CHN Handout

7/27/2019 CHN Handout

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Community Health Nursing

Special field of nursing that combinesthe skills of nursing, public health andsome phases of social assistance andfunctions as part of the total public

health program for the promotion ofhealth, the improvement of the

conditions in the social and physicalenvironment, rehabilitation of illnessand disability. (WHO Expert Committeeof Nursing)

Principles of CHN

1. The need of the community is the basis of

community health nursing.

2. The community health nurse must understand

fully the objectives and policies of the agencyshe represents.

3. The family is the unit of service.

4. CHN must be available to all regardless ofrace, creed and socioeconomic status.

5. The CHN works as a member of the healthteam.

8. There must be provision for periodicevaluation of community health nursing

services.

7. Opportunities for continuing staff educationprograms for nurses must be provided by thecommunity health nursing agency and the CHN

as well

8. The CHN makes use of available communityhealth resources.

9. The CHN taps the already existing activeorganized groups in the community.

10. There must be provision for educativesupervision in community health nursing.

11. There should be accurate recording andreporting in community health nursing.

12. Health teaching is the primary responsibilityof the community health nurse.

Standards of CHN

I. Theory

- Applies theoretical concepts as basisfor decisions in practice

II. Data Collection

- Gathers comprehensive, accurate datasystematically

III. Diagnosis

- Analyzes collected data to determinethe needs/ health problems of IFC.

IV. Planning

- At each level of prevention, developsplans that specify nursing actions unique toneeds of clients.

V. Intervention

- Guided by the plan, intervenes topromote, maintain or restore health, prevent

illness and institute rehabilitation.

VI. Evaluation

- Evaluates responses of clients tointerventions to note progress toward goalachievement, revise data base, diagnoses and

plan.

VII. Quality Assurance & Professional

Development

- Participates in peer review and other

means of evaluation to assure quality of nursingpractice.

- Assumes professional development.

-Contributes to development of others

VIII. Interdisciplinary Collaboration

- Collaborates with other members of

the health team, professionals and communityrepresentatives in assessing, planning,implementing and evaluating programs for

community health.

IX. Research- Indulges in research to contribute to

theory and practice in community healthnursing

Philippine Health Care DeliverySystem

Types of Clientele1. INDIVIDUALS

2. FAMILIES

3. COMMUNITIES

4. POPULATION GROUPS

- Aggregate of people who share

common characteristics, developmental stage orcommon exposure to particular environmentalfactors thus resulting in common health

problems (Clark)


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E.g. children. Elderly, women, workers etc.

Philippine Health Care Delivery

System

Primary Health Care

Essential health care made universallyaccessible to individuals and families in

the community by means acceptable tothem, through their full participation and

at cost that the community can afford atevery stage of development.

PRINCIPLES OF PRIMARY

HEALTH CARE

1. 4 As

- Accessibility, Availability,Affordability & Acceptability

2. COMMUNITY PARTICIPATION

- Heart and soul of PHC

3. People are the center, object and subject of

development.

4. SELF-RELIANCE

5. Partnership between the community and

the health agencies in the provision of qualityof life.

6. Recognition of interrelationship between

the health and development.

7. SOCIAL MOBILIZATION

8. DECENTRALIZATION

8 Essential Health Services in Primary Health

Care (ELEMENTS)

EEducation for Health

LLocally endemic disease control

EExpanded program for immunization

M Maternal and Child Health including

responsible parenthood

EEssential drugs

NNutrition

T Treatment of communicable and non-communicable diseases

S - Safe water and sanitation

FAMILY HEALTH NURSING

that level of CHN practice directed tothe FAMILY as the unit of care withHEALTH as the goal and NURSING asthe medium, channel or provider of care

TYPOLOGY OF NURSINGPROBLEMS IN FAMILY NURSINGPRACTICE

FIRST-LEVEL ASSESSMENTI. Presence of Wellness Condition

Wellness potential is a nursingjudgment on wellness state or condition

based on clients performance, currentcompetencies or clinical data but noexplicit expression of client desire.

Readiness for enhanced wellness stateis a nursing judgment on wellness stateor condition based on clients current

competencies or performance, clinicaldata explicit expression of desire toachieve a higher level of state or

function in specific area on healthpromotion and maintenance.

Example:

1. Potential for EnhancedCapability for:

Healthy lifestyle e.g.

nutrition/diet, exercise/

activity

Health Maintenance Parenting Breastfeeding

2. Readiness for Enhanced Capabilityfor:

Healthy Lifestyle Health Maintenance Parenting Breastfeeding Spiritual Well-being

I. Presence of Health Threats Conditions that is conducive to

disease, accident or failure to realize oneshealth potential.

Example:

1. Family history of hereditary condition,e.g. diabetes


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2. Threat of cross infection from acommunicable disease case

III. Presence of Health Deficits Instances of failure in health

maintenance.

Example:

1. Illness states, regardless of whether it isdiagnosed or by medical practitioner

2. Failure to thrive/ develop according tonormal rate

3. Disability whether congenital orarising from illness; temporary

IV.

Presence of stress Points/ ForeseeableCrisis Situations anticipated periodsof unusual demand of the individual orfamily in terms of family resources.

Example:

Loss of job Hospitalization Death of a family member Additional family member

Second Level Assessment

Focus on determining familys capacityto perform the health tasks

Statements on family health nursingproblem:

a. Inability to recognize the presence of thecondition or problem

b. Inability to make decisions with respectto taking appropriate health action

c. Inability to provide adequate nursingcare to the sick, disabled , dependent orvulnerable member of the family

d. Inability to provide a home environmentconducive to health maintenance or

personal development

e. Failure to utilize community resourcesfor health care

Scale for Ranking Health Conditionsand Problems according to priorities

a. Nature of the condition or problempresented

(Wellness state, health deficit, health threat,foreseeable crisis)

b. Modifiability of the condition or problem

(Easily, partially, not modifiable)

C. Preventive Potential (high, moderate, low)

d. Salience (needs immediate attention, notimmediate, not perceived as a problem)

Community Organizing Participatory

Research (COPAR)

Is a process by which people, healthservice & agencies of the community

are brought together to

Learn about the common problems

Identify these problems as their own

Plan the kind of action to solveproblems

Act on this basis

Principles of COPAR1. People, especially the most oppressed,

exploited and deprived sectors are open

to change, have the capacity to changeand are able to bring about change.

2. COPAR should be based on the interest ofthe poorest sectors of society

3. COPAR should lead to a self-reliantcommunity and society.

Phases of the COPAR Process

I.

Preparation Phase

- Area selection, Profilingof community, Entry &integration

II. Organization Phase

- Social preparation,Spotting & developing

potential leaders, Coregroup formation,

Setting up communityorganization


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Documents

CHN Handout