Introduction to community health nursing Haidar Nadrian School of Nursing & Midwifery Islamic Azad University-Sanandaj Branch

History of Community Health Nursing  Before mid 1800s-Early Home Care with focus in Sick and Poor individual. Orientation: curative agencies: lay & religious orders *St. Phoebe  Mid 1800s to 1900-district Nursing with focus in Sick and poor individual Orientation: curative/less in prevention agencies: voluntary & some government *William Rathbone

History of Community Health Nursing  public health nursing- Pubic Health Needs, focus in family and orientation in Curative and Prevention agencies: government & some voluntary *Lilliam Wald  1970 to present-Community Health Nursing, focus in total community and oriented to population health, services address health promotion; illness prevention agencies: many kinds; some independent practice *Ruth Freedman

Health Beyond Acute Care Settings-Community Care and Public Health

Public Health Definition Public health is the Science and Art of : preventing disease, prolonging life, promoting health and efficiency through organized community effort. (Winslow, 1920)

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.

Characteristics of Community Health Nursing It is a field of nursing It combines public health and nursing It focus on population and environment factors that may impact to people’s health It emphasize in health promotion, illness prevention, and wellness

Characteristics of Community Health Nursing It promotes client responsibility and self-care It uses aggregate measurement and analysis It use principle of organizational theory It involves inter-professional collaboration.

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.

Challenges and Opportunities in CHN (Allender and Spradley 2001) Opportunity Enriching the heritage of early PHN efforts Challenge 1.Understanding early PHN efforts Including communities2.Expanding nursing focus from the individual & the family Designing interventions Shape its service delivery 3.Determining the needs of populations at risk 4.Learning the complexities of the health care system

Community Health & Public Heath Similarities: Both are organized community efforts aimed at promotion, protection and preservation of the public’s health Historically, public health has been associated with official or governmental efforts Currently, it includes both public and private health efforts Difference: Community health focuses on specific designated communities. It’s a part of the larger public health effort.

Community Health Practice Health Promotion 1. Increase the span of healthy life for all citizens 2. Reduce health disparities among population groups 3. Achieve access to preventive services for everyone.

Roles of Community Health Nurses Nurses ClinicianEducatorAdvocateManagerCollaboratorLeadershipResearcher

Health Prevention Tertiary Prevention Secondary Prevention Primary Prevention

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

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

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

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

Setting for community health nursing practice homes ambulatory service settings schools occupational health setting residential institutions the community at large

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