The document discusses community health nursing and defines key concepts. It defines a community as a social group determined by geographical boundaries and common values/interests. Community health nursing aims to promote and preserve the health of populations by focusing on individuals, families, and communities. It utilizes health promotion, education, and coordination of care to meet population needs. The objectives of community health nursing include health promotion, disease prevention and control, and rehabilitation.

1. 2ND YEAR BSC
BCCN
Introduction to community
health nursing

2. INTRODUCTION
Community – Latin word “COMMUNIS”. A community is a social
group determined by geographical boundaries and / or common
values and interests.
 Its members know and interact with each other.
 It functions within a particular structure and exhibits and creates
certain norms, values and social institution.”
 Community is a collection of people. Community is a place.
Community is a social system.
 Community is a highly important habitat of man.
 Health is related to individual. But concerted and cooperated
effort to people in the community is needed for individuals
health.
05-10-2020
2
BCCN

3. DEFINITION
 Community Health Refers To The Health Status of the members
of the community, to the problems affecting their health and to
the totality of health care provided to the community”.. (WHO)
 “Community health Nursing is a unique blend/(mix) of nursing
and community health, woven into a service which when
properly developed and implemented can have a tremendous
impact on human health”
05-10-2020
3
BCCN

4. CONCEPTS OF COMMUNITY HEALTH
NURSING:
 Concepts of community health nursing
 Healthful community.
 Empowerment for health promotion.
 Prevention of premature death
 Prevention of disease, illness and disability.
 Promotion and maintenance.
 Rehabilitation
05-10-2020
4
BCCN

5. PHILOSOPHY OF COMMUNITY HEALTH
NURSING :
 Philosophy of individual’s right of being healthy.
 Philosophy of working together under a competent leader for the
common good.
 Philosophy that people in the community have potential for
continued development and are capable of dealing with their own
problems if educated and helped.
 Philosophy of socialism.
05-10-2020
5
BCCN

6. DEFINITION
• According to American Nursing Association,
• “Community health nursing is a synthesis of nursing and public
health practice applied to promoting and preserving the health
of populations.
• 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
meeting population needs.”
05-10-2020
6
BCCN

7. OBJECTIVE OF COMMUNITY HEALTH
The objective of community health is to provide need based
comprehensive services which include the following:
1. Promotion and protection of health i.e. PRIMARY LEVEL
PREVENTION.
2. Early diagnosis and treatment and control of further spread of
disease i.e. SECONDARY LEVEL PREVENTION.
3. Control of disability and rehabilitation ie. TERTIARY LEVEL
OF PREVENTION.
05-10-2020
7
BCCN

8. Primary Prevention for Health Promotion
• Health Education
• Adequate Nutrition
• Individual Development
• Adequate working environment and recreation, resting
• Pre-marriage counseling and education
• Genetic Counseling
• Regular Physical Examination
05-10-2020
8
BCCN

9. Primary Prevention for Health Protection
• Comply with immunization
• Individual hygiene
• Improve environment sanitary
• Occupational Safety
• Prevent Accident in all ages
• Adequate nutrition
• Avoid cancer cause agents
• Avoid allergic
05-10-2020
9
BCCN

10. Secondary Prevention
• Identify cases in the community
• Screen and test
• Conduct special physical examination
• Treat and prevent the progress of illness
• Avoid the spreading of disease
• Reduce the disability time
05-10-2020
10
BCCN

11. Tertiary Prevention
• Treat and stop the disease progress and avoid complication and
side effect
• Limit the chance for disability
• Provide rehabilitation for physical and psychological well-being,
occupational therapy, availability of long-term care
05-10-2020
11
BCCN

12. The major emphasis is on primary level prevention with the active
involvement of people (as majority of the health problems are
preventable by simple measures).
THESE MEASURES ARE :
• Safe drinking water. • Safe disposal of waste material. •
Maintaining general cleanliness. • Immunization of children.
• Traffic control. • Good nutrition. • Health checkup and mass
screening. • Early diagnosis and mass treatment. • Health
Education.
05-10-2020
12
BCCN

13. COMMUNITY AS A CLIENT
In community health the whole community is a client and the
services are focused and hence it is important to: ..cont..
1. Know the community (COMMUNITY IDENTIFICATION).
2. Identify the health needs of the community (COMMUNITY
DIAGNOSIS).
3. Understand underlying factors affecting health problems.
4. Plan and implement comprehensive services.
05-10-2020
13
BCCN

14. COMMUNITY IDENTIFICATION
“ Is a process of exploring and knowing a defined community for
assessing its health status and determining the possible factors
affecting the health of people in the community
THIS IMPLIES TO EXPLORE & KNOW • Geographical area,
housing pattern and climate. • Population characteristics. • Life
style of people. • Leadership pattern • Family type, family size, &
caste group. • Beliefs, attitude, values and customs etc. •
Community environment. • Institutional facilities. Voluntary
organizations. • Channels of communication, telecommunication
networks, travel modes
05-10-2020
14
BCCN

15. COMMUNITY IDENTIFICATION HELPS TO:
• Prepare community map showing geographical boundaries,
housing patterns, streets, roads, important landmark : Health
centre, school, post office etc.
• Know and describe community profile as per various categories
of information collected.
• Identify health needs and health problems of the community.
05-10-2020
15
BCCN

16. COMMUNITY DIAGNOSIS
Is a written statement of health needs and health problems which
are determined by analysis of data collected for community
identification.
• Following community identification, health needs and problems
are prioritized for planning and implementing community health
actions/community health treatment
05-10-2020
16
BCCN

17. COMMUNITY TREATMENT/COMMUNITY
HEALTH ACTIONS
• Refers to “various health and health related activities which are
planned and implemented to deal with identified health problems
and health needs”
05-10-2020
17
BCCN

18. COMMUNITY HEALTH ACTIONS ARE
PLANNED CONSIDERING
• Nature of problems.
• Effects of problems on health of people at large.
• Felt needs & problems of the community.
• Community resources and capabilities.
• Health agency’s objectives and policies
05-10-2020
18
BCCN

19. PURPOSES OF COMMUNITY HEALTH
• A certain the nature and extent of disease and
disability in the community.
• Take suitable measure to
• Promote healthful living,
• Prevent disabilities, correct remedial defects, treat
illness.
• Evaluate the progress and success of current
programs.
05-10-2020
19
BCCN

20. AIMS OF COMMUNITY HEALTH NURSING
• Reduction of risk factors to reduce morbidity and mortality rate.
• Strengthening self care activities to promote the health and
prevent the occurrence of disease.
• Maintain the quality of life to live productive life.
• Improving standard of living to protect the health against diseases.
05-10-2020
20
BCCN

21. GOALS OF COMMUNITY HEALTH NURSING
1. To promote and preserve health.
2. To restore health when it is impaired.
3. To minimize suffering and distress.
4. To promote quality of living.
5. To develop self care abilities
05-10-2020
21
BCCN

22. OBJECTIVES OF COMMUNITY HEALTH
NURSING
• To increase the competency of individuals, families, groups and
community to deal with their own health and nursing needs.
• To strengthen community resources.
• To control environment and develop resistance to environmental
conditions.
• To prevent and control communicable and non communicable
diseases.
• To provide specific services to mothers, children, workers, elderly,
eligible couples and handicaps etc.
• To conduct research and training programmes.
• To supervise, guide and help health personnel in carrying out their
functions.
05-10-2020
22
BCCN

23. PRINCIPLES OF COMMUNITY HEALTH
NURSING
1. Community health nursing services should be planned according
to the need of the community.
2. Community nurses should function in collaboration and
coordination with other personnel to achieve optimum
community health.
3. Community health services should be provided to all individuals
irrespective to age, gender, caste, creed or colour.
4. Community health nurse should involve the individual, family
and community in plans for achieving their health.
5. Community health nursing personnel should be qualified either a
diploma or graduate or post graduate in nursing.
05-10-2020
23
BCCN

24. 6. Community health nurse should create an awareness among
community through education to promote the health of the
community.
7. Appraisal and evaluation of community health services by
community health nurse helps in taking the remedial steps to
overcome the problem of the community.
8. Community health nurse should follow up to find out the unmet
needs of the community.
9. Community health nurse should be given opportunity for future
education and continuing education programme.
10. Leaders or influential people of the community need to be
involved in carrying out health related activities.
05-10-2020
24
BCCN

25. 11. Community health services should be provided directly or
indirectly to individuals, family or community. Family is the
basic unit and the health of one member affects the health of the
others in the family
12. Community health services should be provided on a continuous
basis so as to improve the health status of the community.
13. Community health nurse assists the family or community in
making decisions related to health matters.
14. Community health nurse should not yield any bad reputation to
the profession by accepting bribe or gift.
15. There should not be any interference by community health
nurse in an individual’s political or religious matters.
05-10-2020
25
BCCN

26. 16. Community health nurse should maintain the record with proper
guidelines. Health problems existing in the community need to be
reported to health authority so as to get appropriate resources and
assistance to eliminate the problem.
17. Community health nurse should follow ethics while working in
the community.
18. Community health nurse should establish a professional not
personal relationship with individual, family or community.
19. The working atmosphere of community health nurse should be
free from frustration, stress or conflicts at job.
20. Health authorities should define the objectives and purposes in
relation to various programmes in order to achieve success.
05-10-2020
26
BCCN

27. THESE INFORMATIONS ARE OBTAINED BY:
• Making observation visits of the community.
• Formal and informal meetings and conversation with community
people, leaders, organized groups etc.
• Discussion with health personnel and other workers in the
community.
• Review of records.
• Formal sample survey of the community.
05-10-2020
27
BCCN

28. SETTINGS FOR CHN PRACTICE
1. Homes
2. Community health centers
3. Schools
4. Occupational health settings (business and industry)
5. Residential institutions: Older age residences
6. charitable mosques related organizations
7. Community at large
05-10-2020
28
BCCN

29. Community Health Practice
05-10-2020
29
BCCN

30. Opportunity for Future Community 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 role and function
of community health sector
05-10-2020
30
BCCN

31. HISTORICAL DEVELOPMENT OF COMMUNITY HEALTH
NURSING
 Community health nursing development has been influenced by
changes in nursing, public health and society that is traced
through several stages.
05-10-2020
31
BCCN

32. EARLY HOME CARE STAGE (Before Mid 1800s)
 Early Home Care with focus in Sick and Poor individual.
 Orientation: curative
 Agencies: Lay & Religious Orders
 For many centuries female family members and friends attended
the sick at home. The focus of this care was to reduce suffering
and promote healing (Kalish and Kalish, 1986). The early roots
of home care nursing began with religious and charitable groups.
 This stage was in the midst of these deplorable conditions and
response to them that Florence Nightingale began her work.
Much of the foundation for modern community health nursing
practice was laid through Florence Nightingale's remarkable
accomplishments
05-10-2020
32
BCCN

33. DISTRICT NURSING (MID 1800S TO 1900)
 Orientation: curative/less in prevention
 Agencies: voluntary & some government
 The next stage in the development of community health nursing
was the formal organization of visiting nursing (Phoebe, 58AD)
or district nursing.
 Although district nurses primarily care for the sick, they also
thought cleanliness and wholesome living to their patients, even
in that early period. Nightingale referred to them as “health
nurse”.
 This early emphasis on prevention and health nursing became one
of the distinguishing features of district nursing and later of
public health nursing as a specialty.
05-10-2020
33
BCCN

34. Problems of district nursing:
 Increased number of immigrants
 Increased crowded city slums Inadequate sanitation practices
 Unsafe and unhealthy working conditions. Nevertheless, nursing
educational programs at that time did not truly prepare district
nurses to cope with their patients, multiple health, and social
problems.
05-10-2020
34
BCCN

35. PUBLIC HEALTH NURSING TRAINING (1900-1970)
 Pubic Health Needs, focus in family
 Orientation :Curative and Prevention
 Agencies: government & some voluntary
 By the turn of the century, district nursing had broadened its focus to
include the health and welfare of the general public, not just the poor.
 Lillian D. Wald’s contributions to public health nursing were enormous.
Her driving commitment was to serve needy populations.
 Wald’s emphasis on illness prevention and health promotion through
health teaching and nursing intervention as well as her use of
epidemiological methodology established these actions as hallmarks of
public health nursing practice .
05-10-2020
35
BCCN

36. COMMUNITY HEALTH NURSING
(1970 TO PRESENT)
 Community Health Nursing, focus in total community
 Orientation: population health, services address, health
promotion; illness prevention
 Agencies: many kinds; some independent practice
 Many other nurses, not necessarily practicing public health, were
based in the community. Their practice settings included
community based clinics, doctor’s office, work sites, schools, etc,
to provide a label that encompassed all nurses in the community.
05-10-2020
36
BCCN

37. Factors Influenced the Growth of Community Health Nursing
Even though many factors influenced the growth of community
health nursing, six are particularly significant:
1. Advanced technology
2. Progress in causal thinking
3. Changes in Education
4. Consumer movement
5. Changing demography
6. Economic forces
05-10-2020
37
BCCN

38. Roles of Community Health Nurse
Seven major roles are:
 Clinician
 Educator
 Advocate
 Managerial
 Collaborator
 Leader
 Researcher
05-10-2020
38
BCCN

39. Nurse
Clinician
Researcher
Leader
Educator
Advocate
Managerial
Collaborator
Researcher
05-10-2020
39
BCCN

40. Clinician Role
• Care provider: The nurse ensures that health services are not
only provided to individuals and families but also provided to
groups and populations
• The clinician role has emphasis on holism, health promotion and
skill expansion.
05-10-2020
40
BCCN

41. Examples at the clinics & Schools
• Immunization of infants andpre-schoolers
• Family planning programs
• Cholesterol screening
• Prevention of behavioral problems inadolescents
 Expanded skills in observation, listening, communication and
counseling are integral to your role as a CHN with emphasis on
psychological and socio-cultural factors
05-10-2020
41
BCCN

42. Educator Role
• Health teacher: one of the major functions of the CHN
(Breckon et.al. 1998)
 Important role because
• Community clients are NOT usually acutely ill and can not
observe and act on health information
• The public has a higher level of health consciousness (client self-
education is facilitated by the nurse. Based on the concept of
self-care, clients are encouraged to use appropriate health
resources
05-10-2020
42
BCCN

43. Advocate Role
• Based on clients’ rights: Every patient or client has the right to
receive just, equal, and humane treatment.
 Goals of advocacy:
1.Help clients gain more independence and self- determination
2.Make the system more responsive and relevant
05-10-2020
43
BCCN

44. Managerial Role
• Nurse directs and administers care to meet goals by:
1.Assessing client needs
2.Planning and organizing to meet those needs
3.Directing and leading to achieve results
4.Controlling and evaluating the progress to make sure that
the results are met
• Nurse oversees client care as:
1. A case manager
2.Supervising ancillary staff
3.Managing case loads
4.Running clinics
5.Conducting community health needs assessment projects
05-10-2020
44
BCCN

45. Nurse as Planner
• Sets the goals for the organization
• Sets the direction
• Determines the means (strategies) to achieve them
• It includes defining goals and objectives
• It may be strategic ( long-term broader goals)
05-10-2020
45
BCCN

46. • Designing a structure for people + tasks to function to reach the
desired objectives
• It includes assignments and scheduling
• It includes:
1. Deciding what tasks to be done
2. Who will do them
3. How to group the tasks
4. Who reports to whom
5. Where decisions will be made (Robbins 1997)
Questions to be addressed by the organizer
1. Is the clinic, program providing the needed services?
2. Are the clients satisfied?
3. Are the services cost-effective?
Nurse as Organiser
05-10-2020
46
BCCN

47. Nurse as Leader
• The nurse directs, influences, or persuades others to make
change to positively influence people’s health.
• Includes persuading and motivating people, directing
activities, effective two-way communication, resolving
conflicts and coordinating the plan
• Coordination: Bringing people and activities together to
function in harmony to achieve desired objectives
05-10-2020
47
BCCN

48. Nurse as Controller and Evaluator
• Controller: Monitors the plan and ensures that it stays on
course.
• Sometimes plans do not proceed as intended and need to be
adjusted
• Monitoring, comparing and adjusting are activities of
controlling
• Comparing performance and outcomes against set goals and
standards = Evaluator role
05-10-2020
48
BCCN

49. Collaborator Role
• Means working jointly with others on a common project to
cooperate as partners .Who?
• Clients
• Other nurses and physicians
• Teachers and health educators
• Social workers
• Physical therapists
• Nutritionists
• Psychologists
• Epidemiologists and Biostatisticians
• Secretaries
• City Planners and legislators
05-10-2020
49
BCCN

50. SUMMARY
05-10-2020BCCN
50
 Definition of CHN
 Concepts of CHN
 Purpose of CHN
 Principle of CHN
 Goals of CHN
 Settings of CHN
 Historical development in community health
 Role of community health nurse

51. 05-10-2020BCCN
51