Community Health Nursing TOPICS
a) Philosophy, goals, objectives &
principles , concept and importance
of Community Health Nursing,
b) Qualities and functions of
Community Health Nurse
c) Steps of nursing process;
community identification,
population composition, health
and allied resources, community
assessment, planning & conducting
community nursing care services.
Community health nursing
Topic:
Philosophy, goal , objectives and principles
To Explain the philosophy of community health nursing :
Generally philosophy implies three components:-
Knowledge:
CHN is based on logical thinking and scientific methods.
Code of ethics values
Existence:
CHN is committed to its own beliefs about professional practice.
BASIC CONCEPTS:
CHN believes that health is a fundamental human right and integral to growth and development.
It supports the entire community
Recognizes the need for a holistic care approach
Health promotion and primary prevention are key activities in the community.
Community-based efforts and community participation.
Supports health-promoting behavior in acceptable ways.
Performs multidisciplinary team activities.
Acts as the overall development and well-being of the individual, family, communities and nation.
Enlist goals of community health nursing:
The overall goals of community health nursing are to help individuals, families, and communities achieve the highest.
Promotion of health
Health maintenance
Prevention of illness
Restoration of health
Treatment of minor ailments
Rehabilitation of the clients
Enlist objectives of community health nursing:
To increase life expectancy
To reduce IMR, MMR and other diseases.
To prevent disability, provide rehabilitation services
Providing health care services
To find out the reason affecting the relationship
Evaluating the health program and future plans.
To diagnose the community
Sector of community health to help NGOs and other organization
To assess the needs and priorities of vulnerable groups of pregnant mothers and children,
To provide reference services
To raise the standard of nursing profession
To provide the overall well-being of the community and maintain their optimal level of functioning.
Enlist principles of community health nursing:
Health services should be based on individual and community need
Health services budget should be appropriate for workers and resources
The family should be recognized as a unit
Health services should be equally available to all.
Health education is an important part of the health nursing community
Should be provided continuously, without any interruption
Accurate preparation and preparation and maintenance of records and reports.
Provides guidance and direction for the work performed, supervising nursing services by qualified CHΝ personnel
One should be dedicated towards one’s duties.
Effective team spirit is essential
Timely evaluation of services
Respect should be given to the customer’s values, customs and beliefs.
Topic:
Concept of community health nursing
Define community, community health & community health nursing:
COMMUNITY:
“A community is a social group defined by geographic boundaries and/or common values and interests. Members know and interact with each other.
COMMUNITY HEALTH:
Community health means…
Health status of community members, problems affecting their health and health care available.
COMMUNITY HEALTH NURSING:
Community Health Nursing is a broad branch of nursing whose acronym RAIGE stands for..
Recognition
Assessment
Intervention
Organization
Evaluation
To explain the philosophy of community health nursing:
In general, philosophy implies three components, knowledge, values and beliefs about adjuncts and existence.
Community health nursing supports all of these in the following ways…
Community health nursing is based on logical thinking and scientific methods.
Community health nursing is committed to its own beliefs about professional practice.
To Explain the significance of community health nursing:
Noting the neglect of direct personal client services or community-based nursing as part of community health nursing practice WHO has defined the following three essential components of community health nursing:-
1) The community health nurse is responsible for ensuring that the necessary health services are provided in the community
2) Vulnerable group in community is given first priority by nurse on priority basis
3) The client (individual, family, group or community) should be a partner in the planning and evaluation of health care.
Values that reflect…that guide community health nursing practice over time and are found in essential health care.
Enlist the goal of community health nursing:
The goal of nursing is often referred to as the care of nursing.
Nurses are now aware that they can be powerful in the position they need to promote health for all.
Thus, the aim of community health nursing lies at the center of primary prevention and health promotion, health maintenance, disease prevention and treatment of minor ailments and health restoration and rehabilitation.
Enlist the principles of
The principles of CHN are as follows:-
1) CHN functions based on the needs of the people and the work of the total health program.
2) The Community Health Nursing Agency defines the objectives & purpose of the service.
4) An active organized citizen group works as a representative of the community health program.
4) Community health nursing provides service to family and community as a unit.
5) Health education & counseling for every individual, family and community is an integral part of nursing.
6) Recipients of health care should participate in the planning of participating for health in order to receive health.
7) Community health nursing should act as an important member of the health team.
8) There should be provision of qualified nurses to supervise community health care.
9) Community health nurses should not accept gifts from patients.
10) Community health agencies should provide continuing education programs for nurses.
🌟 Topic:
Importance of community health nursing
Explain the importance of community meeting:
Explain to the student that first of all it is necessary to meet the community.
Establish contact with community leaders,
Obtain consent from local leaders for a base line survey of existing facility health status.
Explain the importance of CHN to identify the health problems & needs of community:
Various approaches can be used to identify community health problems and health needs including –
Base line survey
Verification of PHC and Sub-Centre records.
Asking specific questions about common diseases in the community.
Inquiring about birth, death, disability, failure to work.
etc..
Set priorities among health problems:
Four criteria are used to determine priorities among health
Problems:-
A. The problem is that what is the frequency. (Prevalence)
B. How serious the problem is to individuals and society.
c. Urgency of problems.
D. What is the potential or sensitivity to control problems with the limitation of financial resources.
E. A scoring system is used to rank priorities. How this can be done is shown in the table.
TABLE
Criteria for fixing priorities:
Health problems: Dental problems
Prevalence: +++
Serious-ness:+
Urgency: ++
Feasibility: ++
Total score: 8
Health problems: Leprosy
Prevalence:+
Serious-ness:++
Urgency: +++
Feasibility:+
Total score: 7
Health problems: diarrheal disease
Prevalence: ++
Serious-ness: ++++
Urgency: ++++
Feasibility: ++++
Total score: 14
Plan regarding min health problem solution:
By identifying whether a problem or need exists, the community health nurse must determine what action should be taken by the health team and whether the health team will be able to take appropriate action.
Planning involves setting objectives and asking why questions to define solutions to problems.
Intervention & implementation activities:
They undertake activities determined to be most effective in meeting a recognized need in the CHN.
This phase includes all tasks, processes and practices performed by nurses.
Evaluate the health problem solution:
Evaluation will measure the extent to which a problem has been solved or to what extent a need has been met.
Evaluation provides “feedback” that can lead to changes in the program, which will make the program more effective.
🌟 Topic:
Qualities and functions of community health nurse:
To explain the educational qualifications of CHN:
Diploma in general nursing and midwifery, and should be registered for nursing in state nursing counselling.
The course of general nursing and diploma in public health should be completed in 9 months.
university course in nursing (Bsc.nursing/post
Must have done basic Bsc.nursing) course.
To explain communication skills of CHN:
A CHN should be an expert in the following.
Good speaker
Interviewer
conversationalist
a good teacher
To explain observation skills of CHΝ:
Must have ability to observe physical, mental and emotional states.
Must have ability to recognize signs and symptoms of disease
Must be able to assess health level of individual, family and community.
To explain ability to lead and take decision of CHN:
Should be able to take decisions according to the right and immediate situation.
Must be able to make independent decisions
Must be able to lead the health team.
To explain other qualities of CHN:
Should have knowledge of available resources and health problems of the community.
Should have an understanding of human behaviour
Should have managerial abilities
Should be physically and mentally fit.
To explain managerial functions of CHN:
CHN’s managerial functional includes the following responsibilities:-
Assessment:
To collect information related to the community.
➤Finding health problems.
➤ Finding the limits and availability of resources.
➤ Deciding the nature and role of nursing services
➤ Epidemiological survey.
Program plans for work area planning services (eg school, home, clinic) should be revised.
Monitoring the work of other health workers e.g. health inspectors etc..
Monitoring care provided by family members.
Gets the cooperation of influential people in the community in health work.
Maintaining contact with Government & non Government, organization and other authorities.
Participating in meeting.
Acting as liaison between health officer and health workers.
Sending work na report to higher officers / health authorities / agencies.
Clinical services, immunization, motivating eligible couples & progress of family welfare program to evaluate the work based on their own progress.
To explain nursing functions of CHN:
To provide comprehensive nursing services to individuals, families and community
assisting in the diagnosis & treatment of diseases
Guiding the family in taking care of the patient
Regular home visit
To explain other educational function of CHN:
To educate individuals & groups.
To participate in school health education program.
Assisting in training programmers of nursing & health workers.
Giving practical training about patient care.
Giving education about improvement & development of environment.
Preparation & intelligent use of audio visual materials.
Assisting in surveys, demographic fact collection & presentation etc. for research purposes…
To explain other work of CHN:
Making appropriate use of referral services.
Helping in the establishment of clinical and functioning of health centers.
To assist in the duty of health workers.
To maintain health records & timely dispatch of reports.
Assisting in health statistics work.
🌟 Topic:
Community identification:
Define community identification:
Community identification is a systematic process of knowing and exploring to evaluate the health condition of a community and to determine the possible factors affecting the health of the people.
Explore the identified community:
It is more than making a relevant medical or nursing diagnosis for the community.
It means knowing the area where people live in the community, other families in the area, especially the community leaders, their lifestyle and their resources. All this information can be obtained through:-
Conducting formal and informal meetings with community people, leaders and organized groups which may include Panchayat members, school teachers, women’s groups, youth clubs/groups of youth researchers etc.
Visiting the community for observation of physical environment, biological environment and psycho social environment.
Informal conversation with people
Going through records
Formal community/sample surveys
Discuss with health and allied health personnel working in the community.
Different dimensions (consequences) are observed about the community whose three basic dimensions are as follows…
Place or space
People or persons
Function
This includes the following components.
Geographical area:
Size, census, blocks, climate, name of area, location, etc.
Geographical boundaries:-
Geographical and administration of community have an important impact on the administration of our country, so the state of election and local administration of community must be mentioned.
Means of transport, foot, bullock cart, bus, bus, boat, train, air etc.
Physical environment:- Land use pattern, housing conditions etc.
It includes demography and characteristics of the community.
It is a fact that without people, community has no meaning.
Therefore, the demography setup should be properly identified for the identification of the community.
More is described in the handling of population composition.
It also implies the following….
Maintenance of social control
Employment/unemployment/partial/seasonal employment status of the community.
Socialization of new members
Production, distribution system consumption of goods and services
Adaptation of ongoing and expected changes
Provisions of mutual aid, cooperation
Description of functions related to cast or religion etc. (description of works related to caste or religion etc.)
Enlist the indicators for commun
Indicators for community identification are:-
Familiarity with the community for the purpose of assessment.
Community identification is provided by nursing data.
Assessment needs to be done in specific communities.
🌟 Topic:
Community assessment
To define community health nursing, process and community assessment:
Introduction:
Community health nursing is a synthesis of nursing and public health practice that is applied to promote and protect the health of populations.
The community health nursing process is a systematic way of determining the health status of the client, identifying health problems, developing a plan to initiate the process of implementing the plan, and evaluating the appropriateness of the plan in solving the problem. Which is as follows… which has 5 phase…
Community assessment
Community nursing diagnosis
Planning
Implementation
Evaluation
Definition:
Community assessment is a process that describes the health status of local people, identification of main risk factors and causes of health.
Or
Community assessment is a process that systematically collects data using quantitative and qualitative methods to understand health in a particular community and analyzes the data.
To describe benefits of community assessment:
Benefits of community assessment:-
Increasing our understanding of the needs of people in the community.
Getting an opportunity to share needs.
Increased community engagement
To identify the strength and weakness of the community.
Increase awareness among community members.
Use data to inform strategic planning and priorities setting.
List out the tools of community assessment:
Tools of community assessment:-
Survey
Asset inventory
Community mapping
Daily activity schedule
Seasonal calendar
Panel discussion etc
To explain steps of community assessment:
Steps of community assessment:-
Define the scope
Collect data
Determine major findings
Set priorities
Create action plan
Components of community assessment:-
People:-
Health and social services
Economics
Communication
Physical environment
Safety and transportation
Politics and government
Recreation
Education
To describe the method of data collection:
Discuss community health nursing assessment together.
Data collection and interpretation:-
Data collection is necessary to get useful information about the community and its health data collection includes community data and its health data collection includes data generation which details can be collected from the following information:-
A. Geographical information
B. Demographic information
C. Environmental information
A. Geographical information:
Name of the locality or area
Physical structure, boundaries
Important roads, streets, buildings,
Important landmarks
Seasonal variation and months.
Getting r preparing a map of the area, locating important institutions of public importance.
B. Demographic information:
Total population with reference to age, sex, caste, education, occupation and income.
Total families: Nuclear, joint, size of the family
Vital health events: CBR, CDR, IMR, Morbidity rate etc.
Specific vulnerable groups: infants, toddlers, expecting and lactating mothers and disease risk groups
C. Environmental information:
Physical environment: Housing, water supply, sanitation
Social environment: social organization, school’s, temples etc. community organization (voluntary welfare organizations), leadership structure
Environmental communication:- Official and non-official channel, common meeting place, important communications events of communication (fairs, festivals)
Media of communication:-radio, TV, cinema, newspapers etc
Environmental resources:- Economic resources (occupation, family income), institutional resources, human resources (doctors, engineers, teachers), natural resources (land, water soil etc).
🌟 Topic:
Community planning
To introduce community health nursing process:
Community:
Community is a social group defined by geographical boundaries and common value and interest.
Planning-
The process of making plans for something.
Community health nursing process:
Nursing process is a systematic way of determining the client’s health status, isolating health problems, developing a plan, initiating action for the implementation of the plan and evaluating the appropriateness of the plan in solving the problem.
Nursing process generally includes 5 phases:-
community assessment
community nursing diagnosis
planning
implementation
evaluation
To define planning & planning phases:
Planning:
It is a decision making process of formulating a program of actions for specific goals and objectives.
Based on the assessment of the community and nursing diagnosis, the planning phase of goal, activities includes several steps as follows-
Setting priorities
Establishing goal & objective,
Plan actions
Measurement of out comes
Recording
To define nursing care plan:
Nursing care plan is a structure that clearly explains the problem, reason, and the process of proper treatment, action and last evaluation related to the patient’s disease is a nursing care plan in which quality care is promoted and patients are provided with convenience. provides services.
individual care
continuity care
communication
evaluation
Characteristics of nursing care plan:-
Nursing care plan should be written by a qualified nurse
Nursing care plan
It should be the most effective because it comes in contact with the patient first and then comes in contact with the nurses, because the information related to the patient has to be collected from the patient first, so it can be said that it comes in contact with the patient first.
Nursing care plan should be for all personal care of the patient.
Nursing care plan should have current information of all patients.
To explain component of nursing care plan:
Components of nursing care plan (PRONE)
problem (P)
Reason (R)
Objectives (0)
Nursing intervention (N)
Evaluation (E)
Problem:
A problem is an unsatisfactory state, which is difficult to change into a future state desire. It is identified in the phase of nursing diagnosis.
It is a situation faced by the patient in which the nurse can help, which shows the nurse’s performance through her professional function.
REASON:
Reason can be the cause, event, sign and symptoms of the disease or condition prevailing in the patient during observation when the patient comes for visit/interview, from which this REASON is helpful for the nurse to make his objectives and listing nursing interventions.
Objective:
This is a small statement of the intended results/outcome action program which is the intended results/outcome of the action program which is helpful for the nurse to evaluate the patient to know the patient’s progress… whose objectives can be as follows…
-Related to the problem statement
-observable and measurable
-Realistic
Nursing interventions:
There are specific approaches that are helpful in assisting the client according to his objectives.
Etiological component is required for nursing diagnostic statement.
Getting information during assessment.
The nurse should interact with the patient and his family members.
Evaluation:
Evaluation means to assess or estimate or give as the last phase in the nursing process to find out the value of the effect of care, is a process that is given care…and that
Implementation is the 4th step of nursing process whose purpose is nursing activities.
Now the individual or the family is not present in front of us to provide face to face care, but the whole community is considered as a patient.
Implementation can be done by an individual or a group, which has established goals and objectives.
The community health nurse is the main key to making implementation efforts centralized.
To explain functions of community nursing care:
Review the prepared nursing care plan and assess the identified objectives.
To provide comprehensive nursing care to individual, family and community.
To prepare working environment to provide effective community health nursing care.
Supervise the care provided by the health team and other members.
Recording and reporting of care provided.
Nursing care in the community should be provided without discrimination and proper distribution of care.
Giving priority to high risk group while providing care.
Using more and more available resources in the community.
To use affordable and acceptable technique while giving care.
Working as a team leader with health team members.
Coordinate with other health agencies in the community and provide care.
Enlist the types Mins of community nursing care services provided:
➤ According to need of community:
-Care of pregnant women’s
-Neonatal care
-Immunization
-Family planning services
-Health education
-Prevention of communicable and non-communicable diseases.
-Recording and reporting.
-treatment of minor ailments.
-bring community awareness of various govt. scheme
e.g.-BSBY, MNDY, JSSY etc.
Nurse’s role:
A nurse should be a content expert, counselor, health educator so that she can implement community health nursing care.
Health problems should be selected according to type.
To participate the community for the solution of the problem.
To know the characteristic of the process of social changes.
Explain methods of intervention:
Individual or family health nursing process
Can be implemented by a nurse but the community health nurse alone is never considered as an implementation method in the community health nursing process.
Small interacting groups:
Lay advisor:
These act as opinion leaders. They hold a high position in the community. Village panch or sarpanch, religious persons ward members etc.; Works as a health assistant.
Mass media:
Tv, radio, video, newspaper, mobile, internet.
Health policies and public health law:
MTP PFA, PCPNDT, RTI
Evaluation of nursing care services given:
Evaluation is the evaluation of the effects of some organized activity or program.
Evaluation of community health nursing process mainly includes two aspects.
-Evaluation of the nurse’s performance
-Evaluation of the behavioral changes in the community