COMMUNITY AND PUBLIC HEALTH NURSING

Aims of public health nursing

- improve the health status of the community in general

- the community is not just the setting or the context for providing care

- according to Nies and Mc Ewen in 2011, it is the focus of nursing care

WHO

According to this institution groups of people that may or may not spatially connected but who share common interests,

concerns or identities

Deimension of community

1. aggregate of people,

2. location in space and time

3. social system

Aggregate of people

• have similar demographic characteristics

Location in space

• geographic boundsries of a group of people

Social system

• relationship of members, interactions to fullfil their essential functions to achieve a goal

People, location and social system

Community has 3 features

Health city

It aims to:

• Achieve a good quality of life

• Create a health supportive environment

• Provide basic sanitation and hygiene needs

• Supply access to healthcare

Community Assessment

Termed as community health needs assessment

Community assessment

• Essential process for understanding the community, identifying needs, weakness, assets or strength.

• A fundamental step that supports actions of the community health nurse in planning and interventions

• A state tribal local or barangay health asssesment

Community assessment

• the nurse collects data on the 3 features of a community which are the people, place, social system

Planned approach to community (PATCH)

• a community health planning model based on Green’s PRECEDE model includes quantitative and qualitative data.

• community profile

• Morbidity and mortality rate

• Behavioral data

• Opinion data

The data collected for the PATCH process for health planning

Comprehensive needs assessment

• the nurse gathers information about the entire community using a systematic process where data are collected regarding all aspects of the community to be able to identify actual and potential health problems

Problem-oriented assessment

• focused on a particular aspect of health

1. Collecting primary data

2. Secondary data sources

These are the tools for community assessment

Community diagnosis

• process of determining the health status of the community and the factors responsible for it.

• the term is applied both to the process of determination and to its findings (WHO, 2004).

• it is quantitative and qualitative description of the health of the citizens and the factors that influence their health

• NANDA NURSING DIAGNOSTIC LABELS

• SHUSTER AND GEOPPINGER

• OHAMA SYSTEM

These are the several schemes in stating community diagnosis

Shuster and Goppinger

• proposed a practical adaptation of a format of nursing diagnoses for population groups previously presented by Green and Slade (2001) 3 part statement.

Ohama System

• a comprehensive and research-based classification system for client problems that exists in the public domain, meaning it is not held under copyright.

• FIRST COMPONENT IS “Classification Scheme” (client assessment”)

• A guide in collecting, classifying, analyzing, documenting and communicating health and health-related needs and strengths

• Environmental

• Psychosocial

• Physiological

• Health-related behaviors

What are the first and most general level of classification?

Second level

• in this level of classification in identifying the problem or areas on concern consist of problems under four domains

Third level

• In this level of indification of problems or areas on concern, classified in 2 sets of qualifiers which are

1. area of concern is categorized into health promotion, potential problem, or actual problem.

2. LEVEL OF CLIENTELE: individual, family, community

First level

• In this level of indification of problems or areas on concern, is the most specific made up of clusters of signs and symptoms to describe actual problems

SOCIAL DIAGNOSIS

• represents the impact of the health problems in terms of the overall quality of life of the people in the community.

• Green and Kreuter (1980) looks at the quality of life as a subjectively defined problem of individuals or communities.

Community diagnosis

In community and public health nursing this diagnosis is more commonly used that the social diagnosis.

Planning

• a logical process of decision making to determine which of the identified health concerns require more immediate consideration (priority setting) and what actions may be undertaken to achieve goals and objectives

GREEN’S PRECEDE-PROCEED MODEL

• it provides structure for assessing health and quality-of-life needs.

• assist in designing, implementing and evaluating and public health programs to meet those needs.

• it examines factors contributing to behavior change:

1. Predisposing factor

2. Enabling factor

3. Reinforcing factor

APEX-PH

• a true self-assessment and is intended to be more of a public endeavor involving the community as well as the public organization.

• a voluntary process for organizational and community self- assessment, planned improvements and continuing evaluation and reassessment.

MAPP Model

• helps public health leaders facilitate community priorities about health issues and identify sources to address them.

• It has 4 phases

• Conduct 4 assessment

1. identifying community strengths

2. local health systems

3. health status

4. forces to change within the population

Steps of Planning

1. Determine where you are.

2. Identify what is important

3. Define what you must achieve

4. Determine who is accountable

5. Review

1. Geopolitical / Territorial

2. Phenomenological / Functional

What are the two types of community

Geopolitcal or Territorial

• What type of community were in it talks about the land areas, How big or wide.

Phenomenological / Functional

• What type of community that talks about culture the interest of each person?

Health

A state of a complete physical mental and social well-being, not nearly the absence of disease or infirmity, according to WHO

WHO

• it is a specialized agency of United nation responsible for international public health.

MILLENIUM

• This is the aim and achieve set of miserable goals, that combat poverty, hunger, and disease, illiteracy environment, degradation and discrimination against woman by 2015.

M1

• Eradicate, extreme poverty and hunger

M2

• To achieve universal primary education

M3

• to promote gender equality and empower woman

M4

• reduce child mortality

M5

• Improve maternal health

M6

• To combat HIV or aids malaria, and other diseases

M7

• to ensure sustainability

M8

• to develop a global partnership for development.

SDG

• 2030

• Officially known as the transforming our world

17

How many goals does the SDG have

Philippine healthcare delivery system

• It is defined as the totality of all policies, facilities, equipment, products, and new human resources, and services.

• It is a large complex multilevel and multidisciplinary

• It includes both government and non-government health facilities

Public Sector

• Large financed through a tax-based budgeting system at both. The national and local levels and warehouse care is generally given for free at the point of service.

Private sector

• largely market oriented and where health care is paid for through user fees at the point of service