UNIT 1B: Definition and Focus: Community Health Nursing

Community Health Nursing

• A specialized field of nursing that combines nursing science with public health principles to promote, protect and preserve the health of populations and communities

True

True or False: CHN focuses on the health needs of individuals, families, groups, and communities, with an emphasis on health promotion, and disease prevention rather than curative care alone.

Community Health Nursing

According to WHO, this is a service directed toward improving health status of the population through preventive, promotive, curative, and rehabilitative care within the community

Community as the patient or unit of care rather than individual alone

Primary focus of CHN

1. Health promotion

2. Disease prevention

3. Population-based care

4. Community participation

5. Environmental health

6. Primary health care

7. Health Equity and Social Justice

7 Focuses of Community Health Nursing

Community Health Nursing

Community Health Nursing or Community-Based Nursing

• Explains prevention and protection of health

Community

Primary clients of Community Health Nursing

Community-Based Nursing

Community Health Nursing or Community-Based Nursing

• Emphasizes on managing acute and chronic health conditions

Individuals and family

Primary clients of Community-Based Nursing

1. The epidemiology or body of knowledge of a particular problem or its solution

2. Information about the community

CHN practice requires the following types of data for scientific approach and populations:

True

True or False: To determine the overall health pattern of the population, data collection for assessment and management decisions within a community should be ongoing, not episodic.

1. Demographic Data

2. Groups at high risk

3. Services/providers available

3 Types of Information

Demographic Data

Types of Information

• Example: Age, gender, race/ethnicity, socioeconomic status, education level

• Sources: Vital statistics, date (national, regional, local), census

Groups at High Risk

Types of Information

• Examples: Health status, health indicators of various subpopulations (like children, elders, PWD)

• Sources: Health statistics (morbidity, mortality, natality); disease

Services/Providers Available

Types of Information

• Examples: Official (public) health departments, healthcare providers, for low income individuals and families, community service agencies and orgs

• Like Red Cross, ERUF

• Sources: City directories, phone books, local or regional social workers, list of low income providers local CH nurse

Public Health Nursing

• Subset or component of CHN

Public Health Nursing

• Field of professional practice in nursing and in public health, in which technical nursing, interpersonal, analytical and organizational skills are applied to problems of health as they affect the community

Freeman

Who defined public health nursing as the field of professional practice in nursing and in public health, in which technical nursing, interpersonal, analytical and organizational skills are applied to problems of health as they affect the community

National League of the Philippine Government Nurses (NLPGN)

Who developed the Standards of Public Health Nursing in the Philippines?

Philippine Nursing Act of 2002 (RA 9173)

What act do the Standards of Public Health Nursing in the Philippines complement?

1. Organization & Management

2. Human Resource Management & Development

3. Quality Nursing Care

4. Management of Resources and Environment

5. Health Education & Health Promotion

6. Legal Responsibility

7. Ethico-Moral Responsibilities

8. Collaboration & Coordination

9. Research

10. Personal & Professional Development

10 Standards of Public Health Nursing in the Philippines

Organization & Management

Standards of Public Health Nursing in the Philippines

• Nursing service should be organized within the local health agency to ensure effective delivery of nursing care and public health programs 

• Should be headed by a qualified nurse leader

• Should have a clear organizational structure, lines of authority and qualified personnel

Human Resource Management & Development

Standards of Public Health Nursing in the Philippines

• Public Health Nurses should be professionally qualified, licensed, and competent

• Continuing professional development, training, and performance evaluation should be provided to maintain quality nursing services

Quality Nursing Care

Standards of Public Health Nursing in the Philippines

• Nurses provide safe, effective, evidence-based, and client-centered care

• Nursing care should utilize the nursing process and focus on health promotion, disease prevention, treatment, and rehabilitation.

Management of Resources and Environment

Standards of Public Health Nursing in the Philippines

• Public health nurses ensure the efficient use of human, financial, and material resources

• They maintain a safe and health-supportive environment for clients and communities

Health Education and Health Promotion

Standards of Public Health Nursing in the Philippines

• Nurses assess learning needs, develop educational plans, implement health teaching, and evaluate outcomes

• Health education is considered a major strategy in improving community health

Legal Responsibility

Standards of Public Health Nursing in the Philippines

• Public health nurses practice according to R.A. 9173, Department of Health policies, local ordinances, and other applicable laws

• Accurate documentation and accountability are essential components of practice 

Ethico-Moral Responsibilities

Standards of Public Health Nursing in the Philippines

• Nurses uphold ethical principles, respect clients’ rights, and adhere to the Code of Ethics for Nurses

• Professional accountability and integrity are expected at all times

Collaboration & Coordination

Standards of Public Health Nursing in the Philippines

• Public health nurses collaborate with health team members, local government units, community organizations, and other stakeholders to achieve health goals

• Intersectoral coordination is essential in community-based health programs

Research

Standards of Public Health Nursing in the Philippines

• Nurses participate in and utilize research to improve nursing practice and public health programs

• Evidence-based practice is encouraged to enhance health outcomes

Personal & Professional Development

Standards of Public Health Nursing in the Philippines

• Nurses engage in lifelong learning and professional growth

• They maintain competence, positive professional values, and commitment to quality service.

Pre-Colonial Period (Before 1521)

Identify the period of evolution of PHN in the Philippines:

• Healthcare is primarily provided by family members & traditional healers (babaylans/herbalists)

Pre-Colonial Period (Before 1521)

Identify the period of evolution of PHN in the Philippines:

• Care focused on indigenous healing practices, herbal medicine, and spiritual rituals

Pre-Colonial Period (Before 1521)

Identify the period of evolution of PHN in the Philippines:

• No formal nursing profession at this time

Spanish Period (1521-1898)

Identify the period of evolution of PHN in the Philippines:

• Religious orders established hospitals and charitable institutions

Spanish Period (1521-1898)

Identify the period of evolution of PHN in the Philippines:

• Early hospitals included: 

  • Hospital Real de Manila (1577)

  • San Lazaro Hospital (1578)

Spanish Period (1521-1898)

Identify the period of evolution of PHN in the Philippines:

• Public health measures such as sanitation and vaccination programs were introduced.

Spanish Period (1521-1898)

Identify the period of evolution of PHN in the Philippines:

• In 1805, Dr. Francisco de Balmis introduced the smallpox vaccine to the Philippines. 

Dr. Francisco de Balmis

Who intoduced the smallpox vaccine to the Philippines?

American Period

Identify the period of evolution of PHN in the Philippines:

• Marked the beginning of organized public health nursing

American Period

Identify the period of evolution of PHN in the Philippines:

• 1898: Department of Public Works, Education and Hygiene was established under the First Philippine Republic

Department of Public Works, Education and Hygiene

In 1898, what department was established under the First Philippine Republic?

American Period

Identify the period of evolution of PHN in the Philippines:

• 1901: No. 157 created the Board of Health for the Philippine islands, strengthening public health administration

Board of Health for the Philippine Islands

In 1901, No. 157 created the what, strengthening public health administration?

American Period

Identify the period of evolution of PHN in the Philippines:

• 1905: Asociacion Feminista Filipino (Breast Milk) established Lacota de Leche, focusing on maternal and child welfare

Lacota de Leche

In 1905, the Asociacion Feminista Filipino (Breast Milk) established what, which focused on maternal and child welfare?

American Period

Identify the period of evolution of PHN in the Philippines:

• 1912: The Fajardo Act created Sanitary Divisions to improve community sanitations and health services

Fajardo Act

In 1912, what act created Sanitary Divisions to improve community sanitations and health services?

American Period

Identify the period of evolution of PHN in the Philippines:

• 1914-1915: School nursing services began Tacloban, Leyte

• The Office of District Nursing was organized to supervise nurses working in communities outside hospitals

Office of District Nursing

In 1914-1915, what was organized to supervise nurses working in communities outside hospitals?

American Period

Identify the period of evolution of PHN in the Philippines:

• 1919: Carmen del Rosario: first Filipino nurse supervisor in the Bureau of Health

• PHN expanded throughout the provinces

Carmen del Rosario

In 1919, who was the first Filipino nurse supervisor in the Bureau of Health?

Japanese Occupation and World War II (1941-1945)

Identify the period of evolution of PHN in the Philippines:

• Public health services were severely disrupted

• Many nurses served in military hospitals, emergency services, and guerrilla units

• Shortages of supplies and personal affected healthcare delivery

Executive Order No. 94

In 1947, what legislature created the Division of Nursing within the Department of Health?

Mrs. Genara M. de Guzman

In 1947, who became the first chief of the Division of Nursing within the DOH?

Republic Act No. 1082 (Rural Health Law)

In 1953, what legislature established Rural Health Units (RHUs)?

• Physician

• Public Health Nurse

• Midwife

• Sanitary Inspector

• Support Staff

In 1953, what did each RHU include?

Modern Public Health Nursing (1970s-Present)

Identify the period of evolution of PHN in the Philippines:

• Public Health nursing became more integrated with:

  • Primary Health Care

  • Maternal and Child Health Programs

  • Expanded Program on Immunization

  • Family Planning Programs

  • Communicable and Non-communicable Disease Control

  • Disaster Risk Reduction and Management Universal Health Care Initiatives

  • Universal Health Care Initiatives 

• Public health nurses now function as clinicians, educators, managers, researchers, advocates, and community organizers

Community Health Nurses (CHNs)

Are frontline healthcare providers who deliver essential health services to individuals, families, and communities

1. Care Provider

2. Health Educator

3. Counselor

4. Advocate

5. Community Organizer and Mobilizer

6. Case Manager

7. Collaborator

8. Program Implementer

9. Researcher

10. Leader & Manager

11. Disaster Preparedness and Response Nurse

12. Record Keeper & Reporter

12 Roles & Responsibilities of a Community Health Nurse

Care Provider

Roles & Responsibilities of a Community Health Nurse

• Provides direct nursing care to individuals, families, and communities

• Conducts home visits and health assessments

• Delivers maternal, newborn, child, and elderly care

• Administers medications, immunizations, and treatments

Health Educator

Roles & Responsibilities of a Community Health Nurse

• Conducts health teaching on disease prevention and health promotion

• Educated clients on nutrition, sanitation, family planning, and healthy lifestyles

• Organizes community health education programs and campaigns

Counselor

Roles & Responsibilities of a Community Health Nurse

• Assists individuals and families in understanding health problems & available resources

• Provides emotional support and guidance

• Encourages healthy decision-making and behavior change

Advocate

Roles & Responsibilities of a Community Health Nurse

• Protects the health rights of individuals and vulnerable populations

• Facilitates access to healthcare services and community resources

• Promotes health equity and social justice

Community Organizer and Mobilizer

Roles & Responsibilities of a Community Health Nurse

• Encourages community participation in health programs

• Assists in organizing health committees and volunteer groups

• Strengthens community capacity to identify and solve health problems

Case Manager

Roles & Responsibilities of a Community Health Nurse

• Coordinates healthcare services for individuals and families

• Refers clients to appropriate healthcare facilities and specialists

• Monitors follow-up care and continuity of services

Collaborator

Roles & Responsibilities of a Community Health Nurse

• Works with physicians, midwives, barangay health workers, LGUs, schools, and non-government organizations

• Participates in interdisciplinary health teams

• Coordinates community health projects and interventions

Program Implementer

Roles & Responsibilities of a Community Health Nurse

• Implements national and local health programs such as:

  • Expanded Program on Immunization (EPI)

  • Tuberculosis Control Program

  • Maternal and Child Health Program

  • Family Planning Program

  • Non-communicable Disease Prevention Programs

• Monitors program outcomes and accomplishments

Researcher

Roles & Responsibilities of a Community Health Nurse

• Collects, analyzes, and interprets community health data

• Participates in evidence-based practice and community health research

• Uses research findings to improve nursing interventions and health programs

Leader & Manager

Roles & Responsibilities of a Community Health Nurse

• Plans, organizes, directs, & evaluates nursing services & community health activities 

• Supervises barangay health workers and other healthcare personnel 

• Participates in policy implementation and resource management

Disaster Preparedness and Response Nurse

Roles & Responsibilities of a Community Health Nurse

• Participates in disaster risk reduction and management activities

• Conducts emergency preparedness education

• Provides nursing care during disasters, emergencies, and outbreak

Record Keeper & Reporter

Roles & Responsibilities of a Community Health Nurse

• Maintains accurate health records and reports

• Documents nursing interventions and community health data

• Submits reports required by the DOH and local government units