COMMUNITY HEALTH NURSING
It is synthesis of nursing knowledge and practice
and the science and practice of public health,
implemented via a systematic use of the nursing
process and other processes to promote health
and prevent illness in population groups.
CHN is the totality of its philosophy and beliefs ,
principles, processes, and standards. As one of the
subsystems, it influences and is influenced by the
health care delivery system.
CHN is practiced within a specific economic,
political, socio-cultural and environmental
context.
Characteristics of CHN
1. Promotion of health and prevention of disease are the
goals of professional practice;
2.Community health nursing practice is comprehensive,
general, continual and not episodic;
3. There are different levels of clientele – individuals,
families, and population groups and the practitioner
recognizes the primacy of the population as a whole;
4. The nurse and the client have greater control in
making decisions related to health care and collaborate
as equals;
5. The nurse recognizes the impact of different factors
on health and has a greater awareness of his/her clients’
lives and situations.
THE ESSENCE OF NURSING IS THE SAME EVEN
IF PRACTICED IN DIFFERENT SETTINGS.
NURSING – is defined as the science and art of
caring.
Nursing as an art is reflected in the nurses’
interactions and communication with clients that
are geared towards the improvement not just of
their health but also their ability to deal with the
determinants and consequences of their health
problems.
Nursing as a science means community health nurses
should use practice-based and evidence- based
methods and tools. They also need to engage in
generating evidence to support their practice through
research.
THE ROLES OF CHN’s BY CLARK
CLIENT-ORIENTED ROLES
Caregiver
Educator
Counselor
Referral Resource
Role model
Case manager
DELIVERY-ORIENTED ROLES
Coordinator
Collaborator
Liaison
POPULATION-ORIENTED ROLES
Case finder
Leader
Change agent
Community mobilizer
Coalition builder
Policy advocate
Social marketer
Researcher
FRAMEWORK OF CHN
Four (4) components:
1. The HCDS and with its CHN subsystems
2. The clients
3. Health
4. Economic, socio-cultural, political and
environmental factors that affect the HCHS,
the practice of CHN and the people’s
health.
4 LEVELS OF CLIENTELE IN CHN
1. Individual sick or well – on a daily basis. They
are the entry point in working with the other
clients.
2. Family – unit of care
Unit of living, is also a unit of illness
Illness in one member affects other family
members and the whole family as a unit
Alterations in health alter relationships
between members (physiologically,
psychosocially, and economically)
Affects the functions & effectiveness of the
family as a whole
Dynamic interplay between health & family
characteristics
Vehicle for preventive & therapeutic health
interventions
3. Population Group
Certain group with common unique health needs
or risk groups whom the nurse delivers health
promotive, preventive, curative or rehabilitative
nursing services
CHN utilizes group approaches in identifying the
common health needs of the members, and
addressing them for the whole group.
4. Community
Refers to a group of people who share common needs,
interests, ethnic or cultural ties, and are committed to their
group’s well-being.
Functions within a particular social and political system &
structure, creates & exhibits certain norms, values and social
institutions, and its members interact and socialize with
each other
Emphasis on the importance of “the greatest good for the
greatest number.”
Mortality & morbidity statistics are broad indicators of a
community’s state of health.
Interventions for community-wide health problems come in
the form of specific programs or special projects
implemented with the participation of the comm & health
care teams.
Must to know…
The three most commonly identified
subspecialties of CHN are Public Health
Nursing, Occupational Health Nursing
and School Health Nursing.
Community Health Nursing
Occupational Health School Health Nursing
Nursing Nursing in an
Nursing in the educational
workplace. environment (school)
Research-based with Aims at promoting the
an emphasis on health of school
optimizing health, children & preventing
preventing illness and health problems that
injury, and reducing would hinder their
health hazards. learning and
performance of their
developmental tasks.
The clientele is an active partner and not a passive
recipient of care.
The most neglected responsibility:
RESEARCH related to Community Health Nursing.
HEALTH
A BASIC HUMAN RIGHT
A state of complete physical, mental, and social well-
being and not merely the absence of disease or
infirmity. (WHO- concept of Health 1995)
The goal of Public Health in general, and community
health in particular.
A quality of life, involving social, emotional, mental,
spiritual and biological fitness on the part of the
individual, which results from adaptations to the
environment. (Rene Dubos (1965)
Factors Affecting Health
Poverty and health
Culture and health
Environment and health
Politics and health`
Public Health by
Dr. Winslow
- it is the science & art of preventing disease, prolonging
life, promoting health and efficiency through organized
community effort; for the sanitation of the environment;
control of communicable infections; the education of
individual in personal hygiene; the organization of medical
and nursing services for the early diagnosis and preventive
treatment of disease and the development of the social
machinery to ensure everyone a standard of living adequate
for the maintenance of health, so organizing these benefits
to enable every citizen to realize his birthright of health and
longevity.
