COMMUNITY HEALTH NURSING 2

ASSIGNMENT

I. Definition
a. Community health nursing is one of the broadest fields of nursing in terms of
setting or place of practice. As a field of specialty in nursing, it is an old,
established one, antedating by several decades the shift in orientation of the
other health professions in the community. In community health nursing,
nurses enter the environment in which people live and practice within the
environment, in addition to the one-to-one or single-family approach to health
care, the community health nurse think in terms of populations, aggregates at
risk within these populations, including families at risk, are identified so that
preventive measures and resources can be targeted for them. Likewise the
community health nurse have committed to help the client take responsibility
for his or her own well-being and wholeness, through genuine interest and
caring. Furthermore the important characteristics of community health nursing
practice are autonomy, continuity of care, collaboration, interactivity,
accountability and intimacy with reality of client’s situations. As community
health nurses makes its unique contribution by ensuring an equitable
distribution of health care, a basic standard of living that supports the health
and well-being of all people and a healthful physical environment.
II. Principles
1. The recognized need of individuals, families and communities provides the basis
for CHN practice. Its primary purpose is to further apply public health measures
within the framework of the total CHN effort.
2. Knowledge and understanding of the objectives and policies of the agency
facilities goal achievement. The mission statement commits Community Health
Nurses to positively actualize their service to this end.
3. CHN considers the family as the unit of service. Its level of functioning is
influenced by the degree to which it can deal with its own problems. Therefore the
family is an effective and available channel for the most of the CHN efforts.
4. Respect for the values, customs and beliefs of the clients contribute to the
effectiveness of care to the client. CHN services must be available sustainable and
affordable to all regardless of race, creed, color or socio-economic status.
5. CHN integrated health education and counseling as vital parts of functions. These
encourage and support community efforts in the discussion of issues to improve
the people’s health.
6. Collaborative work relationships with the co-workers and members of the health
team facilities accomplishments of goals. Each member is helped to see how
his/her work benefits the whole enterprise.
7. Periodic and continuing evaluation provides the means for assessing the degree to
which CHN goals and objectives are being attained. Clients are involved in the
appraisal of their health program through consultations, observations and accurate
recording.
8. Continuing staff education program quality services to client and are essential to
upgrade and maintain sound nursing practices in their setting. Professional interest
 and needs of Community Health Nurses are considered in planning staff
development programs of the agency.
9. Utilization of indigenous and existing community resources maximizing the
success of the efforts of the Community Health Nurses. The use of local available
ailments. Linkages with existing community resources, both public and private,
increase the awareness of what care they need what are entitled.
10. Active participation of the individual, family and community in planning and
making decisions for their health care needs, determine, to a large extent, the
success of the CHN programs. Organized community groups are encouraged to
participate in the activities that will meet community needs and interests.
11. Supervision of nursing services by qualified by CHN personnel provides guidance
and direction to the work to be done. Potentials of employees for effective and
efficient work are developed.
12. Accurate recording and reporting serve as the basis for evaluation of the progress
of planned programs and activities and as a guide for the future
actions. Maintenance of accurate records is a vital responsibility of community as
these are utilized in studies and researches and as legal documents.
III. Philosophy
1. Nursing is a unique and distinct component of health care.
2. CHN subscribes to the philosophy of interdependence among the health
professions.
3. As a special field of nursing practice, CHN shares the humanistic beliefs and
values of the nursing profession.
4. CHN believes in the primacy of health as a goal and as essential element that
affects the quality of life of individuals, families, groups and communities.
5. The goal of nursing is independence and self-reliance in health Care for the client/
patient- be it an individual, a family, a group or the whole community.
6. Nursing, in general, and CHN in particular, recognizes the relationship of non-
health interventions in the solution of health problems.
7. To achieve the goal of community health, the nurse works with, not for, individual
clients/patients, families, specific population groups and the community at large.
8. Nursing goals and standards of care should consider constraints imposed by client,
health agency and community resources.
9. CHN practice is not a body or set of the same repeating tasks.
10. Nurses have the responsibility to keep their knowledge and skills current and up-
to-date according to developments in nursing, public health and other related
sciences.
IV. Theoretical Models/approach
a. MILIO’S FRAMEWORK OF PREVENTION
i. The framework provides that the health status existing in the
population occurs due to too little or excess critical health sustaining
resources whereby people who are have enough and safe food, shelter,
water and environment are vulnerable to infectious diseases which too
much food will lead to obesity. Population behavior patterns also affect
health since knowledge and perception is influenced by informal and
formal learning and also by experience (Milio, n.d). Health is also
influenced by organizational behavior which includes policy makers
 since they provide options available to thus influencing selections
made by individuals.
b. Health Belief Model (HBM)
i. The Health Belief Model (HBM) is a tool that scientists use to try to
predict health behaviors. It was originally developed in the 1950s and
updated in the 1980s. The model is based on the theory that a person's
willingness to change their health behaviors primarily comes from
their health perceptions.
1. According to this model, your individual beliefs about health
and health conditions play a role in determining your health-
related behaviors. Key factors that affect your approach to
health include:
a. Any barriers you think might be standing in your way
b. Exposure to information that prompts you to take action
c. How much of a benefit you think you'll get from
engaging in healthy behaviors
d. How susceptible you think you are to illness
e. What you think the consequences will be of becoming
sick
f. Your confidence in your ability to succeed
c. Nola Pender’s Health Promotion
i. The Health Promotion Model notes that each person has unique
personal characteristics and experiences that affect subsequent actions.
The set of variables for behavioral specific knowledge and effect have
important motivational significance. These variables can be modified
through nursing actions. Health-promoting behavior is the desired
behavioral outcome and is the endpoint in the Health Promotion
Model. Health-promoting behaviors should result in improved health,
enhanced functional ability, and better quality of life at all
development stages. The final behavioral demand is also influenced by
the immediate competing demand and preferences, which can derail
intended health-promoting actions.
d. Lawrence Green’s PRECEDE-PROCEED MODEL
i. The PRECEDE-PROCEED model is a comprehensive structure for
assessing health needs for designing, implementing, and evaluating
health promotion and other public health programs to meet those
needs. PRECEDE provides the structure for planning a targeted and
focused public health program. PROCEED provides the structure for
implementing and evaluating the public health program.
1. PRECEDE stands for Predisposing, Reinforcing, and Enabling
Constructs in Educational Diagnosis and Evaluation. It involves
assessing the following community factors:
a. Social assessment: Determine the social problems and
needs of a given population and identify desired results.
b. Epidemiological assessment: Identify the health
determinants of the identified problems and set
priorities and goals.
c. Ecological assessment: Analyze behavioral and
environmental determinants that predispose, reinforce,
and enable the behaviors and lifestyles are identified.
 d. Identify administrative and policy factors that influence
implementation and match appropriate interventions
that encourage desired and expected changes.
e. Implementation of interventions.
ii. PROCEED stands for Policy, Regulatory, and Organizational
Constructs in Educational and Environmental Development. It involves
the identification of desired outcomes and program implementation:
a. Implementation: Design intervention, assess availability
of resources, and implement program.
b. Process Evaluation: Determine if program is reaching
the targeted population and achieving desired goals.
c. Impact Evaluation: Evaluate the change in behavior.
d. Outcome Evaluation: Identify if there is a decrease in
the incidence or prevalence of the identified negative
behavior or an increase in identified positive behavior.
V. Different Fields of Community Health Nursing
a. School health Nursing
i. School Health Nursing Team is made up of School Health Nurses and
School Health Assistants who are experienced in working with
children and young people. The School Health Nursing Service will
ensure that every parent and child/young person has access to health
advice, support and signposting (including sexual health, emotional
and mental health issues) as well as support in relation to healthy
lifestyles.
b. Occupational health nursing
i. is a specialty nursing practice that provides for and delivers health and
safety programs and services to workers, worker populations, and
community groups. The practice focuses on promotion, maintenance
and restoration of health, prevention of illness and injury, and
protection from work‐related and environmental hazards. Occupational
health nurses (OHNs) aim to combine knowledge of health and
business to balance safe and healthful work environments and a
"healthy" bottom line.
c. Community Mental Health Nursing
i. The community mental health nurse is a professional who works in
collaboration with an interdisciplinary clinical team to provide
specialized support to families and clients who are experiencing mental
health challenges, some of which can include anxiety, depression,
personality, and eating disorders, addiction to drugs or alcohol, and
host of other mental health challenges. They practice in a range of
behavioral health care settings, including residential and nursing
homes, community mental health centers, and detoxification centers;
rehabilitation units, special units within prisons, and mental health
charities.