Lahore School of Nursing

The University of Lahore

2 Years BS Nursing Programme
2014-2016
Course Syllabus
Title: Advanced Concepts in Community Health Nursing (NUR-217):

Credit: 6 Credits: Theory 4 & Clinical 2

Placement: 2 year BSN Year II, Semester I

Day & Time: Theory: Wednesday 0830-0930, 1030-1130

Friday 0930-1030, 1130-1230

Clinical: Thursday 0800-1400

Faculty: Mr. Afsar Ali (AA)

Email: afsar.ali@lsn.uol.edu.pk

Course Description:
This course enhances the knowledge and skills required for advanced nursing practice in
community settings. It will help the learner to develop his/her ability to work with communities
by utilizing nursing process and epidemiological concepts.

Course Objectives:
On completion of the course learners will be able to:
1) Discuss the role of a community health nurse and other health team members.
2) Describe the concept of Primary Health Care as a strategy for achieving the Alma Ata
Declaration of “Health for All by the Year 2000 and beyond (2025).”
3) Identify services provided by the government health care system in Pakistan.
4) Discuss the effects of environment on health.
5) Learn the process of Health Education.
6) Use Nursing Process with guidance to provide nursing care to the clients in communities
through Home visits and health education
7) Demonstrate the role of the community health nurse as a practitioner, researcher,
educator and manager while participating in the health care of the community.
8) Participate in planning, implementing, and evaluating the Health / Developmental project
with the community.
9) Utilize the concepts of Primary Health Care, Health Promotion, Epidemiology and
planning cycle in health / development project in community setting.

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Clinical Objectives for Field Experience:
On completion of field visits the students will be able to:
1) Discuss the structure and functions of health care facilities run by government and non-
government organizations.
2) Discuss the role of CHN in maintaining healthy environment.
3) Begin to use nursing process during the home visits.
4) Utilize various methods of health education while providing health education to the
clients.
5) Analyzed and demonstrated the role of a CHN in the Community.
6) Applied the concepts of community participation and empowerment when addressing the
specific health / developmental needs of the community.
7) Completed community assessment and diagnosis including the identification of high risk
groups, utilizing Gordon’s Functional Health patterns and the principles of community
participation.
8) Collect, interpret, and apply health statistics.
9) Develop and implement action plan relevant to the community’s need.
10) Evaluate interventional strategies and modified the action plan accordingly.
11) Participate in field team activities at the PHC center etc.
12) Identify and utilizes available resources and NGO’s working within the Community, city,
and country.
13) Develop linkages between the PHC centre and the community, NGO’s, CBO’s, etc. for
the sustainability purpose.
14) Complete a community health/development project based on the needs identified by the
community.

Teaching/Learning Strategies:
Interactive discussions, presentation, group activities, visual aids, case studies, slides, role-
plays and field visits.

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Evaluation Criteria:

Class Participation 05%

Quiz 1 10% 4/11/15
Quiz 2 10% 11/12/15
Family Assessment 05% 18/11/15
Teaching Plan 05% 2/12/15
Health Education 10% 10/12/15,
17/12/15
Field project paper 10% 1/1/16
Field Project Presentation 05% 06/1/16,
08/01/16
Final Examination 40% 27/01/16
Total 100%
Clinical Performance Pass / Fail

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 UNIT OBJECTIVES
Unit I: Introduction to Community Health Nursing
Unit Description:
In this unit students will discuss the history, philosophy and definition of Community Health
Nursing. In this unit they will also discuss concepts of health and illness and the role of public
health care team members.

Unit objectives:
At the completion of this unit, students will be able to:
1) Define the terms:
a) Community
b) Community health, and
c) Community health nursing
d) Urban & rural communities
2) Discuss the historical background of Community Health Nursing from Public Health
Nursing.
3) Describe the philosophy of Community Health Nursing.
4) Discuss the concepts of health, wellness, illness and disease.
5) Discuss the roles of the Community Health Nurse in community settings.

Unit II -- Primary Health Care (PHC)

Unit Description:
In this unit, students will have an opportunity to discuss the Declarations of Alma Ata and its
strategy: Primary Health Care. Furthermore, they will discuss the elements principle and
application of PHC in Pakistan.

Unit objectives:
At the completion of this unit, students will be able to:
1) Explain Alma Atta Deceleration “Health for All by the Year 2000” and beyond.
2) Define Primary care and PHC
3) Describe the five basic principle of PHC
4) Explain the elements of PHC in relation to health
5) Discuss application of PHC in Pakistan

Unit III -- Pakistan Health Care System

Unit Description:
In this unit, students will be introduced to Health Services/Organizations available in Pakistan. In
addition students discuss health services available within the Government/Private Health Care
System. Furthermore, they will explore the roles of the health team members within the system.

Unit Objectives:
At the completion of this unit, students will be able to:
1) Define the terms, system, and health care system.
2) Identify the health services available to community by Pakistan Government Health Care
System.
3) Explain the roles of health care team members within the health care system.
4) Discuss the Devolution Plan of 2000

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Unit IV -- The Environment and Its Impact on Community Health
Unit Description:
In this unit, students will explore the effects of environment on individual s’ and community
health. In addition, these students will discuss the CHN role, is played to maintain healthy
environment.

Unit Objectives:
At the completion of this unit, students will be able to learn the:
1) Environment
a) Definition of `environment’
b) Component of environment and
c) Factors and its impact on community health

2) Water
a) Definition of safe and wholesome water
b) Uses of water
c) Daily requirements for one person.
d) Sources of water and its pollution
e) Water-borne diseases (viral, Bacterial, protozoal, worms etc.)
f) Water purification at small and large scales.
3) Community Wastes Management
a) Definition of refuse / solid waste, and sewage
b) Methods for solid waste and sewage disposal
c) Types of latrines used in communities
d) Fecal-borne diseases
e) Control of fecal-borne diseases
f) Types of rodents
g) Disease transmission by rodent
h) Control of rodents
4) Food Sanitation
a) Definition of healthy foods
b) Methods of food preservation.
c) Principles of safe food handling.
d) Prevention at transmission of food-borne diseases
e) Control of food-borne disease.
5) Air/ Ventilation & Housing
a) Define ventilation
b) Discuss the importance of air & ventilation
c) Discuss effects of poor ventilation on health
d) Describe the type’s standard, and needs of housing,
e) Discuss effects of poor housing on health

Unit V: Health Education

Unit Description:
In this unit, students will be introduced to concepts related to health education and its principles
including various approaches to its provision.

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Unit Objectives:
At the completion of this unit, students will be able to:
1) Define the term:
a) Teaching
b) Learning
c) Health education
2) Explain the purpose and goal of health education
3) Discuss principles of teaching learning.
4) Describe various strategies, which can be used to deliver health education.
5) Develop a teaching Plan and conduct mock health session on a selected topic.

Unit VI: Introduction to Home Visiting

Unit Description:
In this unit, students will discuss the principles, purposes and steps of home visiting

Unit Objectives:
At the completion of this unit, students will be able to:
1) Define homes visiting
2) Discuss the principles, purposes and advantages of Home Visiting in community
3) Describe the steps of Home Visiting

Unit VII: Epidemiology

Unit Description:
In this unit learners will learn the potential for preventing or alleviating illness has grown at an
astounding rate. This may be attributed to the rapid pace of discovery, aided by public
confidence and illness to support research, and to the decreasing lags between scientific
discovery and its practical application.

Unit Objectives:
By the end of the unit the learners will be able to:
1) Define epidemiology.
2) Examine the historical development of epidemiology.
3) Identify key concepts in the epidemiological approach.
4) Discuss the significance of the epidemiological approach in community health nursing.
5) Describe the types of epidemiological investigations and study designs.
6) Identify key population measures and vital statistics used in epidemiology.
7) Discuss the uses and application of the epidemiological approach in community health
nursing practice.

Unit VIII: Health Transition and Basic Demography

Unit Description:
In this unit learners will be introduced to the concepts of the demography and health transition.
They will integrate the concepts of the double burden of diseases and the challenges faced by the
Community Health Nurse. Further the learners will be given the opportunity to look at the factors
affecting health status of Pakistan by integrating the epidemiological concepts, to be able to
prevent and control the diseases or health phenomena and monitor the factors by using health
surveillance.
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Unit Objectives:
By the end of the unit the learners will be able:
1) To understand the difference between developed and developing countries population
pyramid and double burden of diseases.
2) To discuss the important health statistics of Pakistan.
3) To compare the different phases of natural history of disease transmission.

Unit IX: Diversity in CHN Role

Unit Description:
In this unit the diverse role of a community health nurse will be discussed in various health care
setting. In addition they will also be given the opportunity to see the role of CHN in Pakistan and
other countries.

Unit Objectives:
By the end of the unit the learners will be able to:
1) Descried the concept of health promotion and its significance.
2) Discuss the child to child health care approach for health promotion.
3) Discuss the role of nurse in maternal and child health.
4) Discuss the role of nurse in school health
5) Describe the common global & national environment health issue.
6) Identify the role of nurses to deal with environment health problems.
7) Discuss the occupational health and role of occupational health towards health
promotion.
8) Discuss the management of disaster in community settings.
9) Explore the role of Community Health Nurse in Pakistan and other countries.

Unit X: Community as a Partner

Unit Description:
In this unit learners will be provided with theory and skill, to assess and diagnose community
problems and develop a workable plan on one of the problem identified. The emphasis will be
given to the community as a partner in their health and developmental needs with the focus on
participation and empowerment. The health needs of community, families, and individuals will
be addressed by using Gordan’s FHP, epidemiological methods, and nursing process. Global
health transition and health problems of developed and developing countries will also be
discussed.

Unit Objectives:
By the end of the unit the learners will be able to:
1) Define the vision, mission, and planning cycle.
2) Describe the concepts of community participation, organization and community
assessment
3) Discuss the components of System framework, monitoring and Management Information
System
4) Perform the priority setting exercise, and developed action plan based on dummy
example
5) Differentiate between risk and population approach at implementation level.

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6) To discuss the implementation process by capturing the concept of Community
participation, and sustainability.
7) Discuss the evaluation process and its types.

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 COURSE SCHEDULE
Wk# Date /Day Time Content Rm#
1 Wed. 28/9/15 0830-0930 Unit I 402
Introduction to Community Health
Nursing
Wed. 28/9/115 1030-1130 Introduction to Community Health Nursing 402
Fri. 2/10/15 0930-1030 Introduction to Community Health Nursing 402
Role of Community Health nurse
Fri. 2/10/15 1130-1230 Unit VI 402
Introduction to Home Visiting
2 Wed. 7/10/15 0830-0930 Unit VI 402
Introduction to Home Visiting
Wed. 7/10/115 1030-1130 Unit VI 402
Introduction to Home Visiting
Fri. 9/10/15 0930-1030 Unit VI 402
Introduction to Home Visiting
Fri. 9/10/15 1130-1230 Unit VI 402
Introduction to Home Visiting
3 Wed. 14/10/15 0830-0930 Unit VI 402
Introduction to Home Visiting
Wed. 14/10/115 1030-1130 Unit VI 402
Introduction to Home Visiting
Fri. 16/10/15 0930-1030 Unit X 402
Introduction: Need Assessment
Friday16/10/15 1130-1230 Community as Partner: 402
Assessment & System Framework
4 Wed. 21/10/15 0830-0930 Community as Partner: 402
Assessment & System Framework
Wed. 21/10/15 1030-1130 Community as Partner 402
MIS & Surveillance
Fri. 23/10/15 0930-1030 Ashura Holiday 402
Fri. 23/10/15 1130-1230 Ashura Holiday 402
5 Wed. 28/10/15 0830-0930 Community as Partner 402
MIS & Surveillance
Wed. 28/10/15 1030-1130 Community as Partners: 402
Community participation
Wed. 28/10/15 Community as Partners:
Community participation
Fri. 30/10/15 0930-1030 Community as Partners: 402
Priority setting
Fri. 30/10/15 1130-1230 Community as Partners: 402
Priority setting
6 Wed. 4/11/15 0830-0930 Community as Partners: 402
Planning & Implementation
Wed. 4/11/15 1030-1130 Quiz 1 402

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 Fri. 6/11/15 0930-1030 Community as Partners: 402
Monitoring & Evaluation
Fri. 6/11/15 1130-1230 Unit V: Health Education 402
7 Wed. 11/11/15 0830-0930 Unit V: Health Education 402
Wed. 11/11/15 1030-1130 Unit V: Health Education 402
Fri. 13/11/15 0930-1030 Unit V: Health Education 402
Fri. 13/11/15 1130-1230 Unit V: Health Education 402
Fri. 13/11/15 Proposal Submission
8 Wed. 18/11/15 0830-0930 Unit V: Health Education 402
Family Assessment assignment
Wed. 18/11/15 1030-1130 Unit VIII 402
Health transition and global health
Demography
Fri. 20/11/15 0930-1030 Unit VIII 402
Health transition and global health
Demography
Fri. 20/11/15 1130-1230 Unit VIII 402
Health transition and global health
Demography
9 Wed. 25/11/15 0830-0930 Unit VIII 402
Health transition and global health
Demography
Wed. 25/11/15 1030-1130 Unit IX 402
Health Promotion
Disasters
Wed. 25/11/15 Unit IX
Health Promotion
Disasters
Fri. 27/11/15 0930-1030 Unit IX 402
School health
Fri. 27/11/15 1130-1230 Unit IX 402
Environmental & occupational health
10 Wed. 2/12/15 0830-0930 Teaching Plan Submission 402
Wed. 2/12/15 1030-1130 Unit IX 402
Environmental & occupational health
Fri. 4/12/15 0930-1030 Unit IX 402
National, International role of CHN
Fri. 4/12/15 1130-1230 Unit II 402
Primary Health Care (PHC)
11 Wed. 9/12/15 0830-0930 Unit II 402
Primary Health Care (PHC
Wed. 9/12/15 1030-1130 Unit II 402
Primary Health Care (PHC)
Fri. 11/12/15 0930-1030 Quiz 2 402
Fri. 11/12/15 1130-1230 Unit II 402
Primary Health Care (PHC)
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12 Wed. 16/12/15 0830-0930 Unit II 402
Primary Health Care (PHC)
Wed. 16/12/15 1030-1130 Unit III 402
Pakistan Health Care System
Fri. 18/12/15 0930-1030 Unit IV: Water 402
Fri. 18/12/15 1130-1230 Unit IV: Water 402
13 Wed. 23/12/15 0830-0930 Unit IV: Food Sanitation 402
Wed. 23/12/15 1030-1130 Unit IV: Food Sanitation 402
Fri. 25/12/15 0930-1030 Quaid e Azam Day 402
Fri. 25/12/15 1130-1230 Quaid e Azam Day 402
14 Wed. 30/12/15 0830-0930 Unit IV 402
Air/ Ventilation & Housing
Wed. 30/12/15 1030-1130 Unit IV 402
Environment
Fri. 1/1/16 0930-1030 Unit IV 402
Environment Field Project Paper
Fri. 1/1/16 1130-1230 Unit IV 402
Community Wastes Management
15 Wed. 6/1/16 0830-0930 Presentation of project 402
Evaluator: Afzal, Ms. Farzana,
M.Hussain,
Wed. 6/1/16 1030-1130 Presentation of project 402
Evaluator: Afzal, Ms. Farzana,
M.Hussain,
Fri. 8/1/16 0930-1030 Presentation of project 402
Evaluator: Afzal, Ms. Farzana,
M.Hussain,
Fri. 8/1/16 1130-1230 Presentation of project 402
Evaluator: Afzal, Ms. Farzana,
M.Hussain,
16 Wed. 13/1/16 0830-0930 Unit IV 402
Community Wastes Management
Wed. 13/1/16 1030-1130 Unit VII: Epidemiology 402
Fri. 15/1/16 0930-1030 Unit VII: Epidemiology 402
Fri. 15/1/16 1130-1230 Unit VII: Epidemiology 402
17 Wed. 20/1/16 0830-0930 Unit VII: Epidemiology 402
Wed. 20/1/16 1030-1130 Unit VII: Epidemiology 402
Fri. 22/1/16 0930-1030 Revision Classes 402
Fri. 22/1/16 1130-1230 Revision Classes 402
18 Wed. 27/1/16 Final Paper

References:

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1. Ansari. I. M., (2003). Community Medicine and Public Health. (6th ed.). Karachi Urdu
Bazaar.

2. Anderson, E.T., & McFarlance, J. (2000). Community as partner: Theory and practice in
nursing. (3rd ed.). Philiadelphia: Lippincott.

3. Edelman, C.L., & Mandle, C.L. (1998). Health promotion through out life span. (4th ed.).
Mosby: Philadelfhia.

4. Kirk, P., & Shutte, A.M. (2004). Community leadership development. Community
Development Journal, 39, 234 -251.

5. Mc. Michael. A. (2000). Urban environment and health in a world of increasing

globalization: Issues for developing countries. Bulletin of World Health Organization, 78,
1117-1126

6. Peterman, W. (2004). Advocacy vs collaboration: Comparing inclusionary community

planning models. Community Development Journal, 39, 266-276.

7. Popple, K., & Redmond, M. (2000). Community development and the voluntary sector in
the new millennium: The implications of the third way in the UK. Community
Development Journal, 35, 391-400.

8. Richardson, J. (2000). Whatever the weather: A tropical dimension to community

development theory. Community Development Journal, 35, 255-263.

9. Stanhope, M., & Knollmueller, R.H. (2001). Handbook of Public and Community Health
Nursing Practice: A Health Promotion Guide. Philadelphia: Mosby

10. Smith. K. R. (2000). Environmental health for rich or for all. Bulletin of World Health
Organization, 78, 1156-1161.

11. WHO Regional Office for Europe, Copenhagen. (2001) The Role of Occupational Health
Nurse in Work Place Health Management. Health Documentation service United States
Energy Information: Pakistan: Environmental Issues (May 2000) Retrieved from
ttp://www.eia.doe.gov/emeu/cabs/pakenv.html

12. Watt, S., Higgins, C., & Kendrick, A. (2000). Community participation in the
development of services: A move towards community empowerment. Community
Development Journal, 35, 120-132.

13. Woodward, V., (2000). Community engagement with the state: A case study of the
Plymouth Hoe Citizen’s Jury. Community Development Journal, 35, 233-244.

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 Teaching Plan Guide Line
05%

Assessment Objectives Content Teaching Time Evaluation

Strategies
Subjective By the end of the Note: write Write in Subjective
Data teaching content in line minutes Data
participants will be with objective
able to:
Define

Objective Objective
Data Data

References
 Write author’s name
 Write book name
 Write year of publication

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 Teaching Plan Implementation
Evaluation Criteria (For Faculty 05 %)
Date: ___________________ Topic: _______________________________________________
Student’s Name: _____________________________________ Roll No: ___________________
Rating Marks: Performance Not done = 0, Weak=1, Fair = 2, Good = 3, Excellent= 4

1 Submit planning on time 0 1 2 3 4

2 Set conducive learning environment 0 1 2 3 4
3 Communicate learning objectives clearly 0 1 2 3 4
4 Use teaching strategies like stories, poem appropriately. 0 1 2 3 4
5 Use relevant simple examples, quotes 0 1 2 3 4
6 Maintained good eye contact 0 1 2 3 4
7 Logical content flow 0 1 2 3 4
8 Within time limits 0 1 2 3 4
9 Encouraged Q & A 0 1 2 3 4
10 Clear and audible speech 0 1 2 3 4

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GUIDELINES FOR EVALUATION OF HEALTH EDUCATION PROCESS (10 %)

Section # 1 Family Assessment

 The learners will collect and document in demographic data in house hold survey format.

Section # 2 Identify and prioritize problems

 List all Identified problems /
 Cluster all identified problems into: Environmental, Social and Health factors categories
with use page 04 of house hold survey form
 Put up all identified problems in prioritize order to depict priority learning need.

Section # 3 Develop written teaching plan

 Develop and submit written teaching plan

Section # 4 Implementation
 The learners will conduct teaching session for a client/family.
 This will be evaluated by using the attached criteria

Section # 5 Follow –up/ Evaluation

 Subjective
 Objective

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 FIELD PROJECT Guide Lines (10%)

The field project is based on components of nursing process. Learners need to assess, diagnose,
plan, implement & evaluate accordingly. It is important for learners to understand the guidelines
given below in order to do the project efficiently.

Things to remember:
 Community involvement.
 Involve PHC team (if required and available)
 Integrate steps of planning cycle, concepts of PHC and epidemiology.

Use the following steps:-

Assess a community.
 Use of previous records, research data observations, interviews etc.

Create a list of major problems in the community.

 Prioritized these problems and choose one particular problem
(A problem which can be resolved).

Identify various strategies to solve the problem

 Based on literature review and choose one strategy (a strategy that is doable)

Formulate a complete plan of action.

Remember to plan for sustainability of the project from the beginning. When planning and
implementing the project, learners must be aware that they are accountable to the community and
responsible to the health stake holders. Learners should be prepared to answer the community or
the health stake holders if they are asked to justify what they are doing, for example, they can
expect question like:
 Why do you think this is a problem?
 Why is this problem you would want to resolve?
 Why is this best strategy to solve this problem?
 Is this the problem the community wants to solve?
 Who is involved?
 Is it sustainable?

Modifications
 The modifications or changes made in the initial plan and why were they needed.

Implementations:
 Resources used, how, where, when and who of the implementation phase.

Evaluation:
 What was the outcome, whether the objectives were achieved and how were they
measured.

Conclusion and discussion:

 A general analytical conclusion including a discussion of problem faced future
recommendations, and research needs.

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 EVALUATION CRITERIA FOR FIELD PROJECT
Paper 10% Presentation 05%
The Situation 10
Assessment of the community: Introduction, population pyramid, dynamics.
Introduction to the problem: what is the problem, specific problem statement,
magnitude of the problem, effect of the problem, and what steps did you and the
community take to select this particular problem etc.
Review of the Literature and Analysis of the Situation 10
A review of literature to support the problem and to outline its effects in the
community. A concise review of literature discussing various possible strategies to
solve the problem.
Recommended Strategy 10
Justify the selected strategy for its appropriateness and relevance to the
community. Sustainability of the project, application of principle of the PHC and
community participation, how scientifically sound is the idea.
Plan of Action 10
Objectives of the plan.
Give a complete plan of action including who, where, how, when of the plan. How
do you plan to evaluate the project?
Implementation with Modification 15
Description of project implementation in the community along with measures
taken to sustain the project. Clear & concise description of modifications needed
along with rationale.
Implementation at Field Level 10
Planning and implementation at field level will also be assessed.
Involvement of PHC team & community from identification to evaluation of
project and efforts made to sustain the project will also be assessed.
Results 15
Provide a complete, analytical description, of the outcomes of your project
including expected and unexpected results.
Conclusion 10
Brief summary of project including limitations and recommendations.
Style of writing 10
APA style, references, organization, flow and transition and succinctness.
Total 100

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