROGRAMS)

5 6
EVALUATE
IMPLEMENTATION PROGRAM
 STEPS IN PROGRAM PLANNING

1 ASSESSMENT 2 DIAGNOSIS

COMMUNITY IDENTIFYING
ASSESSMENT NEEDS

4
3 PLANNING
DEVELOP AN
INTERVENTION
SETTING GOALS
AND OBJECTIVES (EVIDENCE-BASED
PROGRAMS)

EVALUATION

5
INTERVENTION 6
EVALUATE
IMPLEMENTATION PROGRAM
 1
COMMUNITY ASSESSMENT

ASSESSING THE TARGET POPULATION

Geographic Location
Gender
Race
Ethnicity
Health Problem or Challenge
 2
IDENTIFYING NEEDS

DIAGNOSE THE COMMUNITY PROBLEM BY:

Gathering data
Data from RHUs or CHUs, Community profile
Focus Groups
Written surveys
Identify Barriers
 3
SETTING GOALS AND OBJECTIVES

SET GOALS TO ACHIEVE OUTCOME

Reduce the number of undernourished children by 5% in the year 2024

Objectives:
 Implement nutrition sensitive programs aimed at improving dietary quality, access to
clean water and sanitation
 Maternal and child health classes
 Secure domestic funding for nutrition-related programs (Government and NGOs)
 Radio programs teaching on cheap, easy and nutritious recipes
 4
DEVELOP AN INTERVENTION
(EVIDENCE-BASED PROGRAMS)

DO WHAT YOU HAVE WRITTEN IN FIDELITY

 6
EVALUATE PROGRAM

FOLLOW- UP
Immediately after intervention
6-month follow-up
12-month follow-up
Follow-up data (usually takes years)
THANK YOU VERY
MUCH!