Introduction to community health nursing

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Introduction to community health nursing

• Haidar Nadrian
• School of Nursing Midwifery
• Islamic Azad University-Sanandaj Branch

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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

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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

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Health Beyond Acute Care Settings-Community Care
and Public Health
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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)

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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.

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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 peoples health
• It emphasize in health promotion, illness
  prevention, and wellness

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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.

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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 .

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Challenges and Opportunities in CHN (Allender and
Spradley 2001)
Opportunity Enriching the heritage of early PHN efforts Challenge Understanding early PHN efforts
Including communities Expanding nursing focus from the individual the family
Designing interventions Shape its service delivery Determining the needs of populations at risk Learning the complexities of the health care system
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Community Health Public Heath

• Similarities
• Both are organized community efforts aimed at
  promotion, protection and preservation of the
  publics 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. Its a part of the larger
  public health effort.

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Community Health Practice
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Roles of Community Health Nurses
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Health Prevention
Tertiary Prevention
Secondary Prevention
Primary Prevention
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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

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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

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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

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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

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Setting for community health nursing practice

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

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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