COMMUNITY HEALTH
NURSING
Population-focused Nursing
 “Community” or “public” health
nursing is population based.
 Care may be given to individuals and
families, but its purpose is the
improvement of the health of the
population as whole.
Community Health Nursing
 A synthesis of nursing knowledge and
practice and the science and practice of
public health, implemented via
systematic use of the nursing process
and other processes, designed to
promote health and prevent illness in
population groups.
Tenets of Community Health
Nursing - 1
 Systematic and comprehensive populationbased assessment, policy development, and
assurance.
 Partnering with representatives of the
people.
 Priority for primary prevention.
 Intervention to create conditions for health.
Tenets of Community Health
Nursing - 2
 Active outreach
 Concern for the population as a whole
 Resource allocation supports maximum
gain for the population.
 Interdisciplinary collaboration
Source: Quad Council of Public Health
Organizations. (1999).
Community Health Nursing
Standards of Care - 1
 Standard I. Assessment
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Standard II. Diagnosis
Standard III. Outcomes identification
Standard IV. Planning
Standard V. Assurance
Standard VI. Evaluation
Source: Quad Council of Public Health
Organizations. (1999).
Community Health Nursing
Standards of Performance - 1
 Standard I. Quality of care
 Standard II. Performance appraisal
 Standard III. Education
 Standard IV. Collegiality
Community Health Nursing
Standards of Performance - 2
 Standard V. Ethics
 Standard VI. Collaboration
 Standard VII. Research
 Standard VIII. Resource utilization
Source: Quad Council of Public
Health Organizations. (1999).
Attributes of Community Health
Nursing - 1
 Population consciousness
 Health orientation
 Autonomy
 Creativity
Attributes of Community Health
Nursing - 2
 Continuity
 Collaboration
 Intimacy
 Variability
Population Consciousness
 An awareness of how information
about individual clients or families
relates to the health status of the total
population
Health Orientation
 An emphasis on health promotion and
maintenance rather than the cure of
disease or disability
Autonomy
 Independent judgment and action by
the community health nurse
 Active client participation in health
decision making
Creativity
 An ability to develop innovative solutions
to community health problems using
available resources
Continuity
 Long term relationships with clients
 Provision of care across time as old
problems are solved and new ones
occur
 Provision of care across multiple
needs
Collaboration
 Interaction and joint decision making
with multiple health-related and nonhealth-related disciplines to address the
health needs of population groups
Intimacy
 Potential for developing awareness of
intimate details of clients’ lives
 Potential for increased accuracy of
nursing assessment
Variability
 In clients served
 In health problems addressed
 In settings for practice
Community Health Nursing
Roles
 Client-oriented roles
 Delivery-oriented roles
 Population-oriented roles
Client-oriented Roles
 Caregiver
 Role model
 Educator
 Advocate
 Counselor
 Primary care
 Referral resource
provider
 Case manager
Caregiver
 Uses the nursing process to provide
direct nursing intervention to
individuals, families, or population
groups
Educator
 Facilitates learning for positive health
behavior change
Counselor
 Teaches and assists clients in the use
of the problem solving process
Figure 8–1 Problem Solving in Community Health Nursing
Referral Resource
 Links clients to services to meet
identified health needs
Role Model
 Demonstrates desired health-related
behaviors
Advocate
 Speaks or acts on behalf of clients
who cannot do so for themselves
Primary Care Provider
 Provides essential health services to
promote health, prevent illness, and
deal with existing health problems
Case Manager
 Coordinates and directs the selection
and use of health care services to meet
client needs, maximize resource
utilization, and minimize the expense
of care
Delivery-oriented Roles
 Coordinator/Care manager
 Collaborator
 Liaison
Coordinator/Care Manager
 Organizes and integrates services to
best meet client needs in the most
efficient manner possible
Collaborator
 Engages in shared decision making
regarding the nature of health problems
and potential solutions to them
Liaison
 Provides and maintains connections
and communication between clients
and health care providers or among
providers
Population-oriented Roles

Case finder
 Leader
 Change agent
 Community
developer
 Coalition builder
 Researcher
Case Finder
 Identifies clients with specific health
problems or conditions
 Geared toward awareness of
population-level problems
Leader
 Influences clients and others to take
action regarding identified health
problems
Change Agent
 Initiates and facilitates change in
individual or client behaviors or
conditions or those affecting
population groups
Community Developer
 Mobilizes residents and other
segments of the population to take
action regarding identified community
health problems or issues
Coalition Builder
 Promotes the development and
maintenance of alliances of individuals
or groups of people to address a
specific health issue
Researcher
 Conducts studies to explain health-
related phenomena and to evaluate the
effectiveness of interventions to
control them