History of community health nursing
- In the public health perspective, health is defined as the state of total physical, psychological, and social wellness, rather than the absence or presence of disease, infirmity and disability. It also includes the ability of a person to live an economically and socially productive life. Primary prevention, secondary preventive measures, and tertiary protection are the three types of prevention.
The term primary prevention is used to describe actions that are taken prior to the appearance of an illness with the aim of decreasing the risk of it occurring. A primary prevention example is immunizing children against infectious diseases.
In secondary prevention, the goal is to identify and treat diseases in their early stages so as to reduce complications and prevent progression. A routine screening, like mammograms and the Pap test, can be used to detect signs of cervical and breast cancer early.
The goal of tertiary preventive measures is to reduce the severity and impact of a disease that has already been established by preventing its complications and encouraging rehabilitation. Physical therapy is an example of tertiary preventive care. It can be used to help stroke patients improve their independence and mobility.
- The wheel of interventions outlines different community/public healthcare nursing interventions. This includes:
- Surveillance : collecting data and analysing them to identify health trends and monitor events.
- Disease and Health Event Investigation: Investigating and controlling outbreaks and health events.
- Outreach: Reaching out into the community and providing information and resources on health and well-being.
- Screening: Testing individuals for early disease signs.
- Case Finding and Recommendation: Identification of individuals with specific health problems and a referral to resources that can help.
- Case management is the coordination of health care to meet individuals’ and families’ needs.
- Delegated functions: nursing care that is provided at the physician’s or other health provider’s direction.
- Information and resources that help people and communities to make informed health decisions.
- Counseling – providing individuals with emotional and psychological assistance.
- Consultation: working with other health professionals to ensure comprehensive care.
- Collaboration: Working with community partners to improve health and reduce disease.
- Coalition building: the process of bringing diverse groups together in order to reach a goal.
- The steps involved in conducting an assessment of community health include:
- Define the community by defining the geographical boundaries and the demographics.
- Data collection: obtaining information on the state of health of a community. This includes disease rates, health behavior, and social determinants.
- Data analysis: Using epidemiological data, identify trends and patterns in community health.
- Identification of health problems: the analysis of data is used to determine the health concerns that are most important.
- Develop interventions: Create strategies for addressing the health issues identified.
At every stage in the nursing process, data from epidemiology is used to make decisions on patient care or community intervention. In the assessment phase of the nursing process, for example, the epidemiological data collected can be used to identify community health concerns. In the planning phase data can help develop effective interventions. Data can also be used during the evaluation to determine the effectiveness of an intervention.
- Public health nursing focused on the acute illnesses of the early 20th century such as influenza and tuberculosis. Public health principles like sanitation and hygienic practices were employed to stop the spread of diseases. The shift in the early 21st century was towards chronic illnesses, like diabetes and heart diseases. These issues are being addressed using the public health principles that promote prevention and prevent disease.
A few of the issues currently facing public and community health nurses include the opioid crisis, COVID-19, and healthcare disparities. They have their roots in social and systemic injustices, including racism and poverty. To address these issues, a collaborative approach with community partners and a multidisciplinary perspective is required.
Nies, M. A., & McEwen,