1. Introduction to community health nursing
Presented by: DR/Amira Yahia
Assistant professor

2. 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.

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

4. 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

5. History of Community Health Nursing
public health nursing( ) 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

6. Definitions of terms related

7. 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

8. 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.

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

10. 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.

11. 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.

12. 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.

13. 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 .

14. 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.

15. Community Health Practice

16. 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.

17. 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).

18. 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

19. 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.

20. 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.

21. 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.

22. 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.

23. 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.

24. Give examples from your practice24

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

26. 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

27. Roles of Community Health Nurses

28. Delivery-oriented Roles
Coordinator/Care manager
Collaborator
Liaison

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

30. Health Prevention Tertiary Prevention Secondary Prevention
Primary Prevention

31. 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

32. 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

33. 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

34. 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

35. 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

36. THANK YOU
Thankyou