Nursing practice is impacted by community involvement in several ways. Community health is affected by factors like culture, diversity, and access to care. With shorter hospital stays, nurses must find ways to educate and support patients outside of the hospital to improve health. This involves developing chronic care models, conducting outreach programs, and using telemedicine. It is important for nursing practice to understand community needs through data collection and train on diverse cultural beliefs to provide patient-centered care. Higher nursing education is needed to allow nurses to better coordinate care across settings and help patients manage chronic conditions in the community.

1. Running head: HOW COMMUNITY INVOLVEMENT
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How Community Involvement Effects Nursing Practice
Linda Elliston
The Robert B. Miller College
HADM 410 - Nursing Leadership Management II
Johanna Hurst
March 21, 2014

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How Community Involvement Effects Nursing Practice
The nursing practice is effective by the diversity, culture, and health of the community.
Keeping the community healthy and making sure the community has access to care is
imperative. With acute care admission times being shorter and the patients are usually sicker,
there is not enough time to give the patients all the education and support they need. The nursing
practice needs to find ways to adapt to this changing trend to help keep the community healthy
and more involved in there medical care.
The American Organization of Nursing Executives (AONE) has identified diversity
principles for health care organizations. These principles include both “internal and external
resources to meet the needs of the diverse patient and workforce populations served”
(Finkelman, 2011, p. 244). The internal resources include fiscal resources to help develop
educational programs and policies to help train employees about diversity and how to meet the
needs of the community/patients they are caring for. Some of the external resources includes
using outside members of the community, with diverse backgrounds, to help with organizational
with planning processes to help meet the needs of the patients and to help with collecting data on
the local community. The outside members of the community need to collect data in regards to
the primary language spoken, the average age of the population, any disease specific domination
in the community, and the community’s race and ethnicity. This data is important for the
organization since it helps the organization develop processes to improve on the quality care and
patient safety rates for the community.

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Patient centered care is also vital for a diverse population. Nurses need to be trained in the
different culture beliefs to help give the best quality care for each individual patient. The core
competency of patient-centered care is described by the IOM (2003): “’identify, respect, and care
about patients’ differences, values, preferences, and expressed needs; relieve pain and suffering;
coordinate continuous care; listen to, clearly inform, communicate with, and educate patients;
share decision-making and management; and continuously advocate disease prevention,
wellness, and promotion of healthy lifestyles, including a focus on population health”’
(Finkelman, 2011, p. 216). Keeping the patient informed and letting the patient participate in the
decisions made in regards to their care in imperative.
As mentioned above, in today’s world patients are coming to the hospital sicker and stay for
a shorter period of time; one of the ways to help keep the community healthy, and prevent
frequent hospital readmissions is by developing a chronic care model. “The essence of the
chronic care model is the interaction between an informed, activated patient and a prepared,
proactive practice team” (Bodenheimer, 2005). The chronic care model is essential “in
improving care for chronic diseases” (Bodenheimer, 2005). With more Nurse Practitioner (NP)
and Physician Assistance (PA) acting as leaders, this chronic care model can help educate and
keep our communities healthy. Some hospitals have Nurse Practitioners checking on the patients
post- discharge to help the patients manage their chronic illnesses. Hospitals also have Case
Managers that help the patients arrange for at home assistance and follow up care.
Outreach programs and outpatient services are also important areas for nurses to be
competent in to help keep the community stay healthy. “The type of support available to the
patient and family in the community has a major effect on the hospital’s ability to discharge
patients and prevent complications and readmission” (Finkelman, 2011, p.187). With increasing

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drive to provide care in the community, the nursing practice needs to focus more on the
“availability of home health care, medical supplies and equipment, general support such as
Meals-on-Wheels, social services, case management, and so on, and ambulatory care clinics”
(Finkelman, 2011, p.187). The continuum of care to the community also needs to include health
promotion, screening and counseling on disease and illness prevention, tertiary care and
education on the importance of vaccinations, and hospice care. An example of nursing practice
giving back to the community is the Super All Year (S.A.Y) Clinic. The S.A.Y. Detroit Clinic is
“the city's first ever free medical clinic, designed to provide maintenance and preventive
healthcare solely to homeless and uninsured children and their mothers” (Nurse Community
Involvement, n.d.). Nurses have volunteered multitudes of hours at this clinic, performing
healthcare education and patient care (Nurse Community Involvement, n.d.). Another example is
the Beumont Speaker’s Bureau, where nurses provide community education by volunteering “to
go into the community to speak at no charge to civic groups, social clubs and other non-profit
organizations (Nurse Community Involvement, n.d.). .
Telemedicine is another way of assisting the community. Visiting nurses can use this new
technology to help monitor patients with chronic illnesses from the convenience of their own
homes. The visiting nurses can deliver the equipment and educate the patient on the use of the
equipment. This technology can be used to report vital signs, blood sugars, heart rhythms, daily
weight, etc. to the visiting nurse service. Furthermore, telemedicine visits can be arranged for
rural patients that do not have a way of obtaining transportation to and from a doctor’s
appointment, and several states now consider telemedicine visits the same as office visits for the
purposes of insurance billings (Telehealth, 2014).

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Nowadays, “nurses are being called on to coordinate care among a variety of clinicians and
community agencies; to help patients manage chronic illnesses, thereby preventing acute care
episodes and disease progression; and to use a variety of technological tools to improve the
quality and effectiveness of care” (The Future of Nursing, 2010). Nurses need to be competent
in “leadership, health policy, system improvement, research and evidence-based practice, and
teamwork and collaboration, as well as competency in specific content areas such as community
and public health and geriatrics” (The Future of Nursing, 2010). “To respond to these increasing
demands, the Institute of medicine IOM committee calls for nurses to achieve higher levels of
education and suggests that they be educated in new ways that better prepare them to meet the
needs of the population” (The Future of Nursing, 2010).

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References
Bodenheimer, T., MacGregor, K., & Stothart, N. (2005, March). Nurses as leaders in chronic
care. PubMed. Retrieved February 1, 2014, from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC554894/
Finkelman, A. (2011). Leadership and Management for Nurses: Core Competencies for Quality
Care (2nd ed., pp. 187-245). New Jersey: Prentice Hall. Kindle Edition.
Nurse Community Involvement. (n.d.). In Beaumont Health System. Retrieved March 22, 2014,
from http://www.beaumont.edu/nurse-community-involvement/#.Uy3Fe5BOXIV
Telehealth initiatives that vastly improve patient access to care. (2014). In Communication
Solutions for Healthcare. Retrieved February 15, 2014, from
http://www.avispl.com/markets/healthcare?
sid=MVTM&utm_source=bing&utm_medium=cpc&utm_term=telemedicine&utm_cont
ent=Telemedicine&utm_campaign=Bing_VC_Healthcare
The Future of Nursing: Leading Change, Advancing Health. Institute of Medicine. N.p., 5 Oct.
2010. Web. 22 Mar. 2014. <http://www.iom.edu/Reports/2010/The-Future-of-Nursing-
Leading-Change-Advancing-Health.aspx>.

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