COMMUNITY HEALTH NURSING

It is synthesis of nursing knowledge and practice

and the science and practice of public health,
implemented via a systematic use of the nursing
process and other processes to promote health
and prevent illness in population groups.

CHN is the totality of its philosophy and beliefs ,

principles, processes, and standards. As one of the
subsystems, it influences and is influenced by the
health care delivery system.

CHN is practiced within a specific economic,

political, socio-cultural and environmental
context.
 Characteristics of CHN
1. Promotion of health and prevention of disease are the
goals of professional practice;
2.Community health nursing practice is comprehensive,
general, continual and not episodic;
3. There are different levels of clientele – individuals,
families, and population groups and the practitioner
recognizes the primacy of the population as a whole;
4. The nurse and the client have greater control in
making decisions related to health care and collaborate
as equals;
5. The nurse recognizes the impact of different factors
on health and has a greater awareness of his/her clients’
lives and situations.
 THE ESSENCE OF NURSING IS THE SAME EVEN
IF PRACTICED IN DIFFERENT SETTINGS.

 NURSING – is defined as the science and art of

caring.
 Nursing as an art is reflected in the nurses’
interactions and communication with clients that
are geared towards the improvement not just of
their health but also their ability to deal with the
determinants and consequences of their health
problems.
Nursing as a science means community health nurses
should use practice-based and evidence- based
methods and tools. They also need to engage in
generating evidence to support their practice through
research.
THE ROLES OF CHN’s BY CLARK
 CLIENT-ORIENTED ROLES
Caregiver
Educator
Counselor
Referral Resource
Role model
Case manager
 DELIVERY-ORIENTED ROLES
Coordinator
Collaborator
Liaison

 POPULATION-ORIENTED ROLES
Case finder
Leader
Change agent
Community mobilizer
Coalition builder
Policy advocate
Social marketer
Researcher
 FRAMEWORK OF CHN
Four (4) components:
1. The HCDS and with its CHN subsystems
2. The clients
3. Health
4. Economic, socio-cultural, political and
environmental factors that affect the HCHS,
the practice of CHN and the people’s
health.
 4 LEVELS OF CLIENTELE IN CHN

1. Individual sick or well – on a daily basis. They

are the entry point in working with the other
clients.

2. Family – unit of care

 Unit of living, is also a unit of illness
 Illness in one member affects other family
members and the whole family as a unit
 Alterations in health alter relationships
between members (physiologically,
psychosocially, and economically)
 Affects the functions & effectiveness of the
family as a whole
 Dynamic interplay between health & family
characteristics
 Vehicle for preventive & therapeutic health
interventions
3. Population Group
 Certain group with common unique health needs
or risk groups whom the nurse delivers health
promotive, preventive, curative or rehabilitative
nursing services
 CHN utilizes group approaches in identifying the
common health needs of the members, and
addressing them for the whole group.
4. Community
 Refers to a group of people who share common needs,
interests, ethnic or cultural ties, and are committed to their
group’s well-being.
 Functions within a particular social and political system &
structure, creates & exhibits certain norms, values and social
institutions, and its members interact and socialize with
each other
 Emphasis on the importance of “the greatest good for the
greatest number.”
 Mortality & morbidity statistics are broad indicators of a
community’s state of health.
 Interventions for community-wide health problems come in
the form of specific programs or special projects
implemented with the participation of the comm & health
care teams.
Must to know…
The three most commonly identified
subspecialties of CHN are Public Health
Nursing, Occupational Health Nursing
and School Health Nursing.
 Community Health Nursing
Occupational Health School Health Nursing
Nursing Nursing in an
Nursing in the educational
workplace. environment (school)
Research-based with Aims at promoting the
an emphasis on health of school
optimizing health, children & preventing
preventing illness and health problems that
injury, and reducing would hinder their
health hazards. learning and
performance of their
developmental tasks.
The clientele is an active partner and not a passive
recipient of care.

The most neglected responsibility:

RESEARCH related to Community Health Nursing.
 HEALTH
 A BASIC HUMAN RIGHT
 A state of complete physical, mental, and social well-
being and not merely the absence of disease or
infirmity. (WHO- concept of Health 1995)
 The goal of Public Health in general, and community
health in particular.
 A quality of life, involving social, emotional, mental,
spiritual and biological fitness on the part of the
individual, which results from adaptations to the
environment. (Rene Dubos (1965)
 Factors Affecting Health

Poverty and health

Culture and health
Environment and health
Politics and health`
 Public Health by
Dr. Winslow
- it is the science & art of preventing disease, prolonging
life, promoting health and efficiency through organized
community effort; for the sanitation of the environment;
control of communicable infections; the education of
individual in personal hygiene; the organization of medical
and nursing services for the early diagnosis and preventive
treatment of disease and the development of the social
machinery to ensure everyone a standard of living adequate
for the maintenance of health, so organizing these benefits
to enable every citizen to realize his birthright of health and
longevity.