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Title: Nur 473: primary health care nursing


1
Nur 473 primary health care nursing
Foundations of Community Health Nursing

2
Chapter One 1 Opportunities and Challenges of
Community Health Nursing What is Community Health
Nursing

3
  • Objectives
  • After completion the lecture the students
    enable to
  • Define community health and distinguish from
    public health
  • Explain the concept of the community
  • Describe three types of communities
  • Diagram the health continuum
  • Differentiate among the three levels of
    prevention
  • Analyze the six components of community health
    practice
  • Describe the eight characteristics of community
    health nursing


4

To understands what is the community health
nursing
5

We should answer these questions
  • What are the goals of the community health
    nursing (CHN)
  • Who is the client of the CHN
  • What are the setting of the CHN
  • What are the salient role provided by CHN

6
Introduction
The communities in which we live and work have a
profound influence on our collective health and
well-being. Example Research has established
that both smoking and passive exposure to tobacco
smoke are directly associated with serious
negative health effects and premature mortality
among more than 1 billion smokers worldwide
(Institute of Medicine, 2001).

7
Introduction
Just as a whole is greater than the sum of its
parts, the health of a community is more than the
sum of the health of its individual citizens. A
community that achieves a high level of wellness
is composed of healthy citizens, functioning in
an environment that protects and promotes health.
Community health, as a field of practice, seeks
to provide organizational structure, a broad set
of resources, and the collaborative activities
needed to accomplish the goal of an optimally
healthy community.

8
Introduction
In acute care, the health of an individual is the
primary focus. Community health broadens that
focus to concentrate on families, populations,
and the community at large. The community becomes
the recipient of service, and health becomes the
product. Viewed from another perspective,
community health is concerned with the
interchange between population groups and their
total environment, and with the impact of that
interchange on collective health.

9
Introduction
Although many believe that health and illness are
individual issues, evidence indicates that they
also are community issues. The spread of the HIV
pandemic, nationally and internationally, is a
dramatic and tragic case in point (Berkman,
2001). Other community and national concerns
include the rising incidence and prevalence of
sexually transmitted diseases, substance abuse,
tuberculosis, teen pregnancy, family and teen
violence, terrorism, and pollution-driven
environmental hazards. Communities can influence
the spread of disease, provide barriers to
protect members from health hazards, organize
ways to combat outbreaks of infectious disease,
and promote practices that contribute to
individual and collective health (American Nurses
Association ANA, 2000 Clark, 2002Wurzbach,
2002).

10
Introduction
Many different professionals work in community
health to form a complex team. The city planner
designing an urban renewal project necessarily
becomes involved in community health. The social
worker providing counseling about child abuse or
the use of chemical substances among adolescents
is involved in community health. A physician
treating clients affected by a sudden outbreak of
hepatitis and seeking to find the source is
engaged in community health practice. Prenatal
clinics, meals for the elderly, genetic
counseling centers, and educational programs for
the early detection of cancer all are part of the
community health effort

11
Introduction
The professional nurse is an integral member of
this team, a linchpin and a liaison between
physicians, social workers, government officials,
and law enforcement officers. Community health
nurses work in every conceivable kind
of community agency, from a state public health
department to a community-based advocacy group.

12
Introduction
Their duties range from examining infants in a
well-baby clinic, or teaching elderly stroke
victims in their homes, to carrying out
epidemiologic research or engaging in health
policy analysis and decision making. Despite its
breadth, however, community health nursing is a
specialized practice. It combines all of the
basic elements of professional clinical nursing
with public health and community practice.

13
Introduction
Community health and public health share many
features. Both are organized community efforts
aimed at the promotion, protection, and
preservation of the publics health.
Historically, as a field of practice, public
health has been associated primarily with the
efforts of official or government entitiesfor
example, federal, state, or local tax supported
health agencies that target the whole range of
health issues. In contrast, private health
efforts, such as those of the American Lung
Association or the American Cancer Society, work
toward solving selected health problems. The
latter augments the former. Currently, public
health practice encompasses both approaches and
works collaboratively with all health agencies
and efforts, public or private, that are
concerned with the publics health.

14
Definition
Public health is the science and art of
preventing disease, prolonging life, and
promoting health and efficiency through organized
community efforts 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, and the
development of the social machinery to insure
everyone a standard of living adequate for the
maintenance of health, so organizing these
benefits as to enable every citizen to realize
his birthright of health and longevity (Pickett
Hanlon, 1990, p. 5).

15
Nur 473 Primary Health Care Nursing
Definition
Community health is the identification of needs
and the protection and improvement of collective
health within a geographically defined area.

16
Nur 473 Primary Health Care Nursing
Definition
One of the challenges community health practice
faces is to remain responsive to the communitys
health needs. As a result, its structure is
complex numerous health services and programs
are currently available or will be developed.
Examples include health education, family
planning, accident prevention, environmental
protection, immunization, nutrition, early
periodic screening and developmental testing,
school programs, mental health services,
occupational health programs, and the care of
vulnerable populations. A community health and
safety service developed in the aftermath of the
terrorist attack on New York City and Washington,
DC, on September 11, 2001, is the Department of
Homeland Security.

17
Nur 473 Primary Health Care Nursing
THE CONCEPT OF COMMUNITY
  • A community is a collection of people who share
    some important feature of their lives.
  • A collection of people who interact with one
    another and whose common interests or
    characteristics form the basis for a sense of
    unity or belonging. It can be a society
  • of people holding common rights and privileges
    (eg, citizens
  • of a town), sharing common interests (eg, a
    community of
  • farmers), or living under the same laws and
    regulations (eg,
  • a prison community).
  • The function of any community includes its
    members collective sense of belonging and their
    shared identity, values, norms, communication,
    and common interests and concerns


18
Nur 473 Primary Health Care Nursing
Geographic Community
A community often is defined by its geographic
boundaries and thus is called a geographic
community. A city, town, or neighborhood is a
geographic community. The population has certain
identifiable characteristics, such as age and sex
ratios, and its size fluctuates with the
seasons Riady is a social system as well as a
geographic location. The families, schools,
hospital, masques, stores, and government
institutions are linked in a complex network.
This community, like others, has an informal
power structure. It has a communication system
that includes gossip, the newspaper, the co-op
store bulletin board, and the radio station. In
one sense, then, a community consists of a
collection of people located in a specific place
and is made up of institutions organized into a
social system.

19
Nur 473 Primary Health Care Nursing
Common-Interest Community
A community also can be identified by a common
interest or goal. A collection of people, even if
they are widely scattered geographically, can
have an interest or goal that binds the members
together. Example the members of a national
professional organization women who have had
mastectomies are all common-interest communities.

20
Nur 473 Primary Health Care Nursing
Community of Solution
A type of community encountered frequently in
community health practice is a group of people
who come together to solve a problem that affects
all of them. The shape of this community varies
with the nature of the problem, the size of the
geographic area affected, and the number of
resources needed to address the problem. Such a
community has been called a community of
solution. Example a water pollution problem may
involve several counties whose agencies and
personnel must work together to control upstream
water supply, industrial waste disposal, and city
water treatment

21
Nur 473 Primary Health Care Nursing
Populations and Aggregates
population refers to all of the people occupying
an area, or to all of those who share one or
population may more characteristics. A be
defined geographically, such as the population of
the United States or a citys population. This
designation of a population is useful in
community health for epidemiologic study and for
collecting demographic data for purposes such as
health planning. A population also may be
defined by common qualities or characteristics,
such as the elderly population or the homeless
population. In community health, this meaning
becomes useful when a specific group of people
(eg, homeless individuals) is targeted for
intervention the populations common
characteristics (eg, the health-related problems
of homelessness) become a major focus of the
intervention

22
Nur 473 Primary Health Care Nursing
Populations and Aggregates
Aggregate refers to a mass or grouping of
distinct individuals who are considered as a
whole and who are loosely associated with one
another. It is a broader term that encompasses
many different-sized groups. Both communities and
populations are types of aggregates. The
aggregate focus, or a concern for groupings of
people in contrast to individual health care,
becomes a distinguishing feature of community
health practice.

23
Nur 473 Primary Health Care Nursing
THE CONCEPT OF HEALTH
a state of complete physical, mental, and social
well-being and not merely the absence of disease
or infirmity a holistic state of well-being,
which includes soundness of mind, body, and
spirit. Community health practitioners place a
strong emphasis on wellness, which includes the
definition of health just mentioned but
incorporates the capacity to develop a persons
potential to lead a fulfilling and productive
life, one that can be measured in terms of
quality of life..

24
Nur 473 Primary Health Care Nursing
THE CONCEPT OF HEALTH
There is increasing awareness of the strong
relationship of health to environment. This is
not a new concept. Almost 150 years ago, Florence
Nightingale explored the health and illness
connection with the environment. She believed
that a persons health was greatly influenced by
ventilation, noise, light, cleanliness, diet, and
a restful bed. She laid down simple rules about
maintaining and obtaining health, which were
written for lay women caring for family members
to put the constitution in such a state as that
it will have no disease (Nightingale, 1859,
preface).

25
Nur 473 Primary Health Care Nursing
The Health Continuum WellnessIllness
Society suggests a polarized or either/or way
of thinking about health people either are well
or they are ill. Yet wellness is a relative
concept, not an absolute, and illness is a state
of being relatively unhealthy. There are many
levels and degrees of wellness and illness,

26
Nur 473 Primary Health Care Nursing
The Health Continuum WellnessIllness

27
Nur 473 Primary Health Care Nursing
The Health Continuum WellnessIllness
This health continuum applies not only to
individuals but also to families and communities.
A nurse might speak of a dysfunctional family,
meaning one that is experiencing a relative
degree of illness or a healthy family might be
described as one that exhibits many wellness
characteristics, such as effective communication
and conflict resolution, as well as the ability
to work together and use resources appropriately.
Likewise, a community, as a collection of people,
may be described in terms of degrees of wellness
or illness. The health of an individual, family,
group, or community moves back and forth along
this continuum throughout life.

28
Nur 473 Primary Health Care Nursing
The Health Continuum WellnessIllness
A healthy community, first described by Cottrell
(1976) as a competent community, is one in which
the various organizations, groups, and aggregates
of people making up the community do at least
four things 1. They collaborate effectively in
identifying the problems and needs of the
community. 2. They achieve a working consensus on
goals and priorities. 3. They agree on ways and
means to implement the agreedon goals. 4. They
collaborate effectively in the required action.

29
Nur 473 Primary Health Care Nursing
The Health Continuum WellnessIllness
Community health practice ranges over the entire
continuum it always works to improve the degree
of health in individuals, families, groups, and
communities. In particular, community health
practice emphasizes the promotion and
preservation of wellness and the prevention of
illness or disability..

30
Nur 473 Primary Health Care Nursing
Health as a State of Being
Health refers to a state of being, including many
different qualities and characteristics. An
individual might be described in terms such as
energetic, outgoing, enthusiastic, beautiful,
caring, loving, and intense. Together, these
qualities become the essence of a persons
existence they describe a state of
being. Similarly, a specific geographic
community, such as a neighborhood, has many
characteristics. It might be characterized by
the terms congested, deteriorating, unattractive,
dirty, and disorganized. These characteristics
suggest diminishing degrees of vitality Health
balance Is a state of well-being that results
from healthy interaction between a persons body
, mind, spirit and environment individuals want
to avoid illness and its consequences.

31
Nur 473 Primary Health Care Nursing
Health as a State of Being
Health involves the total person or community.
All of the dimensions of life affecting everyday
functioning determine an individuals or a
communitys health, including physical,
psychological, spiritual, economic, and
sociocultural experiences. All of these factors
must be considered when dealing with the health
of an individual or community. The approach
should be holistic. A clients placement on
the health continuum can be known only if the
nurse considers all facets of the clients life,
including not only physical status but also the
status of home, family, and work.

32
Nur 473 Primary Health Care Nursing
Subjective and Objective Dimensions of Health
Health involves both subjective and objective
dimensions that is, it involves both how people
feel (subjective) and how well they can function
in their environment (objective). Healthy people
are full of life and vigor, capable of hysical
and mental productivity. They feel minimal
discomfort and displeasure with the world around
them. Again, people experience varying degrees of
vitality and well-being. Health also involves the
objective dimension of ability to function. A
healthy individual or community carries
out necessary activities and achieves enriching
goals. unhealthy people not only feel ill but are
limited, to some degree, in their ability to
carry out daily activities. Indeed, levels of
illness or wellness are measured largely in terms
of ability to function (Roach, 2000)

33
Nur 473 Primary Health Care Nursing
Subjective and Objective Dimensions of Health
The subjective dimension (feeling well or ill)
and the objective dimension (functioning)
together provide a clearer picture of peoples
health. When they feel well and demonstrate
functional ability, they are close to the
wellness end of the health continuum. Even those
with a disease such as arthritis or diabetes may
feel well and perform well within their capacity.
These people can be considered healthy or closer
to the wellness end of the continuum. Figure 13
depicts the relationships between the subjective
and objective views of health.

34
Nur 473 Primary Health Care Nursing
COMPONENTS OF COMMUNITY HEALTH PRACTICE Mission
of the CHN
  • These components are
  • Promotion of health,
  • prevention of health problems,
  • treatment of disorders,
  • (4) rehabilitation,
  • (5) evaluation, and
  • (6) research


35
Nur 473 Primary Health Care Nursing
COMPONENTS OF COMMUNITY HEALTH PRACTICE
  • Promotion of health
  • Definition
  • action related to lifestyles and choices that
    maintain or enhance a populations health (WHO)
  • "Any combination of educational, organizational,
    economic, and environmental supports for behavior
    and conditions of living conductive to health".


36
Nur 473 Primary Health Care Nursing
COMPONENTS OF COMMUNITY HEALTH PRACTICE
  • Promotion of health
  • Promotion of health is recognized as one of the
    most important components of public health and
    community health
  • practice
  • Health promotion includes all efforts
  • that seek to move people closer to optimal
    well-being
  • or higher levels of wellness. Nursing, in
    particular, has a social
  • mandate for engaging in health promotion
  • Health promotion programs and activities include
  • many forms of health educationfor example,
    teaching the
  • dangers of drug use, demonstrating healthful
    practices such
  • as regular exercise, and providing more
    health-promoting
  • options such as heart-healthy menu selections.


37
Nur 473 Primary Health Care Nursing
COMPONENTS OF COMMUNITY HEALTH PRACTICE
  • Promotion of health
  • Community health promotion, then, encompasses the
    development and
  • management of preventive health care services
    that are responsive
  • to community health needs. Wellness programs in
  • schools and industry are examples they are
    useful when they
  • are accompanied by desire, opportunity, and
    resources that
  • encourage more healthful practices.


38
Nur 473 Primary Health Care Nursing
COMPONENTS OF COMMUNITY HEALTH PRACTICE
  • Promotion of health
  • The goal of health promotion is to raise levels
    of wellness
  • for individuals, families, populations, and
    communities.
  • Community health efforts accomplish this goal
    through a
  • three-pronged effort to
  • 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


39
Nur 473 Primary Health Care Nursing
COMPONENTS OF COMMUNITY HEALTH PRACTICE
  • Promotion of health
  • Healthy People 2010 Focus Areas
  • 1. Access to Quality Health Services
  • 2. Arthritis, Osteoporosis, and Chronic Back
    Conditions
  • 3. Cancer
  • 4. Chronic Kidney Disease
  • 5. Diabetes
  • 6. Disability and Secondary Conditions
  • 7. Educational and Community-Based Programs
  • 8. Environmental Health
  • 9. Family Planning
  • 10. Food Safety
  • 11. Health Communication
  • 12. Heart Disease and Stroke


40
Nur 473 Primary Health Care Nursing
COMPONENTS OF COMMUNITY HEALTH PRACTICE
  • Promotion of health
  • Healthy People 2010 Focus Areas
  • 13. HIV 14. Immunization and Infectious
    Diseases
  • 15. Injury and Violence Prevention 16. Maternal,
    Infant, and Child Health 17. Medical Product
    Safety
  • 18. Mental Health and Mental Disorders
  • 19. Nutrition and Overweight
  • 20. Occupational Safety and Health
  • 21. Oral Health 22. Physical Activity and
    Fitness
  • 23. Public Health Infrastructure
  • 24. Respiratory Diseases
  • 25. Sexually Transmitted Diseases 26. Substance
    Abuse
  • 27. Tobacco Use
  • 28. Vision and Hearing


41
Nur 473 Primary Health Care Nursing
COMPONENTS OF COMMUNITY HEALTH PRACTICE
(2) prevention of health problems Prevention of
health problems constitutes a major part
of community health practice. Prevention means
anticipating and averting problems or discovering
them as early as possible to minimize potential
disability and impairment. It is practiced on
three levels in community health (1) primary
prevention, (2) secondary prevention, and (3)
tertiary prevention(Neuman, 2001).

42
Nur 473 Primary Health Care Nursing
COMPONENTS OF COMMUNITY HEALTH PRACTICE
  • (2) prevention of health problems
  • Primary Prevention Any effort done before or to
    prevent the problem to occur
  • Primary prevention obviates the occurrence of a
    health problem it includes measures taken to
    keep illness or injuries from occurring. It is
    applied to a generally healthy population and
    precedes disease or dysfunction.
  • Example
  • Genetic counseling
  • Immunization
  • Health diet and healthy lifestyle


43
Nur 473 Primary Health Care Nursing
COMPONENTS OF COMMUNITY HEALTH PRACTICE
(2) prevention of health problems, primary
prevention Examples of primary prevention
activities by a community health nurse include
encouraging elderly people to install and use
safety devices (eg, grab bars by bathtubs, hand
rails on steps), to prevent injuries from falls
teaching young adults healthy lifestyle behaviors
so that they can adopt changes for a lifetime,
for themselves and their children or working
through a local health department to help control
and prevent communicable diseases such as
rubeola, poliomyelitis, or varicella by providing
regular immunization programs.

44
Nur 473 Primary Health Care Nursing
COMPONENTS OF COMMUNITY HEALTH PRACTICE
(2) prevention of health problems II. secondary
prevention involves efforts to detect and treat
existing health problems at the earliest possible
stage when disease or impairment already exist.
Hypertension and cholesterol screening programs
in many communities help to identify high-risk
individuals and encourage early treatment to
prevent heart attacks or stroke. Other examples
are teaching breast and testicular
self-examination, encouraging regular
mammograms and Pap smears for early detection of
possible cancer, and providing skin testing for
tuberculosis (in infants at 1 year of age and
periodically throughout life, with increasing
frequency for high-risk groups).

45
Nur 473 Primary Health Care Nursing
COMPONENTS OF COMMUNITY HEALTH PRACTICE
(2) prevention of health problems II. secondary
prevention Secondary prevention attempts to
discover a health problem at a point when
intervention may lead to its control or
eradication. This is the goal behind testing of
water and soil samples for contaminants and
hazardous chemicals in the field of community
environmental health. It also prompts community
health nurses to watch for early signs of child
abuse in a family, emotional disturbances in a
group of widows, or alcohol and drug abuse among
adolescents.

46
Nur 473 Primary Health Care Nursing
COMPONENTS OF COMMUNITY HEALTH PRACTICE
(2) prevention of health problems III. Tertiary
Prevention Tertiary prevention attempts to reduce
the extent and severity of a health problem to
its lowest possible level, so as to minimize
disability and restore or preserve function.
Examples include treatment and rehabilitation of
persons after a stroke to reduce impairment,
postmastectomy exercise programs to restore
functioning, and early treatment and management
of diabetes to reduce problems or slow
their progress..

47
Nur 473 Primary Health Care Nursing
COMPONENTS OF COMMUNITY HEALTH PRACTICE
(3) treatment of disorders The third component of
community health practice is treatment of
disorders. It focuses on the illness end of the
continuum and is the remedial aspect of community
health practice. This occurs by three
methods (1) direct service to people with health
problems, eg. home visits, provides an
educational program and support group for
people wanting to stop smoking or lose weight (2)
indirect service that helps people to obtain
treatment, and (3) development of programs to
correct unhealthy conditions.

48
Nur 473 Primary Health Care Nursing
COMPONENTS OF COMMUNITY HEALTH PRACTICE
(3) treatment of disorders (2) indirect service
that helps people to obtain treatment eg.
assisting people with health problems to obtain
treatment. A young woman with postpartum
bleeding, assisted by the community health nurse,
can obtain an immediate appointment with a
physician at the local clinic. (3) development
of programs to correct unhealthy conditions One
community with a high incidence of alcoholism and
drug abuse initiated a chemical dependency
counseling and treatment center.

49
Nur 473 Primary Health Care Nursing
COMPONENTS OF COMMUNITY HEALTH PRACTICE
(4) Rehabilitation involves efforts to reduce
disability and, as much as possible, restore
function. (5) evaluation is the process by
which that practice is analyzed, judged, and
improved according to established goals and
standards. Evaluation of health and health care
should be an integral part of every kind of
health service, from individual practice to
national and international programs.

50
Nur 473 Primary Health Care Nursing
COMPONENTS OF COMMUNITY HEALTH PRACTICE
(6) Research is systematic investigation to
discover facts affecting community health and
community health practice, solve problems, and
explore improved methods of health
service. Community health practitioners conduct
and use scientific investigations at all levels,
from federal agencies such as the U. S. Public
Health Service to state and local groups
conducting research. Epidemiology (the study of
health and disease determinants and distribution
in populations) and biostatistics (the science of
statistically measuring population health
conditions) are the primary public health
measurement and analytic sciences underlying
community health practice.

51
Nur 473 Primary Health Care Nursing
COMPONENTS OF COMMUNITY HEALTH PRACTICE
(6) What the deffrences between the health
promation and health protection Individual in
health protection want to avoid illness and its
consequences .

52
goal of the community health nursing
Goals
Community health nursing preserves and improves
the health of population and communities
worldwide by meeting the collective needs of the
community and societies

53
CHARACTERISTICS OF COMMUNITY HEALTH NURSING
CHARACTERISTICS OF COMMUNITY HEALTH NURSING
  • Eight characteristics of community health nursing
    are particularly salient to the practice of this
    specialty
  • it is a field of nursing
  • it combines public health with nursing
  • It is population focused
  • (4) it emphasizes prevention, health promotion,
    and wellness
  • (5) it promotes client responsibility and
    self-care
  • (6) it uses aggregate measurement and analysis
  • (7) it uses principles of organizational theory
    and
  • (8) it involves interprofessional collaboration..


54
CHARACTERISTICS OF COMMUNITY HEALTH NURSING
. Cont.
  • it is a field of nursing
  • The two characteristics of any specialized
    nursing practice
  • are (1) specialized knowledge and skills, and (2)
    focus on a
  • particular set of people receiving the service.
    These two characteristics are true for community
    health nursing. As a specialty field of nursing,
    community health nursing adds public health
    knowledge and skills that address the needs and
  • problems of communities and aggregates and
    focuses care on
  • communities and vulnerable populations.


55
CHARACTERISTICS OF COMMUNITY HEALTH NURSING
. Cont.
(2)it combines public health with
nursing Community health nursing, then, as a
field of nursing, combines nursing science with
public health science to formulate a
community-based and population-focused
practice (Williams, 2000). It synthesizes the
knowledge from the public health sciences and
professional nursing theories (ANA, 1999, 2000)
to improve the health of communities and
vulnerable populations.

56
CHARACTERISTICS OF COMMUNITY HEALTH NURSING
. Cont.
Knowledge of the following elements of public
health is essential to community health nursing
(ANA, 1999) 1. History and philosophy of public
health, including emphasis on the greatest good
for the greatest number 2. Concept of
aggregatesassessing needs, planning and
providing services, and evaluating services
impact on population groupsincluding
aggregate-level decision-making 3. Priority of
preventive, protective, and health-promoting strat
egies over curative strategies 4. Means for
measurement and analysis of community health
problems, including epidemiologic concepts
and biostatistics 5. Influence of environmental
factors on aggregate health 6. Principles
underlying management and organization
for community health, because the goal of public
health is accomplished through organized
community efforts 7. Public policy analysis and
development 8. Health advocacy and the political
process

57
CHARACTERISTICS OF COMMUNITY HEALTH NURSING
. Cont.
(3)It is population focused The central mission
of public health practice is to improve the
health of population groups. Community health
nursing shares this essential feature it is
population focused, meaning that it is concerned
for the health status of population groups and
their environment.

58
CHARACTERISTICS OF COMMUNITY HEALTH NURSING
. Cont.
(4) it emphasizes prevention, health promotion,
and wellness In community health nursing, the
promotion of health and prevention of illness are
of first-order priority. There is less emphasis
on curative care. These include services to
mothers and infants, prevention of environmental
pollution, school health programs,
senior citizens fitness classes, and workers
right-to-know legislation that warns against
hazards in the workplace.

59
CHARACTERISTICS OF COMMUNITY HEALTH NURSING
. Cont.
(5) it promotes client responsibility and
self-care The goal of public health, to
increase quality and years of healthy life and
eliminate health disparities (UDHHS, 2000),
requires a partnership effort. Clients health
status and health behavior will not change unless
people accept and apply the proposals (developed
in collaboration with clients) presented by the
community health nurse.

60
CHARACTERISTICS OF COMMUNITY HEALTH NURSING
. Cont.
(5) it uses aggregate measurement and analysis
Community health nursing uses aggregate
measurement and analysis. The need to collect and
examine data on the entire population under study
before making intervention decisions is
fundamental to community health nursing in a
public health practice. Health states,
environmental factors, healthrelated services,
economic patterns, and social policy are among
the many foci of community health research and
evaluation,

61
CHARACTERISTICS OF COMMUNITY HEALTH NURSING
. Cont.
(7) it uses principles of organizational
theory Community health nursing uses principles
from organizational theory to provide effective
administration of health care services. Public
health has long been defined as the protection
and improvement of community health through
organized community efforts. As community health
nurses carefully assess group and community
needs, establish priorities, and plan,
implement, and evaluate services, they are using
public health management and organizational
principles.

62
CHARACTERISTICS OF COMMUNITY HEALTH NURSING
. Cont.
(8) it involves interprofessional
collaboration.. Community health nurses must work
in cooperation with other team members,
coordinating services and addressing the needs of
population groups. This interprofessional
collaboration among health care workers, other
professionals, and clients is essential for
establishing effective services and programs.
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