Transcript Community – based nursing

Community – based
nursing
Key terms:
Community – People and the relationships that
emerge among them as they develop and use in
common some agencies and institutions and
share a physical environment.
Community – based – occurs outside an
institution; services are provided to individuals
and families in a community.
Community – based nursing – the provision of
acute care and care for chronic health problems
to individuals and families in the community.
Growing costs of hospital care
More services are being provided in
community – based settings
Increasingly, nurses will engage in what is
called community – based nursing
(CBN)
The main focus and aim
of CBN
In CBN the nurse focuses on “illness care” of
individuals and families across the life span.
The aim is to manage acute and chronic health
condition in the community, and the practice is
family – centered illness care.
CBN is not a specialty in nursing but rather a
philosophy that guides care in all nursing
specialties.
The main characteristic
features of CBN
Philosophy. Focus is on “illness care” of
individuals and families across the life
span.
Goal. Manage acute or chronic conditions.
Service context. Family – centered illness
care.
Community type. Human ecological.
The main characteristic
features of CBN
Client characteristics.
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Individuals
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Families
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
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
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Usually ill
Culturally diverse
Autonomous
Able to define own problem
Involved in decision making
The main characteristic
features of CBN
Practice settings.

Community agencies
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Home

Work

School
Interaction patterns. One – to- one
Type of service. Direct illness care
The main characteristic
features of CBN
Emphasis on levels of prevention.

Secondary
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Tertiary
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May be primary
The main characteristic
features of CBN
Roles.
Client and delivery oriented.
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Caregiver
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Educator
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Counselor
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Advocate
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Case manager
Group oriented.

Leader (disease management)
 Change agent (managed – care services)
The main characteristic
features of CBN
Priority of nurse activities.
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Care management (direct care)
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Patient education
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Individual and family advocacy
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Interdisciplinary practice
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Continuity of care provider
Four key nursing modes in
the community
1. Community-Oriented Nursing Practice: a
philosophy of nursing care delivery that
involves generalist or specialist public
health and community health nurses
providing "health care" through community
diagnosis in order to create conditions in
which people can be healthy.
Four key nursing modes in
the community
2. Public Health Nursing Practice:
the synthesis of nursing and public
health theory applied to promoting
and preserving the health of
populations. The goal is to prevent
disease and disability and promote
and protect the health of the
community as a whole.
Four key nursing modes in
the community
3.
Community Health Nursing Practice:
the synthesis of nursing and public health
theory to promote, preserve, and
maintain the health of the population
through the delivery of personal health
services to individuals, families, and
groups. Focus is on the health of
individuals, families, and groups and how
their health status affects the community
as a whole.
Four key nursing modes in
the community
4. Community-Based
Nursing
Practice: a setting-specific practice
whereby care is provided for "sick"
individuals and families where they
live, work, and attend school.
Challenges for the future
At present, the trend is to move more care into
community settings and to reduce the
number of hospital days for "sick" clients
Reasons:
community care is often much less
expensive than hospital care
care in the community is usually more
appealing to people who prefer to remain at
home rather than be treated in a hospital
The role of the nurse in
community settings will
likewise grow and
continue to change
Community – based ethical
theory
Ethics is a body of knowledge
and, as such, is more than
"being a good person." Ethics is
a part of clinical decision
making and practice