1. 1
CHAPTER

2. Definition of Community Health Nursing
Science and practice of public health
Systematic use of nursing process
Promotes health and prevent illness
Focuses on population groups

3. Past and Present Public health Community health
Environmental sanitation
Control of communicable diseases
Community health
Health education
Individual behavior change
Actions to change factors that influence health

4. Community-Based Nursing
Provides care to individuals (often to those who are ill)
Delivers care in a community setting

5. Community-Focused Nursing
Brings nursing knowledge and expertise to community

6. Community-Driven Nursing
Focuses on whole community needs as identified by community members
Emphasizes community participation to determine needs

7. Community Health Nursing
Mission, goals, and expectations
Promote and improve health
Prevent illness and injury
Protect from threats
Biological
Behavioral
Social
Environmental

8. Program-focused Service delivery system Specific health problems
Specific target populations
Specialist practice
Focus on a specific set of services
More focus on services to groups

9. Problem Solving in Community Health Nursing
FIGURE Problem Solving in Community Health Nursing.

10. District Nursing Originated in England
Addresses health needs of given geographic segment of the population
Broad spectrum of services
Generalist practice
More services to individuals

11. Eight Unique Attributes of Community Health Nurses
Population consciousness
Orientation to health
Autonomy
Creativity

12. Eight Unique Attributes of Community Health Nurses (continued)
Continuity
Collaboration
Intimacy
Variability

13. Advocacy
Definition
Nursing advocacy

14. Community Health Nursing Advocacy
Definition

15. Advocacy Models Guardian of legal rights
Preservation of patient values
Champion of social justice and access to care
Client empowerment

16. Advocacy Process A recipient of the advocacy An advocate An adversary
A consequence for all the participants in the process

17. Advocacy Process (continued)
Factors that influence participants in an advocacy situation
Knowledge
Conviction
Emotion

18. Approaches to Effective Advocacy
Advocate takes action that is situation- and client-specific
Use a collaborative and cooperative approach with the adversary
Educate the advocacy recipient or adversary
Confront the adversary
Request a change
Explain
Enlist the aid of others

19. Community Health Nurse Functions in the Advocacy Role
Determine the need for advocacy
Determine the point at which advocacy is most effective
Collect facts surrounding the problem
Present the client’s case to the appropriate decision makers
Prepare clients to speak for themselves

20. Standards of Practice
Essential to a profession

21. Developed by Quad Council of Public Health Nursing Organizations
Apply nursing process to community/public health nursing practice
Incorporate core functions of pubic health

22. Professional Standards
Expected levels of professional performance
Quality of practice
Education
Practice evaluation
Collegiality

23. Professional Standards (continued)
Ethics
Collaboration
Research
Resource utilization
Leadership
Advocacy

24. Eight Domains of Competency
Analytic assessment
Policy development and program planning
Communication
Cultural competence

25. Eight Domains of Competency (continued)
Community dimensions of practice
Basic public health practice
Financial planning and measurement
Leadership and systems thinking

26. Community Health Nursing Roles
Vary based on specific practice setting
Focus of activity
Client-oriented roles
Delivery-oriented roles
Population-oriented roles

27. Focus of Services
Types and emphasis placed on specific roles vary by practice setting
Client-oriented roles
Emphasize direct care of specific individuals or families
Delivery-oriented roles
Focus on mechanisms of care delivery
Primarily address care delivery to individuals and families
Population-oriented roles
Care of communities or populations

28. Client-Oriented Objectives
Apply the nursing process
Assess client needs
Develop nursing diagnoses
Plan nursing interventions
Evaluate nursing care and outcomes

29. Client-Oriented Roles
Caregiver
Educator
Counselor
Referral resource
Role model
Primary care provider
Case manager

30. Caregiver Functions Assess client health status
Derive nursing diagnosis
Plan nursing intervention
Implement plan of care
Perform delegated medical treatments or provide primary care as needed

31. Caregiver Functions (continued)
Introduce other supportive services as needed
Teach and supervise others
Teach clients self-care
Coordinate health care services
Serve as liaison between client and system
Evaluate the outcome of nursing intervention and modify plan

32. Educator Role Assess client’s need for education
Develop health education plan
Present health education
Evaluate outcome of health education

33. Counseling Role: Choose Viable Solutions to Health Problems
Assist client to identify and clarify problem
Help identify alternative solutions to problem
Assist client to develop criteria for acceptable solution
Assist client to evaluate alternative solutions
Evaluate problem-solving process
Point out use of problem-solving process for future use

34. Referral Resource: Direct Client to Resources Required to Meet Their Needs
Obtain information on community resources
Determine need for and appropriateness of referral
Make and follow up on the referral

35. Role Model Demonstrate behaviors Influence health related behaviors
Response to crisis
Treatment of clients
Types of client-focused activities
Display competence

36. Case Manager Identify need for case management
Assess and identify client health needs
Design plan of care
Oversee implementation of care by others
Evaluate outcome of care

37. Delivery-Oriented Roles
Enhance operation of health care delivery system
Coordinator/care manager
Collaborator
Liaison

38. Coordinator/Care Manager
Determine who is providing care to client
Communicate with other providers regarding client situation and needs
Arrange case conferences as needed
Assist in development of care networks

39. Collaborator Communicate with other health team members
Participate in joint decision making
Participate in joint action to resolve client problems
Participate in joint activities to evaluate the outcome of care

40. Liaison Serve as initial point of contact between client and agency
Facilitate communication between client and agency personnel
Interpret and reinforce provider recommendations
Serve as client advocate as needed

41. Population-Oriented Roles
Promote, maintain, and restore the health of population
Case finder
Leader
Change agent
Policy developer

42. Population-Oriented Roles (continued)
Community organizer/mobilizer
Coalition builder
Social marketer
Researcher

43. Case Finder Role
Develop knowledge of signs and symptoms of health-related conditions and contributing factors
Use diagnostic reasoning process to identify potential cases of disease or other health-related conditions
Carry out investigation of specific cases of disease as needed
Provide follow-up care to identified cases

44. Leadership Role Identify need for action
Assess situation and followers to determine appropriate leadership style
Motivate followers to take action
Coordinate group member activities in planning and implementing action
Assist followers to evaluate the effectiveness of action taken

45. Change Agent Plans, controls, and enhances health processes
Recognizes need for change
Makes others aware of need
Motivates others to change
Initiates and directs desired change

46. Community Mobilizer
Assists community members to identify health issues of concern
Participates in data collection relevant to issues of concern
Mobilizes community members to take action
Assists with coalition development to foster community action
Assists community members to identify achievable goals
Participates in the development of strategies to accomplish identified goals
Participates in the implementation of community strategies to achieve goals

47. Coalition Builder Creating Temporary/Permanent Alliances
Functions include
Identify potential coalition members based on common interest, assets available, etc.
Present potential coalition members with the benefits to be achieved through alliance
Participate in the delineation of coalition goals
Assist in the development of operating guidelines for the coalition
Participate in the selection and implementation of strategies to accomplish coalition goals

48. Policy Advocate Determine need for policy development
Analyze factors influencing the policy situation
Identify key decision makers
Assist in policy formation
Communicate the proposed policy
Monitor the progress of policy development

49. Social Marketer Identify the need for societal behavior change
Analyze motivation and perceived benefits and barriers to the desired change
Identify target markets and their unique features
Develop and test social marketing strategies appropriate to target markets
Assist with implementation strategies
Evaluate the effectiveness of social marketing strategies in achieving the desired change

50. Researcher Critically review relevant research
Apply research findings to practice
Identify researchable problems
Design and conduct research
Collect and analyze data
Disseminate research findings

51. Resources
The Center for Nursing Advocacy The Center for Nursing Advocacy seeks to increase public understanding of the central, front-line role nurses play in modern health care. The focus of the Center is to promote more accurate, balanced and frequent media portrayals of nurses and increase the media's use of nurses as expert sources. The Center's ultimate goal is to foster growth in the size and diversity of the nursing profession at a time of critical shortage, strengthen nursing practice, teaching and research, and improve the health care system.