COMMUNITY HEALTH

NURSING

K SWARJANA
2005
 ATTRIBUTES OF CHN
• HEALTH ORIENTATION
• POPULATION FOCUS
• AUTONOMY
• CONTINUITY
• COLLABORATION
• INTERACTIVITY
• PUBLIC ACCOUNTABILITY
• INTIMACY
• VARIABILITY
 ATTRIBUTES OF CHN
• HEALTH ORIENTATION
Health promotion and disease prevention rather
than cure of illness.
• POPULATION FOCUS
Health of pop. Groups rather than individuals or
famillies.
• AUTONOMY
Health care decisions by both nurse and client.
• CONTINUITY
Continuing, comprehensive basis rather than a
short-term, efisodic basis.
• COLLABORATION
Interaction between nurse and clients
 ATTRIBUTES OF CHN
• INTERACTIVITY
Awareness of interaction of a variety of factors
with health.
• PUBLIC ACCOUNTABILITY
Accountability to society for the health of the
general population
• INTIMACY
Awareness of the reality of clientlives and
situations.
• VARIABILITY
Clients : different levels, from different ethnic
background, and in different setings.
 ANA STANDARDS FOR CHN
1. The nurse applies theoritical as a basis for
decisions in practice.
2. The nurse systematically collect data that are
comprehensive and accurate.
3. The nurse analyzes data colected about the
community, family, and individual to determine
diagnoses.
4. At each level of prevention, the nurse develops
plans that specify nursing actions unique to
client needs.
5. The nurse, guided by the plan, intervenes to
promote, maintain, or restore health, to
prevent illness, and to effect rehabilitation.
 ANA STANDARDS FOR CHN
6. The nurse evaluates responses of the
community, family, and individuals to
interventions, to determine progress toward
goal achievement and to revise the database,
diagnosis, and plan.
7. The nurse participates in peer review and other
means of evaluation to assure quality of nursing
practice. The nurse assumes responsibility for
profesional develovment and contributes to the
profesional growth of others.
 ANA STANDARDS FOR CHN
8. The nurse colaborates with other health care
provides, profesional and community
representatives in assessing, planning,
implementing, and evaluating programs for
community health.
9. The nurse contributes to theory and practice in
community health nursing through research.
 CLIENT-ORIENTED CHN ROLES AND
RELATED FUNCTIONS

• CAREGIVER
• EDUCATOR
• COUNSELOR
• REFERRAL RESOURCE
• ROLE MODEL
• ADVOCATE
• PRIMARY CARE PROVIDER
• CASE MANAGER
 CLIENT-ORIENTED CHN ROLES AND
RELATED FUNCTIONS

• CAREGIVER
Assess client health status
Derive nursing dx
Plan nursing intervention
Implement the plan of care
Evaluate the outcome of nursing intervention
• EDUCATOR
Assess client’s need for education
Develop health education plan
Present health education
Evaluate outcome of health education
 CLIENT-ORIENTED CHN ROLES AND
RELATED FUNCTIONS
• COUNSELOR
Identify and clarify problem to be solved
Help client identify alternative solutions
Assist client to develop criteria for solutions
Assist client to evaluate alternative solutions
Assist clien to evaluate effects of solutions
Make client aware of problem-solving process.
• REFERRAL RESOURCE
Obtain information on community resources
Determine the need for and appropriateness of
a referral
Make the referral
Follow up on the referral
 CLIENT-ORIENTED CHN ROLES AND
RELATED FUNCTIONS
• ROLE MODEL
Perform the behavior to be learned by clients
or others
• ADVOCATE
Determine the need for advocacy
Determine the appropriate avenue for advocacy
Obtain facts related to the solution
Present the client’s case to decision makers
Prepare clients to stand alone
 CLIENT-ORIENTED CHN ROLES AND
RELATED FUNCTIONS
• PRIMARY CARE PROVIDER
Assess client health status and identify
problems
Plan and provide treatment for problems
Introduce other supportive services as needed
Teach and supervise others
Modify care plan as required
Teach clients self-care
Coordinate health care services
Serve as liaison between client and system
 CLIENT-ORIENTED CHN ROLES AND
RELATED FUNCTIONS
• CASE MANAGER
Identify need for case management
Assess and identify client health needs
Design plan of care to meet needs
Oversee implementation of care by others
Evaluate outcome of care.
DELIVERY-ORIENTED CHN ROLES AND
RELATED FUNCTIONS
• COORDINATOR
 Determine who is providing care to client
 Communicate with other propiders regarding
client situation and needs
 Arrange case conferences as needed
• COLLABORATOR
 Communicate with other health team members
 Participate in joint decision making
 Participate in joint action to resolve client
problems
DELIVERY-ORIENTED CHN ROLES
AND RELATED FUNCTIONS
• LIAISON
 Serve as initial point of contract between client
and agency
 Facilitate communication between client and
agency personel
 Interpret and reinforce provider
recommendations
 Serve as client advocate as needed
 POPULATION-ORIENTED CHN ROLES
AND RELATED FUNCTIONS
• CASE FINDER
– Develop knowledge of signs and symtoms of
health-related conditions and contributing
factors
– Use diagnostic reasoning process
– Provide follow up care to identified cases
 POPULATION-ORIENTED CHN
ROLES AND RELATED FUNCTIONS
• LEADER
– Identify the need for action
– Assess situation, leadership style
– Motivate followers to take action
– Coordinate group member activities in
planning and implementing action
– Assist followers to evaluate the effectiveness of
action taken
– Facilitate adaptation of group members
– Represent the group to outsiders
 POPULATION-ORIENTED CHN
ROLES AND RELATED FUNCTIONS
• CHANGE AGENT
– Identify driving and restraining forces
operating in change situation
– Assist in unfreezing and creating motivation for
change
– Assist in implementation of change
– Assist group to internalize change
 POPULATION-ORIENTED CHN
ROLES AND RELATED FUNCTIONS
• COMMUNITY CARE AGENT
– Diagnose the community’s level of health
– Develop solutions to identified community
health problems
– Prepare the community identify and meet
health needs
– Evaluate health care delivery
 POPULATION-ORIENTED CHN
ROLES AND RELATED FUNCTIONS
• RESEARCHER
– Crically review research findings
– Apply research findings to practice as
appropriate
– Identify researchable problems
– Design and conduct nursing research
– Collect data
– Disseminate research findings.