“I am sure that God who began the good work within you will keep right on helping you grow in his grace until his task within you is finally finished… “ Philippians 1:6

NR 402

History of Community Health Nursing Goal: Preservation/ improvement of the health of populations and community. Rapid urbanization during 18/19 th C., resulted in higher infant mortality, poor working conditions, occupational dse., and epidemic infectious dse. CHN developed as a result of illness of those who couldn’t pay for private nursing care. 1860: Florence Nightingale established a training school for nurses 1893: Lillian Wald established the Henry Street Settlement 1925: Mary Breckinridge established the Frontier Nursing Service

Principles guiding of Community H.N. practice include: Ethical Consideration Advocacy Epidemiology Epidemiological Calculations Epidemiological Triangle The Epidemiological Process Community-Based Health Education

Epidemiology Epidemiology is the investigative study of disease trends in populations for the purposes of disease prevention. Epidemiology relies on statistical evidence to determine the mortality or morbidity. Epidemiology is used to evaluate the effectiveness of disease prevention and health promotion activities.

Epidemiological Triangle HOST (Living being ) AGENT (Bacteria, Virus,..) ENVIRO NMENT VECTOR (fleas, rodents, birds, ticks..)

Host: Susceptible individuals, living being that will be affected by the agent. Agents: the animate or inanimate object that causes the disease. i.e., Viruses, Fungi, Bacteria, Protozoa, Drugs, Toxins, Trauma. Environment: temp, rainfall, crowded… Intermediary (living) vectors: Mosquitos, Fleas, Birds, Rodents Epidemiology (Cont.)

Disease Prevention Primary Prevention: Prevention of the initial occurrence of disease or injury. Ex) family education, nutrition counseling, immunization, assessment, Prenatal classes Secondary Prevention: Early detection of disease and treatments with the goal of limiting severity and adverse effects. Ex) Screenings, treatment, control of outbreaks of communicable diseases

Disease Prevention (Cont.) Tertiary Prevention: Maximization of recovery after an injury or illness (rehabilitation). Ex) Exercise rehabilitation, Shelters, support groups, exercise for hypertensive clients.

Responsibilities of Local Health Dept. The Primary focus is the health of its citizens. Assessment of the health status of populations Coordination of directives from state and federal levels. Determination of how well community health needs are being met. Community Health Nurse provides direct services such as referring, teaching, advocating, coordinating, and consulting. Funded through local taxes with support from federal and state funds.

Community Health Nurses Practice as: Home health nurses Hospice nurses Occupational health nurses Parish nurses School nurses Case managers