1. 1
CHAPTER

2. Definition of Community Health Nursing
There are many definitions of Community Health Nursing, the most comprehensive one was the ANA definition:
“ Synthesis of nursing practice and public health practice applied to promoting and preserving the health of populations”

3. 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

4. Public Health
Public Health was described by Winslow (1952) as follows:
Is the science and art of:
Preventing disease.
Prolonging life.
Promoting health; by:
Organized community effort for the sanitation of the environment
Control of communicable and non-communicable diseases.
Education of individuals in personal hygiene
Early diagnosis and prevention .
Maintenance of health

5. 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

6. KEEP IN MIND THAT
The nature of this practice is general and comprehensive.
It is not limited to a particular age or diagnostic group.
It is continuous not episodic.
The dominant responsibility is to the population as a whole.

7. Definition of Community
Defining the community is based on different aspects:
Some definition focus on functions performed by communities; for example;
A system of formal and informal groups characterized by independence and whose function is to meet the collective needs of group members.

8. Definition of Community Conti
some definitions use locale as basis for community. For example;
A social system, a place, and people.
Some definitions based on existence of commonalities among members of the community; for example
Collection of people who share some important features of their lives.

9. Definition of Community Conti
Other authors take more elective view that community can be defined either in terms of geography or special interest.

10. Critical Attributes of Communities
Despite the diversity in definitions of community, certain common elements are revealed; which are:
Group orientation
Bond between individuals
Human interaction

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

12. Health (Community View)
World Health Organization(WHO) defines health as
a state of complete physical, mental, and social well-being and not merely the absence of disease.

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

14. Professional Standards of Community Health Nurses
Expected levels of professional performance
Quality of practice
Education
Practice evaluation
Collegiality

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

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

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

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

19. 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

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

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

22. 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

23. 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

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

25. 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

26. 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

27. Role Model Demonstrate behaviors Influence health related behaviors
Display competence

28. 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

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

30. 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

31. 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

32. 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

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

34. Population-Oriented Roles (continued)
Community organizer/mobilizer
Coalition builder
Researcher

35. Case Finder Role
Develop knowledge of signs and symptoms of health-related conditions and contributing factors
Carry out investigation of specific cases of disease as needed
Provide follow-up care to identified cases

36. 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

37. 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

38. 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

39. 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

40. 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

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

42. 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.