Community Health Nursing

Prepared by
Salma Batool
Instructor BCON

salma batool 04/08/21

What is CHN
“Community health nursing is a synthesis of nursing and
public health practice applied to promoting and preserving
the
health of people”.(ANA,1980)

 The practice is general

 Not limited to a particular age group or diagnosis and is
continuing , not episodic.
 The dominant responsibility is to the people as whole ,
nursing directed to the individuals, families or groups
contributes to the health of total population.
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What is PHN
“Public health nursing is synthesises the body of
knowledge from
public health sciences and professional nursing theories for
the
purpose of improving the health of the entire community”.
(APHA,1982)
 This goal lies at the heart of primary prevention and
health promotion , and is the foundation for public health
nursing practice.
 To accomplish this goal , public health nurses work with
groups , families and individuals , as well as
multidisciplinary teams and programmes.

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CHN VS PHN
Community health Public health nurses
nurses provide direct function in a community
primary care in settings based setting established
outside the health care to address the health
institutions e.g in the problems of specific
houses , at work places , identified population.
clinics schools and
recreational settings .

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salma batool 04/08/21
Philosophy of C.H.Nursing
The essential, dignity and worth of the individual
The possession by individuals of potentialities and
resources for managing their own lives.
The importance of freedom to express one’s individuality
The great capacity for growth within all social beings
The right of the individual to basic necessities (food ,
shelter, medical care) without which fulfilment of life is
often blocked.
The need for individuals to struggle and strive to improve
their life and environment
The right of individual to help in times of need and crisis.

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Scope of C.H.Nursing
The scope of community health nursing includes…
-Health promotion
-Illness prevention
-Restoration of health of individuals , families and
communities
The scope of nursing is wide , there is still a much
wider scope for a nurse.
Nurse can work in different place , such as home care ,
nursing home , school health centre , old age home ,
industries.
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Scope of C.H.Nursing
Industrial nursing
Domiciliary nursing
Mental health nursing
School health nursing
MCH and family planning services
Nursing care
Home care
Geriatric care
Rehabilitation centre

salma batool 04/08/21

Assumptions and beliefs of C.H.Nursing
Assumptions Beliefs
 The health care system is  Health care should be
complex available , accessible and
 Primary , secondary and acceptable to all person.
tertiary health care are the  Recipient of health care
components of health care services should participate
system. in the making of health
 Nursing as a subsystem of policy.
 The nurse as a provider and
health care system , is the
product of education and the client as a consumer of
practice based upon health services can form a
research. conjoint relationship to
 The provision of primary
advocate and effect change
in health policies and
health care predominates in services .
community health nursing  Prevention of illness is
practice , with lesser essential to promoting
involvement in secondary health.
and tertiary care.
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Tenets of C.H.Nursing
Population-based assessment , policy development and
assurance processes are systematic and comprehensive.
All processes must include partnering with
representatives of the people.
Primary prevention is given priority.
Intervention strategies are selected to create healthy
environmental , social , and economic conditions in
which people can thrive.
CHN practice includes an obligation to actively reach out
to all who might benefit from an intervention or service.

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Modes of delivery of care

-Determined by patient’s needs and pattern that nursing

care takes in meeting those needs.
Types
i .Direct care to individuals, families and groups in a
certain community
ii. Nursing within the community is delivery of service
to the community as whole.

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Components of C.H.Nursing
i .Community health nurses are responsible for ensuring that
needed health services are provided in the community

ii.The care of vulnerable groups in a community is a priority.

iii.The client ( individual , family , group or community )

must be a partner in planning and evaluating health care.
iv.Prevention of illness

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Goals of C.H.Nursing
Health promotion
Health maintenance
Prevention of illness
Restoration of health

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 HSN vs CHN
Hospital staff nurse Community health
nurse
Health focus -on the treatment and care of -multiple
the sick -promoting health ,
-restoring individual balance maintaining a degree of
towards life. balance towards health ,
Early detection of disease
and care measures.
Range and variability Works with disease Works with the entire
classification in hospital units spectrum of health and illness
of work Medical , surgical , paeds condition

Boundaries of service Deals with one hospital or Deals with all institutions
one institution

Co-ordination With all medical personnel With medical or non-

,medical personnel
Unite of service Single -double
salma batool
-individual hospitalized -small group.
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patient or patients in ward. -family
Functions of community health nurse
Assessment
Planning
Implementation
Evaluation
Research

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Principles of C.H.Nursing
1. Community health nursing is an established activity based on
recognised needs and functioning within the total health
programme.
2 .The community health nursing agency has clearly defined
objectives and purposes for its services.
3. An active organised citizens group , representative of the
community is an integral part of community health
programme.
4 . Community health nursing recognised the family and
community as units of service.
5 .The community health nurse should be qualified as full-
fledged nurse.

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Community health nursing Roles
1- Client- oriented roles 2-Delivery –oriented Role
i. Care giver I .Coordinator/ care manager
ii. Educator ii ..Collaborator
iii. Counselor iii.Liaison
iv.Referral resources 3-population- oriented
v. Role model Roles
vi. advocate i-Case finder
vii. Primary care provider ii.Leader
Viii .Case manager iii.Change agent
ix.Good observer iv. Community developer
x.consultant V .Coalition builder
vi. Researcher

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Responsibilities of community health
Nurse
Providing care to disabled ones.
Maintaining healthy environment
Teaching
Identify the needs and referring them for service.
Preventing and reporting neglect and abuse.

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FACTORS INFLUENCING COMMUNITY HEALTH
NURSING
IN THE 21ST CENTURY
Health care delivery system.
Globalization.
Demographics.
Poverty and growing disparities.
Violence ,injuries ,social disintegration.

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 TEN GREAT PUBLIC HEALTH ACHIEVEMENTS IN
THE
20TH CENTURY
1. Immunizations
2. Improvements in motor vehicle safety
3. Workplace safety
4. Control of infectious diseases
5. Decline in deaths from heart disease and stroke
6. Safer and healthier foods
7. Healthier mothers and babies
8. Family planning
9. Fluoridation of drinking water
10. Recognition of tobacco as a health hazard

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 THE EIGHT PRINCIPLES OF PUBLIC HEALTH
NURSING
 1. The Client or “unit of care” is the population.
 2. The primary obligation is to achieve the greatest good for the greatest number
 of people or the population as a whole.
 3. The processes used by public health nurses include working with the client(s) as an
 equal partner
 .
 4. Primary prevention is the priority in selecting appropriate activities.
 5. Selecting strategies that create healthy environmental, social, and economic
 conditions in which populations may thrive is the focus.
 6. There is an obligation to actively reach out to all who might benefit from a specific
 activity or service.
 7. Optimal use of available resources to assure the best overall improvement in the
 health of the population is a key element of the practice.
 8. Collaboration with a variety of other professions, organizations, and entities is the
 most effective way to promote and protect the health of the people.

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Reference
 B.T. Basavanthappa (2016) Concept of Community
and Health, Community Health Nursing, (3rd Edition)
Publisher, Jaypee Brothers Medical (P) Ltd.
 community as Partner sixth edition
THEORY AND PRACTICE IN NURSING
ELIZABETH T. ANDERSON, DrPH, RN, FAAN

salma batool 04/08/21