COMMUNITY HEALTH NURSING

Population-focused Nursing “Community” or “public” health nursing is population based. Care may be given to individuals and families, but its purpose is the improvement of the health of the population as whole.

Community Health Nursing A synthesis of nursing knowledge and practice and the science and practice of public health, implemented via systematic use of the nursing process and other processes, designed to promote health and prevent illness in population groups.

Tenets of Community Health Nursing - 1 Systematic and comprehensive population-based assessment, policy development, and assurance. Partnering with representatives of the people. Priority for primary prevention. Intervention to create conditions for health.

Tenets of Community Health Nursing - 2 Active outreach Concern for the population as a whole Resource allocation supports maximum gain for the population. Interdisciplinary collaboration Source: Quad Council of Public Health Organizations. (1999).

Community Health Nursing Standards of Care - 1 Standard I. Assessment Standard II. Diagnosis Standard III. Outcomes identification Standard IV. Planning Standard V. Assurance Standard VI. Evaluation Source: Quad Council of Public Health Organizations. (1999).

Community Health Nursing Standards of Performance - 1 Standard I. Quality of care Standard II. Performance appraisal Standard III. Education Standard IV. Collegiality

Community Health Nursing Standards of Performance - 2 Standard V. Ethics Standard VI. Collaboration Standard VII. Research Standard VIII. Resource utilization Source: Quad Council of Public Health Organizations. (1999).

Attributes of Community Health Nursing - 1 Population consciousness Health orientation Autonomy Creativity

Attributes of Community Health Nursing - 2 Continuity Collaboration Intimacy Variability

Population Consciousness An awareness of how information about individual clients or families relates to the health status of the total population

Health Orientation An emphasis on health promotion and maintenance rather than the cure of disease or disability

Autonomy Active client participation in health decision making Independent judgment and action by the community health nurse Active client participation in health decision making

Creativity An ability to develop innovative solutions to community health problems using available resources

Continuity Long term relationships with clients Provision of care across time as old problems are solved and new ones occur Provision of care across multiple needs

Collaboration Interaction and joint decision making with multiple health-related and non-health-related disciplines to address the health needs of population groups

Intimacy Potential for increased accuracy of nursing assessment Potential for developing awareness of intimate details of clients’ lives Potential for increased accuracy of nursing assessment

Variability In health problems addressed In settings for practice In clients served In health problems addressed In settings for practice

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

Client-oriented Roles Caregiver Educator Counselor Referral resource Role model Advocate Primary care provider Case manager

Caregiver Uses the nursing process to provide direct nursing intervention to individuals, families, or population groups

Educator Facilitates learning for positive health behavior change

Counselor Teaches and assists clients in the use of the problem solving process

Figure 8–1 Problem Solving in Community Health Nursing

Referral Resource Links clients to services to meet identified health needs

Role Model Demonstrates desired health-related behaviors

Advocate Speaks or acts on behalf of clients who cannot do so for themselves

Primary Care Provider Provides essential health services to promote health, prevent illness, and deal with existing health problems

Case Manager Coordinates and directs the selection and use of health care services to meet client needs, maximize resource utilization, and minimize the expense of care

Delivery-oriented Roles Coordinator/Care manager Collaborator Liaison

Coordinator/Care Manager Organizes and integrates services to best meet client needs in the most efficient manner possible

Collaborator Engages in shared decision making regarding the nature of health problems and potential solutions to them

Liaison Provides and maintains connections and communication between clients and health care providers or among providers

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

Case Finder Geared toward awareness of population-level problems Identifies clients with specific health problems or conditions Geared toward awareness of population-level problems

Leader Influences clients and others to take action regarding identified health problems

Change Agent Initiates and facilitates change in individual or client behaviors or conditions or those affecting population groups

Community Developer Mobilizes residents and other segments of the population to take action regarding identified community health problems or issues

Coalition Builder Promotes the development and maintenance of alliances of individuals or groups of people to address a specific health issue

Researcher Conducts studies to explain health-related phenomena and to evaluate the effectiveness of interventions to control them