3. Health
WHO
"Health is a state of
complete physical
mental and social well-
being, and not merely
an absence of disease or
infirmity"
4. Community Health
WHO’s
“Community health refers to
the health status of the
community, to the problems,
affecting their health & to the
totally health care provided
to the community.”
5. Acc. To AAPH
“The art and science of maintaining,
protecting and improving health of the
people through organized efforts.”
Acc. To CEA. Winslow
“Community health is the science and
arts of preventing diseases, prolonging life
and promoting health and efficiency through
organized efforts”
6. Community health
Nursing
ANA’s
“It is field of practice that
synthesizes knowledge & skill
from nursing & public health &
applied them toward
preventing, promoting,
curative & rehabilitative care
to family & community.”
7. Acc. To AAPH
“Public health Nursing synthesizes
the body of knowledge from
public health sciences and
professional nursing theories for
the purpose of improving the
health of entire community.”
8. Acc. toWHO Expert Committee of
Nursing
“Special field of nursing that combines
the skills of nursing, public health and
some phases of social assistance and
functions as part of the total public
health program for the promotion of
health, the improvement of the
conditions in the social and physical
environment, rehabilitation of illness
and disability.”
9. Objective of C.H.
Nursing
1. To participate in the development of an
over all health plan for the community.
2. To provide quality nursing services to
individuals, families & communities.
3. To coordinate nursing services with various
members of health team.
4. To participate in and/or conduct researches
relevant to community health and
community health nursing services and
disseminate their results for improvement
of health.
10. Purpose of C.H. Nursing:
1. To ascertain the nature & extent of disease & disability
in the community.
2. To take suitable measures to….
-Promote healthful living.
-Prevent Disabilities.
-Correct re-medical defects.
-Treat illness & Rehabilitate those and handicaps.
3. To evaluate the progress and success of current
programmes.
4. To conduct research in community causes and diseases.
5. To provide the medical & nursing care to common ill
health.
6. To educate the public in prevention of health hazards.
11. Characteristic of Community
health nursing practice
► The practice is general and comprehensive.
► Encompasses nursing practice areas emphasizing health
promotion, illness prevention,
► Building social and community support for health.
► The promotion of health & Prevention and health protection
► It promote clients responsibility and self care
► synthesizes knowledge from public health sciences and
professional nursing theory;
► promotes linkages between individuals, communities, the
broader health system and other health determining sectors;
and works with communities to develop specific services
12. SCOPE OF CHN
COMMUNITY HEALTH NURSING
Education Practice Research Administration
-Principal
-Vice Principal
-Professor
-Lecturer
-School health nurse
-Occupational health nurse
-Travel nurse
-Home nursing
-Street nurse
-National health programe
-Domiciliary nursing services
-Rehabilitation center
-Space nurse
-Giariatric nursing services
-Mental health nursing services
- Coordinate
- Conduct
- DPHN
- SHN
- VHN
- CHN
13. Setting for community
health nursing practice
homes
ambulatory service settings
schools
occupational health setting
residential institutions
the community at large
14. Hospital nursing and community
nursing
Hospital nursing Community health nursing
-She follows orders
-Services are provided in
response to patient
demand
-Hospital administration is
in command: controls
Patient/family
-Planning is limited to
providing
episode-based curative
service
-She observes, thinks, decides
and acts
-Services reach out to the
community
-Family is in command, accepts
or rejects Health Worker's
advice and care
-The focus of planning is
preventive and promotive
services
-Community is the patient
15. Opportunity for Future
Community Health Nursing
Chronic Disease management
Home Care
Extended care from Acute care setting
Elderly care
Rehabilitation care in different population
Health promotion in every level
Health system referral, emphasize individual
role and function of community health sector
16. 1. Community health nursing is
an established activity based
on recognized needs.
2. The community health nursing
agency has clearly defined
objectives and purpose for its
services.
3. Community health nursing is
an integral part of the
community health programme.
17. 4. Community health nursing services
should be available to people
irrespective of age, sex, creed, and
nationality, cultural and economic
resources.
5. Community health nursing
recognized the family and
community as unit of service.
6. Community health nursing should
include health education and
counseling.
7. Community health nurse should be
qualified as a full-fledged.
18. 8. Community health nursing
service should be based on the
needs of the patient.
9. The Community health nurse
should function as an important
member of the health team.
10.The Community health nurse
should not accept gifts or bribes
from the patient.
19. 11. The Community health nurse should not
belong to any one section or any political
group.
12. The Community health agency should
provide a continuing education
programme for nurses.
13. The Community health nursing services
should develop proper guideline, in
maintaining records and reports.
14. The Community health nurses should
maintain professional relationship with all
the leaders in the community and maintain
ethics at all times.
20. 1. Meet the community
2. Identification (or recognition) of
health problems and needs
3. Setting priorities among health problems
4. Planning and problem solving
5. Intervention or Implementation
6. Evaluation
21. It is first necessary to meet the
community, in order
To establish contact with
community leaders, existing
institutions.
To obtain consent of the local
leaders for a base-line survey of
the health situation.
22. Various approaches may be used to identify
community health problems and health
needs; they include
base-line survey
scrutinizing the records of PHC and sub
centre
specific questions regarding diseases
common in the area
Questions regarding births, deaths, disability,
failure to work, etc.
23. Four criteria are used for setting priorities
among health problems:
I Frequency with which the problem
occurs (prevalence)
II Seriousness of the problem for individuals
and society
III Urgency of the problem.
IV Feasibility or susceptibility to control
the problem within the financial resource
limitations.
24. Having recognized that a problem or need
exists, the community health nurse must
decide what action should be taken by the
Health Team and whether the Health Team
will be capable of taking any action. Planning
involves questions of setting objectives, and
defining solutions to the problem.
25. The community health nurse carries out
activities decided upon as being most
effective, in order to fulfill the recognized
need. This phase contains all the tasks,
procedures and practices which are
performed by nurses.
26. Evaluation will measure the extent to which the
problem has been solved or the need met.
Evaluation provides "feed-back" that can lead
to programme modification, which will make
the programme more effective.
27. “An especially prepared registered nurse
employed in a community agency to
safeguard the health of people in the
community, giving care to the sick in their
homes, promoting health and well-being by
teaching families how to keep well, and
assisting in programs for the prevention of
disease.”
28.
29. The CHN implements same roles as other nurse
specialists, because she works with individuals,
families, the community, and selected
subgroups of the community, her roles are:
Advocate
Consultant
Coordinator
Provider
Educator
Counselor
Evaluator
Planner
Researcher
30. 1. Care provider
It is the most familial role of CHN
2. Advocate
The definition of advocate is “the act of informing and
supporting a person so that he can make the best decisions
possible for himself”.
The CHN can work directed to providing care which promotes
and preserves the health and well-being of communities.
The CHN can provide the client with information about
options available, allows the client to make a decision &
support the final decision.
The CHN can write letters, talk to the agency involved to care
& provide appropriate information, and plead the case for the
family.
Community advocacy involves workings with the community
members to determine solutions for identified problems and
supporting ultimate decisions.
31. 3. Consultant
• The community health nurse may serve as
consultant to a number of different groups. This
includes consultation to other health care
providers, health care agencies, agencies who
relate to health care agencies, politicians and
special interest community groups. The most
commonly role applied with individuals and
families is counselor. The counselor can provide
crisis intervention, supportive counseling &
other types of counseling that are appropriate
with education and skills.
32. 4. Coordinator
The CHN is often responsible for coordinating
activities of other health care agencies.
5. Educator
The role of educator includes education of
individual’s clients, family & specific community
groups. Skills of teaching are incorporated with
knowledge of the learning process in order to provide
the best possible educational experience.
33. 6.Evaluator
The evaluator role of the CHN is implemented in
many ways. A nurse may be involved in evaluating
health care programs through inspection duties. The
role of evaluator requires careful preparation of the
evaluation process to be used in selected situations.
Preparation for the role of evaluator will include
becoming familiar with the purpose of the evaluation,
the person or content to be evaluated and the
communication skills needed to communicate
effectively the findings of the evaluation.
34. 7. Planner
The role of the CHN in planning ranges from planning
nursing care for individuals and families to
participating in large community programs planning
for specific health related needs and also participate
in implementation of the planning phase of the nurse
process. This role could involve gathering data. The
role of provider, the type of nursing care provided
may vary depending on the employing agency e.g.
the administration of specific nursing treatments
prescribed by a physician & performs various
assessment activities.
35. 8. Researcher
Depending on educational preparation, the CHN may
participate in research, the preparation for
undergraduates includes learning the nature of
inquiry, introduction to research grand, process and
methodology and the use of research findings. Some
CHN specialize in a particular aspect of nursing care.
A clinical specialist may be employed in a community
health agency as well as in a hospital. Clinical
specialists are prepared on the master’s level with a
specialty in a specific field, e.g. family health,
pediatrics, midwifery, mental health counseling and
family therapy.
