Module 1: Foundations of Community Health Nursing

Public Health What communities and members of society do to ensure the health of its' citizens. Also known as community health. 3 core functions of public health Assessment Policy development Assurance Assessment Examining a community in terms of their health and health status. Data collection and analysis. Ethical responsibility to communicate back to that community about the information that we have - dissemination of knowledge. Policy Development A responsibility to engage in the policy process to ensure that policies are in place to ensure the community's health. Ensure that any policy decision that is being made are based on science and evidence Assurance Ensuring that we have a current, competent workforce. Ensuring that nurses working in the community have appropriate credentials. Assure that essential health benefits are available to all people in the community. Fair distribution of benefits and burdens. Work with un-insured, under-insured, and transient populations. Transient populations Migrant workers, homeless, undocumented citizens. Un-insured Illegal residents of a county; those who cannot afford insurance. Often safety-net organizations will not ask for their status upon check in. 3 key statements about public health 1 - people come from somewhere and go back to that place 2- relationships and partnerships are critical 3- we work with communities, not to or for them. Community-based nursing Care that occurs in the community; tends to have an illness care focus. Care of acute and chronic conditions. Goal is to increase the capacity of the individual or their family for self-care and management of the condition. Nursing activities are direct, one-on-one, illness care. Ex- home care, school nurse, staff nurse in clinic. Community-oriented nursing Has a focus on populations. There is emphasis on health promotion, disease prevention, and health protection. There is a responsibility to understand the connection between individual, population, community health, and the environment. Nursing activities are indirect; such as program management. Ex- director of nursing in health department. Systems thinking How an individual interacts with other organizations. Is useful in examining cause and effect relationships. Upstream thinking Focus on interventions that promote health or prevent illness. Nightingale's Environmental Theory Highlights relationship between an individual's and environment's health. Health is a continuum. Preventative care. Health Belief Model Predict/explain health behaviors. Change at the individual level. The likelihood of taking an action to avoid disease is based off of: the perceived susceptibility/seriousness, modifying factors, cues to action, and perceived benefits versus risks. Milo's framework for prevention Change at the community level. Relationship between health deficits and availability of health-promoting resources. Behavior change within a large number of people leads to social change. Pender's Health Promotion Model Factors that affect individual actions to promote health: personal, feelings, benefits, barriers, attitudes of others, competing demands, preferences. Essentials of community nursing Determinants of health Health indicators Nurses Community Determinants of health Factors that influence the client's health: nutrition, stress, education. Health indicators Mortality rates, disease prevalence, levels of physical activity, obesity Nurses Determine a community's health by examining the degree to which the community's collective health needs are identified and met. Community A group of people and institutions that share geographic, civic, and/or social parameters. Goal of public health nursing Promote health and prevent disease Key principles of public health nursing Emphasize primary prevention Work to achieve the greatest good for the largest number of individuals Recognize that the client is partner in health Use resources wisely to promote the best outcomes.