CHN

• Community


  A group of people with common characteristics or interests living together within a territory or geographical boundary
• Characteristics of a Community


  • Has one or more roles that define its identity within society
  • Has a set of goals - provides a sense of direction
  • Is organized within a set of formal/informal beliefs, values, expectations and behaviors that defines the boundary of the community
  • The boundary may be explicit (physical) or implicit (defined by the shared characteristics of its members)
  • Has ownership of it's members
  • There is some form of communication between members
  • Has skills and resources that are shared between the members
  • Balance the needs of the community with the needs of its members
  • Often has clubs, teams, groups etc. within the community
• Community Health


  Part of paramedical and medical intervention/approach which is concerned on the health of the whole population
• Health (WHO definition)


  A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity
• Health (Primary Health Care definition)


  A state of ENOUGH physical, mental and social well-being OF AN INDIVIDUAL TO PARTICIPATE ACTIVELY and PRODUCTIVELY IN THE SOCIAL and ECONOMIC LIFE OF THE COMMUNITY IN WHIHC HE LIVES IN
• Principles of Health


  • The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition
  • The health of all peoples is fundamental to the attainment of peace and security and is dependent on the fullest co-operation of individuals and States
  • The achievement of any State in the promotion and protection of health is of value to all
  • Unequal development in different countries in the promotion of health and control of diseases, especially communicable disease, is a common danger
  • Healthy development of the child is of basic importance; the ability to live harmoniously in a changing total environment is essential to such development
  • The extension to all peoples of the benefits of medical, psychological and related knowledge is essential to the fullest attainment of health
  • Informed opinion and active co-operation on the part of the public are of the utmost importance in the improvement of the health of the people
  • Governments have a responsibility for the health of their peoples which can be fulfilled only by the provision of adequate health and social measures
• Community Health Nursing


  The utilization of the nursing process in the different levels of clientele-individuals, families, population groups and communities, concerned with the promotion of health, prevention of disease and disability and rehabilitation
• Goal of Community Health Nursing


  To raise the level of citizenry by helping communities and families to cope with the discontinuities in and threats to health in such a way as to maximize their potential for high-level wellness
• Characteristics of Community Health Nursing


  • It is a specialty field of nursing
  • Its practice combines public health with nursing
  • It is population-based
  • It emphasizes wellness and other than disease or Illness
  • It includes interdisciplinary collaboration
  • It amplifies the client's responsibility and self-care
• Functions of Community Health Nursing

  • Identification of community culture and resources that lead as a key factor in the community health care delivery system
  • Evaluate community health conditions, health risks, and problems to identify the health-care demands of the people
  • Plan and implementation of comprehensive community health interventions, care, services, and programs
  • Develop health policy at the local community level to drive policies/agreements at the state and national levels for collaborative endeavors and actions
• Dimensions of Health Nursing

  Both profession & a vocation. Assisting sick individuals to become healthy and healthy individuals achieve optimum wellness
• Community Health Nursing (definition)


  The utilization of the nursing process in the different levels of clientele-individuals, families, population groups and communities, concerned with the promotion of health, prevention of disease and disability and rehabilitation
• Basic Concepts and Principles of Community Health Nursing


  • The FAMILY is the unit of care, the community is the patient and there are four levels of clientele in CHN
  • The goal of improving community health is realized through multidisciplinary effort
  • The community health nurse works WITH and not for the individual patient, family, group or community. The latter are active partners, not passive recipients of care
  • The practice of CHN is affected by changes in society in general and by developments in the health field in particular
  • CHN is part of the community health system which in turn is part of the larger human services system
• Basic Principles of Community Health Nursing

  • The community is the patient in CHN, the family is the unit of care and there are four clientele: individual, family, population group (those who share common characteristics, developmental stages and common exposure to health problems - e.g. children, elderly), and the community
  • In CHN, the client is considered as an ACTIVE partner NOT PASSIVE recipient of care
  • CHN practice is affected by developments in health technology, in particular, changes in society, in general
  • The goal of CHN is achieved through multi-sectoral efforts
  • CHN is a part of health care system and the larger human services system
• Philosophy of Community Health Nursing


  The philosophy of CHN is based on the worth and dignity on the worth and dignity of man
• Responsibilities of Community Health Nursing


  • Be a part in developing an overall health plan, its implementation and evaluation for communities
  • Provide quality nursing services to the three levels of clientele
  • Maintain coordination/linkages with other health team members, NGO/government agencies in the provision of public health services
  • Conduct researches relevant to CHN services to improve provision of health care
  • Provide opportunities for professional growth and continuing education for staff development
• Standards in Community Health Nursing


  • Applies theoretical concepts as basis for decisions in practice
  • Gathers comprehensive, accurate data systematically
  • Analyzes collected data to determine the needs/ health problems of IFC
  • At each level of prevention, develops plans that specify nursing actions unique to needs of clients
  • Guided by the plan, intervenes to promote, maintain or restore health, prevent illness and institute rehabilitation
  • Evaluates responses of clients to interventions to note progress toward goal achievement, revise data base, diagnoses and plan
  • Participates in peer review and other means of evaluation to assure quality of nursing practice
  • Assumes professional development
  • Contributes to development of others
  • Collaborates with other members of the health team, professionals and community representatives in assessing, planning, implementing and evaluating programs for community health
  • Indulges in research to contribute to theory and practice in community health nursing
• Home Visit


  A family-nurse contact which allows the health worker to
• Purposes of Home Visits


  • Make use of the inter-referral system and to utilization of community services
  • Assess the living condition of the patient and his family and their health practices in order to teaching
  • Give health teachings regarding the diseases
  • Give care to the sick, to a postpartum mother and her newborn with the view
  • Establish close relationship between the health agencies and the public for the promotion of health
• Principles of Home Visits


  • Consider and give priority to the essential needs if the individual and his family
  • Use of all available information about the patient and his family through family records
  • Must have a Purpose or objective
  • Involve the individual and family
  • Should be Flexible
• Bag Technique


  A tool by which the nurse, during her visit will enable her to perform a nursing procedure with ease and deftness, to save time and effort with the end view of rendering effective nursing care to clients
• Public Health Bag


  An essential and indispensable equipment of a public health nurse which she has to carry along during her home visits
• The bag should contain all the necessary articles, supplies and equipment that will be used to answer the emergency needs
• The bag and its contents should be cleaned very often, the supplies replaced and ready for use anytime
• The bag and its contents should be well protected from contact with any article in the patient's home
• Consider the bag and its contents clean and sterile, while articles that belong to the patients as dirty and contaminated
• The arrangement of the contents of the bag should be the one most convenient to the user, to facilitate efficiency and avoid confusion
• Contents of Public Health Bag


  • Paper lining
  • Extra paper for making waste bag
  • Plastic/linen lining
  • Apron
  • Hand towel
  • Soap in a soap dish
  • Thermometers (oral and rectal)
  • 2 pairs of scissors (surgical and bandage)
  • 2 pairs of forceps (curved and straight)
  • Disposable syringes with needles (g. 23 & 25)
  • Hypodermic needles (g. 19, 22, 23, 25)
  • Sterile dressing
  • Cotton balls
  • Cord clamp
  • Micropore plaster
  • Tape measure
  • 1 pair of sterile gloves
  • Baby's scale
  • Alcohol lamp
  • 2 test tubes
  • Test tube holders
• Solutions in Public Health Bag


  • Betadine
  • 70% alcohol
  • Zephiran solution
  • Hydrogen peroxide
  • Spirit of ammnonia
  • Ophthalmic ointment
  • Acetic acid
  • Benedict's solution
• BP apparatus and stethoscope are carried separately and are never placed in the bag
• Health Problem


  Identified health condition that was presented during home visit
• Goal of Care


  Goal of care should be SMART
• Nursing Intervention


  Independent nursing action mainly will focus on how to answer the health problem through health teachings and actions that are appropriate and evidence-based
• Resources


  Materials needed in conducting health teachings during home visit
• Expected Outcome


  Assumption after providing health teaching
• "Public Health is directed towards assisting every citizen to realize his birth rights and longevity."
• "The science and art of preventing disease, prolonging life and efficiency through organized community effort for: the sanitation of the environment, the control of communicable infections, the education of the individual in personal hygiene, the organization of medical and nursing services for the early diagnosis and preventive treatment of disease, the development of a social machinery to ensure every one a standard of living, adequate for maintenance of health to enable every citizen to realize his birth right of health and longevity (Dr. C.E Winslow)"
• Roles of the Public Health Nurse


  • Clinician, who is a health care provider, taking care of the sick people at home or in the RHU
  • Health Educator, who aims towards health promotion and illness prevention through dissemination of correct information; educating people
  • Facilitator, who establishes multi-sectoral linkages by referral system
  • Supervisor, who monitors and supervises the performance of midwives
  • Health Advocator, who speaks on behalf of the client
  • Advocator, who act on behalf of the client
  • Collaborator, who working with other health team member
• In the event that the Municipal Health Officer (MHO) is unable to perform his duties/functions or is not available, the Public Health Nurse will take charge of the MHO's responsibilities
• Community Health Nursing Process


  A systematic, scientific, dynamic, on-going interpersonal process in which the nurses and the clients are viewed as a system with each affecting one and another and both being affected by the factors within the behavior