Community Nursing

Community as partner model
To gain access to the community, the community must:
-Perceive that a need exist
-Believe that the CHN can help address this need
-Perceive that its information and contributions are valued -Be assured of confidentiality for non-public information
-Be involved from the beginning in this partnership
Compare Neuman System Model & Community as Partner Model
-the inner circle represents the community
-the dotted circles represents resistance
-spiritual, psyschosocial, physiological
-the other circles represents line of defence
Look up Appendix 11
Community as a partner looks at the 8 sub groups, and if one of them is distorted; everything will also be impacted. Determinants of health and community
The determinants of health relevant to the community
-chn need to consider the determinants of health that might exists in their community, such as crime, social and physical environments, education level, socio economic status, poverty. WHY? -Every community that you go to has individuals strengths and crisis, as the chn investigate a community Assessing acommunity

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-Social system
Structure (locale)
Name of community/ neighbourhood
Geopraphuc boundaries
Water and sanitation
Population (people)
Age distribution
Sex distribution
Growth trends
Education level
Predominant cultural and religious groups
Social System
Education system
Communication system
Transportation system
Welfare system
Volunteer programs
Health system
Assessing the community:
-What are some common health needs of communities
-Vulnerable populations
-Poor and homeless clients
-Risk takers
-Client with chronic illness
-Woman and girls
Community assessment
-A logical, systematic approach to
-Identifying community
-Strengths, resources, assets, capabilities, and opportunities -Clarifying/ validating concerns – community leaders
-Identifying the constraints: the economic, political, and social factors, and the determinants of health Why collect data?
-Goal is to acquire usable info. About the community; its concerns, strengths and problem Assessing the community
-Gathering data: the process of obtaining existing, readily available data, such as age and gender of residents oHow do we collect data
Information interviews
Focus groups
Participants observation
Windshield surveys
Secondary analyses of existing data
Windshield survery (pg. 257)
-Core elements
oValues and beliefs
oPhysical environment
oHealth and social services
oEconomic theory
oPolitics and govt
Assessment issues/ barrier (pg. 258)
-A chn from outside the community- gaining entry or acceptance is a major hurdle to assessment oStrategies or overcome?
-As a CHN “member of the community” what barriers might be present. How would you deal with this? Identifying community health concerns
-Each health concern uncovered by data collection and analyst must Planning Phase
-The chn seeks to clarify the nature of the concern, the points at which intervention might be undertaken, and the parties that have an interest in the health concern and its solutions. -Perception

oWhat is the nature of the concern
oWhat factors contribution to the health concern?
oWhat is the possible outcome of the concern?
oWhat are the relationships between or affect of other health concerns? Teenage pregnancy: infant malnutrition: hooking them up with education
Setting health concern priorities:
-6 helpful ranking criteria are:
oCommunity awareness of the concern
oCommunity motivation to resolve or better manage the concern oCHN’s ability to influence the solution.- you need to be realistic oAvailability of expertise to provide a solution
oSeverity of the outcomes if the concern is not resolved
oHow quickly the health concern can be solved
Establishing goals and objectives
-Goals are broad
-Work and activities aimed at achieving the goal
oChange agents
oDuring this phase ask: for each situation who will implement? CHN, community group involved, individual oHow should the CHN use her knowledge, skills, and position? Many roles=role model, analyst, expert, advisor, educator, advocate. oWhat is the ultimate CHN goal? To change the community for the better, empowerment, education, moving them to solve their own problems The nurse’s role depends on:

-The nature of the health problem,
-The community’s decision making ability
-And professional and personal choices
-The social change process and how receptive the community is to CHANGE. -SNOW BALL EFFECT: influence the pro change in the community and the rest will follow. Evaluation = the appraisal of the effect

Evalution phase: outcomes measures answer questions about the results of the intervention -Has the health conc3ern has resovled?
-Has the health risk been reduced?
-(for example compare
-SAFETY be aware of your surrounding, watch your own back; develop trusted partners in the community -population
-Data generation: the process of developing
-Database analysis

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