Your role as a public health nurse is to respond to the needs of the community you serve and its accompanying policies. A recent movement in public health of interest to nurses is the Health in All Policies movement (APHA, 2013).
PERSPECTIVES: POLICY IMPACTS AT LOCAL, STATE, AND NATIONAL LEVELS
LEGISLATIVE PROCESS AT THE NATIONAL LEVEL
There are other important aspects of the legislative process that the PHN should be aware of. If this involves removing part of the law, this can be done while enforcement continues.
POLICY ANALYSIS FOR THE PUBLIC HEALTH NURSE
An example from Sri Lanka involves reaching a consensus on the public health problem of high suicide rates (47 overall and 80 for men per 100,000 – the highest in the world at the time). The second step, once the PHN has determined that the issue is indeed a public policy issue, is to conduct a brief policy analysis using Kingdon's framework initially: What is the problem.
POLITICAL ACTION AND ADVOCACY FOR PHNS
AMERICAN
NURSES ASSOCIATION (ANA) LOBBYING EFFORTS TOWARD HEALTH CARE
REFORM
Nurses must be full partners, with physicians and other health professionals, in the redesign of health care in the United States. Recommendation 8—Build an infrastructure for data collection and analysis of the interprofessional health care workforce.
CURRENT U.S. HEALTH POLICY OPTIONS
The focus of the ACA, in the minds of the public, was to make health insurance coverage mandatory for all US. Additional components of the ACA that have the potential for major changes in health and health policy at the community level include value-based procurement and accountability of health care organizations (ACOs), along with the expanded IRS requirement for nonprofit hospitals to regularly review the health needs of assess the community and develop implementation plans based on this data to improve the health of their communities (Knickman & Kovner, 2015).
POWER AND EMPOWERMENT
Even with the advent of recent health reform legislation, nurses need to be even more actively involved in the policy advocacy process. How many nurses have written to their legislators about upcoming healthcare legislation or legislation affecting nursing.
PERSPECTIVES VOICES FROM THE COMMUNITY
Policy competence, or the understanding of policy formulation, implementation, and modification, is important for public health nurses because of the ability to influence both the policy process and the impact of policies on clients. The political process is inherent in health policy development and the public health nurse has a role in policy and advocacy within these processes.
ACTIVITIES TO PROMOTE CRITICAL THINKING
Retrieved from http://www.nursingworld.org/EspeciallyforYou/StudentNurses/Thenursingprocess.aspx American Public Health Association (APHA). Retrieved from http://www.ncsl.org/research/health/state-policies-on-sex-education-in-schools.aspx. Retrieved from http://www.hhs.gov/healthcare/about-the-law/read-the-law/index.html.
Retrieved from http://www.wsna.org/assets/entry-assets/Nursing-Practice/Publications/Position-Paper-on-Public-Health-r2.pdf.
4 UNIT THE COMMUNITY AS CLIENT
14 CHAPTER Theoretical Basis of Community/Public
What are theories, models and principles and what is their relevance to daily public nursing practice. First, however, we review some of the basic characteristics of community/public health care that we began to explore in Unit 1.
COMMUNITY/PUBLIC HEALTH NURSING PRACTICE
As discussed in Chapter 1, a community is a group of people who share a number of characteristics, are bound by time, interact with each other, and feel connected. Determines how the community's knowledge, values, beliefs, and past experience of infectious diseases can influence disease interpretation, response to the outbreak, and treatment preferences. Community-based, population-based care uses population-based skills and is shaped by the characteristics and needs of a particular community.
Public health nurses provide community-based, population-based care when they count and interview homeless people sleeping in a park and, based on this data, help develop a program to provide them with food, clothing, shelter, health care, and job training. population.
THEORIES AND MODELS FOR COMMUNITY/PUBLIC HEALTH NURSING
EXAMPLES OF SOCIAL DETERMINANTS OF HEALTH
Availability of community resources to support community living and opportunities for recreation and leisure activities. Exposure to crime, violence and social disorder (e.g. presence of litter and lack of community participation).
EXAMPLES OF PHYSICAL DETERMINANTS OF HEALTH
Although Orem's model focused primarily on individuals, it can be applied to public health nursing practice. Using this model, the public health nurse can focus on community-environment interaction; the community functions interdependently with others and with the environment. As we have noted throughout this text, health promotion is a priority in community/public health nursing practice.
This model helps the public health nurse understand how a community's ability to adapt to stressors will affect community health (Fig. 14-2).
PUBLIC HEALTH PRACTICE MODELS
It offers public health nursing as a specialty practice within the field of nursing (Public Health Nursing Section, Minnesota Department of Health, 2001). The Los Angeles County Public Health Nursing Practice Model (LAC PHN Practice Model) was developed in response to an identified need for a model that could blend public health nursing practice and the principles of public health, applicable to both the general nursing and nurses working in specific programs (Smith & Bazini-Barakat, 2003). Used by permission of the Los Angeles County Department of Public Health, Public Health Nursing.
With the continued pressure on public health program funding, outcome data is vital and can be achieved through the application of the Omaha system.
PRINCIPLES OF COMMUNITY/PUBLIC HEALTH NURSING
- PRINCIPLES OF PUBLIC HEALTH NURSING
- Focus on the Community
- Give Priority to Community Needs
- Work in Partnership with the People
- Focus on Primary Prevention
- Promote a Healthful Environment
- Target All Who Might Benefit
- DETERMINING WHETHER PROGRAMS SERVE
A public health nurse is obligated to actively identify and contact all those who may benefit from a particular activity or service. The third principle requires the public health nurse to work in partnership with the community. The fourth principle of public health nursing emphasizes the importance of primary prevention in promoting people's health.
In contrast, public health care has an obligation to prevent health problems and promote a higher level of well-being.
INTENDED POPULATIONS
Promote Optimum Allocation of Resources
The nurse must ensure that the community uses limited resources in a way that leads to the greatest improvement in health (Bekemeier, Chen, Kawakyu, & Yang, 2013). Evaluate existing programs and policies for ways to improve or discontinue them. Communicate this information to community decision-makers so that they can make resource allocation decisions that are likely to improve the health of the community. In current research on resource allocation in public health agencies, the majority of agencies in one study reported little impact due to public input, but more influence from health boards.
Public health nurses should continue to work at all levels to promote greater funding for public health programs and more efficient allocation of resources.
Collaborate with Others in the Community
SOCIETAL INFLUENCES ON COMMUNITY- ORIENTED, POPULATION-FOCUSED
DETERMINING WORTH OF HEALTH INFORMATION ON
Public health nursing is a community-based, population-centered nursing specialty that is based on interpersonal relationships. Theories and models of community/healthcare nursing practice assist the nurse in understanding the rationale behind community-based care. Describe a situation in community/health care nursing practice where the use of an educational intervention would be most appropriate.
Conceptual models for population-focused public health nursing interventions and outcomes: state of the art.
15 CHAPTER Community as Client: Applying the
State three specific aspects of each of the three dimensions of community as a customer. The concept of community as client refers to a group or population of people that is the focus of nursing services (Anderson & McFarlane, 2015). As described in Chapter 1, understanding the concept of community as client is a prerequisite for effective service at all levels of community nursing practice.
It is this population-centered practice that distinguishes community nursing from other nursing specialties (American Nurses Association [ANA], 2013; American Public Health Association, Public Health Nursing Section, 2013).
WHAT IS A HEALTHY COMMUNITY?
Within this framework, the priorities provide evidence-based recommendations most likely to reduce the burden of the leading causes of preventable death and major illness, and include. The NPS serves as a roadmap for community health providers, collaborating with stakeholders and community partners, to address priority areas such as healthy eating, active lifestyles and tobacco control through prioritizing prevention and integrating recommendations and actions across multiple settings. By working on shared priorities, community health nurses can serve as a valuable partner in identifying community health needs and connecting communities with available resources (Jarris & Schneider, 2013).
Nurses can also serve as community educators, empowering people to make healthy choices while working to create environments where healthy choices are more accessible and affordable, which is the ultimate intent of the strategy (Lushniak, Alley, Ulin, . & Graffunder, 2015 ).
DIMENSIONS OF THE COMMUNITY AS CLIENT
The way a community responds to these populations, whether wild or domesticated, can affect the health of the community. Leadership for improving the health of the community can change so often that joint action. Because this interaction between parts determines the health of the whole, it is the total social system that concerns community health nurses.
The main function of the health system is to promote the health of the community.
THE NURSING PROCESS APPLIED TO THE COMMUNITY AS CLIENT
QUAD COUNCIL CORE COMPETENCIES OF PUBLIC
HEALTH NURSING (2011)
Community Based, Population Focused
Develop quality improvement indicators and core measures as part of the process to improve public health programs and services. Use quality improvement indicators and core measures as part of the process to improve public health programs and services. Use input from a variety of community/aggregate stakeholders in the development of public health programs and services.
It identifies gaps in scientific evidence related to public health issues, concerns, and interventions at the population level.
PERSPECTIVES
Whether health service is aimed at families, groups, subpopulations, populations or communities, the consumers of that service are equally important members of the team. Community health nurses cannot lose sight of the need for client involvement at all levels and at all stages of community health practice (see Perspectives: Voices from the community).
VOICES FROM THE COMMUNITY Public Health Nurse
The family members rarely came out; they made almost no use of society's recreational system. A quick survey of the religious system in the local community revealed two job change support groups, one of which would welcome mr. at the women's clinic.
Key informants are experts in one specific area of the community or they may know the community as a whole.
PUBLIC HEALTH NURSING INSTRUCTOR
This can result in a fragmented approach to solutions to the community's problems rather than an approach focused on the community's capabilities, strengths and assets. Specific skills, talents, interests and experiences of individual community members, such as individual businesses, cultural groups and professionals living in the community. Local civic associations, organizations and institutions that are largely community-controlled, such as libraries, social services agencies, voluntary organizations, schools and police.
Local institutions originating outside the community were largely controlled outside the community, such as welfare spending and public capital (p. 14).
COMMUNITY ASSESSMENT METHODS
A survey is an evaluation method in which a series of questions are used to collect data for the analysis of a specific group or area. Survey findings can be combined with other health data to better understand community health status and the determinants of health. Considering these data together with the survey results allows for a more complete understanding of the health status of communities and the conditions that affect health.
In addition to their value in assessing the health status of a population, descriptive epidemiological studies are useful in suggesting which individuals are at greatest risk and where and when the condition may occur.
