3036

• Community health nursing


  Focuses on disease prevention, can provide direct/indirect care
• Canadian community health nursing standards of practice

  • Population focused practice: reducing health inequalities for a defined population or aggregate
  • Upstream thinking: big picture approach
  • Downstream thinking: individual focus
• Canadian community health nursing standards of practice

  • Health promotion
  • Prevention and health protection
  • Health maintenance, restoration and palliation
  • Professional relationships
  • Capacity building
  • Health equity
  • Evidence informed practice
  • Responsibility and accountability
• Florence Nightingale was the first to look at prevention (epidemiology)
• William Rathbone organized home care nursing
• CHN specialties


  • Home health nurses: in patient's home providing direct nursing care
  • RN's in primary care/family practice nurses
  • Public health nurses
• Population health promotion model

  Preventing victim blaming, provides a clearer picture, provides a planning tool
• SDOH


  Factors that influence health and wellbeing
• Shifting the thought of blaming the person for their health disparities and considering the SDOH that may affect them
• Equity


  • Differences in status can have significant health effects
• Social justice


  • Ensuring fairness + equality
• Roles of CHN


  • Care and counselling: risk assessment and response, therapeutic interventions
  • Continuity of care
  • Discharge planning
  • Referral process
  • Team building, community development, and collaboration
• Evidence-informed practice in CHN

  • Research evidence
  • Practitioner wisdom
  • Family experience and insights
• PICO


  Population, intervention, comparison, outcomes
• Epidemiology


  The study of what may be affecting a population
• Types of epidemiology


  • Descriptive: the who, when, and where
  • Analytical: the why and how
• Epidemiological measures used in CHN

  • Mortality: # of deaths
  • Morbidity: occurrence of disease
  • Incidence rate: new cases
  • Prevalence rate: all cases
  • Relative risk
  • Odds ratio
• In public health, your patient is a population
• Community as partner model

  A partnership conveys an equal relationship between the CHN and the community
• Components of community development in relation to nursing practice

  • Capacity building
  • Intersectional networking
  • Local area development
• Stages of working in teams

  • Forming: group members getting to know each other
  • Storming: expressing their feelings and focusing on the issues
  • Norming: feeling part of a group
  • Performing: sharing ideas and creating a supportive environment
  • Adjourning: working towards completion of tasks
• Types of group conflict

  • Intrapersonal: with oneself
  • Interpersonal: between 2+ people
  • Intergroup: between 2+ groups of people
• Approaches to health promotion

  • Biomedical approach: treatment and prevention of disease, including all 3 levels of prevention
  • Behavioural approach: lifestyle changes and risk factors
  • Socioenvironmental approach: psychosocial and environmental risks
• Foundational concepts in health promotion

  • Health protection
  • Risk avoidance
  • Risk reduction
  • Disease prevention
  • Harm reduction
  • Health enhancement
  • Resiliency
  • Risk factors
  • Protective factors
• Levels of prevention


  • Primary prevention: preventing the risks from happening
  • Secondary prevention: risks already present, includes screening to prevent illness
  • Tertiary prevention: disease already present, prevention of worsening disease
• Health promotion models, theories, and frameworks

  • Transtheoretical model
  • Theory of planned behaviour
  • Diffusion of innovation theory
  • Precede-proceed model
  • Social ecological model
• Health promotion strategies


  • Community mobilization framework: social planning, locality development, social action
  • Ottawa charter: strengthen community action, develop personal skills, create supportive environments, reorient health services, enable, mediate, advocate
• Health promotion skills for CHN


  • Empowerment and engagement
  • Actively involving communities
  • Influencing a healthy public policy
  • Stating their health requirements and be involved in and lead strategies
  • Developing personal skills: stress, healthy eating, PE, improved literacy
  • Working with focus groups
  • Preparing funding applications
  • Program planning and implementation
  • Developing health promotion capacity
• Health literacy


  Access, comprehend, evaluate, and communicate information
• Low literacy is a barrier to accessing and understanding health information
• Low literacy has a direct impact on health
• The four P's of social marketing

  • Products
  • Price
  • Place
  • Promotion
• Using plain language, usually at a grade 7-9 level
• Misinformation/disinformation


  Having too much information makes it difficult to know what's valid, what relates to the situation. It's easy to jump to conclusions.
• Infodemic


  Misinformation widespread, can have physical, social, economic, political and psychological consequences
• Spreading health literacy from reliable sources, letting the public know that the information being shared is peer reviewed and fact checking any misinformation
• Health program


  Planned activities to address public health concerns
• Types of health program planning

  • Strategic planning: matching client health needs and client provider strengths
  • Operational planning: smaller scaled aggregates, starting with a more specific objective
• Logic model


  Visual of a program's resources, activities and expected outcomes. Simplifies complex relationships between various components.
• Precede-proceed model


  Comprehensive planning model to think logically about the end goal. Precede: stages 1-5, setting objectives and direction. Proceed: stages 6-9, addressing interventions and approaches for health promotion.