CHAPTER 2

FOUNDATIONS OF
COMMUNITY AND
PUBLIC HEALTH
NURSING PRACTICE
LEARNING OBJECTIVES
❑ Define the key concepts of community and public health nursing
❑ Enumerate the different levels of clientele in community and public health
nursing
❑ Explain the various principles underpinning the practice of community health
nursing
❑ Identify the myriad roles and functions of the nurse in community and public
health nursing
❑ Discuss the various public health interventions applied in practice.
KEY TERMS
❑ Community and Public health nursing
❑ Public health
❑ Levels of Clientele
❑ Healthcare
❑ Health Promotion
❑ Disease Prevention
 Hierarchy of nursing science

Focused on all population groups. Community

&
Public
Health Nursing

Mental Health & Psychiatric

Nursing
Focused on individuals and their
specific health issues in a hospital
setting. Mother & Child Nursing

Adult Health Nursing

 Key concepts of community & public health nursing

Community as a client
Health as a goal
Nursing as the vehicle or means to achieve to aims
 Key concepts of community & public health nursing

Attributes of a community

• Geographic boundaries
• Culture

In the Philippines, health and illness can be summed up as the

presence or absence of signs and symptoms.
 Key concepts of community & public health nursing

Nursing is traditionally defined as the art and science of nursing.

Theorists:
❖ Florence Nightingale
• Defined nursing as a means of ensuring that people are placed in an optimum
condition where nature can contribute to healing and wellness.
• Nursing becomes an act of modifying and manipulating the environment.
❖ Virginia Henderson
• Nursing as a way to help people achieve self-reliance in health, allowing them
to do things through their efforts.
 Definitions of community and public health nursing
(CPHN)

CHN
⮚ Defined as a specialized field of nursing practice that renders care to individuals,
families, and communities.
⮚ Focused on health promotion and disease prevention.
⮚ “an area of human services directed toward developing and enhancing the health
capabilities of people- either singly, as individuals, or collectively, as groups and
communities”- (Heinrich and Freeman, 1981).

❖ Vaccination
❖ Screening activities e.g. bp & blood sugar monitoring
 Definitions of community and public health nursing
(CPHN)

Occupational Health Nursing Faith Community Nursing

Community Health Nursing

Public Health Nursing

Correctional Nursing School Health Nursing

 Characteristics & features of community and public
health nursing

CPHN
⮚ Developmental
▪ Health education is a primary activity to help people acquire knowledge and
skills and ultimately instill consciousness among them.

⮚ Multidisciplinary
▪ The nurse fosters collaboration with different professionals and sectors of
society.

⮚ Ecology oriented
▪ Care provided in the natural environment of people.
 Characteristics & features of community and public
health nursing

CPHN
⮚ Promotes social justice
▪ The nurse allocates resources and healthcare budget for the benefit of all for
the greatest number.

⮚ Values consumer involvement

▪ Consumers are considered health partners.

⮚ Uses prepayment mechanism

▪ Funded by taxes of the people.
 Characteristics & features of community and public
health nursing

CPHN
⮚ Focuses on prevention service
▪ Nurses constantly search for risks that make people vulnerable to diseases
and implement interventions to modify and mitigate these vulnerabilities.

⮚ Offers comprehensive care

▪ Caring is from womb to tomb.
▪ Holistic care is expected.
 Philosophical and Ethical underpinnings

Responsibility for health rests on Promoting the common

people and not on agencies and good - social justice and not
professionals merely fair to all
 Philosophical and Ethical underpinnings

Universal Ethical Principle

❖ Beneficence & Nonmaleficence

❖ Veracity
❖ Fidelity
❖ Autonomy
 Roles of the community and public health nurse

❖ Healthcare Provider
❖ Health Educator
❖ Program Implementer
❖ Community Organizer
❖ Manager/ Leader
❖ Researcher/ Epidemiologist
❖ Client Advocate
 Levels of clientele in CPHN

The Philippine Nursing Law of 2002 (RA 9173)

“A person shall be deemed to be practicing nursing within the meaning of

this Act when he/she singly or in collaboration with another, initiates and
performs nursing services to individuals, families, and communities in any
health care setting……”
 Levels of clientele in CPHN

The Philippine Nursing Law of 2002 (RA 9173)

“…As independent practitioners, nurses are responsible for the promotion

of health and prevention of illness.”
Levels of clientele in CPHN

❖Individuals
❖Families
❖Groups
❖Communities
 Public Health

C. E. Winslow
“Public health is the science and art of (1) preventing disease, (2) prolonging life,
and (3) promoting health and efficiency through organized community effort for:
1. Sanitation of the environment
2. Control communicable infections
3. Education of the individual in personal hygiene
4. Organization of medical and nursing services for the early diagnosis and
preventive treatment of disease, and
5. Development of the social machinery to ensure everyone a standard of living
adequate for the maintenance of health, so organizing these benefits as
to enable every citizen, realize his birthright of
health and longevity.
 Public Health

As a science
✔ Concerned with the knowledge and skills required of a nurse to be able to institute
interventions for the welfare of the public.

As an art
✔ Requires creativity in executing the knowledge and skills for the comfort of the
people.

Mission
✔ Social Justice
 Public Health

Assessment Regular collection, analysis and information

sharing about health conditions, risks, and
resources in a community.
Policy development Use of information gathered during the
assessment to develop local and state health
policies and to direct resources towards policies.
Assurance Focuses on the availability of necessary health
services throughout the community. It includes
maintaining the ability of both public and private
to manage day-to-day operations and the
capacity to respond to critical situations and
emergencies.

Core Public Health Functions

 Public Health

✔ The efforts focus on preventing and promoting population health at the national and
local levels.

❑ National level- Concentrate on providing support and advisory services to public

health structures at the local level.

❑ Local level- Provide direct services to communities through 2 avenues

1. Community health services
Ex: Protect the public from hazards

2. Personal health care services

Ex: Immunization and Family Planning
 Public Health

In 1994 the American

Public Health Association
drafted a list of 10 essential
public health services
which the U.S. Department
of Human and Human
Services adopted.
 Public Health

Purposes:
✔ Promoting healthy lifestyles
✔ Preventing disease and injury
✔ Protect the health of communities
The focus of healthcare professionals:
✔ Promoting healthy lifestyles
✔ Proving preventive and primary care
✔ Expanding and ensuring access to cost-effective and technologically appropriate care
✔ Participating in coordinated and interdisciplinary care
✔ Involving patients and families in the decision-making process.
 Public health interventions

PHN focuses on the care of;

✔ Individuals
✔ Groups
✔ Aggregates
✔ Homes, Clinics, Worksites, Schools
 Public health interventions

PHN must also work with the community to identify and implement programs that meet
health needs and to evaluate the effectiveness of the program after implementation.

Before
✔ School nurses were once responsible only for running first aid stations and
monitoring compliance.
Now
✔ Actively involved in assessing the needs of their population and defining programs
 Public health intervention
wheel
3 Elements

1. Population-based
2. Three levels of practice
3. Identifies and defines 17 public
health interventions