Conceptual frame work for CHN
Community nursing reflected art and science and to consider nursing as professional it should base on theories.
A set of concepts can be integrated to form a conceptual frame work
CHN conceptual model is the focus on the prevention, promotion and maintenance of health through the NSG activities.
Assumptions:
•The health care system is complex
•Primary, secondary and tertiary health care system are the component of health care.
•Nursing is the product of education and practice
•The focus of the CHN on the primary more secondary and tertiary.
Beliefs:
•Health care should be available, accessible, and acceptable.
•Nursing activities include client’s education, counseling, advocacy & management of care.
3. The effect of the environment on the populations, groups, families and individuals.
4. Prevention of illness is essential to promote health.
5. The health care team should encourage the self care responsibilities of the clients and consider them as active
participants.
•Concepts and theories applied to the practice
The model used emphasis services to individuals, groups and communities. Health influenced by multiple factors.
Components of CHN practice
Practice priorities
The ANA identified nine standards of functions
•Prevention:
Aims at avoiding the occurrence of the illness or injury
e.g. enforcement of seat belt use.
•Protection:
The effort to shield the public from harmful effects of elements in the environment
e.g. physical agents such as cigarette smoking, chemical dust and fumes.
•Promotion:
Refers to activities that maintain or keep and enhance the community’s level wellness. Adequate nutrition.
Others like treatment of disorders, rehabilitation and others.
•Practice intervention
Three categories as priorities
•Education: providing information to encourage people to modify their behavior in health promoting ways e.g.
encouraging proper diet.
• Engineering: actions directs to manage the variables in the environment
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e.g. specific actions such immunization against diseases.
3. Enforcement: uses more threats such as laws prohibiting child abuse.
•Health determinants:
White (1982) form the basis for the health determinants in our conceptual frame work.
•Human biological factors and others that influence who is at risk.
•Environmental factors that affecting health.
•The health care system type.
•Psycho-social and cultural factors like life style.
CHN dynamics
Driving forces are
1. The nursing process
2. The valuing process to judge the worth of something the determines what are the priorities in our life behaviors and
others.
Scope of practice:
•What is practiced: the emphases on the protection, promotion of wellness, and prevention more the curative aspects.
•For whom: it is a public health so all categories in the community, in the health center, day care centers.
•Where: the setting of practice like homes, schools, occupational health settings.
Characteristics of CHN
1. Field of nursing:
CHN seeks to give humanistic, accessible, and holistic care. Nursing process is one of it’s basic tools.
2. Combines public health with nursing
a. Emphasis the greatest good for the greatest number.
b. The concepts of aggregates, assessing the needs, impact of the aggregates decision making
c. Priorities for the prevention more the treatment
d. Measurements and analysis of health problems can be done by the epidemiological concepts and biostatistics.
e. Influence of environmental factors on aggregate health.
f. Community health organized by the community effort.
g. Public policy analysis and development
h. Health advocacy and political process.
There are many ways to integrate public health knowledge in to the practice like using health statistics.
3. Population focused:
The central mission is to improve the health of population groups. A population may include all the people living in a
neighborhood, district, city It is a population focused that distinguish it from other specialties.
4. Wellness emphasis:
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As what is considered wellness- illness continuum focused on the positive health. More deal with the prevention
•CH nurses concentrate on the this continuum in a variety of ways: Teach proper nutrition, encourage regular physical
and dental check ups.
5. Interdisciplinary collaboration:
Working with the health team with full collaboration That requires clarification of each team member role.
6. Client responsibility and self care: Client encouragement of client responsibility in the
Health care. Self- care: Nurses need to encourage the client to take responsibility for their own health and the community
not always depend on the health professionals People maintain their own life. Nurses can help clients to return to or reach
at level of functioning (orem, 1985)
Role of community health nurses
1. Care provider:
Providing care of a clinician, giving nursing care
If it is group nurses need skills to assess the needs
When nurses receive a referral to visit a family with multiple problems.
2. Holistic care:
Viewing the client as a larger system.
Client most often a family or group.
Working with a group of teenage pregnant mothers.
3. Focus on wellness:
Emphases on the promotion of health and prevention of illness
Nursing care includes seeking out the client in order to offer preventive services rather than waiting for them to come for
help after problems arise
4. Educator role: Health teaching is part of good nursing care
Giving for two reasons:
•The client in the community are not in an acute state of illness
• The health educator role is significant because People have acquired a higher level of consciousness.
Topics for health education can be nutrition, managing alcoholic patient.
5. Advocate role:
Support the client’s rights, every client has the right to receive just, equal, and human treatment
Advocacy goals
1. To help clients gain independence
The CH nurse shows clients what services are available
2. To make the system more responsive and Relevant to the needs of the clients.
Advocacy actions and characteristics
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•Assertive to identify the needs and find appropriate solution
•Pointed out the delay in the services or poor standards of care given
•Nurse can write a letter and arrange for meetings to improve the standards.
•The ability to communicate well
•The ability to identify sources of power and put them in the client benefit.
Manage role
Community health nurses are managers of client care Serving as supervisors
Planning:
It is basic function of a nurse manager Decide on an objective and to achieve the nursing process
Organizing
Structuring the activities and placing people into functioning whole Make sure that equipment and supplies are present,
required staff are present in duty.
Coordinating
Means bringing people and activities together so that they function in harmony It occurs on a nurse-patient level or nursefamily level Other roles are leading, staffing, supervising.
Collaborative role
Community health nurse has practice in isolation Need for other professionals, like physicians, As a member of the
health team the community health nurse assumes the role of a collaborator To work jointly with the others.
Leader role:
They becoming active leaders. They guide decision making Direct a preventive program and influence health policy
Their role will be more than organizing on the low levels they motivated to plan on the local, state, national and even
international.
Research role:
They are requested to do the epidemiological study, the nursing process. Using the problem solving process The nurse
identifies the problem or question
•Collect and analyze data
•Suggest and evaluate possible solution
•Select a solution and reject them all
•Restart the investigative over again
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