NURSING

1. COMMUNITY HEALTH NURSING
BY SAMUEL O
LIRA UNIVERSITY

2. Learning objectives
• Define community health nursing
• Describe the characteristics of the community
health nursing
• Mention the components of the community
health nursing practice
• Discuss the roles of the community health
nurse.

3. Community health nursing
• Refers to specialized, population focused
nursing practice, which applies public health
science and nursing science.
• Refers to as the synthesis of nursing and
public heath practice applied to promoting
and protecting the health of population.
• It is specialized field of nursing that focuses on
the health needs of the communities,
aggregates ,and in particular vulnerable
populations.

4. Characteristics of the community
health nursing.
1. It is a field of nursing.
• Specialized knowledge and skills.
• As a specialty, community health nursing adds public health knowledge
and skills that address the needs and the problems of the communities
• Focus on particular set of people receiving the service
2. It combines public health and nursing
• It has been recognized as a subspecialty of both fields
• Knowledge of the following element of PHC is essential to the community
health nursing
- concepts of aggregates; assessment needs, planning, providing services, and
evaluating services.
-Priority of preventive, protective and health promoting strategies over
curative strategies.

5. Contd
• Means of measurement and analysis of community health problems,
including epidemiologic concepts and biostatistics.
• Influence of environmental factors on aggregate health
3. Population focused
• The central mission of PHC practice is to improve the health of the
population
• It is concerned for the health status of the population groups and their
environment
4. It emphasizes prevention, health promotion and wellness
• Promotion of health and prevention of illness are of first order priority
• Less emphasis on curative

6. Contd
5. Promotes client responsibility and self- care
• Clients’ health status and health behavior will not change
unless people accept and apply the proposals presented by
the community health nurse
• It develops one’s own health potential
• As people monitors their own lives, health and well-being,
they are engaged in self-care.
6. Uses aggregate measurement and analysis.
• The need to collect and examine data on the entire
population under study before making intervention
decision is fundamental.

7. Contd
7. Uses principles of organizational theory
• It is the organization and administration of such services that
enables practitioners to ultimately address the community needs.
8. It involves inter professional collaboration
• Community health nurse must work in cooperation with other team
members, coordinating services and addressing the needs of the
population needs.
• It is essential for establishing effective services and programs.
• Individualized effort and specialized programs when planned in
isolation, can lead to fragmentation and gaps in health services.

8. Components of the community health
practice
1. Promotion of health
• Includes all efforts that seek to move people closer to optimal well-
being or higher levels of wellness.
• Involves forms of health education; danger signs of drug use,
demonstrating healthful practices e.g. regular exercises.
2. Prevention of health problems.
• Anticipating and averting problems or discovering them as early as
possible to minimize potential disability and impairment.
• It is done on 3 levels in the community health

9. Contd
Primary prevention.
• Includes measures taken to keep illness or injuries from occurring
• It is applied to generally healthy population and precedes diseases
or dysfunction.
Example; education program that teach safe-sex practices, or
dangers of smoking and substance abuse; overweigh individual on
how to follow a well- balanced diet.
Secondary prevention
• Efforts to detect and treat existing health problems at the earliest
possible stage when the disease/impairment already exists.
Example

10. Contd
• Hypertension and cholesterol screening program- helps
to identify high risk individuals and encourage earlier
treatment to prevent heart attacks or stroke
Tertiary prevention
• Attempts to reduce the extent or the severity of the
health problem to its lowest possible level so as to
minimize the disability and restore or preserve
functions
Example.
• Treatment and rehabilitation of persons after stroke to
reduce impairment

11. Contd
3. Treatment of disorders
• Focuses on the illness end of the continuum and is the remedial
aspect of the community health practice
• Involves 3 methods
-Direct service to people with health problem (screening, education,
and referral)
-Indirect service that help people to obtain treatment (a young woman
with postpartum bleeding- assisted by the nurse to immediate
appointment with the physician at the local clinic)
-Development of programs to correct unhealthy conditions
(community with high incidence of alcoholism and drug abuse-
initiates a chemical dependency counseling and treatment center).

12. Contd
4. Rehabilitation
• Involves efforts to reduce disability and as much as
possible, to restore function.
• People whose handicaps are congenital or are acquired
through illness or accidents can be helped to regain
some measure of lost function or to develop new
compensating skills.
Example; a factory worker who lost his leg in an
industrial accident received good medical treatment
and nursing care, prosthetic fittings, and physical and
occupational therapy. He then retained to assume an
office job.

13. Contd
5. Evaluation
• Is the process by which the practice is analyzed, judged
and improved according to the established goals and
standards.
• Also helps to solve problems and provides direction for
future health care efforts.
6. Research
• Is a systematic investigation to discover a fact affecting
the community health and community health practice;
solves problems and explores improved methods of
health service.

14. Roles of the community health nurse
Clinician/care provider
• Ensures that health services are provided not just to the individuals and
families; but also to the groups and the population
• The clinician emphasizes on 3 issues; holism, health promotion, and skill
expansion(listening, communication, observation and counselling) .
Educator/ health teacher
• Useful in promoting public health because
• Clients are not usually actively ill and can absorb and act on the health
information (e.g. a class of expectant parent).
• Wider audience can be reached
• The nurse has the opportunity and mandate to develop educational
programs based on the community needs that seek a community –wide
impact.

15. Contd
Advocate
• Many clients especially the poor, the disadvantaged, those without
the health insurance, and people with the language barriers-
frequently are denied of their rights. They become frustrated,
confused, degraded, and unable to cope with the system on their
own.
• The nurse act as advocate for clients, acting on their behalf to
receive just, equal and humane treatment.
Manager
• Exercise administrative direction toward the accomplishment of
specified goals
• Oversee client care as a case manager, supervising ancillary staff,
managing case loads, running clinics, or conducting health need
assessment projects.

16. Contd
Collaborator
• Does not work in isolation
• Work jointly with others in a common endeavor to cooperate as partners.
Everyone on the team has an important and unique contribution to make health
care effort.
• Includes other nurses, physicians, teachers health educators, social workers
nutritionists, occupational therapist, environmentalist, etc..
Leader
• He directs, influences, or persuades others to effect change so as to positively
affect people’s health and move towards the goal.
• Emphasizes on persuading and motivating people, directing activities, ensuring
effective 2-way communication, resolving conflicts and coordinating the plan.
Researcher
• Engages in systematic investigation, collection, and analysis of data for solving
problems and enhancing community health practice.