MODULE 1: OVERVIEW OF COMMUNITY HEALTH NURSING

Community health nursing

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* One of the 2 major field of nursing in the philippines, apart from hospital nursing
* Focuses on community and population groups

Community

* Group of people with common characteristics or interest living together within a territory or geographical boundaries
* Social system that includes: health, family, economic, educational ,religious, welfare, political, recreational, legal, and communication systems (alleneder and spradley)
* Webs of people shaped by relationships, interdependence, mutual interest and patterns of interactions. (Leonard, 2000)
* Object or focus of CHN, Family, unit of service

Health

* Is the basic human right, on the 6th global conference on health promotion in 2005


* State of complete physical, mental, and social well-being and not merely the absence of disease or infirmity
* High levels of wellness; towards maximizing the potential which the individual is capable within the environment where he is functioning (Dunn)
* A quality of life, involving social, emotional, menta, spiritual and biological fitness (Rene Dubos)
* Health and illness in relation to the environment. (Florence Nightingale)
* State characterized by soundness and wholeness of human structures and bodily and mental functions.

FACTORS AFFECTING HEALTH

1. Poverty and health
2. Culture and health
3. Environmental and health
4. Politics and health

Culture and health

Includes many things like beliefs, values and customs or practices. Culture can positively or negatively affect health.

Environmental and health

Plays a direct influence on the health of the people. 

Politics and health

Reflect the priorities of the government and the value system of the policy makers. 

COMMUNITY HEALTH

* Part of the paramedical and medical intervention approach which is concerned on the health of the whole population.
* Aims: 


1. Promote health
2. Prevention of disease
3. Management of factors affecting health

* Means: Information education conference (IEC)

NURSING

* Is the science and art of caring


* Nursing as art: geared toward the improvement not just of their health but also their ability to deal wit the determinants and consequences of their health problems.
* Nursing with public health: operates at three levels of clientele, individuals, families or groups, and communities.

COMMUNITY HEALTH NURSING

* Utilization of the nursing process in the different levels of clientele- individuals, families, population groups and communities, concerned with the promotion of health prevention of disease and disability and rehabilitation.


* Learned practice discipline with the ultimate goal of contributing as individuals and in collaboration with others to the promotion of the client’s optimum level of functioning. (jacobson)
* Service rendered by a professional nurse to IFCs, population groups in health centers, etc. (Ruth Freeman)

CHARACTERISTICS OF CHN

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1. Promotion of health and prevention of disease are the goals of professional practice
2. Community health nursing practice is comprehensive, general, continual, and not episodic.
3. There are different levels of clientele; individuals, families and population groups and the practitioner recognize the primacy of the population as a whole
4. The nurse and the client have greater control in making decisions related to health care and the collaborate equals
5. The nurse recognizes the impact of different factors on health and has a greater awareness of his/her client’s lives and situations

GOAL OF CHN

* Raise level of health of citizenry by:


1. Help communities and families cope with the discontinuities in health and threats
2. Maximize their potential for high level of wellness
3. Promote reciprocally supportive relationship between people and their physical and social environment

PRIMARY FOCUS OF CHN

* Health promotion of the people wherein the primary responsibility of the community and health nurse is health teaching, who is termed as generalist in practice.

GOAL OF HEALTH EDUCATION

1. Encourage client to participate in health decision making
2. Increased potentials of the client to comply with the health recommendations
3. Development of self-care skills
4. Improved client and family coping in their live situation in the community
5. Increased participation in the continuing care for specific conditions
6. Be able to adapt to healthier lifestyles.

COMPONENTS OF THE FRAMEWORK FOR COMMUNITY PRACTICE

1. The health care delivery system, with its subsystem
2. The clients (Individual, Family, Community)
3. Health which is the goal of the health care delivery system
4. The economic, sociocultural, political and environmental factors that affect the health care delivery system, the practice of community health nursing and the people’s health

CLIENTS OF COMMUNITY HEALTH NURSES

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1. Individual - the primary client in the CHN.
2. Population group - group of people who share common characteristics, developmental stages or common exposure to particular environmental factors and consequently  common health problems, issues and concern.
3. Community

PRINCIPLES OF CHN EMPOWERMENT

* Education is the primary tool and responsibility


* Made available to all regardless of race, creed, and socioeconomic status
* Policies and objectives of the agency is fully understood by the nurse
* Organizing for health, with the family as a unit of service
* Works as a member of the health team
* Existing active organizations are utilized
* Recording and reporting are accurate
* Monitoring and evaluation of services is periodically done
* Existing indigenous resources of the community is used
* Needs of clienteles is recognized and serves as basis for CHN
* Training and development as opportunities for  continuing staff education programs.

PUBLIC HEALTH NURSE

* Most of the community health nurses in the Philippines that work in health centers.

OCCUPATIONAL NURSE

* Nurses that work in industries and companies

SCHOOL NURSE

* Nurses that works in educational companies and other works.

RA9173

* Roles and functions of nurses are defined by this nursing law. 

3 P’S OF PUBLIC HEALTH AS A SCIENCE:

* Prevention of disease


* Prolonging of life
* Promotion of health and efficacy through organized community effort

PUBLIC HEALTH NURSING

They act as a program coordinator for an expanded program for immunization, tuberculosis control program, leprosy control program, etc.

PUBLIC HEALTH NURSES FUNCTIONS AND ACTIVITIES

1. Management function
2. Training function
3. Supervision function

Management function

* Plan and organized the nursing services of the health uniy


* Participates in planning and implementation
* Monitors and evaluate implementation

Training function

* Participates in meeting the needs of colleague


* Prioritize the identified needs of the rural health affiliates
* Organizes and conduct education program and coaching session

Supervision function

* Supervises the rural health midwives


* Formulate and implement a supervisory plan
* Monitor and evaluates performance of RHU midwives
* Maintain records and report.

PROVISION OF HEALTH AND NURSING CARE

* Provide health and nursing care to IFC


* Identifies health needs of IFC
* Formulates and implements NCP
* Evaluates the nursing intervention

HEALTH EDUCATION FUNCTION

* Conducts health education activities


* Identifies client’s need for health education
* Assesses the effects of health education activities on the capabilities of clients.

ROLES OF PUBLIC HEALTH NURSE

1. Planner or programmer
2. Provider of nursing care
3. Community organizer
4. Coordinator of services
5. Trainer or health educator
6. Health monitor
7. Role model
8. Change Agent
9. Recorder / reporter/ statistician
10. Researcher

Planner or programmer

* Identifies needs, priorities, and problems of IFC


* Formulates municipal health plan in the absence of MD
* Interprets and implements the NCP
* Provides technical assistance

Provider of nursing care

* Provides direct nursing care to sick or disabled


* Develops the family’s capability to take care of the sick

Community organizer

* Motivates and enhances community participation


* Initiates and participates in community development activities

Coordinator of services

* Coordinates with IFC for health-related services


* Coordinates the nursing program with other health programs

Trainer or health educator

* Identifies and interprets training needs of the RHM


* Conducts training in the RHU
* Initiates  use of tri-media for health education
* Conducts pre-marital counseling

Health monitor

Detects deviation from health of IFC

Role model

Provides good example of the healthful living to IFC

Change Agent

Motivates changes in health behavior in IFC

Recorder / reporter/ statistician

* Prepares and submits required reports and records


* Maintain, reviews and prepare statistical data needed for reporting

Researcher

Participates in the conduct of survey studies and research on nursing and health-related subjects.

OCCUPATIONAL HEALTH NURSING

Aimed at assisting workers in all occupations to cope with  actual and potential stresses in relation to their work and work environment

DUTIES AND RESPONSIBILITIES OF OHN

1. Curative or palliative care
2. Preventive
3. Educative
4. Administrative function

MAJOR AREAS OF CONCERN OF OHN

1. Family planning
2. Counselling
3. Immunization
4. Environmental sanitation
5. Work safety
6. Disaster prevention and control
7. Orientation of new employee
8. Dissemination of health information/ health education

SCHOOL HEALTH NURSING

* Aims to promote the health of the school personnel and students,


* Aims to prevent health problems that could hinder student’s learning and performance 

FOCUS OF SHN

* Health advocacy
* Health promotion
* Disease prevention
* Early detection of disease

DUTIES AND RESPONSIBILITIES OF SCHOOL NURSE

1. Health and nutrition assessment, screening, and case finding
2. Treatment of common ailments and attending to emergency cases
3. Counseling and health education
4. Nursing procedures
5. Supervision of the health and safety of the school
6. Referrals and follow-ups of pupils of pupils and personnel.