COMMUNITY HEALTH NURSING

LECTURE / SECOND YEAR / FIRST SEMESTER

FOUNDATIONS OF COMMUNITY AND PUBLIC HEALTH NURSING PRACTICE

COMMUNITY o Goal: “To raise the level of

o a group of people with citizenry by helping
common characteristics or communities and families to
interests living together within a cope with the discontinuities in
territory or geographical and threats to health in such a
boundary way as to maximize their
o place where people under potential for high-level wellness”
usual conditions are found (Nisce, et al)
o Derived from the Latin word o Special field of nursing that
“comunicas” which means a combines the skills of nursing,
group of people. public health and some phases
of social assistance and
COMMUNITY HEALTH functions as part of the total
o Part of a paramedical and public health program for the
medical intervention/approach promotion of health, the
which is concerned on the improvement of the conditions
health of the whole population in the social and physical
o Aims: environment, rehabilitation of
1. Health Promotion illness and disability (WHO
2. Disease Prevention Expert Committee of Nursing)
3. Management of factors o A learned practice discipline
affecting health with the ultimate goal of
contributing as individuals and
NURSING in collaboration with others to
o Both a profession and vocation. the promotion of the client’s
Assisting sick individuals to optimum level of functioning
become healthy and healthy through teaching and delivery
individuals achieve optimum of care (Jacobson)
wellness. o A service rendered by a
professional nurse to IFCs,
COMMUNITY HEALTH NURSING population groups in health
o “The utilization of the nursing centers, clinics, schools,
process in the different levels of workplace for the promotion of
clientele-individual, family, health, prevention of illness,
population group, community, care of the sick at home, and
concerned with the promotion rehabilitation (DR. Ruth B.
of health, prevention of illness, Freeman).
and disability and
rehabilitation” (Maglaya, et al).

TUMULAK, JOEY U.
COMMUNITY HEALTH NURSING
LECTURE / SECOND YEAR / FIRST SEMESTER
FOUNDATIONS OF COMMUNITY AND PUBLIC HEALTH NURSING PRACTICE

5. Social Justice
BASIC PRINCIPLES OF COMMUNITY
HEALTH NURSING PHILOSOPHY OF COMMUNITY
1. The community is the HEALTH NURSING
patient in CHN, the family is “The philosophy of CHN is based on
the unit of care and there the worth and dignity of man.” (Dr.
are four levels of clientele: M. Shetland)
individual, family,
population group (those ROLES OF PUBLIC HEALTH NURSES
who share common  Clinician, who is a health care
characteristics, provider, taking care of the sick
developmental stages and people at home or in the RHU.
common exposure to  Health Educator, who aims
health problems – e.g. towards health promotion and
children, elderly), and the illness prevention through
community. dissemination of correct
2. In CHN, the client is information; educating people.
considered as an ACTIVE  Facilitator, who establishes
partner NOT PASSIVE multi-sectoral linkages by
recipient of care. referral system.
3. CHN practice is affected by  Supervisor, who monitors and
developments in health supervises the performance of
technology, in particular, midwives.
changes in society, in  Health Advocator, who speaks
general on behalf of the client.
4. The goal of CHN is  Advocator, who act on behalf
achieved through multi- of the client.
sectoral efforts.  Collaborator, who working with
5. CHN is a part of health care other health team member.
system and the larger o Other Specific Responsibilities of
human services system. a Nurse, spelled by the
implementing Rules and
MISSION OF COMMUNITY HEALTH Regulations of RA 7164
NURSING (Philippine Nursing Act of 1991)
1. Health Promotion includes:
2. Health Protection  Supervision and care of women
3. Health Balance during pregnancy, labor and
4. Disease Prevention puerperium

TUMULAK, JOEY U.
COMMUNITY HEALTH NURSING
LECTURE / SECOND YEAR / FIRST SEMESTER
FOUNDATIONS OF COMMUNITY AND PUBLIC HEALTH NURSING PRACTICE

 Performance of internal agencies in the provision of

examination and delivery of public health services
babies.  conduct researches relevant to
 Suturing lacerations in the CHN services to improve
absence of a physician. provision of healthcare
 Provision of first aid measures  provide opportunities for
and emergency care. professional growth and
 Recommending herbal and continuing education for staff
symptomatic meds…etc. development
o In the care of the families:
 Provision of primary health care NINE STANDARDS OF COMMUNITY
services. HEALTH NURSING
 Developmental/Utilization of 1. Theory
family nursing care plan in the  Applies theoretical
provision of care. concepts as basis for
o In the care of the communities: decisions in practice
 Community organizing 2. Data Collection
mobilization, community  Gathers comprehensive,
development, and people accurate data
empowerment systematically
 Case finding and 3. Diagnosis
epidemiological investigation  Analyzes collected data to
 Program planning, determine the needs/
implementation, and health problems of IFC.
evaluation 4. Planning
 Influencing executive and  At each level of prevention,
legislative individuals or bodies develops plans that specify
concerning health and nursing actions unique to
development needs of clients.
o Responsibilities of CHN 5. Intervention
 be a part in developing an  Guided by the plan,
overall health plan, its intervenes to promote,
implementation, and maintain or restore health,
evaluation for communities prevent illness and institute
 provide quality nursing services rehabilitation.
to the three levels of clientele 6. Evaluation
 maintain coordination/linkages  Evaluates responses of
with other health team clients to interventions to
members, NGO/government note progress toward goal

TUMULAK, JOEY U.
COMMUNITY HEALTH NURSING
LECTURE / SECOND YEAR / FIRST SEMESTER
FOUNDATIONS OF COMMUNITY AND PUBLIC HEALTH NURSING PRACTICE

achievement, revise data individuals, families and

base, diagnoses and plan. communities in any health care
7. Quality Assurance and setting. It includes, but not
Professional Development limited to, nursing care during
 Participates in peer review conception, labor, delivery,
and other means of infancy, childhood, toddler,
evaluation to assure quality pre-school, school age,
of nursing practice. adolescence, adulthood and
Assumes professional old age.”
development. Contributes Furthermore …
to development of others. o ” As independent practitioners,
8. Interdisciplinary Collaboration nurses are primarily responsible
 Collaborates with other for the promotion of health and
members of the health prevention of illness. As
team, professionals and members of the health team,
community representatives nurses shall collaborate with
in assessing, planning, other health care providers for
implementing and the curative, preventive, and
evaluating programs for rehabilitative aspects of care,
community health. restoration of health, alleviation
9. Research of suffering, and when recovery
 Indulges in research to is not possible, towards a
contribute to theory and peaceful death”
practice in community
health nursing. CLIENTS OF COMMUNITY HEALTH
NURSING
o Composed of different levels of
LEVELS OF CLIENTELE IN clientele:
COMMUNITY AND 1. Individual
PUBLIC HEALTH NURSING(CPHN) 2. Family
3. Population Group
THE PHILIPPINE NURSING LAW OF 4. Community
2002 (RA 9173) ONE HEALTH CONCEPT
states that… A FRAMEWORK FOR
o “A person shall be deemed to COMMUNITY AND PUBLIC HEALTH
be practicing nursing within the NURSING
meaning of this Act when o The world in the present times, is
he/she singly or in collaboration faced with immense challenges
with another, initiates and for health.
performs nursing services to o
TUMULAK, JOEY U.
COMMUNITY HEALTH NURSING
LECTURE / SECOND YEAR / FIRST SEMESTER
FOUNDATIONS OF COMMUNITY AND PUBLIC HEALTH NURSING PRACTICE

o Jones, et al., 2008 reported the policy-making and funding

appearance of 335 infectious resolution (Day, 2011)
disease among human o One Health Approach Activities
population between 1940 and example includes:
2004.  National Rabies Prevention
o COVID 19 immergence in the and Control Program
past 2 years and still occurring (NRPCP)
at the present.  Avian Influenza Protection
o Emerging infectious diseases Program (AIPP)
(EIDs) are a matter of  Philippines Inter-Agency
importance to a great extent if Committee on Zoonoses
there is a rapid increase in cases o Thus, guided by this framework,
and high incidences of deaths nurses in communities can
caused by these diseases better promote awareness of
(Petrosillo, 2019). people on how all these factors
o The most effective way to act in impact wellness and spawn
response to the threats of EIDs is collective action for better
the One Health Approach- health.
recognizing the connection
between human, animal, and HIERARCHY OF NURSING PRACTICE
environmental health (Johnson
et al., 2019). COMMUNITY AND
 consolidated interaction PUBLIC HEALTH
NURSING
between human health,
veterinary medicine, and MENTAL AND
PSYCHIATRIC
public and environmental NURSING
health professionals, MATERNAL AND
clinicians, researchers, and CHILD HEALTH
agencies functioning hand NURING
in hand for a worthwhile
and sustainable health ADULTHEALTH NURSING
interventions in addressing
worldwide and
environmental health
challenges. The reciprocal
actions may occur at
several levels which is from
management of zoonotic
infectious disease
outbreaks to consolidated
TUMULAK, JOEY U.
COMMUNITY HEALTH NURSING
LECTURE / SECOND YEAR / FIRST SEMESTER
FOUNDATIONS OF COMMUNITY AND PUBLIC HEALTH NURSING PRACTICE

FIELDS OF COMMUNITY AND PUBLIC and satisfying relationship with

HEALTH NURSING others.” (Pender et al., 2006).

COMMUNITY-BASED NURSING
OCCUPATIONAL HEALTH FAITH COMMUNITY
NURSING NURSING o “Application of the nursing
process in caring for individuals,
COMMUNITY HEALTH
NURSING OR PUBLIC families and groups where they
HEALTH NURSING live, work or go to school or as
CORRECTIONAL SCHOOL HEALTH they move through the health
NURSING NURSING care system.”
o RELATED TERMS:
 Population
BASIC CONCEPTS AND PRINCIPLES  Typically used to denote a
OF COMMUNITY HEALTH NURSING group of people having
o HEALTH… common personal or
o “The extent to which an environmental
individual or group is able, on characteristics
the one hand, to realize  Aggregates
aspirations and satisfy needs;  Subgroups or
and, on the other hand, to subpopulations that have
change or cope with the some common
environment. Health is, characteristics or concerns
therefore, seen as a resource for
everyday life, not the objective COMMUNITY: MAIN TYPES
of living; it is a positive concept I. GEOPOLITICAL
emphasizing social and COMMUNITIES
personal resources and physical o a.k.a. Territorial communities
capacities.” o Formed by man-made and
o “A state of well-being in which natural boundaries
the person is able to use
purposeful, adaptive responses II. PHENOMENOLOGICAL
and process physically, COMMUNITIES
mentally, emotionally, spiritually o a.k.a functional community
and socially.” (Murray et al., o people share a group
2009). perspective or identity based
o “Actualization of inherent and on culture, values, history,
acquired human potential interests, and goals
through goal-directed
behavior, competent self-care,

TUMULAK, JOEY U.
COMMUNITY HEALTH NURSING
LECTURE / SECOND YEAR / FIRST SEMESTER
FOUNDATIONS OF COMMUNITY AND PUBLIC HEALTH NURSING PRACTICE

COMMUNITY: DEFINING ATTRIBUTES REALIZE HIS BIRTHRIGHT TO

o People HEALTH AND LONGEVITY
o Place ---DR. C. E. WINSLOW---
o Interaction o The art of applying science in
o Common characteristics, the context of politics so as to
interests, or goals reduce inequalities in health
while ensuring the best health
PUBLIC HEALTH for the greatest number.
o “Public Health is directed ---World Health Organization---
towards assisting every citizen to
realize his birth rights and FOCUS OF PUBLIC HEALTH NURSING
longevity.” ”The science and art o Health promotion
of preventing disease,  Activities enhance
prolonging life and efficiency resources directed at
through organized community improving well-being.
effort for: o Disease Prevention
1. The sanitation of the  Activities protect people
environment. from disease and the
2. The control of communicable effects of disease.
infections.
3. The education of the LEVELS OF PREVENTION
individual in personal hygiene. 1. PRIMARY PREVENTION
4. The organization of medical o Directed at preventing a
and nursing services for the problem before it occurs by
early diagnosis and preventive altering susceptibility or
treatment of disease. reducing exposure for
5. The development of a social susceptible individuals.
machinery to ensure everyone  General health promotion
a standard of living, adequate  Specific protection
for maintenance of health to 2. SECONDARY PREVENTION
enable every citizen to realize o Early detection and prompt
his birthright of health and intervention during the period of
longevity (Dr. C.E Winslow). early disease pathogenesis.
o Organized, legislated, and tax- 3. TERTIARY PREVENTION
supported efforts that serve all o Targets populations that have
people through health experienced disease or injury
departments or related and focuses on limitation of
governmental agencies. disability and rehabilitation.
o So, organizing these benefits as o Aims to reduce the effects of
to ENABLE EVERY CITIZEN TO disease and injury and to
TUMULAK, JOEY U.
COMMUNITY HEALTH NURSING
LECTURE / SECOND YEAR / FIRST SEMESTER
FOUNDATIONS OF COMMUNITY AND PUBLIC HEALTH NURSING PRACTICE

restore individuals to their  S – scientific and up-to-

optimal level of functioning. date
 T – tasks of CH nurse vary
POPULATION-FOCUSED APPROACH with time and place
AND COMMUNITY HEALTH NURSING  I – independence or self-
INTERVENTIONS reliance is the end goal
o Focuses on the entire  C – connectedness of
population. health & development
o Is based on assessment of the regarded
populations’ health status.
o Considers the broad LEVELS OF CLIENTELE
determinants of health.
o Emphasizes all levels of I. INDIVIDUAL AS A CLIENT
prevention. o Deals with sick or well
o Intervenes with communities, o Consults the health center &
systems, individuals and families. receives health services in
different forms
PHILOSOPHY OF CHN PRACTICE o Can be seen both as clients and
o Defined as a system of beliefs patients
that provides a basis for and o Can be used as an “entry point”
guides action. in working
o It provides the direction and o with the whole family
describes the whats, whys and o Can be seen in two
hows of activities within the ways/approach:
profession. a. atomistic
 H – humanistic values of b. holistic
the nursing profession
upheld ATOMISTIC APPROACH
 U – unique & distinct o Proposed by Byrne and
component of healthcare Thompson
 M – multiple factors of o Views man as an organism
health considered o Sees the whole as equal to the
 A – active participation of sum of its parts or subparts
clients encouraged o Levels of organization include:
 N – nurse considers 8-12
availability of resources a. chemical level
 I – interdependence b. organelle level
among health team c. cellular level
members practiced d. tissue level
e. organ level
TUMULAK, JOEY U.
COMMUNITY HEALTH NURSING
LECTURE / SECOND YEAR / FIRST SEMESTER
FOUNDATIONS OF COMMUNITY AND PUBLIC HEALTH NURSING PRACTICE

f. system level  Capable of perception,

cognition &
HOLISTIC APPROACH communication
o Traces the pattern of man’s  Capable of logical thinking
relationship with other beings in and reasoning
the supra system of society. 5. PSYCHOLOGICAL BEING
o How man acts and reacts to  capable of feeling,
situational stimuli provides clues rationality, and all
in understanding his responses  conscious and unconscious
and the reasons behind them. mental states
o Man as a whole is different from
and is more than the sum of his II. FAMILY
component parts. O Defined by Murray and Zentner,
o Dimensions include: physical, 1997, a small social system and
social, spiritual, cognitive and primary reference group made
psychological. up of two or more persons living
together who are related by
FIVE DIMENSIONS OF MAN blood, marriage, or adoption or
1. PHYSICAL BEING who are living together by
 Genetic endowment arrangement over a period of
 Sex time.
 Physical attributes o IN THE CARE OF FAMILIES
2. SOCIAL BEING  Provision of primary health
 Capable of relating to care services.
others  Development/utilization of
 Process of social learning by family nursing care plan in
which a person acquires the provision of care.
KSA and roles appropriate
to sex, social class, and III. POPULATION
ethnic or cultural group GROUP/AGGREGATE
3. SPIRITUAL BEING o Is a group of people sharing the
 capable of virtues such as same characteristics,
faith, hope and charity developmental stage, or
 Believes in a power beyond common exposure to particular
himself and in transcending environmental factors.
one’s limitations in order to o Examples are:
become a better person a. children
4. THINKING OR INTELLECTUAL b. women
BEING c. farmers
d. cultural minorities
TUMULAK, JOEY U.
 COMMUNITY HEALTH NURSING
LECTURE / SECOND YEAR / FIRST SEMESTER
FOUNDATIONS OF COMMUNITY AND PUBLIC HEALTH NURSING PRACTICE

e. elderly

IV. COMMUNITY
o IN THE CARE OF THE REFERENCES
COMMUNITIES
 Community organizing, Notes from the discussion by Ms.
mobilization, community Lilibeth de la Pena RN, MAN
development, and people
empowerment. University of Cebu - Banilad
powerpoint presentation:
 Case finding &
epidemiological 1.2 FOUNDATIONS OF
investigation. COMMUNITY AND PUBLIC HEALTH
 Program planning, NURSING PRACTICE
implementation &
evaluation.
 Influencing executive and
legislative individuals or
bodies concerning health &
development.

SPECIALIZED FIELDS OF CHN

1. COMMUNITY MENTAL HEALTH
NURSING
o A unique clinical process which
includes an integration of
concepts from nursing, mental
health, social psychology,
psychology, community
networks and the basic
sciences.
2. OCCUPATIONAL HEALTH
NURSING
o The application of nursing
principles & procedures in
conserving the health of
workers in all occupations. TUMULAK, JOEY U.
3. SCHOOL HEALTH NURSING
o Application of nursing theories
& principles in the care of the
school population.