Community Health Nurs ing

Arianne C. Jamison, MAN, RN Click to edit Master subtitle style

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CONCEPTS OF COMMUNITY HEALTH NURSING

What is Community?

A group of people with common characteristics or interests living together within a territory or geographical boundary Place where people under usual conditions are found WHO DOH

Definitions:
 

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Concept of Community

Derived from the Greek word “komunitas” meaning people Sander defines community as: - a collection of people - a place - a social system

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WHO Expert Committee o f Nursing

“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 program for the promotion of health, the improvement of the conditions in the social and physical environment, rehabilitation of illness and disability.”

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in place of work. Its responsibilities extend to the care and supervision of individuals and families in their homes. in schools and clinics.DOH Definition:  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.  5/1/12 .

in school. groups. in places of work for the promotion of health. in clinics. individuals at home. prevention of illness. families. According to Ruth B. Freeman:  “service rendered by professional nurse with communities. in health centers. care of the sick at home and rehabilitation” 5/1/12 .

American Nurses Associa tion  CHN practice promotes and preserves the health of populations by integrating the skills and knowledge relevant to both nursing and public health 5/1/12 .

“To raise the level of citizenry by helping communities and families to cope with the discontinuities in and threats to health in such a way as to maximize their potential for high-level wellness”  GOAL OF CHN  5/1/12 . PHILOSOPHY OF CHN (Margaret Shetland)  The philosophy of Community Health Nursing is based on the worth and dignity of man.

Basic Principles in CHN  The community is the patient of the community health nurse. population group and the community. the client is considered as an active partner not a passive recipient of care The goal of improving the community’s health status is achieved through multidisciplinary effort CHN practice is affected by developments in health technology in particular. In community health nursing. the family is the unit of care and there are four levels of clientele.    5/1/12 . family.individual. and changes in society in general.

Community Health Nursi ng Goal of professional practice Nature of practice Knowledge base Levels of clientele Focus of practice Promotion and preservation of the health of the population Comprehensive. continual and not episodic Nursing and public health Individual. general. community Primacy of the population as a whole . family. population group.

mental and social well-being and not merely the absence of disease or infirmity Health as a A dynamic state in the life cycle of an relative concept individual. implies continuous adaptation to the physical. biologic and social environment . family or community. 1986 A state of complete physical.Concept of Health World Health Organization (WHO).

promotion of health and prevention of illness .effective management and organization of health services Involves interdisciplinary collaboration with other professionals Promotes client self-care for their own health    5/1/12 .emphasis on populations .Characteristics of CHN Pr actice  A field of nursing practice.use of measurement and analysis of aggregates . a nursing specialty within a larger discipline Combines the specialized knowledge of public health with nursing practice .

periodic basis Nurse and client as equals.Attributes of Community Health N ursing Population consciousness Health orientation Autonomy Creativity Continuity Collaboration Intimacy Variability 5/1/12 Awareness of factors that impinge on health of populations as well as individuals Emphasis on health promotion and disease prevention rather than cure and illness Greater control over health care decisions by both nurse and client Use of innovative approaches to health promotion and resolution of health problems Provision of care on continuing. ethnic backgrounds and settings . comprehensive basis rather than short-term. collaboration with other segments of society Greater awareness of the reality of client lives and situations Wide array of clients at different levels.

Scope of CHN Practice Curative Medicine Individuals Aggregates Epidemiology or Nursing Basic Nursing Community Health Public Health 5/1/12 .

places of work Promote and maintain health Prevent disease Recovery and restoration of the sick to health and rehabilitation Enhance capabilities of individuals. families and population groups for self-care .Salient Features of CHN Theoretical bases for practice Setting/Place of practice and activities Objectives Knowledge and skills from the sciences of public health and nursing Outside of purely curative institutions.health centers. homes. based in the community . schools.

rather than solely the needs of an individual patient or family Range of services Whole range of services from health provided promotion. preventive.Salient Features of CHN Patient and levels Individual patients. families. population groups of clientele at risk and the community as a whole Perspective and orientation when establishing priorities of care Health of total population or community as a whole The greatest good for the greatest number Impact on community health. curative and rehabilitative nursing services .

Salient Features of CHN Priority concern/ Health promotion and maintenance stress or emphasis Disease prevention in care Types of people/patients seen and served All types of patients representing total health spectrum All conditions of health and illness All age group .

2 Major Fields of Nursing in the Philippines   Hospital Nursing Community Health Nursing   School Health Nursing Occupational Health Nursing 5/1/12 .

Basic Skills of a CHN   Observation Communication  for one to build the kind of relationship that result in improved patient care and outcomes  Interpersonal relations 5/1/12 .

CORE COMPETENCIES OF A CHN   Analytic assessment skills Policy development/program planning skills Communication skills Cultural competency skills Community dimensions of practice skills Basic public health sciences skills      5/1/12 .

COMPETENCY STANDARD S OF NURSING PRACTICE IN THE PHILIPPINES   SAFE AND QUALITY NURSING CARE MANAGEMENT OF RESOURCES AND ENVIRONMENT HEALTH EDUCATION LEGAL RESPONSIBILITY ETHICO-MORAL RESPONSIBILITY PERSONAL AND PROFESSIONAL DEVELOPMENT     5/1/12 .

skills and attributes in dealing with the health needs and problems of his/her clients Is familiar with the structure and dynamics of the health care systems and its broader socio-cultural.ROLES & FUNCTIONS OF C HN  Has the necessary knowledge. economic and political context  Is knowledgeable of laws and policies affecting the health care system in 5/1/12  .

Role Model Planner/Program mer Researc her Manager/Superv isor Provider of Nursing Care Communit y Organizer Recorder/Repo rter/ Statistician Health Monit or Coordinator of Services Change Agent Traine r Health Educator/ Health Counselor 5/1/12 .

Interprets and implements the nursing care plan. program politics.5/1/12 Formulates nursing component of health plans. families and . Identifies needs. priorities and problems of individuals. memoranda and circulars for the concerned staff/personnel. she/he is responsible for the formulation of Provides the municipal technical health plan. assistance to rural health midwives in health matters like target setting. etc. In doctor less area.

Provides direct nursing care to the sick. clinic. disabled in the home. Provides continuity of patient care.Develops the family’s capability to take care of the sick. 5/1/12 . disabled or dependent member. school or place of work.

MANAGER/SUPERVISOR REQUIREMENTS: Philippine RN ü At least 2 yrs. Experience in general nursing service administration ü With at least 9 units in Management and Administrative courses in MA üBe a member of good standing of the accredited professional organization of nurses ü Interprets and implements program policies memoranda and circulars. 5/1/12 .

Initiates and participates in community development. organizing and implementing and . 5/1/12 Responsible for motivating and enhancing community participation in terms of planning.

Coordinates with individuals. dental health and mental health. 5/1/12 . health education. and groups for health and relaxed health services provided by various members of health team and other GOs an NGOs. families. Coordinates with nursing program with other health programs such as environmental sanitation.

Conducts pre-marital counseling Trains new parents Seminars on basic health services Teaches health prevention 5/1/12 .

Uses symptomatic and objective observation and other forms of data gathering Morbidity Registry Questionnaire Checklist Annual report record to monitor growth and development Health status of individuals. 5/1/12 . groups of the community through contact/visits with them. families. families and communities.Detects deviation from health of individuals.

5/1/12 .Provides good example/ model of healthful living to the public/community.

families.Motivates changes in health behavior of individuals. 5/1/12 . group and community including lifestyle in order to promote and maintain health.

Epidemiological Skills § Records and reports appropriately to the authorities § 5/1/12 .

5/1/12 .RESEARCHER  Participates/assists in the conduct of surveys. studies and researches on nursing and health-related subjects.  Coordinates with GOs and NGOs in the implementation of studies/research.

History of Public Health Nur sing • PHN started in 1912 when the Bureau of Health employed 4 graduate nurses from the Philippine General Hospital School of Nursing. They were assigned in Cebu and engaged purely on maternal and child nursing 5/1/12 .

• PHN inaugurated its pioneer work in Tondo. problem on these areas posed a serious problem. As a remedy. hold a clinic and dispensary work with special emphasis on maternal care. At that time. Balbina Basa made a house to house visit. Manila in 1919 when a visiting nurse Ms. Red Cross introduced the operation on puericulture centers in the crowded districts of Manila which was later on extended to the provinces 5/1/12 .

one group was engaged in puericulture centers and were known as health center nurses while the other group assigned in 3 towns were called district nurses. they were merged and became known as Public Health Nurses 5/1/12 .• There were 2 groups of nurses. Later.

The Commonwealth Government appropriated fund for 215 positions for public health nurse in 1935 which include 26 positions for nurse supervisors. This was done to intensify campaign against the high infant mortality rates • 5/1/12 .• In 1933. 175 nurses performed maternal and child health work in Manila and provinces.

Mrs. Soledad Buenafe became the assistant chief nurse of the Section of Nursing 5/1/12 .• Puericulture centers were under the supervision of the Office of the Public Welfare Commission until the Reorganization Act of 1933 took effect placing them under the Bureau of Health.

• The Section of Nursing was transferred to the Division of Maternal and Child Hygiene and later became the Section of Public Health Nursing in 1935 in when Mrs. This formed the nucleus of the present Division of Nursing of Manila 5/1/12Health Department • . Buenafe became the chief The Department of Health and Welfare was created in 1940 where 6 of the public health nurses of the Bureau of Health were transferred in 1941.

Buenafe. 1941. She also created the Division of Nursing to replace the Section of Nursing of the Bureau of Health 5/1/12 . October 1.• Public Health Nurses wore a beige uniform which later are replaced by the blue and white stripes due to scarcity of materials. PHN donned a nurse’s cap but was discontinued upon recommendation of Mrs.

1942 5/1/12 . twelve emergency units were organized. 1941. During the WWII on December 8. one of them was sent to Bataan  31 nurses who were taken prisoners of war by the Japanese army and confined at the Bilibid Prison in Manila were released on July 22.

many of the public health nurses found jobs in the US Army Hospitals and Manila Health Department which was managed by the US Army The PHN service in the DOH received a big boost in 1953 with the creation of 81 Rural Health Units which was made possible through bilateral agreement between US and Philippine Government which paved the way for progressive PHN especially in the rural areas 5/1/12 .  During early liberation period of 1945.

known as the Rural Health Unit Act which was implemented in July of the same year. 1082. 5/1/12 . On May 18. 1954. the Philippine Congress passed and approved Republic Act No.

1082 entitled “An Act Strengthening Health and Dental Services in Rural Areas and Providing funds” therefore was approved RA No. 4. Republic Act No. 1891 “An Act to Amend Sections 2. 1891 created 8 categories of rural health units corresponding to 8 population groups to be served  5/1/12 . In June 1957. 7 and 8” of RA No. 3.

000 midwives were recruited and trained to serve in the rural areas. In 1975.000 population Executive Order No. 2. 119 reorganized the DOH and created several offices and services within the DOH  5/1/12 . The aim was for the ratio of one Rural Health Midwife per 5.

 In May 24. EO 102 “Redirecting the Functions and Operations of the DOH” was signed by President Joseph E. Between 1990-1992 the Local Government Code of 1991 RA 7160 was passed and implemented. 1999. Estrada 5/1/12 .

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