COMMUNITY HEALTH NURSING – II

Time : Theory – 90 hours

Practical – 135 hours

Course description:
This course is designed for students to practice community health nursing for the individual,
family and groups at both urban and rural setting by using concept and principles of health and
community health nursing

Specific objectives: At the end of the course student will be able to:
1. Understand the concepts, scope, principles and historical development of community health
and community health nursing.
2. Appreciate the national health planning, polices, problems.
3. Describe the system of delivery of community health services in rural and urban area.
4. Develop understanding about community health nursing approaches, concepts and roles and
responsibilities of nursing personnel.
5. Participate in assisting individuals and groups to promote and maintain their health.
6. Appreciate the national health and family welfare programme and the role of the nurse.
7. Understand the health agencies at the international and national level.

Teaching
Time Learning Assessment
Unit Contents Learning
(hrs) Objectives Methods
Activities
I 4 • Define Introduction • Lecture • Essay
Concepts, • Definition, concept & scope discussion Type
scope, of community health nursing • Short
Principles and • Historical development of answers
historical  Community Health
development  Community Health Nursing
of Community - Pre- Independence
Health and - Post – Independence
Community Client’s rights-CPA
health Nursing Professional responsibility in
community health care
Ethical principles
Application of ethics in
Community health practice
Govt. & legal influence on
community health nursing
practice
Law in community health nursing
 Teaching
Time Learning Assessment
Unit Contents Learning
(hrs) Objectives Methods
Activities
II 6 • Describe Health Planning and Polices • Lecture • Essay type
health plans, and Problems discussion • Short
polices, • National health planning • Panel answers
various in India Five year Plan’s discussion
health • Various committees and
committees commissions on health
and health and family welfare
problems in  Central council for
India health and family
welfare (CCH and
FW)
 National Health
polices (1983, 2002)
 National population
policy
 Rural health mission
• Health problems in India
III 15 • Describe the Delivery of community • Lecture • Essay type
system of health services discussion • Short
delivery of • Planning, budgeting and • Visits to answers
community material management of various
health SCs, PHC and CHC health
services in • Rural: Organization, delivery
rural and staffing and functions of systems
urban areas rural health services • Supervised
• List the provided by government field
functions of at: practice
various  Village • Panel
levels and  Subcentre discussion
their  Primary health center
staffing  Community health
pattern center/ sub divisional
• Explain the  Hospitals
components  District
of health  State
services  Center
• Describe • Urban: Organization,
alternative staffing and functions of
systems of urban health services
health provided by government
promotion at:
and health  Slums
maintenance  Dispensaries
• Describe the  Material and child
chain of health centers
referral  Special Clinics
system  Hospitals
 Corporation/
Municipality/ Board
 Teaching
Time Learning Assessment
Unit Contents Learning
(hrs) Objectives Methods
Activities
• Components of health
services
 Environmental
sanitation
 Health education
 Vital statistics
 M.C.H. antenatal,
natal, postnatal, MTP
Act, female feticide
act, child adoption act
 Family welfare
 National health
programmes
 School health services
 Occupational health
 Defense service
 Institutional services
• Systems of medicine and
health care
 Allopathy
 Indian system of
medicine and
Homeopathy
 Alternative health care
systems like yoga,
meditation, social and
spiritual healing etc.
• Referral system
IV 25 • Describe Community health nursing • Lecture • Essay type
Community approaches, concepts and discussion • Short
Health roles and responsibilities of • Demonstrat answers
Nursing nursing personnel ion
approaches • Approaches • Practice
and concepts  Nursing theories and session
• Describe the nursing process • Supervised
roles and  Epidemiological field
responsibility approach practice
of  Problem solving • Participatio
Community approach n in camps
health  Evidence based • Group
nursing approach empowering project
personnel people to care for
themselves
• Concepts of primary
Health Care:
 Equitable distribution
 Community
participation
 Focus on prevention
 Use of appropriate
technology
 Multi sectoral
approach
 Teaching
Time Learning Assessment
Unit Contents Learning
(hrs) Objectives Methods
Activities
• Roles and responsibilities
of Community health
nursing personnel in
 Family health services
 Information Education
Communication (IEC)
 Management
information System
(MIS): maintenance of
Records & Reports
 Training and
supervision of various
categories of health
workers
 National Health
Programmes
 Environmental
sanitation
 Maternal and child
health and family
welfare
 Treatment of minor
ailments
 School health services
 Occupational health
 Organization of clinics,
camps: types,
preparation, planning,
conduct and evaluation
 Waste management in
the center, clinics etc.
• Home visit: Concept,
Principles, Process,
techniques: Bag Technique
home visit
• Qualities of Community
Health Nurse
• Job description of
Community health nursing
personnel
V 15 • Describe and Assisting individuals and • Lecture • Essay type
appreciate the groups to promote and discussion • Short
activities of maintain their health • Demonstrati answers
Community • Empowerment for self care on
health nurse of individuals, families and • Practice
in assisting groups in – session
individuals A. Assessment of Self and • Supervised
and groups to family field
promote and  Monitoring growth and practice
maintain their development
health - Mile stones
- Weight measurement
- Social development
 Teaching
Time Learning Assessment
Unit Contents Learning
(hrs) Objectives Methods
Activities
 Temperature and Blood • Individual
pressure monitoring group/
 Menstrual cycle family/
 Breast, self examination community
and testicles health
 Warning signs of various education
diseases
 Tests: Urine for sugar
and albumin, blood sugar
B. Seek health services for
 Routine checkup
 Immunization
 Counseling diagnosis
 Treatment
 Follow up
C. Maintenance of health
records for self and family
D. Continue medical care and
follow up in community for
various diseases and
disabilities
E. Carryout therapeutic
procedures as prescribed/
required for self and family
F. Waste Management
 Collection and
disposable of waste at
home and community
G. Sensitize and handle social
issues affecting health and
development for self and
family
• Women Empowerment
• Women and child abuse
• Abuse of elders
• Female feticide
• Commercial sex workers
• Food adulteration
• Substance abuse
H. Utilize community
resources for self and
family
 Trauma services
 Old age homes
 Orphanage
 Homes for physically
and mentally challenged
individuals
 Homes for destitute
 Teaching
Time Learning Assessment
Unit Contents Learning
(hrs) Objectives Methods
Activities
VI 20 • Describe National health and family • Lecture • Essay type
national welfare programmes and the discussion • Short
health and role of a nurse • Participation answers
family 1. National API programme in national
welfare 2. Revised National health
programmes tuberculosis control programmes
and role of a programme (RNTCP) • Field visits
nurse 3. National Anti- Malaria
• Describe the programme
various 4. National Filaria control
health programme
schemes in 5. National Guinea worm
India eradication programme
6. National Leprosy eradication
programme
7. National AIDS control
programme
8. STD control programme
9. National Programme for
Control of blindness
10.Iodine deficiency disorder
programme
11.Expanded programme on
immunization
12.National Family welfare
Programme – RCH
programme historical
development, organization,
administration, research,
constraints
13.National water supply and
sanitation programme
14.Minimum Need programme
15.National diabetics control
programme
16.Polio eradication: pulse polio
programme
17.National cancer control
programme
18.Yaws eradication
programme
19.National Nutritional Anemia
Prophylaxis programme
20.20 point programme
21.ICDS programme
22.Mid day meal applied
nutritional programme
23.National mental health
programme
• Health Schemes
- ESI
-CGHS
-Health insurance
 Teaching
Time Learning Assessment
Unit Contents Learning
(hrs) Objectives Methods
Activities
VII 5 • Explain the Health Agencies International • Lecture • Essay type
roles and – WHO, UNFPA, UNDP, World discussion • Short
functions of Bank, FAO, UNICERF, • Field visits answers
various DANIDA, European,
national and Commission (EC), Red Cross,
international USAID, UNESCO, Colombo
health plan, ILO, CARE etc.
agencies National – Indian Red Cross,
Indian Council for child welfare,
Family planning Association of
India etc.

Student References (Bibliography)

1) Jayawanti, TNAI Nursing Manual, TNAI publication

2) K.Park, ‘Text Book Of Preventive & Social Medicine’
3) K.Park, Essentials Of Community Health Nursing,
4) Rao Kasturi, ‘An Introduction To Community Health Nursing’, I publications.
5) Freeman Ruth, ‘Community Health Nursing Practice’
6) Stanthope Lancaster, ‘Community Health Nursing Process & Practice’, Popular publication.
7) Basvantappa B.T, ‘Community Health Nursing’

8) Anderson, ‘Community as Partner, Theory & Practice’.

9) Allender, ‘Community Health Nursing’ B.I. Publications
10) Harpson, ‘Hand Book of Community Health Nursing’
11) Shastr , ‘Preventive & Social Medicine’, National Publications
12) Sathe , ‘Epidemiology & management of Health Care’, Popular Publications
13) Vasundhara & Basvantappa , ‘Community Health Nursing’, Jaypee Publication
14) Mc. Evens M. ‘Community based Nursing’, Sanmdess publication
15) Kulkarni & Baride, ‘Text Book of Community medicine’, Vora Publications.
16) Cookfair Joan, ‘Nursing Care in Community’, Moby Publications
17) Maxey Public, ‘Health & Preventive Medicine’, Applin Colage Publications
18) Lippincotts, ‘Community Health Nursing’, Lrppincotts Publications
19) K.Park , ‘Text Book of Preventive & Social Medicine’
20) Saunder, ‘Essentials of Community based Nursing’, Jones & Balet Publications
21) Mahajan Gupta, ‘Textbook of Preventive & Social Medicine’, Jaypee Publications
22) Walton, ‘Community Concepts & Practice’, Scuzt Foresmen Publications
23) Ghai Gupta, ‘Essential Preventive Medicine’, Vikas Publications
24) Babu Sheshu, ‘Review in Community Medicine’, Paras Publication
25) Lancaster, ‘Community Health Nursing Process and Practice for Promoting Health’, Morby
Publications
26) Bhalerao, ‘Synopsis in Preventive & Social Medicine’, National Publications
27) Fromer Margareg, ‘Community Health care & the Nursing Process’, CV Mosby & Company
Publications
28) Clarke, ‘Preventive & Community Medicine’, Boston Little Brown Company.
 COMMUNITY HEALTH NURSING – II – PRACITCAL
Placement: Fourth Year Time: Practical – 135 hours

Areas Duration Objectives Skills AssignmentsAssessment

(in week) Methods
Community 1 wk for • Identify • Community health • Community • Assess
health urban community survey survey clinical
nursing 4 wk for profile • Community report performanc
rural • Identify diagnosis • Family care e with
prevalent • Family care: Home study-1 rating scale
communicable adaptation of • Project –1 • Evaluation
and non- common • Health talk of
communicable procedures • Case book community
diseases • Home visit: Bag recording survey
• Diagnose health technique report
needs of • Organize and family care
Individual, conduct clinics study,
families and antenatal, project and
community postnatal, well health talk
• Plan, provide baby clinic, camps • Completion
and evaluate etc. of activity
care • Screen manage and record
• Participate in referrals for:
school health  High risk
programme mothers and
• Participate in neonates
national health  Accidents and
programmes emergencies
• Organize group  Illness: Physical
for self help and mental
and involve  Disabilities
clients in their • Conduct delivery at
own health center/home:
activities episiotomy and
• Provide family suturing
welfare services • Resuscitate
• Counsel and newborn
educate • School Health
individual, programme
family and  Screen, Manage
community refer children
• Collect vital • Collaborate with
health statistics health and allied
• Maintain agencies
records & • Train and supervise
reports health workers
• Provide family
welfare services:
insertion of IUD
Areas Duration Objectives Skills Assignments Assessment
(in week) Methods
• Counsel and
teach
individual,
family and
community
about: HIV, TB,
Diabetes,
Hypertension,
Mental Health,
Adolescents,
elderly’s health,
physically and
mentally
challenged
individuals etc.
• Collect and
calculate vital
health statistics
• Document and
maintain
 Individual,
family and
administrativ
e records
 Write reports
center,
disease, and
national
health
programme/
projects.
 Evaluation

Internal assessment

Theory Maximum marks 25

Midterm – 50 Marks
Prefinals – 75 Marks
___________________
TOTAL – 125 Marks
Convert to 15

Assignment
Seminar – 50 Marks

Convert to 10 Marks

Practical Maximum marks 50

Family Care Study – 50 Marks

Health Talk – 100 Marks
Procedure evaluation – 50 Marks
Family Folders (5x10) – 50 Marks
Clinical evaluation – 200 Marks

Practical examination
Midterm – 50 Marks
Prefinal – 50 Marks
________________
TOTAL – 550 Marks

External assessment
University examination
Theory Marks 75
Practical Marks 50

Below mentioned assignment have to be completed during clinical posting, however they are not for
evaluation.
Group project 01(Exhibition/ Street Play/ Puppet Show)
Survey report – 01
Daily diary –
 FAMILY CARE STUDY (FORMAT)
I Initial Data
1. Name of head of family
2. Address
3. Date of visit commenced
4. Date of visit conducted

II Bio data

Name of Relation
Family With Socio Economic Health
Member Head of
s Family
Ag Se Edn Occupatio Incom Marital Healt Nutritiona F
e x . n e Status h l P
Status Status

Immunization
BCG DPT Polio Measles Booster Any Other Remark
1 2 3 1 2 3

III Resources

A. Community Resource used by family members

a. Regular
b. In emergencies

B. Financial
a. Monthly family income
b. Possessions
c. Cattle & pets
d. Numbers of dependents
e. Monthly pattern of family expenditure
f. i. Food
ii. Education
iii. Medical
iv. Electricity bill
v. Clothing & entertainment
IV Environment

A. Community
- Socio economic Status
- Cleanliness
- Water Facility
- Toilet
- Location of Slum area
B. Family
- Environmental hygiene
- Toilets
- Sewage Sullage
- Water disposal

C. Physical Environment
1. Housing location
2. Type of floor
3. Lighting
4. Ventilltion
5. Water supply
6. Attitude towards drinking
7. Waste disposal
- Garbage
- Latrines
- Liquid Waste
- Mosquitoes & fly breeds

V Social Environment
1. Type of community
2. Socio economic background
3. Relationship among family members
4. Relationship with neighbors
5. Relationship with others
6. Common Health Habits
a. In community
b. In family
7. Family concept about health
8. family concept about disease
a. In community
b. In Family
9. Festival celebration
a. In community
b. In family

10. Number of working mothers

a. In community
b. In family
11. Care during pregnancy
a. In community
b. In family
12. Care of infant
a. In community
b. In family
13. Concept about education
a. In community
b. In family
14. Concept about girls education
a. In community
b. In family
15. Knowledge & attitudes of people towards health
a. In community
b. In family
VI Family Health
1. Health of family – past & present
2. Gynaec & Obst. history of female adults

VII. Nutrition

VIII. Family life style

a. Basic life style of family
b. Family decision-making pattern
c. Family relationship & communication
d. Family response in crisis situation
e. Family attitude towards health

Nursing Care Plan

Summary:

Conclusion :
 FAMILY CARE STUDY (EVALUATION CRITERIA)
50 MARKS

Sr. Particular TOTAL MARKS TOTAL

No. MARK OBTAINE
S D
I Personal and professional
qualities
1. Grooming 1
2. Mannerisms 1
3. Language 1
4. Voice 1
5. Confident 1

II Identification of family

1. Type of family 1
2. Initial data 1
3. Basic information 1
4. Resources used 1
5. Environment 6

III FAMILY HEALTH

1. Health of each member 2
2. Gynae & Obstetric health 2
3. Nutritional data 2
4. Rest & sleep 2
5. Use of health resources 2
6. Family planning status 2
7. Health practices for each 2
member
8. Family life style 2
IV NURSING CARE
1. Identification of needs & 2
problems
2. Aims& Objectives 2
3. Nursing interventions 8
4. Evaluation of care given 4
5. Self assessment 3
 COMMUNITY HEALTH NURSING
HEALTH TALK FORMAT
Name of the student:
Topic:
Group to be taught:
A.V. aids:
Area:
Date & Time:
Method of teaching:
Language:
Aim:
Specific objectives:
Introduction:
Sr. Time Specific Subject matter T/L A.V Evaluation
No. objectives activity aids

Summary
Bibliography
EVALUATION FORMAT FOR HEALTH TALK

NAME OF THE STUDENT: ----------------------------------------------------------------------------

AREA OF EXPERIENCE: ___________________________________________________
PERIOD OF EXPERIENCE: __________________________________________________
SUPERVISOR: _____________________________________________________________
Total 100 Marks
Scores: 5 = Excellent, 4 = Very good, 3 = Good, 2 = Satisfactory / fair, 1 = Poor

Sr. No. Particular 1 2 3 4 5

1 I) Planning and organization
a) Formulation of attainable objectives
b) Adequacy of content
c) Organization of subject matter
d) Current knowledge related to subject Matter
e) Suitable A.V.Aids
II) Presentation:
a) Interesting
b) Clear Audible
c) Adequate explanation
d) Effective use of A.V. Aids
e) Group Involvement
f) Time Limit
III) Personal qualities:
a) Self confidence
b) Personal appearance
c) Language
d) Mannerism
e) Self awareness of strong & weak points
IV) Feed back:
a) Recapitulation
b) Effectiveness
c) Group response
V) Submits assignment on time

Signature of the student Signature of the teacher

 EVALUATION CRITERIA FOR PROCEDURE EVALUATION USING BAG TECHNIQUE
NAME OF THE STUDENT: -----------------------------------------------------------------------------------
AREA OF EXPERIENCE: _________________________________________________________
PERIOD OF EXPERIENCE: _______________________________________________________
SUPERVISOR: __________________________________________________________________
Total – 50
Scores: 5 = Excellent, 4 = Very good, 3 = Good, 2 = Satisfactory / fair, 1 = Poor
Sr. No. Particular 1 2 3 4 5
1) Approach to the family
2) Selection of procedures based on family needs
3) Preparation of the bag for the procedure
4) Caring out all the steps of procedure correctly
5) Scientific principles followed while doing procedure
6) Involvement of family while doing procedure
7) Post care of bag and equipment
8) Health education while during and the procedure
9) Disposal of waste
10) Recording and reporting

FAMILY FOLDER FORMAT

Learners Name :
Family Name :
Address :
Date Of Service
Directions :

BASIC INFORMATION
Name Age Sex Position Occupation Education Language Nutritional Health Health
in Income Spoken Status Status Problems
Family

2. RESOURCES (COMMUNITY RESOURCES IN EMERGENCY)

Resources Location Member Using Reason Frequency
Provided

3. PHYSICAL & SOCIAL ENVIRONMENT

a) Community
b) Family
 4. FAMILY HEALTH

Name Age Height Weight Immunizations Habits/ Developmental Summary Current

Addictions Stage of Health Status
History including
Medications

5. Family Health Practice

a. Nutritional status – diet, meal pattern, shopping habits, knowledge of good nutrition.
b. Recreation & exercise
c. Sleeping pattern.
d. Family use of health resource, person responsible for health care decision-making
e. Any other attitudes, which significantly relate to health status.
f. Family strengths & limitations related to their health practice

6. Family life style

a. Basic life style
b. Inter family relationship & communication pattern
c. Family decision-making
d. Family response in crisis
e. Dominant values of family
f. Family attitude towards health care & health care providers

7. Nursing Care Plan

8. Student remarks
a. How did family perceive overall expenses of your visit (give supportive data)
b. Discuss achievement of goals & nursing interventions
c. In what aspect of nursing practice did your experience most growth & in what area would you
like to improve?
 FAMILY FOLDERS
10 marks

Sr. No. Particular 1 2 3 4 5 Score

I Subject Matter

II Nursing Care Plan

CLINICAL EVALUATION
Name of the student _________________________________________________________
Area of experience __________________________________________________________
Period of experience _________________________________________________________
Supervisor _________________________________________________________________
Total 100 Marks
Scores: 5 = Excellent, 4 = Very good, 3 = Good, 2 = Satisfactory / fair, 1 = Poor

Sr. No. Particular 1 2 3 4 5

I Personal and Professional Qualities :
a) Leadership
b) Punctuality
c) Grooming
d) Relationship with others
e) Attitude Towards suggestions
II Assessment In Home and Clinic:
a) History taking
b) Physical assessment
c) Assisting & guiding for investigation
d) Home / clinic observation of signs &
symptoms
e) Identification of needs & problems
III Planning
a) Selection of priority needs / problems
b) Setting objectives
c) Planning appropriate interventions
d) Resource allocation
IV Implementation :
a) Approach to family & manner of greeting
b) Explaining the purpose of visit to family
c) Providing home care
d) Doing simple procedure at home/Clinic
e) Assisting in clinical services
f) Giving health education in home clinic
g) Recording and reporting
V Evaluation :
a) Health teaching
b) Family care
c) Self assessment
d) Submitting assignment on time

Remarks:

Signature of student Signature of the teacher

 COMMUNITY SURVEY REPORT FORMAT

INTRODUCTION

Objectives:
 To assess the area & identify health problems of people
 To understand the socioeconomic status of the community
 To identify the sources of health services available in community
 To identify various health practices prevailing in the community
Community as a place – boundaries, environment, housing
Community as a social system –recreational facilities, transportation, stores & shops, official health
agencies, communication media, education, socioeconomic status, occupational status, social activities
related to health.
Health problems and needs in the area
Conclusion

SURVEY REPORT

Sr. No. Particular

1 Introduction
2 Community as a place
• Boundary
• Environment
• Housing
3 Social system
• Recreational facilities
• Transportation
• Stores & Shops
• Official health Agencies
• Communication media
• Education
• Socioeconomic status
• Occupational Status
• Social activities related to health
4
Planning and organization
• Formulation of objectives
• Selection of method of presentation
• Adequacy of content
• Organisation of Subject matter
5 • Presentation
6 Individual participation
Submission on time
 DAILY DAIRY

NAME OF THE STUDENT: -----------------------------------------------------------------------------------

AREA OF EXPERIENCE: _________________________________________________________
PERIOD OF EXPERIENCE: _______________________________________________________
SUPERVISOR: ____________

Sr. No. Particular

1 Activities planned
2 Activities done

ASSIGNMENT FORMAT FOR GROUP SEMINAR

1. Introduction to the topic

2. Concept, Definition
3. History
4. Subject matter
5. Application in nursing field
6. Summary
7. Conclusion
8. References

VISITS SUGGESTED

I Community Resources For Self & Family

1. Trauma center
2. Old Age Home
3. Orphanage
4.Home for physically & mentally challenged individuals
5. Home for Destitutes
II Social Nurse affecting health
1. Mahila Mandal
2. Food & Adulteration Lab
3. Community Kitchen
4. NARI
III. Others
1. Family Welfare Bureau
2. Industrial Visit
3. IEC Bureau
4. B.D.O.
5. Gram Panchayat
6. Zilla Parishad
7. Panchayat Samiti
8. PHC
9. Sub Center
10. Rural Hospital
11. Community Health Center
12. Anganwadi
Above visits should be completed in related subject during 4 years
 Maharashtra University of Health Sciences
External Practical Evaluation Guidelines
IV Basic B.Sc Nursing
Subject:- Community Health Nursing 50 Marks

Internal Examiner 25 Marks

Nursing Procedure (Home visit) (15 marks)
15 marks
• Approach to family 3
• Selection of need based procedure 3
• Bag Technique(Skills in performing procedure) 4
• Follow the scientific principles 3
• Post care of bag and equipment 2

Viva (10 Marks) 10 Marks

• Health planning and national health policies 2
• Family health care 3
• Role and responsibilities of CHN in primary health care 3
• National and International agencies 2

External Examiner 25 Marks

Nursing Process (Health Education) (15 Marks) 15 marks

• Need based health teaching 3
• Content, Organization and Presentation 4
• Used of A.V.aids 3
• Professional qualities 3
• Effectiveness 2

Viva (10 Marks) 10 Marks

• National Health and family welfare programmes 3
• Public health and community health nursing administration 3
• Health Care delivery system (Rural and Urban) 4
 COMMUNITY HEALTH NURSING PRACTICAL EXAMINATION
PRACTICAL / ORAL MARK LIST

NAME OF THE EXAMINATION : COMMUNITY HEALTH NURSING PRACTICALS

MONTH : YEAR :

FOURTH YEAR Basic B. Sc NURSING : MARKS : 50

SUBJECT : COMMUNITY HEALTH NURSING

CENTRE :

Roll No Internal Examiner External Examiner Total Total

Procedure Viva voce Nursing Viva voce
process
15 10 15 10 50 25

Signature of the Internal Examiner Signature of the External Examiner

Date : Date :