Foundations of Community Health Nursing

Community Health

Define public health.

•activities that society undertakes to assure the conditions in which people can be heal

Define community health.

•identification of needs and the protection and improvement of collective health within a geographically defined area (Community)

Define public health nursing.

•community based and, most importantly, it is population focused

Define geography in terms of concept of community.

defined by geographical boundaries; ex: Kennesaw

Define Common-Interest in terms of concept of community.

community defined by common interest

Define Solution of Interest in terms of concept of community.

group of ppl w/in a community that come together to solve the problem; ex, school committees (SADD, MADD)

Define aggregate

group of individ that share common charac or in similar situs that make them a target for a health intervention; ex: teen moms

Define population.

larger grp individ that live in specific geographic area such as city or county

What are the characteristics of community health nursing?

•Field of nursing with a shift from individual to aggregate

•Combines nursing science with public health science

•Community based and population focused

•Public health sciences and nursing theory

•Focus on population-level outcomes

•Emphasis on prevention

•Population is client or unit of care

•Primary obligation to achieve greatest good for greatest number of people or population as a whole

•Processes used include working with the client as an equal partner

•Primary prevention is the priority

•Strategies are selected to create health environmental, social, and economic conditions in which populations may thrive

•There is an obligation to actively reach out to all who might benefit from a specific activity.

•Optimal use of available resources to assure best overall improvement in health of population is a key element.

•Collaboration with a variety of other professions, organizations, and entities is the most effective way to promote and protect the health of people.

Describe the primary level of prevention.

goal is to prevent disease or issue before it happens

ex: vaccinations

Describe the secondary level of prevention.

goal is to find and treat disease early using screening or early tx.

ex. screenings

Describe the tertiary level of prevention.

•prevent damage and pain from the disease

•slow down the disease

•prevent the disease from causing other problems (These are called "complications.")

•give better care to people with the disease

•make people with the disease healthy again and able to do what they used to do 

ex: dialysis, infusions for pts w/autoimmune disease, AA meetings

Describe Florence Nightingale.

Crimean war nurse & worked to improve hospital sanitation and hygiene

Devel standards of care; known for sanitation/HH

Contributes w/cleanliness, safety, improving nutritional outcome, lighting

Started the first professional school of nursing

Describe Clara Barton

•Known as the ”Angel in the Battlefield”

•Participated in the office for missing Soldier’s for Family Unification. 

•Founder of the American Red Cross, 1881

•First collaboration of Red Cross military collaboration

•Red Cross known activity is blood collection 

Describe Lillian Wald.

• Pioneer of public health nursing

• Advocated for improved health conditions in urban areas; Devel green spaces for kids to get air at school that lead to increase attendance

• Promoted nursing education and community-based care

• Focused on social reform and healthcare access for the poor

• Founded the Henry Street Settlement and formalized community-based nursing care.

• Coined the term “public health nurse.”

• Helped establish the National Organization for Public Health Nursing.

• Advocated for school nurses, workplace safety, child labor laws, and women’s rights.

• Partnered with organizations like the Red Cross and led campaigns for healthcare reform and social welfare.

“Baptism by Fire” refers to Wald’s first major experience in community nursing. During a home visit in a tenement, she witnessed the extreme poverty and lack of access to healthcare that many immigrant families faced.

Describe Mary Breckenridge.

After the death of both of her children at young ages, she became committed to improving maternal and child health. Witnessing the poor health conditions and lack of medical care in rural Kentucky during a visit further inspired her to act. These experiences, combined with her nursing education and work abroad, shaped her resolve to bring professional healthcare to isolated communities.

• Established the Frontier Nursing Service, which brought nurse-midwives on horseback to care for patients in remote mountain areas.

• Introduced the concept of nurse-midwifery to the U.S.

• Reduced maternal and infant mortality rates in Appalachia dramatically.

• Trained nurse-midwives through the Frontier Graduate School of Midwifery, which still exists today as Frontier Nursing University.

Roles in community health nursing: Clinician

•Care provider

•Home health

•Urgent care

•Health department

•And others

•Focus on holism, health promotion, and prevention while using expanded skills

Roles in community health nursing: Educator

•Health teacher

•Plan for community-wide impact

Roles in community health nursing: Advocate

•Pleader of the client’s cause or actor on behalf of the client

•Support the client’s self-determination and independence

•Make the system responsive and relevant to the client’s needs

Roles in community health nursing: Manager

•Administrative direction of goals: plan, organize, lead, control, evaluate

•Participative approach with community

Roles in community health nursing: Manager

•Administrative direction of goals: plan, organize, lead, control, evaluate

•Participative approach with community

Roles in community health nursing: Collaborator

•Joint working with others

•Multidisciplinary collegiality and leadership

Name some community health settings.

•Homes

•Ambulatory service

•Schools

•Occupational health

•Residential institutions

•Faith communities

•Community at large (domestic and international)

What are the social determinants of health?

•the circumstances in which people are born, grow up, live, work, and age, as well as the systems, put in place to deal with illness

•These circumstances are shaped by a wider set of forces including economics, social policies, education, and politics

•Factors that influence an individuals' health include safe housing; quality education’ clean water, food and air’ safe workplaces, equitable social interactions; and adequate community resources

What are health disparities?

•Differences among populations as it relates to….

•Quantity of disease

•Burden of disease

•Age and rate of mortality due to disease

•Health behaviors and outcomes

•Other health disparities

•Can be viewed as a disproportionate burden of morbidity, disability, and mortality found in specific portion of the population in contrast to another.

•Ex. Poor access to care, discrimination, language barriers, and non confident providers

What can affect a client/community’s healthcare outcomes?

•Lack of health insurance

•Problems with transportation

•No choices for healthcare close by

•Lack of healthcare providers