Rahmatullah Vinjhar. Lecturer Nursing ION DUHS.

Transcription

1 community health nursing Rahmatullah Vinjhar Lecturer Nursing ION DUHS.

2 Introduction to Course

3 Prerequisites Health Assessment Culture, Health and society Introduction to Biostatistics Teaching/Learning

4 Community People living in one place, district, or country, considered as a whole. The condition of sharing, having things in common or being a like in some way (i.e. feeling of sharing the same attitude intrests etc.) The term community suggests a shard pattern of feelings, behaviors and life style together within close and frequent personal relationship with other. ( Little wood,1985)

5 According to WHO community is a social group determined by geographical boundaries and common values and interests. A group of inhabitants living together in a some what localized area under the same general regulation and having common interests, function, needs and organizations.

6 Society A system in which people live together in organized communities. Organization of the people formed for a particular purpose. ( A club, an association i-e the school debating society, modern industrial society, a cooperative society etc.

7 History of community health nursing Ruth Freedman Early home care stage ( 1800s) focus: sick poor nursing orientation: individuals service: curative St. Phoebe District nursing (1800s to 1900) focus: sick poor nursing orientation: ti individuals service: curative/preventive William rathbone public health nursing( ) Focus: needy ypublic Nursing orientation: families Service: curative; preventive Lilliam wald community health nursing(1970 to present) Focus: total community Nursing orientation: population Service: health promotion; illness prevention

8 Public Health & Community Health Health care is vital to all of us some of the time, but public health is vital to all of us all of the time. C. Everett Koop

9 Public health (Winslow, 1920) Public health is the Science and Art of (1)preventing disease, (2)prolonging life, and (3)promotinghealth ot t and efficiency e cy through organized community The public health nurse effort 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. The development of the social machinery to insure everyone a standard of living adequate for the maintenance of health. So organizing these benefits as to enable every citizen to realize his birthright of health and longevity.

10 Community health nursing (ANA, American Nurses Association, 1980) Community health nursing is a synthesis of nursing and public health practice applied to promoting and preserving the health of populations. The practice is general and comprehensive. It is not limited to a particular age group or diagnosis, and is continuing, not episodic.

11 The dominant responsibility is to the population as a whole; nursing directed to individuals, families, or groups contributes to the health of the total population. Focus to Health promotion, health maintenance, health education, and management, coordination, and continuity of care are utilized in a holistic approach to the management of the health care of individuals, id families and groups in a community.

12 Brief History of Public Health 1854 Florence Nightingale 1887 Hygiene 1893 Lillian Wald Nurse s Settlement 1906 Pure Food and Drug Act TB Vaccinations Penicillin Discovered 1940 s Penicillin used to combat disease 1955 Polio Vaccine Released 1970 s WHO declares Smallpox eradicated 1975 Nurse Training Act 1990 s HIV/AIDs

13 Greatest Public Health Achievements Vaccination Safer workplaces Control of infectious diseases Decline in deaths from coronary heart disease and stroke Safer and healthier foods Healthier mothers and babies Family planning Safe drinking water Recognition of tobacco use as a health hazard

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15 Prevention Levels of Prevention: Primary Prevention refers to those measures that focus on prevention of health problems before they occur Secondary Prevention begins when pathology is involved and is aimed at early detection through diagnosis and prompt treatment Tertiary Prevention is the treatment of an established disease Nurse s s Role in Prevention (Assignment-16 th April 2008)

16 Conceptual framework for community health nursing (White, 1982) 1.Practice priorities Promotion, protection, prevention primary prevention, secondary prevention,tertiary prevention 2.Practice Education, engineering, enforcement 3.scope of practice from individual to worldwide aggregate g

17 Cont. 4.Health determinants (resolve) (Canadian government, 1974) Human biological determinants, environmental determinants, medical -technological-organizational determinants, psycho-socio-culture determinants (life style) 5.Community health nursing dynamics Nursing process and valuing process

18 Characteristics of community health nursing It is a field of nursing It combines public health h with nursing It is population-focused It emphasizes wellness It involves interdisciplinary collaboration It promotes clients responsibility and self care

19 Mastery of progress awareness... to knowledge..... to proficiency... which is on a continuum.

20 Process 1. Orientation tools reviewed for content 2. Ideas shared from each other county competency project 3. Language adapted for Project implementation and competencies

21 Implementing Tool Program Areas Communicable Disease Control (CDC) Surveillance, Immunizations, Resource PHN Maternal Child Health (MCH) Prenatal Plus, Partners for Healthy Families, Health Care Program for Children with Special Needs Clinic Services Family Planning, STD, HIV, Adult Health, Cancer Control

22 Setting for community health nursing practice Homes Ambulatory service settings Schools Occupational lhealth lhsetting Residential institutions The community at large

23 Community Health Nursing

24 Community Health Nursing Quick Facts: Mission ( Nurses in Community Health) Community Service Clinics Offer free or low-cost services to all community members Never deny services

25 Services Include: Community Health Nursing Family Planning, Education, Counseling and Treatment; Health Education; Cancer Screening; Immunizations; Well-Child Examinations and Healthy Kid Screenings; Sexually Transmitted Disease Education, Counseling, and Treatment; HIV/AIDS Counseling, Education and Testing; Communicable Disease Investigation; Tuberculosis Screening and Education; School Health Promotion and Education; and Children's Special Health Care Needs referrals

26 Community Health Nursing Scope of Practice? Impact of Nurses?

27 Community Health Nursing Levels of Priority Communicable Diseases ~ Casual Transmission Least Communicable Diseases ~ Non-Casual (Intimate) Transmission Communicable Infection & Disease Prevention Frequency of Services Other Prevention Activities and Primary Care Greatest

28 In order to best address population health, it is essential to understand the order of priority for delivering services. Communicable diseases that can be spread through casual transmission, such as active tuberculosis or chick pox, are of the highest priority and must be treated immediately. Diseases that can be transmitted casually can infect numerous people within a short period of time. Though these cases are rare, it is important to treat them as soon as possible. Though the use of treatment in tertiary prevention is used for the individual with the infection, it is also primary prevention for the population. Communicable diseases that are spread through intimate contact, such as sexually transmitted diseases, are of the second highest h priority. i

29 These diseases, such as HIV/AIDS, can spread quickly if infected individuals are having intimate contact, but they do not spread at a rate as fast as casually transmitted diseases.\ It is extremely important to make sure that individuals with casually and non-casually transmitted diseases receive the full treatment t t of medication for their disease in order to ensure it is completely eradicated and does not become treatment resistant. The third priority level is communicable infection and disease prevention. This would include utilizing immunizations for diseases and infections that are available and education when a vaccine is unavailable (HIV).

30 The final level of priority consists of all other activities that the community health nurse conducts such as family planning, screening, and physical exams. These activities are essential for a healthy community, but these services are designed for individuals more so than populations. The priority level decrease as you move down the pyramid, but the frequency of services increases as you move down. Prevention Activities and Primary Care will be the bulk of the services that the Community Health Nurse will encounter. The most effective way a CHN can impact the community is through h direct services either on an individual id or group level.

31 Reporting Refer to the Standard of Care Guidelines and Protocols Majority of Patients Unique Cases If Standard of Care Guidelines do not apply to a particular case or you need clinical advice, contact a CHN, supervisor or Health Officer

32 Public Health Process Patient Diagnosis Community Health Nurse Private Provider Emergency Room or Other Disease Investigation Office of Epidemiology Disease Investigator Follow-up Office of Epidemiology Disease Investigator Treatment Community Health Nurse Private Provider

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34 Helpful Information Administration: Organizational Chart Distribution of Funds Funding Sources Meeting Needs Community Resources Equally distribution of task. OTHERS IF YOU WANT DISCUSS.

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