Introduction to community health nursing Presented by: DR/Amira Yahia Assistant professor E.mail:a.yahia@mu.edu.sa

Objectives At the end of this session you will be able:--- To Illustrate the historical evolution in the term of community health nursing To define terms related to CHN To be able to describe what is CHN. To analyze the characteristics of community health nursing. To verify the factors influence the CHN.

To discuss the CHN practice To describe the setting for community health nursing To identify the factors affecting community health

History of Community Health Nursing Before mid 1800s- Home Care which focus on Sick and Poor individual. Orientation: curative Agencies: religious orders Mid 1800s to 1900- District Nursing with focus on Sick and poor individual. Orientation: curative/less in prevention Agencies: voluntary & some government

History of Community Health Nursing public health nursing(1900-1970) focus: public needs nursing orientation: families service: curative; preventive agencies: government & some voluntary community health nursing(1970 to present) focus: total community nursing orientation: population service: health promotion; illness prevention agencies: many kinds; some independent practice

Definitions of terms related

Definitions Community: A group of people sharing common interest, needs, resources and environment. Health: Is defined as a state of well -being resulting from harmonious interaction of body, mind, spirit and the environment

Cont…. Community health: Is achieved by meeting the collective needs of the community and society by identifying problems and supporting community participation in the process Community health nursing: Is a field of nursing practice that applies knowledge and skills from nursing and public health toward the promotion of optimal health for the total community.

Public Health Definition Public health is the Science and Art of : preventing disease, prolonging life, promoting health and efficiency through organized community effort.

Definition of Community Health (ANA,2000） Community health nursing is a synthesis of nursing and public health practice applied to promoting and preserving the health of populations. Treat “ Population as a Whole” Focus on individual, family, groups, community Utilizing Health promotion, health maintenance, health education, and management, coordination, and continuity of care for meeting population needs.

Characteristics of community health nursing: Community health nursing has 6 important characteristics: It is field of nursing i.e. especially within the large discipline. It combines the specialized knowledge of public health with nursing practice (i.e. .epidemiology, vital statistics…etc) It is population oriented and does not deal only with individual clients.

Cont…… It emphasized health rather than disease or illness. It involves interdisciplinary collaboration i.e. team work with other professionals. It promotes client participation by fostering a sense of responsibility among people for their own health.

Pubic Health is for: The sanitation of environment, The control of communicable infections, The education of the individual in personal hygiene, The organization of medical and nursing services for The early diagnosis and preventive treatment of disease, and The development of the social machinery to insure everyone a standard of living adequate for the maintenance of health , Healthy Life Style and Longevity .

Functions of community health nursing: Control of communicable disease. Environmental sanitation. Mental and child health. Health education. Laboratory services. Vital statistics Any community heath program is built on these 6 basic functions in addition to school, industrial and rural heath programs.

Community Health Practice

Factors influencing the development of community health nursing: Advanced technology which solved some health care problems thus nurse's attention was shifted to problems of aging, chronic illness and prevention. Progress in causal thinking has broadened our perspective to multiple causes including stress, environmental hazards and the community structure. Changes in education, which led the community health nurse to emphasize collaborating with clients rather than planning for them.

cont…… The changing role of women helped to open new avenues of leadership for community health nurses. The consumer movement has increases the public's concern for quality health services (as consumers have assumed responsibility for their own health, the community health nurse became a catalyst to assist client toward autonomy in health).

Settings for Community Health Nursing Practice:- The types of places in which community health nurses practice are increasingly varied and include a growing number of nontraditional settings and partnerships with non health groups

Cont….. These settings are grouped into six categories: (1) Homes (2) Ambulatory service settings (3) Schools (4) Occupational health settings (5) Residential institutions (6) The community at large.

Community Health Nurse Practice Is focussed on wellness not sickness. Is focussed on prevention not just treatment of problems. Is focussed on assisting people and communities make their own decisions regarding health care. Is focussed on assisting those with existing health conditions to maximise their potential and prevent deterioration if possible.

Cont.. Is based in the community in a range of settings, wherever there is a need for support, information and education. Responds to public health needs in relation to communicable diseases.

Cont… Has the whole community as their client, as well as groups, families and individuals. Recognises the impact of life course and social determinants of health and works in partnership with the community to address these.

Cont…. Community health nurses recognise health as “ a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity” W.H.O. Community health nurses deal with clients in a holistic manner, working with them wherever they are on the health – illness continuum.

Give examples from your practice 24

Community Health Nursing Roles Client-oriented roles Delivery-oriented roles Population-oriented roles

Role of the community health nurse. The community heath nurse must be capable to performing multiple role functions of the setting of employment. These role functions include: Care provider (function role) Educator role Counselor role Manger (Administrative role) Leader role Collaborator role Coordinator role Advocate role Researcher role Evaluation role

Roles of Community Health Nurses

Delivery-oriented Roles Coordinator/Care manager Collaborator Liaison

Population-oriented Roles Case finder Leader Change agent Community developer Coalition builder Researcher

Health Prevention Tertiary Prevention Secondary Prevention Primary Prevention

Primary Prevention for Health Promotion Health Education Adequate Nutrition Individual Development Adequate working environment and recreation, resting Pre-marriage counseling and education Genetic Counseling Regular Physical Examination

Primary Prevention for Health Protection Comply with immunization Individual hygiene Improve environment sanitary Occupational Safety Prevent Accident in all ages Adequate nutrition Avoid cancer cause agents Avoid allergic

Secondary Prevention Identify cases in the community Screen and test Conduct special physical examination Treat and prevent the progress of illness Avoid the spreading of disease Reduce the disability time

Tertiary Prevention Treat and stop the disease progress and avoid complication and side effect Limit the chance for disability Provide rehabilitation for physical and psychological well-being, occupational therapy, availability of long-term care

Opportunity for Future Community Health Nursing Chronic Disease management Home Care Extended care from Acute care setting Elderly care Rehabilitation care in different population Health promotion in every level Health system referral, emphasize individual role and function of community health sector

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