nursing

1. Community health nursing
Introduction -
From the last two decades , there has been significant shift from institution based care to
community based care because of a change from curative to preventive aspect .
The nurse who are providing services directly to individual , family , or community outside of
a traditional hospital or clinical setting are community health nurse .
Communityhealth nursing are also called public health nursing or community nursing ,
combine primary health care and nursing practice in a community setting . community
health nurse provide health services , preventive care, intervention and health education to
communities or populations .
Definition –
Community –
A community is a group of interacting people living in a common geo-graphical
area or having same culture or are associated to each other on the basis of education ,
occupation etc.
Community health –
Community health is “ in totality , community health means the state of health of
the member of community , problem affecting their health and health care available in
community . According to WHO
Community healthnursing -
Community health nursing is a synthesis of nursing practice
and public health practice applied to promoting and preserving health of population . the
nature of this practice is general comprehensive . it is not limited to a particular age or
diagnostic group. According to American Nursing Association
Historical development of community health nursing –
 Ancient period
 British period

2.  Post independence period
1. Ancientperiod
 Vedic period - ( 3000 BC )
- The public health and its origin in vedicperiod .
- During this period there were well planned cities with proper housing , good
drainage system, water supply public toilet and baths .
- In 1400 AYURVEDA & SIDDHA system of medicine advocated holistic health care .
 Postvedic period - (post500 BC – 700 AD )
- This period was influenced by Buddhism .
- Out of the principle of Buddhism was care of the sick and welfare of the
humanity .
- King ashoka controlled greatly in the exercise of the principle
- He establish many hospital instituted medical system and one doctor was
appointed for every 10 villages .
- Monastic universities were set-up in takshshila and nalanda to train doctor.
 Mougal period - ( 700 – 1850 AD )
- All hospital anduniversitiesweredemolished.
- Around1000 AD Arabicsystemof medicine ,popularknownasUNANIwasintroduced.
2. British period - ( 1858 - 1947 )
-During this period the civil and military services was started by eastindiacompany in
1957 .
- In 1920 allopath medicine started in india by britishdoctors .
- Various acts were passed in this period .
3. Post- independence period - ( 1947 –onwards)
1) First five year plan (1951-1956)
2) Second five year plan ( 1956-1961 )
3) Third five year plan ( 1961-1969 )
4) Fourth five year plan ( 1969-1973 )
5) Fifth five year plan ( 1974-1979 )
6) Sixth five year plan ( 1980-1985 )
7) Seventh five year plan ( 1985-1990 )
8) Eighth five year plan (1992-1997)
9) Ninth five year plan (1997-2002)
10) Tenth five year plan ( 2002-2007)

3. 11) Eleventh five year plan ( 2007-2012 )
12) Twelfth five year plan ( 2012-2017 )
goals of community health nursing –
 To help individual , families and community in attaining highest standard of
health by means of prevention of illness and promotion of health .
 To reduce morbidity and mortality rate among community
 To prevent disabilities and providing rehabilitation services .
 To evaluate the health programmes.
 To maintain the quality of life .
Principles of community health nursing –
 Health services should be based on the needs of individual and the community .
 Community nurse should function in collaboration and co-ordination with other
personnel to achieve optimum community health .
 Community health nurse should involve the individual, family and community in plan
for achieving their health .
 Health services should be equally available to all without any discrimination of age ,
sex, caste , religion social or economical level etc.
 Community health nurse should create an awareness among community through
education to promote the health of the community .
 Community health services should be provided in continuity in making decision
related to health matters .
 The community nurse should maintain professional dignity and must never accept
any gifts or money as bride .
 Health education , guidance and supervision are integral part of the community
health nursing services .
 Community health nurse should maintain the record with proper guideline .
 Community health nurse should establish a professional , not personal relationship
with individual , family or community.
 It is necessary that nurses and other health workers , working in the community
should be guided and supervised by highly educated and skilled nurses .
 Community health nurses is community focused ; it is therefore essential to know
the defined community , make a map and establish effective working relationship .
Scope of community health nursing –

4.  Home care
 Nursing home
 School health nursing
 MCH and family planning
 Community health nursing services
 Industrial nursing services
 Domiciliary nursing services
 Mental health nursing services
 Rehabilitation centers
1. Home care -
 Extendednursingcare servicesare receivedbynumberof patientattheirhome
whenhospital are overcrowdedforadmittingthe patientwhorequire indoor
care or whena patientisinneedof isolatedtreatment.Evenpreventive and
promotive servicesare providedtothe peopleattheirhome tomaintainand
achieve health.
2. Nursing home –
The nursing home are privately run . they have better medical care facilities
than the government hospital because they charge more fees . the nursing
component in nursing home is generally well catered for .
3. School health nursing -
 The nurse can also work as SHN in school .
 The school health programme carried out by PHC .
 The school health nursing render services
1. To preventdiseases.
2. To promote and maintaingoodhealthof the school children.
 The nurse provide forservicesinthe arealike
1. Healtheducation
2. Immunization
3. Firstaid
4. Dental health
5. School sanitation,maintenance of healthrecordsfollow upand
referral services.
4.MCH and family planning -
 The childhealthnurse playsa majorrole inthe MCH and familyplanning
services.
 It consistantenatal ,postnatal andchildcare services.
 Nurse can easilymotivate the mothertoacceptthe familyplanningmethods
and gaintheirco-operationinadoptingtoasmall familynorm.
5. community health nursing services -

5.  The CHN includesnursingcare of the familyinsicknessandhealth.
 The CHN shouldbe able to …
1. To provide primaryhealthcare incommunity.
2. To conduct routine antenatal andpostnatal visitandtoconduct
deliverieswhenrequired
3. To carry outimmunization
4. To promote healthof the childrenbyconductingunderfive clinic
and refferingcaseswhorequiremedical care .
5. To assessthe social environmentandnutritionalneedsof the
communityandgetthe helpof social workerto meetthese needs.
6. industrial nursing services -
 Thenurse canalso workinindustries.So manynurse are workin
industries,where 500 are more workerare employed
 The nursingservicesinindustriesare…….
1. First aid
2. Regularhealthcheck-ups
3. Care of the sick and injured.
4. Industrial safety.
7. Domiciliary nursing services -
 The areas where domiciliarynursingispracticedinthiscountryare.
 Maternityserviceshealth supervision.
 Disease preventionservices.
 Servicesforillnessand accidents.
8. Mental health nursing services –
 Many developingcountrieshave mental healthservicestoday.
 These servicesinclude …
1. Early diagnosisandtreatment
2. Rehabilitation
3. Psychotherapy
4. Use of modernpsychotropicdrugsandaftercare services
9. Rehabilitation center –
1. Rehabilitationmeansrestorationof all treatedcasestothe highest

6. level of fuctional ability
2. Nursingisan importantcomponentinthe rehabilitationof the disabled.
Conclusion -
Community health nursing is a synthesis of nursing practices applied in
promoting and preserving the health of population .
The aim of community nurse is to help individual, family, and community in
attaining highest standard of health and to reduce morbidity and mortality
rate among community .
The principle of community health nurse is based on community needs,
community participation , no discrimination age , caste and sex , create
awareness thorough education , follow up and maintain record .
The scope of community health nurse vary depending on where they work
and need of their community .
BIBLIOGRAPHY
 Essential of communityhealthnursing
Writer- neelamkumari
Publication - Pee Vee
Edition2011
Page number– 20 - 47
 Communityhealthnursing
Writer- N.R.Brothers
Publication -swarnkar’s
Edition – 3RD
Page number–01-37
 WWW.Slideshare.net/krishnagar90/concept - objective-scope-principle

7. Multiple choice question–
1. A group of people livinginthe same place or havinga particular characteristic incommon
and having common intrests?
a) Community
b) Nation
c) State
d) Society
Answer- A
2. Branch of publichealthwhich focuseson people and theirrole as determinantsof their
own and other people healthin contrast to environmentandits impact on people health?
a) Physical health
b) Communityhealth
c) Health care access and quality
d) Mental health
Answer– B
3. Whichis the primary goal of communityhealth nursing?
a) To support and supplementthe effortof the medical professionin the promotion of health
and preventionof disease
b) To increase the productivity ofthe people by providingthemwith service that will
increase their level ofhealth
c) To enhance the capacity of individual ,familiesand communityto cope with their health
need
d) To contribute to national developmentthroughpromotionof familywelfare , focusing
particularly on mother and children
Answer– C
4. The nurse assignedin the rural health unitas a beginningnurse practitioner is described
ass one of the following?
a) Specialist
b) generalist
c) Mother childnurse
d) Home care nurse
Answer– B
5. CHN is a community – basedpractice. Whichbest explainthisstatement ?
a) The service are basedon the available resource within the community
b) The servicesinthe providednatural environmentof people
c) Priority settingis basedon the magnitude of the healthproblemidentified
d) The nurse has to conduct community diagnosisto determiningnursingneedsand
problems
Answer– B
6. To encourage communityparticipation , which of the followingshoulda nurse do ?
a) Encourage sponsorshipto program
b) Invite people fromcivic organization
c) Referto the doctor for prescriptions
d) Listenwhen people relate theirproblem
Answer– D

8. 7. AYURVEDA & SIDDHA system ofmedicine started inwhich period?
a) Vedicperiod
b) Mougal period
c) British period
d) None of the above
Answer– A
8. Monastic universitywere setup in
a) Takshshila
b) Nalanda
c) Both A and B
d) None of the above
Answer– C
9. UNANImedicine isstarted in which period
a) Mougal period
b) British period
c) Vedicperiod
d) Post independence period
Answer– A
10. Allopathmedicine isstarted in india
a) 1920
b) 1850
c) 1990
d) 2000
Answer– A
11. Total completedfive year plan is
a) 10
b) 12
c) 05
d) 02
Answer– B
12. First five year plan duration is
a) 1951-1956
b) 1969-1973
c) 1980-1985
d) 2002-2007
Answer– A
13. Goal of community healthnurse is ?
a) To reduce morbidityand mortality rate among community
b) To prevent disabilityandproviding rehabilitationservices
c) To maintain quality of life
d) All of the above
Answer– D
14. Communityhealth nurse is work in from followingoption

9. a) Home care
b) Nursinghome
c) School healthnursing
d) All of above
Answer– D
15. The school health nurse servicesis ?
a) Health education
b) Immunizationand first aid
c) School sanitation
d) All of the above
Answer– D
16. Mental health nurse servicesare
a) Early diagnosis and treatment
b) Rehabilitation
c) Psychotherapy
d) All of the above
Answer- D
17. Communityhealth nurse is also called
a) Publichealth nurse
b) Psychiatric healthnurse
c) Operationtheater nurse
d) None of the above
Answer– A
18. Originof public healthin
a) Vedicperiod
b) Mougal period
c) British period
d) None of the above
Answer– A
19. Childmarriage acts establishedin
a) 1946
b) 1930
c) 1950
d) 1976
Answer– B
20. Birth and deathregistration acts in
a) 1940
b) 1920
c) 1887
d) 1857
Answer- C