NURS 375

COMMUNITY HEALTH NURSING I

• I welcome you all to NURS 375- Community
Health I.
• This course deals with common community
health issues in our communities, primary
health concept, personal hygiene, food
hygiene, pest and vector control, waste
management, safe water supply and industrial
pollution. The student is also exposed to
occupational hygiene, ergonomics
 RULES
• No lateness or absenteeism will be tolerated
• Dress decently for the class
• All lectures are compulsory
• All quizzes and presentations are compulsory
 COURSE LEARNING OUTCOMES
• 1. Describe the scope of work of the public health
nurse in the community
• 2. Explain the primary health care concept
• 3. Describe the community-based health plaining and
services (CHPS) concept and implementation steps.
• 4. Explain environmental and occupational hygiene
• 5. Apply safety measures in work environment
• 6. Discuss the concept of occupational health
• 7. Identify and describe pest control measures
 Definition of community health
• Community Health is the part of health that
deals with individuals, families and
communities.
 COMMUNITY HEALTH NURSING
• It is defined as the synthesis of nursing and
public health practice applied to promoting
and protecting the health of population.
• It is a specialized field of nursing that focuses
on the health needs of communities,
aggregates, and in particular vulnerable
populations
 COMMUNITY HEALTH NURSE
• A community health nurse provides direct
care in setting outside health care institutions
whiles a Public health nurse function in the
community –based settings established to
address the health problems of the specific
identified populations and instituting
programmes.
COMMUNITY SETTINGS FOR NURSING CARE

• Community health nursing takes place in a

wide variety of settings and seeks to promote
health, prevent illness, maintain health,
restoration, coordination, management and
evaluation of care of individuals, families, and
aggregates, including communities. The client
assumes responsibility for health care
divisions and care provision.
• The change in health care services resulted in
changes in nursing care as well. Settings are
changed to the community and especially to
home. The intent of care is not to fix with
treatment but to enhance the quality of life
and support actions that make the client’s life
as comfortable as possible
 COMMUNITY SETTINGS CONT’
• Homes
• Communities
• CHPS zones
• Schools
• Workplace
• Clinics
• Maternity Homes
MISSION OF COMMUNITY HEALTH NURSING

• The primary mission is improving the overall

health of the population through health
promotion, illness prevention and protection
of the public from a variety of
threats( biological, physical, social etc)
Uosukaines, 2001)

• FOCUS: Promote the good of all

 CHARACTERISTICS OF COMMUNITY HEALTH
NURSING
• It is a specialty field of nursing
• Its practice combines public health with
nursing
• it is population focused.
• it emphasizes on wellness and other than
disease or illness
• it involves inter-disciplinary collaboration
• it promotes client’s responsibility and self-care
 PRINCIPLES OF COMMUNITY HEALTH
NURSING
• The recognized need of individuals and
communities provides the basis for CHN
practice.

• Knowledge and understanding of the

objectives and policies of the agency facilitates
goal achievement.
 PRINCIPLES CONT’
• CHN considers the family as the unit of
service. (family is an effective and available
channel for most of CHN efforts)
• Respect for the values, customs and beliefs of
the clients contribute to the effectiveness of
care to the client
• CHN integrates 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 health team facilitates
accomplishments of goals
7. Periodic and continuing evaluation provides
the means for assessing the degree to which
CHN goals and objectives are attained.

8.Continuing staff education program, quality

services to client are essential to upgrade and
maintain sound nursing practices in their setting.
9. Utilization of indigenous and existing
community resources maximizing the success of
the efforts of the community health nurse.

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 CHN programmes
• 11. Supervision of nursing services by qualified
CHN personnel provides guidance and
direction for the work to be done.

• 12. accurate recording and reporting sere as

the basis for evaluation of the progress of
planned programs and activities and as a
guide for the future actions.
 FUNCTIONS & ROLES OF COMMUNITY
HEALTH NURSES
• Based on
• client – oriented roles
• Delivery – oriented roles
• Population- oriented roles
 CLIENT- ORIENTED ROLES
• This involves direct provision of services to
individuals, families and occasionally groups of
people.
FUNCTIONS& ROLES OF A COMMUNITY
HEALTH NURSE
 CAREGIVER
• The care giver / provider role involves applying the
principles of epidemiology and the nursing process
to the care of clients at any level ( individual, family,
group etc)

• The nurse provides continuous and comprehensive

care to the family, group of people and community
at large.
• Emphasis on promotive than preventive health care
 FUNCTIONS OF THE CARE GIVER
• Assessing client needs
• Deriving nursing diagnoses
• Planning appropriate interventions
• Implementing the plan of care
• Evaluating nursing care
• Care is provided at home, clinic, school, work
place
• In some cases, the care giver role may involve
provision of primary care to individuals and
families
• Education is the process of facilitating learning that leads
to positive health behaviour

• The community health nurse educates the individual,

family, groups of people and community at large.
• The nurse conducts planned health education sessions
for organised community groups such as school children,
antenatal mothers, etc

• These functions refer to ‘Health educator role’

 COUNSELLOR
• Counselling is the process of helping a client to
choose viable solutions to health problems
• The community health nurse helps individual,
families and the community at large to
recognize and understand their problems to
be solved, find solutions and implement
feasible and acceptable solutions
• Counselling involves several steps:
• Assist client to identify and clarify the problem
to be solved
• Together examine factors that contribute to the
problem( those that may enhance or impede)
• 2. identify alternative solutions
• 3. assist client to develop criteria for acceptable
solution to the problem
• 4.assist client to evaluate each alternative
sloutions
 Role model
The community health nurse serves as a role
model for a variety of people with whom they
come into contact
Eg. Ability to deal with crisis without panic
provides guidance for clients to do same.
 Case Manager
• Coordinates and directs the selection and use
of health care services to meet clients needs,
maximize resource utilization and minimize
the expense of care.
 DELIVERY ORIENTED ROLES
• Coordinator:
• Organizes and integrates services to best meet
the needs of clients in the most efficient
manner

• Collaborator : focuses on the coordination role

• Collaboration entails communication and a
joint decision making
 Liaison
• Provides a connection, relationship or
intercommunication.
• As a liaison the CHN serves ads initial point of
contact between client and agency
• Facilitates communication between client and
agency personnel
• Serves as client advocate when needed
 Population – Oriented Roles
• Roles directed toward promoting, maintaining
and restoring the health of the population

• Case finder:
• Identifying individual cases or occurrence of
specific diseases or other health related
services
 LEADER
• Ability to influence the behaviour of others.
• CHN assumes leadership roles
• These include
• Identifying need for action
• Assessing leadership needs
 CHANGE AGENT
• One who initiates and brings about change.
• This role is performed in conjunction with the
leadership role
 COMMUNITY MOBILIZER
• Community mobilization – process by which
community groups identify common goals and
mobilize assets to address local concerns
• Policy Advocate
• A person who work for and argue on behalf of
policy formation or changes in the policy that
influence health of population groups

• Researcher: one who explores phenomena

observed with the intent of understanding,
explaining and controlling them
QUALITIES OF A COMMUNITY HEALTH NURSE

• Must be a risk taker

• Must be knowledgeable about disease and
health
• Should be able to adjust
• Ability to function independently
• Must be creative
• Must be able to make scientific decisions
• Must be an educator
 Skills used in community health
• Interviewing skills
• Public speaking skills
• Counseling skills