Course Title here

COURSE CODE: NCM113

LEVEL OFFERING: Level 3, First Semester AY 2020
NUMBER OF UNITS: 1

COURSE DESCRIPTION:
This course deals with the concepts, principles, theories and techniques in the care of
population groups and communities utilizing community organizing strategies toward health
promotion, disease prevention, restoration and maintenance, and rehabilitation and community
development. The learners are expected to provide safe, appropriate and holistic nursing care
to clients utilizing the community health nursing process.

MODULE OVERVIEW:
This module consists of community health nursing concepts, the philosophy and principles,
salient features of community health nursing, and roles and functions of the community health
nurse. Content mastery of this module will enable students to work with the community in
assessing the health problems. Together they will plan, implement, and evaluate community
health problems to address the health problems identified. For this related learning experience,
you will be catered to flexible clinical learning experiences through this self-instructed module.
In addition, this learning activity might not be a substitute for actual clinical experience
due to Covid-19 pandemic. However, this will help you to direct through your nursing practice in
providing nursing care to your patient in the virtual platform. This module has the following RLE
learning process:

RLE LEARNING PROCESS

1 • Module Overview
2 • Learning Map
3 • Small leaps
4 • Bigger leaps
5 • Conquering the heights
6 • Recapturing the trail

INTRODUCTION OF SELF TO CLASS

Name of Clinical Instructor: PROF. Michael Z. Isanan

Contact number: 09338209020
Email add: mikeisanan@yahoo.com
RLE schedule: ThFS; 8am - 4pm
 RLE Module in Hi-Flex Learning
RLE Focus: COMMUNITY HEALTH NURSING II
Clinical Area: Barangay Health Center
Date of Clinical Exposure: (as per RLE rotation)
Number of Hours: 48 hours

LEARNING MAP

At the end of this course, the students should be able to:

Apply knowledge of physical, social, natural, health resources, and humanities in the care
of individual and family in the community setting.

Apply guidelines and principles of evidence-based practice in the delivery of care to

individual and family in the community setting

Adopt the nursing core values in the delivery of care to individuals and families.

Module 1

I. Community Health Nursing Concepts

 A. Definition

Community Health Nursing 

“The utilization of the nursing process in the different levels of clientele-individuals,

families, population groups and communities, concerned with the promotion of health,
prevention of disease and disability and rehabilitation.” ( Maglaya, et al)

Goal: “To raise the level of citizenry by helping communities and families to cope with the
discontinuities in and threats to health in such a way as to maximize their potential for
high-level wellness” ( Nisce, et al)

Special field of nursing that combines the skills of nursing, public health and some
phases of social assistance and functions as part of the total public health program for
the promotion of health, the improvement of the conditions in the social and physical
environment, rehabilitation of illness and disability ( WHO Expert Committee of Nursing)

A learned practice discipline with the ultimate goal of contributing as individuals and in
collaboration with others to the promotion of the client’s optimum level of functioning
thru’ teaching and delivery of care (Jacobson)

A service rendered by a professional nurse to IFCs, population groups in health centers,

clinics, schools, workplace for the promotion of health, prevention of illness, care of the
sick at home and rehabilitation (DR. Ruth B. Freeman)

B. Philosophy and Principles

Philosophy of CHN
“The philosophy of CHN is based on the worth and dignity of man.”(Dr. M. Shetland).

Basic Principles of CHN

 The community is the patient in CHN, the family is the unit of care and there

are four levels of clientele: individual, family, population group (those who share
common characteristics, developmental stages and common exposure to health
problems – e.g. children, elderly), and the community.
 In CHN, the client is considered as an ACTIVE partner NOT PASSIVE recipient of
care
 CHN practice is affected by developments in health technology, in particular, changes
in society, in general
 The goal of CHN is achieved through multi-sectoral efforts
 CHN is a part of health care system and the larger human services system.

Community Health Nursing (CHN) is a vital part of Public Health and there are 12
principles the govern CHN.
 1. The recognized need of individuals, families and communities provides the
basis for CHN practice. Its primary purpose is to further apply public health
measures within the framework of the total CHN effort.

2. Knowledge and understanding of the objectives and policies of the agency facilities
goal achievement. The mission statement commits Community Health Nurses to positively
actualize their service to this end.

3. CHN considers the family as the unit of service. Its level of functioning is influenced
by the degree to which it can deal with its own problems. Therefore the family is an
effective and available channel for the most of the CHN efforts.

4. Respect for the values, customs and beliefs of the clients contribute to the
effectiveness of care to the client. CHN services must be available sustainable and
affordable to all regardless of race, creed, color or socio-economic status.

5. CHN integrated health education and counseling as vital parts of functions. These

encourage and support community efforts in the discussion of issues to improve the
people’s health.

6. Collaborative work relationships with the co-workers and members of the health team
facilities accomplishments of goals. Each member is helped to see how his/her work
benefits the whole enterprise.

7. Periodic and continuing evaluation provides the means for assessing the degree to
which CHN goals and objectives are being attained. Clients are involved in the appraisal
of their health program through consultations, observations and accurate recording.

8. Continuing staff education program quality services to client and are essential to
upgrade and maintain sound nursing practices in their setting. Professional interest and
needs of Community Health Nurses are considered in planning staff development
programs of the agency.

9. Utilization of indigenous and existing community resources maximizing the success of

the efforts of the Community Health Nurses. The use of local available ailments.
Linkages with existing community resources, both public and private, increase the
awareness of what care they need what are entitled.

10. Active participation of the individual, family and community in planning and making
decisions for their health care needs, determine, to a large extent, the success of the
CHN programs. Organized community groups are encouraged to participate in the
activities that will meet community needs and interests.

11. Supervision of nursing services by qualified by CHN personnel provides guidance and
direction to the work to be done. Potentials of employees for effective and efficient
work are developed.

12. Accurate recording and reporting serve as the basis for evaluation of the progress of
planned programs and activities and as a guide for the future actions. Maintenance of
accurate records is a vital responsibility of community as these are utilized in studies
and researches and as legal documents.
 C. Features of CHN

Salient Features of Community Health Nursing

1. Population or Aggregate-Focused
The Hallmark of Community Health Nursing is that it is population or aggregate-
focused the whole community is the patient/client.

a. Priorities for care for care when resources or supplies are primarily allotted for
the health needs and problems of the individuals or families as they impact or
relate to the health of the total population or community.
b. Population-based assessment, policy development and assurance processes are
systematic and comprehensive.

2. Greatest Good for the Greatest Number – the emphasis of CHN is on the importance
of the “greatest number where the nurse first looks at the health needs and
problems of the community rather than focusing solely on the needs of individuals or
families. When a particular situation is seen as a risk or hazard to the health of the
total community or can afflict a greater number of individuals, this is now seen as a
community health problem which needs community-wide interventions.

3. Utilizes the Nursing Process – CHN involves the assessment of health needs, planning,
implementation and evaluation of the impact of health services on population groups
using the problem-solving method also known as the nursing process.

4. Promotive-Preventive by Nature – the priority of CHN is on health-promoting and

disease-preventing strategies over curative interventions. Nonetheless, the demand
for curative services is higher because people usually go to the health centers when
they are already sick and all home remedies have failed. The health center
consultation becomes the entry point to the health care system and provides the
initial contact between the nurse and client.

5. Uses a Variety of Instruments – CHN makes use of tools for measuring and analyzing
community health problems like public health statistics or vital statistics. Community
map is also a very useful tool. Interview, schedule, survey forms and questionnaires
may also be used.

6. Requires Management Skills – CHN applies the principles management especially

during the organization of the nursing service in the local health agency and in
activities that require the effective management of a certain program or health
service.

D. Different Fields

Introduction:

The Community Health Nurse is also involved in other specialized fields. As a school nurse,
he/she provides health supervision and nursing interventions to school children, conducts
home visits or home follow-up, identifies cases needing immediate medical attention and
makes the necessary referrals as needed.

As an occupational health nurse. He/she provides health supervision and nursing

interventions to workers in factories or workplaces especially in areas where they are
 exposed to certain health hazards: institutes appropriate health preventive and
promotive measures.

As a community mental health, he/she assesses the environment in the home and
community to identify factors which may aggravate or trigger mental illness. Psychiatric
nursing is concerned with the promotion of mental health, prevention of mental disorders
and the nursing care of patients during mental illness and rehabilitation.

II. Concept of the Community

Levels of Clientele in CHN

Population Group

Vulnerable Groups:
 Infants and Young Children
 School age
 Adolescents
 Mothers
 Males
 Old People

Community

Community comes from the old French word “communite” which is derived from the Latin
“communitas (cum, “with/together” + munus, “gift”), a broad term for fellowship or
organized society.

Community is a social group determined by geographic boundaries and/or common values

& interests. Its members know and interact with each other

Types of Community

1. Rural or the Open lands – often agricultural in nature which is more spacious and less
densely populated. Usually small and the occupation of the people is usually farming,
fishing and food gathering.
2. Urban or the City – densely populated, non-agricultural occupations. The major source of
income are industrial products and technology. (e.g. Quezon City, Pasig City)
3. Suburban or rurban or the capitals – usually the capital of provinces where there is a mix
of agriculture and industry. (e.g. San Pablo City, Calamba City)

Characteristics of Healthy Community

A healthy community consists of people who are partners in health care.

A healthy community:
1. prompts its members to have a high degree of awareness that “we are community”.
2. uses it natural resources while taking steps to conserve them for future generations.
3. openly recognizes the existence of sub-groups & welcomes their participation in
community affair.
4. is prepared to meet its crises.
5. has open channels of communication that allows information to flow among all sub-groups
of its citizens and in all directions.
 6. seeks to make each of its system’s resources available to all members of the
community.
7. has legitimate and effective ways to settle disputes and meets needs that
arise within the community.
8. encourages maximum citizen participation in decision-making.
9. promotes a high-level wellness among all its members.

Components of a Community

1. The People – this represents the “core” that makes up the community. Included in the
community core is a study of demographic characteristics of the population as well as
values, beliefs and history of the people.

2. EIGHT (8) SUBSYSTEMS OF THE COMMUNITY:

a. Housing – this subsystem includes the type and characteristics of housing facilities in
the community; availability of housing facilities; presence of housing law/regulations
governing the people.
b. Education – this include laws, regulations, facilities, activities affecting education;
ratio of health educators to learners, distribution of educational facilities in the
community including a look into who utilize these; presence of informal educational
facilities and activities existing in the community.
c. Fire and Safety – availability & accessibility of fire protection & safety services &
facilities.
d. Politics and Government – existing political structure, decision – making
process/pattern, leadership styles observed, etc.
e. Health – health facilities & services/activities & its availability & accessibility; ratio
of providers & clients availing of the service
f. Communication – systems, types of forms of communication existing & how this
influence community health.
g. Economics – occupation, types of economics activities engaged by the people.
h. Recreation – recreational activities & facilities including types of consumers,
appropriateness of recreational activities to consumers.

Factors Affecting Health of the Community

1. Physical factors
a. Industrial development
Communities that are industrially developed are more likely to be affected by
numerous diseases due to toxic waste products from the industries that are released
into body of waters and the atmosphere and due to congestion of settlement leading
to slum development hence contagious disease compared to areas that are not
industrially developed.
b. Community size
An outbreak of communicable diseases in a densely populated community can easily
manifested.
c. Geographical location
The Geographical location of some communities is more prone to acquire
transmittable diseases.
d. Environment
In a dirty environment, the occurrence of transmittal of infectious diseases is
inevitable
 2. Social/Cultural factors
a. Traditions and beliefs are affecting the perception of people’s health
status.
b. Economy has a great impact in sustaining health condition.
c. Government plays a big role in the provision of community services such as water,
medical supplies and other needs to directly affect the health of the community

3. Community Organization
Ways in which communities organize their resources in terms of paying their taxes,
regularly and honesty

4. Individual behaviors
a. Educational factors - in terms of health has a great influence in dealing with their
health condition.

Community Health Nurse Roles and Functions

The priority of Community Health Nurse (CHN) is to promote and maintain health and prevent
the occurrence of disease or illness. The community health nurse conducts a continuing and
comprehensive practice that is preventive, promotive, curative, and rehabilitative using the
nursing process as its primary tool. Nursing services are delivered in community settings like
the home, rural health center, clinics, schools, factories and other industrial sites and offices.

Qualifications
1. Bachelor of Science in Nursing
2. Registered Nurse of the Philippines

CHN Roles and Functions

A. Planner/Programmer
a. Identifies needs, priorities, and problems of individuals, families, and communities
b. Formulates municipal health plan in the absence of a medical doctor
c. Interprets and implements nursing plan, program policies, memoranda, and circular
for the concerned staff personnel
d. Provides technical assistance to rural health midwives in health matters

B. Provider of Nursing Care

a. Provides direct nursing care to sick or disabled in the home, clinic, school, or
workplace
b. Develops the family’s capability to take care of the sick, disabled, or dependent
member

C. Community Organizer
a. Motivates and enhances community participation in terms of planning, organizing,
implementing, and evaluating health services
b. Initiates and participates in community development activities

D. Coordinator of Services
a. Coordinates with individuals, families, and groups for health-related services
provided by various members of the health team
 b. Coordinates nursing program with other health programs like environmental
sanitation, health education, dental health, and mental health

E. Trainer/Health Educator
a. Identifies and interprets training needs of the RHMs, Barangay Health Workers
(BHW), and Barangay Nutritionist.
b. Conducts training for RHMs on promotion and disease prevention
c. Conducts pre- and post-consultation conferences for clinic clients; acts as a resource
speaker on health and health related services
d. Initiates the use of tri-media (radio/TV, cinema plugs, and print ads) for health
education purposes
e. Conducts pre-marital counseling

F. Health Monitor
a. Detects deviation from health of individuals, families, groups, and communities
through contacts/visits with them

G. Role Model
a. Provides good example of healthful living to the members of the community

H. Change Agent
a. Motivates changes in health behavior in individuals, families, groups, and communities
that also include lifestyle in order to promote and maintain health

I. Recorder/Reporter/Statistician
a. Prepares and submits required reports and records
b. Maintain adequate, accurate, and complete recording and reporting
c. Reviews, validates, consolidates, analyzes, and interprets all records and reports
d. Prepares statistical data/chart and other data presentation

J. Researcher
a. Participates in the conduct of survey studies and researches on nursing and health-
related subjects
b. Coordinates with government and non-government organization in the implementation
of studies/research

Reference:

1. Araceli S. Maglaya, (2004). Nursing Practice in the Community (4th ed). Philippines
2. Monina H. Gesmundo, RN RM MAN, (2010). The Basics of Community Health Nursing; A
study Guide for Nursing Students and Local Board Examinees. Philippines
3. DOH, (2008). Public Health Nursing in the Philippines. Philippines
4. https://www.slideshare.net/anastacioanna/week-1-15694706
 Let’s begin with small leaps.

RLE Activity 1:

Instructions:

1. All questions apply to this activity pertains to the concepts and theories discussed. Your
responses should be detailed and direct to the point. When asked to provide several
answers, list them in order of priority or significance.
2. Please submit on or before _______, 2020 thru LMS and or to the designated place in
your barangay, and to be collected by PNC personnel.

You’re on your way!

Base on your observation describe your community (Purok, Phase, Street, Compound, or
Clan) according to its components. Draw/Make a simple spot map of your area. (You don’t need
to go outside to accomplish this activity your safety is our priority.)

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Spot Map
 Now, try some big leap.

RLE Activity 2:

Instructions:

1. All questions apply to this activity pertains to the concepts and theories discussed. Your
responses should be detailed and direct to the point. When asked to provide several
answers, list them in order of priority or significance.
2. Please submit on or before _______, 2020 thru LMS and or to the designated place in
your barangay, and to be collected by PNC personnel.

Keep going.

We’re ready to conquer the heights!

I. Enumeration: Enumerate the following, write your answer below, on the space provided.
A. Give at least 4 subsystems in the community
1.__________________________________________________________
2. _________________________________________________________
3. _________________________________________________________
4. _________________________________________________________

B. Give the 6 Features of Community Health Nursing?

1. _________________________________________________________
2. _________________________________________________________
3. _________________________________________________________
4. _________________________________________________________
5. _________________________________________________________
6. _________________________________________________________

C. 4 Level of Clientele in Community Health Nursing?

1. _________________________________________________________
2. _________________________________________________________
3. _________________________________________________________
4. _________________________________________________________

D. 3 Types of Community?
1. _________________________________________________________
2. _________________________________________________________
3. _________________________________________________________

E. Give at least 3 Characteristics of Healthy Community?

1. _________________________________________________________
2. _________________________________________________________
 3. _________________________________________________________

We’re ready to conquer the heights!

RLE Activity 3:

Instructions:

1. All questions apply to this activity pertains to the concepts and theories
discussed. Your responses should be detailed and direct to the point. When asked
to provide several answers, list them in order of priority or significance.
2. Please submit on or before _______, 2020 thru LMS and or to the designated
place in your barangay, and to be collected by PNC personnel.

You’re doing fine! Carry on.

Identification. Base on the functions given below please identify the role of the community
health nurse, write the letter of your answer on the space provided before each number.
A. Planner/Programmer F. Health Monitor
B. Provider of Nursing Care G. Role Model
C. Community Organizer H. Change Agent
D. Coordinator of Services I. Recorder/Reporter/Statistician
E. Trainer/Health Educator J. Researcher

________1. Participates in the conduct of survey studies and researches on nursing

and health-related subjects.
________2. Reviews, validates, consolidates, analyzes, and interprets all records
and reports.
________3. Provides technical assistance to rural health midwives in health
matters.
________4. Motivates and enhances community participation in terms of planning,
organizing, implementing, and evaluating health services.
________5. Coordinates nursing program with other health programs like
environmental sanitation, health education, dental health, and mental
health.
________6. Provides good example of healthful living to the members of the
community.
________7. Detects deviation from health of individuals, families, groups, and
communities through contacts/visits with them.
________8. Coordinates with government and non-government organization in the
implementation of studies/research.
________9. Develops the family’s capability to take care of the sick, disabled, or
dependent member.
________10. Identifies and interprets training needs of the RHMs, Barangay Health
Workers (BHW), and Barangay Nutritionist.
________11. Motivates changes in health behavior in individuals, families, groups, and
communities that also include lifestyle to promote and maintain
 health.
________12. Interprets and implements nursing plan, program policies, memoranda,
and circular for the concerned staff personnel.
________13. Conducts pre- and post-consultation conferences for clinic clients and
acts as a resource speaker on health and health related services.
________14. Coordinates with individuals, families, and groups for health-related
services provided by various members of the health team.
________15. Initiates and participates in community development activities.

Recapturing the trail.

Reflection Point:

“As a nurse, we have the opportunity to heal the mind, soul, heart and body of
our patients, their families and ourselves. They may forget your name but they
will never forget how you made them feel” – Maya Angelou.

Having been drawn with concepts of community health nursing, how would you
anticipate your clinical exposure from which you can connect this inspirational
quote.

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Module Evaluation:

As we move along, I appreciate to hear your feedback to this module. Kindly rate each
component with a scale of 1 – 5; 1 as the lowest and 5 as the highest.

Component Rating
1. Contents are inclusive in the
course topics.
2. Contents are relevant.
3. Clarity of instructions.
4. Alignment of assessment
tasks to course learning
outcomes
TOTAL
Comments/Suggestions:
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Congratulations for completing the module. May the learning you have gained from this
course work contribute in developing your competencies in the clinical nursing practice.
Carry on and continue your journey in reaching greater heights!