COMMUNITY HEALTH NURSING Flashcards
“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.” -Maglaya,et.al
COMMUNITY HEALTH NURSING
Major Goal of CHN
Preserve the health of the community by focusing on health promotion and health maintenance of individual, family and group within community
- A specialized field of nursing practice that focuses on a group of people with common interests living together within a territory or geographical boundary
COMMUNITY
Is part of the paramedical and medical intervention/approach which is concerned on the health of the whole population that aims health promotion, disease prevention and management of factors affecting the health
COMMUNITY HEALTH
Is the term used before for community health nursing
PUBLIC HEALTH NURSING
CHN subspecialties
Public health nursing, school health nursing, occupational health nursing
BASIC PRINCIPLES OF CHN
- The community is the patient in community health nursing, the family is the unit of care and there are four levels of clientele: individual, family, population group, and the community.
- In CHN, the client is considered as an ACTIVE partner, not a 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 the health care system and the larger human services system
3 ELEMENTS IN CHN
- Science of Public Health
- Public Health Nursing Skills
- Social Assistance Functions
The synthesis of public health and nursing practice PHC according to FREEMAN (1963)
PUBLIC HEALTH NURSING
defined as the field of professional practice in nursing and in public health
PUBLIC HEALTH NURSING
Skills applied in PHN
technical nursing, interpersonal, analytical, and organizational skills
Technical nursing, interpersonal, analytical, and organizational skills. These skills are applied in concert with those of other persons engaged in health care through?
comprehensive nursing care of families and other groups
The practice of promoting and protecting the health of populations using knowledge from nursing social and public health sciences
PHC
with the goals of the promoting health and preventing disease and disability for all people through the creation of conditions in which people can be healthy
Population-focused
Objectives of Public Health
C-ontrol of Communicable Disease O-rganization of Medical and Nursing Services D-evelopment of Social Machineries E-ducation of IFC on personal hygiene S-anitation of the environment
ROLES AND FUNCTIONS OF A COMMUNITY HEALTH NURSE
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- Identifies needs, priorities, and problems of individuals, families, and communities
- Formulates municipal health plan in the absence of a medical doctor
- Interprets and implements nursing plan, program policies, memoranda, and circular for the concerned staff personnel
- Provides technical assistance to rural health midwives in health matters
Planner Programmer
- Provides direct nursing care to sick or disabled in the home clinic school or workplace
- Develops the family’s capability to take care of the sick, disabled, or dependent member
Provider of Nursing Care
- Identifies and interprets training needs of the RHMs, Barangay Health Workers (BHW), and hilots
- Conducts training for RHMS and hilots on promotion and disease prevention
- Conducts pre and post-consultation conferences for clinic clients; acts as a resource speaker on health and health related services
- Initiates the use of tri-media (radio/TV, cinema plugs, and print ads) for health education purposes
- Conducts pre-marital counseling
• Trainer/Health Educator
- Motivates and enhances community participation in terms of planning, organizing, implementing, and evaluating health services
- Initiates and participates in community development activities
• Community Organizer
- Coordinates with individuals, families, and groups for health related services provided by various members of the health team
- Coordinates nursing program with other health programs like environmental sanitation, health education dental health, and mental health
• Coordinator of Services
- Detects deviation from health of individuals, families groups, and communities through contacts/visits with them
• Health Monitor
- Provides good example of healthful living to the members of the community
• Role Model
- Motivates changes in health behavior in individuals, families, groups, and communities that also include lifestyle in order to promote and maintain health
Change Agent
- Participates in the conduct of survey studies and researches on nursing and health-related subjects
- Coordinates with government and non-government organization in the implementation of studies/research
• Researcher
- Prepares and submits required reports and records
- Maintain adequate, accurate, and complete recording and reporting
- Reviews, validates, consolidates, analyzes and interprets al records and reports
- Prepares statistical data/chart and other data presentation
• Recorder/Reporter/Statistician
The Philippine Nursing Act of 2002
Republic Act 9173
Republic Act 9173
The Philippine Nursing Act of 2002
Scope of Nursing is written on?
Article VI, Section 28.
Phases of Human Development
conception, labor delivery, infancy, childhood, toddler, preschool, school age, adolescence, adulthood, and old age
nurses are primarily responsible for the promotion of health and prevention of illness
independent practitioners
It shall be the duty of the nurse to:
(a) Provide nursing care through the utilization of the nursing process.
(b) Establish linkages with community resources and coordination with the health team
(c) Provide health education to individuals, families and communities
(d) Teach guide and supervise students in nursing education programs
(e) Undertake nursing and health human resource development training and research
a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity
WHO
a state of well-being in which the person is able to use purposeful, adaptive responses and processes physically, emotionally, mentally, spiritually, and socially
Murray
actualization of inherent and acquired human potential through goal-directed behavior, competent self-care, and satisfying relationship with others
Pender
a state of person that is characterized by soundness or wholeness of developed human structures and of bodily and mental functioning
Orem
Is seen as a group or collection of locality-based individuals, interacting in social units and sharing common interests, characteristics, values, and/or goals
COMMUNITY
a collection of people who interact with one another and whose common interests of characteristics form the basis for a sense of unity or belonging
Allender
- a group of people who share something in common and interact with one another, who may exhibit a commitment with one another and may share geographic boundary
Lundy and Janes
a group of people who share common interests, who interact with each other, and who function collectively within a defined social structure to address common concerns
Clark
a locality-based entity composed of systems of formal organizations reflecting society’s institutions, informal groups and aggregates
Shuster and Goeppinger
Two main types of communities is form by?
Maurer and Smith
- also called as territorial communities
- are most traditionally recognized
- defined or formed by both natural and man-made boundaries and include barangays, municipalities, cities, provinces, regions and nations.
Geopolitical communities
- also called as functional communities
- refer to relational, interactive groups, in which the place or setting is more abstract and people share a group perspective or identity based on culture, values, history, interest and goals.
Phenomenological communities
DETERMINANTS OF HEALTH
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- higher income and social statue ore linked to better health. The greater the gap between the richest and poor health, the greater differences in health
Income and social status
- low education levels are linked with poor health, more stress and lower self-confidence
Education
- safe water and clean air, healthy workplaces safe houses communities and roads all contribute to good health
Physical environment
- people in employment are heather particularly those who have control over their working conditions.
Employment and working conditions
greater support from families, friends, and communities is linked to better health
Social support networks
customs and traditions, and the beliefs of the family and community all affect heath
Culture
- inheritance plays a part in determining lifespan, healthiness and the likelihood of developing illnesses
Genetics
- balanced eating, keeping active, smoking, drinking and how we deal with life’s stresses and challenges all affect heath
Personal behavior and coping skills
-access and use of services that prevent and treat disease influences health
Health services
men and women suffer from different types of diseases at different ages
Gender
- provide morbidity, mortality and other health status related data.
National Epidemiology Center of DOH, PSA
rate of death
mortality
rate of illness
morbidity
- are responsible for collecting morbidity and mortality data and forwarding the information to the higher level of health, such as Provincial Heath Office
Local health centers/offices/departments
should participate in investigative efforts to determine what is precipitating the increased disease rate and work to remedy the identified threats or risks.
Nurses
Public health is the science and art of (1) preventing disease, (2) prolonging life, and (3) promoting health and efficiency through organized community effort is by?
CE Winslow
- activities enhance resources directed at improving well-being
Health promotion
- activities protect people from disease and effects of
Disease prevention
Three Levels of Prevention by?
Leavell Clark
- relates to activities directed at preventing a problem before it occurs by altering susceptibility or reducing exposure for susceptible individuals.
Primary prevention
- early detection and prompt intervention during the period of early disease pathogenesis
- implemented after a problem has begun but before signs and symptoms appear and targets populations who have risk factors
Secondary prevention
- targets populations that have experienced disease or injury and focuses on limitations of disability and rehabilitation
Tertiary prevention
concentrates on specific groups of people and focuses on health promotion and disease prevention, regardless of geographical location
POPULATION-FOCUSED NURSING
Focused-practice includes:
- Focuses on the entire population
- Is based on assessment of the populations health status
- Considers the broad determinants of health
- Emphasizes all levels of prevention
- Intervenes with communities, systems, individuals and families
Demographic example
Vital statistics, Census
Groups at high risk example
Health statistics, disease statistics
Services/Providers available example
City directors, phone books, local/regional social workers, list of low income providers, CH nurse
basic unit of care in CHN
Family
focus in the clinic or health center
Individual
Proposed in the late 1990s by nurses from the Minnesota Department of Health to describe the breadth and scope of public health nursing practice
•The Intervention wheel
recognized as a framework for community and public health practice- consist of 17 health interventions are grouped into 5 wedges
•The Intervention wheel
3 IMPORTANT ELEMENTS OF INTERVENTION WHEEL
- It is population-based
- It contains 3 levels of practice (Community, systems and individual/family)
- It identifies and defines 12 public health interventions
COMMUNITY HEALTH INTERVENTIONS
C10 S3 D2 ORHAP
- monitors health events
Surveillance
- systematically gathers and analyzes data regarding threats to the health of populations
Disease and other health event investigation
- locates populations of interests or populations at risk
• Outreach
- identities individuals with unrecognized health risk factors
• Screening
- identifies risk actors and connects them with resources
Case finding
- assists individuals and families, groups, organizations ad communities to identify and access necessary resources
• Referral and follow-up
- optimizes self-care capabilities of individuals and families
Case management
- direct care tasks that the nurse carries out
• Delegated functions
- communicates facts, ideas and skills that change knowledge, attitudes values, behaviors and practice
• Health teaching
- establishes an interpersonal relationships, with the intention of increasing or enhancing their capacity for self-care and coping
• Counseling
- seeks information and generates optional solutions to perceived problems
• Consultation
- commits two or more persons or an organization
• Collaboration
- develops alliances among organizations
• Coalition building
helps community groups to identity common problems or goals mobilizes resources and develop and implement strategies
• Community organizing
- pleads someone’s cause or acts on someone’s behalf
• Advocacy
- utilizes commercial marketing principles for programs
• Social marketing
- place issues on decision makers’ agendas, acquires plan of resolution
• Policy development and enforcement
- this practice involves providing nursing care nursing care to individuals and families in their own places of residence mainly to minimize the effects of illness and disability.
HOME HEALTH CARE
-homecare rendered to the terminally ill
and Palliative care is particularly important.
HOSPICE HOME CARE
A project initiated by the Department of Labor and Employment (DOLE), in collaboration with the Board of Nursing of the Philippines, Department of Health, Philippines Nurses Association and other stakeholders to promote nurse entrepreneurship by introducing a home health care industry in the Philippines
• ENTREPRENURSE
COMPETENCY STANDARDS IN CHN
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- Franciscan Friar Juan Clemente opened medical dispensary in Intramuros for the indigent
1577
Dominican Father Juan de Pergero worked toward installing a water system in San Juan del Monte and Manila
1690
smallpox vaccination was introduced by Francisco de Balmis, the personal physician of King Charles IV of Spain
• 1805
- first medicos titulares were appointed by the Spanish government
• 1876
- 2 year courses consisting of fundamental medical and dental subjects was first offered in the University of Santo Tomas. Graduated were known as “cirujanosministrantes” and serve as male nurses and sanitation inspectors
• 1888
- United States Philippines Commission, through Act 157 created the Board of Health of the Philippine Islands with a Commissioner of the Public Health as its chief executive officer (now the Department of Health)
• 1901
- enacted in 1957 amended certain provisions in the Rural Health Act and created 8 categories of rural health units corresponding to the population size of the municipalities
• RA 1891
- enacted in 1991,amended that devolution of basic health services including health services, to local government units and the establishment of a local health board in every province and city of municipality
• RA 7160 (Local Government Code)
- adopted during the world summit in September 2000
Millennium Development Goals (MDGs)
FOURmula One (F1) for Health
2005
Universal Health Care
2010
• FOURmula One (F1) for Health and Universal Health Care launched in
1999
- aims to achieve the health system goals of better health outcomes, sustained health financing, and responsive health system that will provide equitable access to health care
Universal Health Care
was the first nurse to formulate a conceptual foundation for nursing practice
Florence Nightingale
• She believed that clean water, clean linen, access to adequate sanitation and a quiet environment would improve health outcomes
Florence Nightingale
theorist with shared perspectives of health
Dorothy Johnson, Sister Callista Roy, Imogene King, Betty Neuman and Jean Watson
The goal of theory is?
to improve nursing practice by acting as a guide
COPAR
COMMUNITY ORGANIZING PARTICIPATORY RESEARCH ACTION
GOOD CHOLESTEROL
HIGH DENSITY LIPOPROTEIN
SYSTEMATIC PROCESS FOR IDENTIFYING ROOT CAUSES
ROOT CAUSE ANALYSIS
HIGHER MORTALITY RATE
MEN
X-RAY PICTURE OF THE BREAST
MAMMOGRAM
STEP BY STEP METHOD TO EXAMINE BREAST
BREAST SELF EXAM
LEPROSY IS CAUSED BY?
HANSEN’S DISEASE FROM MYOBACTERIUM LEPRAE
SOUND DECISION MAKING
Safe and Quality Nursing Care
MAINTENANCE OF SAFE ENV. AND ORGANIZATION OF WORKLOAD
Management Of Resources And Environment
ASSESSMENT OF CLIENT LEARNING NEEDS AND DEVELOPMENT OF HE PLAN
Health Education
ADHERENCE TO NURSING LAWS INCLUDING DOCUMENTATION OF CARE
Legal Responsibility
RESPECT FOR THE RIGHTS OF CLIENT IN ACCORDANCE TO THE CODE OF ETHICS
Ethico-moral Responsibility
CONTINUING EDUCATION
Personal and Professional Development
DATA GATHERING FOR QUALITY IMPROVEMENT
Quality Improvement
FORMULATION OF SOLUTIONS TO THE PROBLEMS
Research
ACCURATE AND RELATED DOCUMENTATION OF CLIENT CARE AND RECORD KEEPING
Records Management
USE OF THERAPEUTIC COMMUNICATION
Communication
COLLABORATIVE RELATIONSHIP WITH COLLEAGUES AND OTHER HEALTH TEAM MEMBER
Collaboration and Teamwork
- is the basis, in part, of several nursing theories.
• It is applicable to the different levels of the community health nurse’s clientele: individuals, families, groups or aggregates and communities
General Systems Theory
considered as a set of interacting elements that exchange energy, matter or information with the external environment to exist
client
is useful when analyzing interrelationships of the elements within the client and the environment
General Systems Theory
HAS BASIC STRUCTURES OF ALL OPEN SYSTEMS HAVE
Family Environment
SEPARATE FROM ITS ENVIRONMENT
BOUNDARIES
DICTATES THE BOUNDARIES
CULTURE AND FAMILY CODE
EXAMPLE OF THE General Systems Theory
IPO
THE EXTRANEOUS VARIABLE OR OUTSIDE FACTOR
ENVIRONMENT
HAS FEEDBACK FROM CLIENT AND INFLUENCES
IPO
THE MOST IMPORTANT MECHANISM SINCE ALL INFO IS LEARN AFTER
FEEDBACK