COMMUNITY 

HEALTH NURSING work for the promotion of health, prevention of illness,

care of the sick at home, and rehabilitation.  (Ruth B.
Freeman)

Community

A collection of people who interact with one another and

whose common interests or characteristics form the
basis for a sense of unity or belonging (Allender et.al)
Community Health Nursing (Dr. Araceli Maglaya)
A group of people who share common interests, who
interact with each other and who function collectively  The utilization of the Nursing Process in the
within a defined social structure to address common different levels of clientele-individuals, families,
concern (Clark, population groups and communities, concerned
with the promotion of health, prevention of disease
A group or collection of individuals interacting in social and disability and rehabilitation
units ns sharing common interests, characteristics,
values and goals (Maurer and Smith) Community Development

 An organized effort of people to improve the

Community Health
conditions of community life and the capacity of the
people for participation, self-direction and
The health status of a community and the
integrated efforts in community affairs (Jimenez)
organized responsibilities of public health,
school health, transportation, safety and other
tax-supported functions with voluntary and
private actions to promote and protect the Community Development
health of local population identified as
communities.  A process where community members come
together to take collective action and generate
  solutions to common problems. Community
wellbeing (economic, social, environmental and
Community Health Nursing   (American Nurses cultural) often evolves from this type of collective
Association) action being taken at a grassroots level.

A synthesis of nursing practice and public health Community Organizing

applied to promoting and preserving the health
of the populations.  A process consists of steps or activities that instill
and reinforce the people’s self-confidence on their
own collective strengths and capabilities (Manalili)
 A process of educating and mobilizing members of
The focus of community health nursing: the community to enable them to resolve
community problems.
 A means to build the community’s capacity to work
for the common good in general and health  goals
(Famorca et al)
 prevention of illness
 promotion of health
 maintenance of health
Epidemiology

 The study of the distribution and determinants of

Community Health Nursing
health related states or events in specified
populations and the application of this study to the
It is service rendered by a professional nurse to
prevention and control of health problems.
communities, groups, families and individuals at home,
in health centers, in clinics, in schools, and in places of Health Statistics
 They refer to the numbers that summarize non-profit agencies and organizations. They are
information related to health which are collected by often used to learn about public health and health
researchers, experts from government, private, care.

Health INDICATORS

 A list of information that would determine the

health of a particular community or country 

Population Group

 A group of people who share common

characteristics, developmental stage or common
exposure to particular environmental factors, and
common health problems, issues and concerns
(Maglaya)

Developed by social psychologists into explain why

people failed to participate in screening for TB.
 Population groups are the usual targets or  Provide the basis for current health education and
beneficiaries of social services and health programs. health promotion practices.
 HBM has been used to explain behavior change and
maintenance of behavior change and to guide
health promotion interventions (janz et. Al. )
Definition of Philosophy
Major limitation of HBM – burden of action is on the
client
Health Belief Model (HBM) 

 A philosophy is defined as a system of beliefs that Milio’s Framework for Prevention by Nancy Milio
provides a basis for and guides action. 
 It provides the direction and describe
the whats, the whys and the hows of activities
within a profession.

 Humanistic values of the nursing

profession.  
 Unique and distinct component of
health care
 Multiple factors of health considered
 Active participation of clients is
encouraged  Complements the HBM and provides mechanism for
 Nurse considers availability of resources directing and examining opportunities for nursing
 Interdependence among health team interventions at the population level.
members is practiced  Proposed that health deficits often result from an
 Scientific and up-to-date imbalance between a population’s health needs and
 Tasks of community health nurse vary its health-sustaining resources
with time and place  Milio’s framework encourages the nurse to
 Independence or self-reliance of the understand health behaviors in the context of their
people is the end goal societal milieu
 Connectedness of health and
development Milio’s Framework for Prevention

Theories and Approaches (Community Health Nursing Application of Milio’s Framework in CHN
Practice)

Health Belief Model (HBM)

  Enabling factors refer to conditions in people and
the environment that facilitate or impede health
related behavior.
 Reinforcing factors refer to feedback given by
support persons or groups resulting from the
performance of the health-related behavior.

PRECEDE-PROCEED MODEL
Application of Milio’s Framework in CHN

Pender’s Health Promotion Model

 Develped by Nola Pender

 Explores may biopsychosocial factors that influence
individuals to pursue health promotion activities.
 Depicts the multidimensional factors with which Principles of Community Health Nursing
people interact as they work to achieve optimum
health. Principles of Community Health Nursing

Pender’s Health Promotion Model The focus is the community as the unit of care.
 The responsibility of the nurse is to the community
as a whole

Give priority to the community needs

 The CHN nurse should develop skills in nursing
process and population- focused skills to help the
community identify their needs and produced
benefits for the community.
 Demographics and vital statistics are the tools used
by the Community Health Nurse to achieve this
benefits.
PRECEDE-PROCEED MODEL

 Developed by Dr. Lawrence W. Green and

colleagues
 Provides a model for community assessment, health Work with the community as an equal partner of the
education, planning and evaluation. health team.
 In this model, predisposing factors refer to people’s
characteristics that motivate them towards health-  The client is considered as an active partner, not a
related behaviors. passive recipient of care. Team approach and
partnership between the health care worker and
 the community produce effective and sustainable
results.(Famorca) Functions of Community Health Nursing

In selecting appropriate activities, focus on primary  Identification of community culture and resources
prevention. (key factor in HCDS)
 Evaluate community health conditions, health risks
 The strategies implemented are focused on and problems
achieving optimal health, prevent diseases and  Plan and implementation of comprehensive
disability. community health interventions, care, services and
program.
Promote a healthful physical and psychosocial  Develop health policy at the local community level
environment.
School Nursing
 health team should focus on designing strategies           A specialized practice of professional nursing that 
that focus on environmental determinants of advances the well-being, academic success, and lifelong 
health such as education, socioeconomic status, achievement of students.
physical environment and social supports
         School nurses facilitate positive student responses
Promote optimum use of resources to normal development, promote health and safety,
intervene with actual and potential health problems,
 Effective usage of community resources for provide case management services and actively
strategies that will produce long term effects. collaborate with others to build student and family
capacity for adaptation, self-management, self-
Collaborate with others working in the community advocacy,     and learning (National Association of School
Nurses).
 The nurse has to work with a variety of sectors to
settle issues that affect health, which is considered  
as a product of multiple health determinants
LEGAL BASIS:
Features of Community Health Nursing             School health services are governed by R.A. "An
Act to Provide for Medical Inspection of Children
Community Health Nursing Enrolled in Private Schools, Colleges and Universities in
the Philippines"
Basic Concepts
              This law states that it is the duty of the school
Medical
heads of private schools with a total of enrollment
Rehabilitation
Treatment
of 300 or more to provide for a part-time or full time 
Prevention of
Evaluation of
physician for the annual medical examinations of pupils
Disease and
Health
Problems
CHN health
care services or students.  

   
Promotion of
Health Living CHN Research
AIMS: (Maglaya)

 School Nursing aims to promote the

It is the job of a community health nurse to help and health of school personnel and
keep the community health problems under control students.
(Mona)  School Nursing aims to prevent health
problems that could hinder students'
Features of Community Health Nursing learning and performance of their
 It is a specialty field of nursing developmental tasks.
 Its practice combines public health with nursing.
 It is population based. QUALIFICATIONS OF A SCHOOL NURSE:     
 It emphasizes on wellness and other than disease or
Illness.
 It involves inter-disciplinary collaboration. Registered Nurse
 It increases client’s responsibility and self-care.
Member of  Professional Organization
With Basic ICT Skills Rapid classroom inspection

Emergency Care
 SCHOOL NURSING PRACTICE:
Management of Acute and Chronic Conditions
 School nursing is a specialty unto itself.
Appropriate Referrals
 prepared to work with children of different
ages and under highly variable Regular Deworming
circumstances.
 School nurse's practice is relatively D.   Nutrition
independent and autonomous and is
comprised of many roles  School-Based Feeding Program (SBFP)
 The school setting is a perfect place to
conduct research and advocate for health
  - aims to rehabilitate at least 70% of the identified
promotion
severely wasted school children to normal nutritional
status at the end of feeding days
Integrated School Health and Nutrition Program (ISHNP)

  - designed to maintain and improve the health of school Eating Disorders

children by preventing diseases and by promoting
health-related knowledge, skills and practices (DepEd)  Obesity

COMPONENTS OF SCHOOL HEALTH NURSING Nutritional Education Programs

A.    Health Education
E.   Counseling, Psychological and Social Services
Prevention of communicable diseases
 Children and teens often struggle with
depression, substance abuse, conduct disorders,
Use of traditional and alternative health care in the
self-esteem, suicide ideation, eating disorders,
management of common health conditions
and under or overachievement
 The school nurse may help the child learn how
Oral hygiene
to solve problems, how to cope, and how to
build self-esteem.
Injury prevention and developing safety conscious
behavior
Psycho-Social Intervention Project

Tobacco use
  - allows training of other school personnel on crisis
management especially in war-torn and calamity-
Substance Abuse stricken areas

HIV/AIDS and other sexually-transmitted Infections F.   Healthy School Environment

B.   Physical Education  The school environment should consist of

(WHO,
 Habits in childhood are likely to continue into
adulthood, making it imperative that children A physical, psychological, and social environment that is
are taught the importance of being physically developmentally oriented and culturally appropriate,
active at a young age and that enables student to achieve their potential

C.   Health Services  A healthy organizational culture within

the school
 Health Screening  Productive interaction between the
school and the community.
Annual individual health assessment

Height and weight measurement

  Consultation with other health professionals about
treatment plan
 Provision of care and psychotherapy
G.   Health Promotion for School Staff  Maintenance of medical records
 Support and education to the patients and their
family
 Health  promotion programs improve morale,
reduce job stress and absenteeism and
increases interest in teaching health-related This primary role of a mental health nurse is to provide
topics to students. care to patients with a psychiatric disorder, mental
 Health promotion programs at work also health issue, or behavioral problems. Many of the tasks
have positive effects on blood pressure control, performed by a mental health nurse are similar to that of
daily physical activity, smoking cessation and a psychiatrist and include diagnosis, psychotherapy, and
weight control. prescription of medications.
 DOH and Nutrition service offers a Teachers' Some mental health nurses also choose to specialize
Health Welfare Enhancement Program which further, such as in the management of individuals with a
conducts health examination and health psychiatric disorder of a certain age or association. These
profiling of all teachings and non-teaching may include pediatrics, adolescents, geriatrics, substance
personnel. abuse, and eating disorders

H.   Family and Community Involvement Mental Health Nursing - Keep it in Mind

 Provide health content to families, parents, and

Training and Education
communities on topics such as  communicable
diseases and substances abuse. There are several training education pathways that can
 Programs are designed to positively lead to a career  mental health nurse practitioner (APRN-
influence parents. staff and others in matters PMH). As it is a specialization of nursing, an individual
related to health. must first complete a Bachelor degree in Nursing and
 Nurses can help develop physical activity pass the board examination in order to become a
programs in the community that include both Registered Nurse (RN).
the child and the family.
Following graduation and registration, they may then go
Mental Health Nursing on to complete a master’s degree or doctorate in
advanced practice nursing, with a specialization
Mental health nursing, also known as psychiatric nursing, in psychiatry and mental health. This degree includes
is a specialized field of nursing practice that involves the extensive clinical experience as a core part of the
care of individuals with a mental health disorder to help curriculum and, upon graduation, the nurse may also
them recover and improve their quality of life. choose to complete a one-year residency to develop
their skills further.
Mental health nurses have advanced knowledge of the
assessment, diagnosis, and treatment of psychiatric In the United States, mental health nurses are certified
disorders that helps them provide specialized care. They as a psychiatric mental health nurse practitioner
typically work alongside other health professionals in a (PMHNP-BC), which is conducted through the America
medical team with the aim of providing the optimal Nurses Credentialing Center
clinical outcomes for the patient.
 
Mental illness can affect individuals of any age, ethnic
origin, or socioeconomic status. For this reason, a mental Career
health nurse may need to work with many different An individual well suited to a career as a mental health
individuals from various backgrounds. nurse may have the following qualities:
Role
 Interest in mental illness and behavioral disorders
A mental health nurse is responsible for the  Compassionate, empathetic, and non-judgmental
 Exemplary communication skills
 Assessment and evaluation of the patient’s mental  Emotionally stable with strong self-awareness
health  Problem-solving and critical thinking skills
 Development of treatment care plan  Attentive to detail
Mental health nurses may work in a range of The services of a full-time registered nurse when the
environments, depending on the position and the role number of employees exceeds fifty (50) but not more
that they play. This includes hospitals, psychiatric than two hundred (200) except when the employer does
practices, substance abuse programs, in-home care not maintain hazardous workplaces, in which case, the
services, and community agencies. services of a graduate first-aider shall be provided for the
protection of workers, where no registered nurse is
The work schedule of the nurse will depend greatly on available.
the setting in which they work. For those working in
hospitals or practices with round-the-clock care, it may
include shifts at nighttime, on weekends, and holidays.
However, those in community agencies or private
practices tend to work regular daytime hours.

Occupational Health Nursing  

Occupational Health  Nurse’s Role in Occupational Health Nursing

- the application of public health, medical and  

engineering practice for the purpose of conserving,
restoring the health and effectiveness of workers thru 1.   Assists/participates in developing an adequate health
their places of employment program. 

   2.  Encourages periodic physical examination (PE)

Occupational Health Nursing 3.  Cooperates with occupational medical programs in  

the prevention of accidents       
           - the application of nursing principles and
procedures in providing health service to employees in 4. Helps in teaching others in giving good nursing care  
their place of work by means of: to the sick or handicapped in their own homes

1. Prompt and efficient nursing care of the ill and

impaired
2. Participation in teaching health and safety practices on MAJOR AREAS OF CONCERNS IN OCCUPATIONAL HEALTH
the job NURSING
3. Cooperation with plant department administrators
4. Keeping the health clinic and staff ready to handle Emergency and palliative care
emergencies
5. Advising workers in the utilization of community and
Family planning
welfare services
Counseling
 

Objectives of OHN Immunization

Ø  Assist, maintain and promote  positive health of Environmental sanitation

laborers and   employees thru early detection

Ø  Prevent occupational diseases and hazards of Work safety

industrial processes
Disaster prevention
Ø  Coordinate and cooperate with activities of other
community   health and welfare services Dissemination of health information/education
 
 
Legal Basis:

Presidential Decree No. 442,   " The Philippine Labor

Code" as amended   May 1, 1974
 - Various forms of chemical agents, including
medications, solutions and gases, that interact with body
tissues and cells and are potentially toxic or irritating to
body systems

ASSESSMENT and CONTROL OF HAZARDS IN THE 3.   Enviromechanical Hazards

WORKPLACE (Famorca, 2013) - Factors encountered in the work environments that
1.  HEALTH HAZARDS  cause accidents, injuries, strain or discomforts (eg. poor
equipment, lifting devices and slippery floors)
- are the elements of in the work environment that can
cause work-related diseases to the worker. 4.   Physical Hazards

2.  SAFETY HAZARDS - Agents within work environments such as radiation,

electricity, extreme temperatures and noise that can
-  are the unsafe conditions or unsafe acts that cause tissue trauma through transfer of energy from
significantly increase the risk of a worker to be injured these sources.

  5.   Psychosocial Hazards

CATEGORIES OF HEALTH AND SAFETY HAZARDS - Factors and situations encountered or associated with
the job or work environment that create stress,
1.  Biological-infectious Hazards emotional strain or interpersonal problems
- Infectious-biological agents such as bacteria, viruses,  
fungi or parasites that may be transmitted via contact
with infected clients or coworkers and contaminated CONTROL MEASURES FOR OCCUPATIONAL HAZARDS
materials.
1.  Administrative Controls
2.  Chemical Hazards
- refers to the development and implementation of
policies, standards, training, job design 

2.  Engineering

- refers to the adoption of physical, chemical or

technological improvements to limit the exposure if
workers to the hazards of the workplace.

3.  Materials Provision

- refers to providing the workers with supplies or

supplements that can decrease their exposure or
susceptibility to occupational hazards (eg. PPEs,
immunizations, vitamin supplementation)