Introduction
to community health
nursing
Presented by: DR/Amira Yahia
Assistant professor
E.mail:a.yahia@mu.edu.sa
Objectives
At the end of this session you will be able:-- To Illustrate the historical evolution in the term of
community health nursing
 To define terms related to CHN
 To be able to describe what is CHN.
 To analyze the characteristics of community health
nursing.
 To verify the factors influence the CHN.
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To discuss the CHN practice
To describe the setting for community
health nursing
To identify the factors affecting
community health
History of Community Health Nursing
Before mid 1800sHome Care which focus on Sick and Poor individual.
Orientation: curative
Agencies: religious orders

Mid 1800s to 1900District Nursing with focus on Sick and poor individual.
Orientation: curative/less in prevention
Agencies: voluntary & some government
History of Community Health Nursing
public health nursing(1900-1970)
focus: public needs
nursing orientation: families
service: curative; preventive
agencies: government & some voluntary
community health nursing(1970 to present)
focus: total community
nursing orientation: population
service: health promotion; illness prevention
agencies: many kinds; some independent practice

Definitions of terms related
Definitions
Community:
A group of people sharing common
interest, needs, resources and
environment.
 Health:
Is defined as a state of well -being
resulting from harmonious interaction of
body, mind, spirit and the environment

Cont….
Community health:
Is achieved by meeting the collective needs of
the community and society by identifying
problems and supporting community
participation in the process
Community health nursing:
Is a field of nursing practice that applies
knowledge and skills from nursing and public
health toward the promotion of optimal
health for the total community.
Public Health Definition
Public health is the Science and Art of :

preventing disease,

prolonging life,

promoting health and efficiency through
organized community effort.
Definition of Community
Health (ANA,2000）
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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:
Community health nursing has 6 important characteristics:

It is field of nursing i.e. especially within the large
discipline.
It combines the specialized knowledge of public
health with nursing practice
(i.e. .epidemiology, vital statistics…etc)
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It is population oriented and does not deal only with
individual clients.
Cont……
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It emphasized health rather than disease or
illness.
It involves interdisciplinary collaboration i.e.
team work with other professionals.
It promotes client participation by fostering a
sense of responsibility among people for their
own health.
Pubic Health is for:

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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 .
Functions of community health nursing:
Control of communicable disease.
2.
Environmental sanitation.
3.
Mental and child health.
4.
Health education.
5.
Laboratory services.
6.
Vital statistics
Any community heath program is built on these
6 basic functions in addition to school,
industrial and rural heath programs.
1.
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.
Factors influencing the development of
community health nursing:
1.
2.
3.
Advanced technology which solved some health
care problems thus nurse's attention was shifted to
problems of aging, chronic illness and prevention.
Progress in causal thinking has broadened our
perspective to multiple causes including stress,
environmental hazards and the community
structure.
Changes in education, which led the community
health nurse to emphasize collaborating with clients
rather than planning for them.
cont……
4.
5.
The changing role of women helped to open
new avenues of leadership for community
health nurses.
The consumer movement has increases the
public's concern for quality health services
(as consumers have assumed responsibility
for their own health, the community health
nurse became a catalyst to assist client
toward autonomy in health).
Settings for Community
Health Nursing Practice:
The types of places in which community
health nurses practice are increasingly
varied and include a growing number of
nontraditional settings and partnerships
with non health groups
Cont…..
These settings are grouped into six
categories:
(1) Homes
(2) Ambulatory service settings
(3) Schools
(4) Occupational health settings
(5) Residential institutions
(6) The community at large.
Community Health Nurse
Practice
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Is focussed on wellness not sickness.
Is focussed on prevention not just treatment
of problems.
Is focussed on assisting people and
communities make their own decisions
regarding health care.
Is focussed on assisting those with existing
health conditions to maximise their potential
and prevent deterioration if possible.
Cont..
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Is based in the community in a range of
settings, wherever there is a need for
support, information and education.
Responds to public health needs in
relation to communicable diseases.
Cont…
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Has the whole community as their
client, as well as groups, families and
individuals.
Recognises the impact of life course
and social determinants of health and
works in partnership with the
community to address these.
Cont….
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Community health nurses recognise health as
“ a state of complete physical, mental and
social well-being and not merely the absence
of disease and infirmity” W.H.O.
Community health nurses deal with clients in
a holistic manner, working with them
wherever they are on the health – illness
continuum.
Community Health Nursing
Roles
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Client-oriented roles
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Delivery-oriented roles
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Population-oriented roles
Role of the community health nurse.
The community heath nurse must be capable to performing
multiple role functions of the setting of employment. These
role functions include:
1.
Care provider (function role)
2.
Educator role
3.
Counselor role
4.
Manger (Administrative role)
5.
Leader role
6.
Collaborator role
7.
Coordinator role
8.
Advocate role
9.
Researcher role
10.
Evaluation role
Roles of Community Health Nurses
Clinician
Educator
Researcher
Nurses
Advocate
Leadership
Collaborator
Manager
Delivery-oriented Roles
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Coordinator/Care manager
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Collaborator
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Liaison
Population-oriented Roles
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Case finder
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Leader
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Change agent
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Community
developer
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Coalition builder
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Researcher
Health Prevention
Tertiary Prevention
Secondary Prevention
Primary Prevention
Primary Prevention for Health
Promotion
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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
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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
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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
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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
Opportunity for Future
Community Health Nursing
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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
THANK YOU