Community health nursing
The concepts of community and health together provide
the foundation for understanding community health.
Broadly defined, a community is a collection of people
who share some important feature of their lives. In this
text, the term community refers to 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 (e.g., citizens of a
town), sharing common interests (e.g., a community of
farmers), or living under the same laws and regulations
(e.g., 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 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
In community health, it is useful to identify a geographic area as a community.
A community demarcated by geographic boundaries, such as a city or county,
becomes a clear target for the analysis of health needs.
Available data, such as morbidity and mortality figures, can augment assessment studies to
form the basis for planning health programs.
The concept of population has a different meaning.
In this text, the term population refers to all of the
people occupying an area, or to all of those who share one or more characteristics. In
contrast to a community, a population is made up of people who do not necessarily interact
with one another and do not necessarily share a sense of belonging to that group.
A population may be defined geographically
THE CONCEPT OF HEALTH
Health, in the abstract, refers to a person’s physical, mental, and spiritual state; it can be
positive (as being in good health) or negative (as being in poor health).
Optimal health is defined as “a dynamic balance of
physical, emotional, social, spiritual, and intellectual health”
The World Health Organization
(WHO) defines health positively as “a state of complete physical, mental, and social
wellbeing and not merely
the absence of disease or infirmity”
A healthy community is defined as one that “continuously
creates and improves both its physical and social
environments, helping people to support one another in
aspects of daily life and to develop to their fullest potential”
CHARACTERISTICS OF 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.
Public health nursing is grounded in both public
health science and nursing science, which makes its
philosophical orientation and the nature of its practice
unique.
It has been recognized as a subspecialty of both fields.
Community health nursing, then, as a specialty
of nursing, combines nursing science with public
health science to formulate a community-based and population- focused practice
Public health nursing is the practice of promoting
and protecting the health of populations using
knowledge from nursing, social, and public health sciences”
The later title of community health nursing
was adopted to better describe where the nurse practices.
Eight characteristics of community health nursing
are particularly salient to the practice of this specialty
1. The client or “unit of care” is the population.
2. The primary obligation is to achieve the greatest
good for the greatest number of people or the population
as a whole.
3. The processes used by public health nurses include
working with the client as an equal partner.
4. Primary prevention is the priority in selecting appropriate activities.
5. Public health nursing focuses on selecting strategies
that create healthy environmental, social, and
economic conditions in which populations may
thrive.
6. A public health nurse is obligated to actively identify
and reach out to all who might benefit from a specific
activity or service.
7. Optimal use of available resources to assure the best overall improvement in the health of
the population is a key element of the practice.
8. Collaboration with a variety of other professions, organizations, and other stakeholder
groups is the most effective way to promote and protect the health of people
Community Health Nursing (CHN) is a vital part of Public Health and there are 12 principles
the govern CHN.
1. The recognized need of individuals, families and communities provides the basis for CHN
practice. Its primary purpose is to further apply public health measures within the
framework of the total CHN effort.
2. Knowledge and understanding of the objectives and policies of the agency facilities goal
achievement. The mission statement commits Community Health Nurses to positively
actualize their service to this end.
3. CHN considers the family as the unit of service. Its level of functioning is influenced by
the degree to which it can deal with its own problems. Therefore the family is an effective
and available channel for the most of the CHN efforts.
4. Respect for the values, customs and beliefs of the clients contribute to the effectiveness
of care to the client.
CHN services must be available sustainable and affordable to all regardless of race, creed,
color or socio-economic status.
5. CHN integrated health education and counseling as vital parts of functions. These
encourage and support community efforts in the discussion of issues to improve the
people’s health.
6. Collaborative work relationships with the co-workers and members of the health team
facilities accomplishments of goals.
Each member is helped to see how his/her work benefits the whole enterprise.
7. Periodic and continuing evaluation provides the means for assessing the degree to
which CHN goals and objectives are being attained. Clients are involved in the appraisal of
their health program through consultations, observations and accurate recording.
8. Continuing staff education program quality services to client and are essential to
upgrade and maintain sound nursing practices in their setting. Professional interest and
needs of Community Health Nurses are considered in planning staff development programs
of the agency.
9. Utilization of indigenous and existing community resources maximizing the success of
the efforts of the Community Health Nurses. The use of local available ailments. Linkages
with existing community resources, both public and private, increase the awareness of what
care they need what are entitled.
10. Active participation of the individual, family and community in planning and making
decisions for their health care needs, determine, to a large extent, the success of the CHN
programs. Organized community groups are encouraged to participate in the activities that
will meet community needs and interests.
11. Supervision of nursing services by qualified by CHN personnel provides guidance and
direction to the work to be done. Potentials of employees for effective and efficient work
are developed.
12. Accurate recording and reporting serve as the basis for evaluation of the progress of
planned programs and activities and as a guide for the future actions. Maintenance of
accurate records is a vital responsibility of community as these are utilized in studies and
researches and as legal documents.
Goals and objectives of community health nursing
Main goal:
Help the individuals, families, & community in attaining highest standard of health by
means of prevention of illness and promotion of health.
Other goal:
 Increase the life expectancy
 To decrease the IMR, MMR & other morbidities
 To prevent disabilities, providing rehabilitation services
 To provide health care services
 To evaluate the health programmes & make further plan
 To make the community diagnosis
 To help the NGOs & other organization working in the field of community health.
 To assess the need & priorities of vulnerable groups, pregnant mothers &
children.
 To provide referral services at various health care levels.
 To enhance the standard of nursing profession through;
Conducting nursing researches
•
Providing quality assurance in community health nursing
•
Establishing great need of nursing personnel in the community by close & cordial
relation and care.
•
Performing the role of nurse epidemiologist.
 To enhance the standard of nursing profession through;
•
Conducting nursing researches
•
Providing quality assurance in community health nursing
•
Establishing great need of nursing personnel in the community by close & cordial
relation and care.
Scope for community health nurse
 Rural areas & slums of cities
 Special clinics
 Mobile camps
 Schools
 Industrial organizations
 Outdoor patients departments of big hospitals
 Fairs & other places of social functions/ gathering
 Rural & poor urban families etc
Functions of community health nurse
1.Managerial function:
a) Assessment
b) Planning
c) Supervision
d) Co-ordination & co-operation
e) Evaluation
2.Nursing functions
3.Educational functions
4.Other work