COMMUNITY
HEALTH NURSING
PROCESS
Prepared by: Ma. Tonnette Aurora T. Tan, R.N.
• Community health nurse is responsible to provide general
and comprehensive public health and nursing services to
the people at large in a defined community.
• This process of rendering care can be done by making use
of NURSING PROCESS and PRINCIPLES as
applicable in the community settings.
NURSING PROCESS
Definition
• Community Health Nursing Process is a systematic, scientific, dynamic,
ongoing interpersonal process in which the nurses and the clients are viewed
as a system with each affecting one and another and both being affected by
the factors within the behaviour.
Definition
• “Community Health Nursing Process refers to systematic series of steps
which are followed by public health nurse in community health and nursing
problems using community approaches and resources”.
Advantage
• Community Health Nursing process is an effective tool to help people solve
their health problems and meet their health and nursing needs.
Steps:
1. Establishing and maintaining working relationship
2. Assessment of Health needs and health problems.
3. Setting objectives.
4. Planning and Implementing interventions.
5. Evaluation of interventions.
STEPS IN NURSING PROCESS
I. Establishing &
Maintaining Working
Relationship
• Community Health Nursing process is helping the community, people and
families identify their health problems and develop competencies to solve
their health problems and meet their health and nursing needs.
• Working relationship is productive in nature.
• In a “working relationship between community health nurse and the
community, people and families, there is a free dialoguing and an attitude of
trust and confidence in the integrality and capabilities of each other to meet
health and nursing goals.
A working relationship between a nurse and the community is
initiated and maintained by the following means:
1. Knowing the client (community).
2. Communicating intensions and nature of help and assistance that would be
extended.
3. Active listening and responding in between.
4. Answering their queries.
A working relationship between a nurse and the community is
initiated and maintained by the following means:
5. Considering their views.
6. Appreciating what is worthwhile.
7. Empathetic attitude.
8. Meeting their immediate needs and needs which are considered important by
them.
II. Assessment Of Health
Needs & Health Problems
• The community health nurses comes to know the health needs and
problems of the community as the nurse explores the community.
• The problems could be a large family size, malnutrition in
children, incomplete immunization, anemia in pregnant and
nursing mothers, several morbidity conditions.
• The priority is determined on the basis of underlying criteria:
1. The nature of the problem, it’s prevalence, impact and prognosis.
2. Community’s perception of the problem.
3. Preventive potential
III. Setting Objectives
• Once the problems are prioritized, it is very important to set up objectives
relevant to each of the problems identified.
• For example: Malnutrition
– to assess the growth and development of
all under five children in a defined
community to find out malnourished
children.
– To get the medical examination done for
all the malnourished children.
– To carry out prescribed treatment and
provide care to all malnourished
children.
– To do a regular monitoring of nutrition
status of all children.
– To encourage all the children in the
community to eat well and avail food
supplements.
– To educate mothers and population in
general about the malnutrition and
importance of nutritious diet.
IV. Planning and
Implementation of
Interventions
• This is otherwise called the ACTION PLAN.
• Once the objectives are formulated it is necessary to identify
interventions to be implemented to achieve the objectives.
V. Evaluation of Action
Plan
• The evaluation of interventions determines the effectiveness of
actions implemented – i.e. whether the desired results intended are
achieved or not.
• This helps in making further improvement (feedback and re-plan,
re-implement and re-evaluate)
• The effectiveness of intervention depends upon its objectives and is
determined on the basis of the following criteria:
1. Population coverage.
2. Utilization of services provided.
3. Outcomes in terms of reduction in morbidity rates (increase in life
expectancy).
4. Change in knowledge, attitude and practice, degree of independence.
5. Evaluation thus made is both qualitative and quantitative.
• The effectiveness of intervention depends upon its objectives and is
determined on the basis of the following criteria:
6. An effective evaluation strategy has the following characteristics:
Well defined measurable objectives.
Well defined action plan.
Has a baseline statistical information for comparison.
Observe changes in health knowledge, attitudes and practices.
Analyze and interpret the facts (data) observed and recorded.
Principles of
Community Health
Nursing Process
Principles of Community Health Nursing
Process
• Principles are rules for community health practice or actions.
• These provide guidelines to function in the community effectively and
efficiently
1. Community health nurse must explore and know various aspects of a defined
community.
2. Community health nurse must make a map of the community showing the geographical
boundaries, important roads, streets, housing networks, church/temple/mosque, school,
post office.
3. Community health nurse must establish good working relationship.
4. Community health nurse must know the health care delivery system , health
policies, health goals, health actions, national health care programs while
rendering heath services.
5. The community health nurse should provide realistic health services.
6. Community health nurse must organize health services at large for the
community and render the services to the family which is the unit of
community.
7. Community health nurse must continuously keep in touch with the
community and provide wellness oriented comprehensive services
continuously.
8. Community health nurse must work in collaboration with other team members.
9. Community health nurse educates in giving care o individual, family and
communication.
10. Community health nurse must maintain proper health records, registers.
11. The community health nurse must evaluate her services to find out achievement.
12. The community health nurse must provide services to all without any discrimination of
age, gender, color, caste, nationality, political affiliation, religion.
13. The community health nurse must not interfere with people’s religious, political
beliefs, but respect every one without any prejudice.
14. Community health nurse should work in close consultation with employing
authority(Government, public trust, NGO’s).
15. Community health nurse should develop and maintain professional relationship with
health and health allies agencies.
16. Community health nurse must never accept any bribe or gift against professional ethics.
17. The community health nurse must have an active participation with the community in
taking care of their own needs and health problems.
18. The community health nurse must be aware and closely coordinate with the local formal
and informal leaders.
Thank you.
