Introduction to community health

nursing

Haidar Nadrian

School of Nursing & MidwiferyIslamic Azad University-Sanandaj

Branch

History of Community Health Nursing

Before mid 1800s-Early Home Care with focus in Sick and Poor individual.

Orientation: curative agencies: lay & religious orders *St. Phoebe

Mid 1800s to 1900-district Nursing with focus in Sick and poor individual

Orientation: curative/less in prevention agencies: voluntary & some government *William Rathbone

History of Community Health Nursing

1900-1970 public health nursing- Pubic Health Needs, focus in family and orientation in Curative and Prevention

agencies: government & some voluntary *Lilliam Wald

1970 to present-Community Health Nursing, focus in total community and oriented to population health, services address

health promotion; illness prevention agencies: many kinds; some independent practice *Ruth Freedman

Health Beyond Acute Care Settings-Community Care and Public Health

Public Health Definition

Public health is the Science and Art of :

preventing disease,

prolonging life,

promoting health and efficiency through organized community effort.

(Winslow, 1920)

Definition of Community Health (ANA,2000 ）

Community health nursing is a synthesis of nursing and public health practice applied to promoting and preserving the health of populations.

Treat “ Population as a Whole” Focus on individual, family, groups, community Utilizing Health promotion, health

maintenance, health education, and management, coordination, and continuity of care for meeting population needs.

Characteristics of Community Health Nursing

It is a field of nursing It combines public health and nursing It focus on population and

environment factors that may impact to people’s health

It emphasize in health promotion, illness prevention, and wellness

Characteristics of Community Health Nursing

It promotes client responsibility and self-care It uses aggregate measurement and

analysis It use principle of organizational theory It involves inter-professional collaboration.

Pubic Health is for: The sanitation of 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, and

The development of the social machinery to insure everyone a standard of living adequate for the maintenance of health ,

Healthy Life Style and Longevity .

Challenges and Opportunities in CHN (Allender and Spradley 2001)

Challenge1.Understanding early PHN efforts

Opportunity Enriching the heritage of early PHN efforts

2.Expanding nursing focus from the individual & the family

Including communities

3.Determining the needs of populations at risk

4.Learning the complexities of the health care system

Designing interventions

Shape its service delivery

Community Health & Public Heath

Similarities: Both are organized community efforts aimed at

promotion, protection and preservation of the public’s health

Historically, public health has been associated with official or governmental efforts

Currently, it includes both public and private health efforts

Difference: Community health focuses on specific designated communities. It’s a part of the larger public health effort.

Community Health Practice

Health Promotion

1. Increase the span of healthy life for all citizens

2. Reduce health disparities among population groups

3. Achieve access to preventive services

for everyone.

Roles of Community Health Nurses

Researcher

Leadership

Collaborator Manager

Advocate

Educator

Clinician

Nurses

Health Prevention

Tertiary Prevention

Secondary Prevention

Primary Prevention

Primary Prevention for Health Promotion Health Education Adequate Nutrition Individual Development Adequate working environment and

recreation, resting Pre-marriage counseling and education Genetic Counseling Regular Physical Examination

Primary Prevention for Health Protection Comply with immunization Individual hygiene Improve environment sanitary Occupational Safety Prevent Accident in all ages Adequate nutrition Avoid cancer cause agents Avoid allergic

Secondary Prevention

Identify cases in the community Screen and test Conduct special physical

examination Treat and prevent the progress of

illness Avoid the spreading of disease Reduce the disability time

Tertiary Prevention

Treat and stop the disease progress and avoid complication and side effect

Limit the chance for disability Provide rehabilitation for physical and

psychological well-being, occupational therapy, availability of long-term care

Setting for community health nursing practice

homes ambulatory service settings schools occupational health setting residential institutions the community at large

Opportunity for Future Community Health Nursing

Chronic Disease management Home Care Extended care from Acute care setting Elderly care Rehabilitation care in different population Health promotion in every level Health system referral, emphasize individual

role and function of community health sector