Introduction to communityhealth nursingLily L. HsuSchool of NursingShanghai Jiao Tong University
History of Community Health NursingBefore mid 1800s-Early Home Care with focus in Sick andPoor individual.Orientation: curativeagencies: lay & religious orders*St. Phoebe Mid 1800s to 1900-district Nursing with focus in Sick andpoor individualOrientation: curative/less in preventionagencies: voluntary & some government*William Rathbone
History of Community Health Nursing 1900-1970 public health nursing- Pubic Health Needs,focus in family and orientation in Curative andPreventionagencies: government & some voluntary*Lilliam Wald1970 to present-Community Health Nursing, focus in totalcommunity and oriented to population health, services addresshealth promotion; illness preventionagencies: many kinds; some independent practice*Ruth Freedman
Public Health NursingDevelopment in China Early Stages:1925 Beijing Union Hospital-Public Health Agency(Dr. Gland).1930 rural Health Education2000 Pay attention to city and rural areas communitycenter development and practice model2006-2007 Government emphasize the importanceof Community health, improve community healthcenters, functions, farmer health insurances 。
Challenge for China’sCommunity Health Nursing Elderly care issues2000 Population 2050 Population
Health Beyond Acute CareSettings-Community Care andPublic Health
Public Health DefinitionPublic health is the Science and Art of : preventing disease, prolonging life, promoting health and efficiency throughorganized community effort.(Winslow, 1920)
Definition of CommunityHealth (ANA,2000 ） Community health nursing is a synthesis ofnursing and public health practice applied topromoting and preserving the health ofpopulations. Treat “ Population as a Whole” Focus on individual, family, groups, community Utilizing Health promotion, health maintenance,health education, and management,coordination, and continuity of care for meetingpopulation needs.
Characteristics of CommunityHealth Nursing It is a field of nursing It combines public health andnursing It focus in population andenvironment factors that mayimpact to people’s health It emphasize in health promotion,illness prevention, and wellness
Characteristics of CommunityHealth Nursing It promotes client responsibility andself-careIt uses aggregate measurement andanalysisIt use principle of organizationaltheory It involves inter-professionalcollaboration.
Pubic Health is for: The sanitation of environment, The control of communicable infections, The education of the individual in personal hygiene, The organization of medical and nursing services forThe early diagnosis and preventive treatment ofdisease, and The development of the social machinery to insureeveryone a standard of living adequate for themaintenance of health ,Healthy Life Style and Longevity .
Community Health PracticeHealth Promotion1. Increase thespan of healthylife for all citizens2. Reduce healthdisparities amongpopulation groups3. Achieve access topreventive servicesfor everyone.
Roles of Community Health NursesResearcherLeadershipCollaborator ManagerAdvocateEducatorClinicianNurses
Health PreventionTertiary PreventionSecondary PreventionPrimary Prevention
Primary Prevention for HealthPromotion Health Education Adequate Nutrition Individual Development Adequate working environment andrecreation, resting Pre-marriage counseling and education Genetic Counseling Regular Physical Examination
Primary Prevention for HealthProtection Comply with immunization Individual hygiene Improve environment sanitary Occupational Safety Prevent Accident in all ages Adequate nutrition Avoid cancer cause agents Avoid allergic
Secondary Prevention Identify cases in the community Screen and test Conduct special physical examination Treat and prevent the progress ofillness Avoid the spreading of disease Reduce the disability time
Tertiary Prevention Treat and stop the disease progress andavoid complication and side effect Limit the chance for disability Provide rehabilitation for physical andpsychological well-being, occupationaltherapy, availability of long-term care
Characteristics ofcommunity health nursing it is a field of nursing it combines public health with nursing it is population-focused it emphasizes wellness it involves interdisciplinary collaboration it promotes clients’ responsibility and selfcare
Setting for community healthnursing practice homes ambulatory service settings schools occupational health setting residential institutions the community at large
Opportunity for FutureCommunity 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 roleand function of community health sector