Introduction to community health nursing

Lily L. Hsu School of Nursing Shanghai Jiao Tong University

History of Community Health Nursing

Before mid 1800s-Early Home Care with focus in Sick and Poor individual. Orientation: curative agencies: lay & religious orders *St. Phoebe Mid 1800s to 1900-district Nursing with focus in Sick and poor individual Orientation: curative/less in prevention agencies: voluntary & some government *William Rathbone

History of Community Health Nursing

1900-1970 public health nursing- Pubic Health Needs,

focus in family and orientation in Curative and Prevention agencies: government & some voluntary
*Lilliam Wald
1970 to present-Community Health Nursing, focus in total community and oriented to population health, services address health promotion; illness prevention agencies: many kinds; some independent practice *Ruth Freedman

Public Health Nursing Development in China

Early Stages: 1925 Beijing Union Hospital-Public Health Agency (Dr. Gland).
1930 rural Health Education 2000 Pay attention to city and rural areas community center development and practice model

2006-2007 Government emphasize the importance of Community health, improve community health centers, functions, farmer health insurances

Challenge for Chinas Community Health Nursing

Elderly care issues

2000 Population

2050 Population

China Adult Population

National Health Statistics

4011.30% 13.15 10 3540 20073000WHO 20104 880

National Health Statistics

Maternal Mortality Rate 48.3/10 2004 Skillful Professional Handle delivery 97 2003 Female : male children attending school 11 Junior school admission 0.92 2002 Female children attending elementary school 95.8% (2002) 1525 98 2004 Newborn mortality rate 15.4/1000, 2004 < 1 year old infant death rate30/1000 2003 <5 years old children mortality 37/1000 2003

The Top Five Major Cause of Death in China

Cardiovascular Diseases Malignant Tumor Cerebrovascular Disease Disease of Respiratory System Injury Intoxication (National data, 2004)

Issues in Chronic Diseases

DM Hypertension Stroke Cardiovascular diseases Obese Smoking TB

Health Beyond Acute Care Settings-Community Care and Public Health

Public Health Definition

Public health is the Science and Art of :

preventing disease, prolonging life, promoting health and efficiency through organized community effort.
(Winslow, 1920)

Definition of Community Health (ANA,2000

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

It is a field of nursing It combines public health and nursing It focus in population and environment factors that may impact to peoples health It emphasize in health promotion, illness prevention, and wellness

Characteristics of Community Health Nursing

It promotes client responsibility and self-care It uses aggregate measurement and analysis It use principle of organizational theory It involves inter-professional collaboration.

Pubic Health is for:

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 .

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.

Roles of Community Health Nurses

Clinician
Researcher Educator

Nurses Leadership Advocate

Collaborator

Manager

Health Prevention
Tertiary Prevention

Secondary Prevention

Primary Prevention

Primary Prevention for Health Promotion

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

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

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

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

Characteristics of community health nursing

it is a field of nursing it combines public health with nursing it is population-focused it emphasizes wellness it involves interdisciplinary collaboration it promotes clients responsibility and self care

Setting for community health nursing practice

homes ambulatory service settings schools occupational health setting residential institutions the community at large

Opportunity for Future Community Health Nursing

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