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ATI RN Community Health Nursing Study Guide
Chapter 1- Overview of Community Health Nursing
- Community Health Nursing
o A population focuses approach in planning, delivering, and evaluating nursing care.
o Nurses promote health and welfare of patients across the lifespan and from diverse
populations.
o Nurses should understand the foundations of community health nursing, health
promotion, and disease prevention.
- Foundations of Community Nursing
o Advances in knowledge about health led to appropriate education of providers and
regulation of water and other environmental factors.
o Local health boards began to monitor disease, promote health, and collect statistics about
the community.
- Community Health Nursing Theories
o Systems thinking- studies how an individual or unit interacts with other
organizations/systems; useful in studying cause and effect relationships.
o Upstream thinking- used to focus on interventions that promote health or prevent illness.
- Essentials of Community Nursing
o Determinants of health- patient or environmental factors that influence the patient’s
health.
Example- nutrition, social support, stress, education, finances, transportation,
housing, biology, genetics, and personal health practices.
o Health indicators- describes the health status of a community and serves as targets for the
improvement of a community’s health.
Example- mortality rates, disease prevalence, levels of physical activity, obesity,
tobacco use, substance abuse.
o Nurses- determine the community’s health by examining the health needs of the
community and if they are met or not. Goal of community health nurses is to promote,
preserve and maintain the health of populations by the delivery of health care services.
Example- they can work at community health care clinics or department of
health.
o Community- group of people and institutions that share geographic, civic, and/or social
parameters. Vary in characteristics and health needs.
Example- aggregate, population
- Types of Community Health Nursing
o Public Health Nursing
Population-focused with the goal to promote health and prevent disease.
Assessment- using systematic methods to monitor the health of a population.
Diagnose and investigate health problems and health hazards in the community.
Policy Development- developing laws and practices to promote the health of a
population based on scientific evidence.
Inform and educate about health issues, mobilize community
partnerships to identify and solve health problems, develop policies and
plans to support individual and community health efforts.
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Assurance- ensuring healthcare services are accessible, enforcing laws and
regulations that protect health and ensure safety, link people to needed personal
health services.
o Population-focused nursing
Includes assessing to determine needs, intervening to protect and promote health
and preventing disease within a specific population.
Community partnership occurs when community members, agencies and
businesses actively participate in the process of health promotion and disease
prevention
Key principles of public health nursing include an emphasis on primary
prevention, achieving the greatest good for the largest number of people.
- Principles Guiding Community Health Nursing
o Ethics
Preventing harm, doing no harm, promoting good, respecting both individual and
community rights, respecting autonomy and diversity, and providing
confidentiality, competency, trustworthiness, and advocacy.
o Respect for Autonomy
Individuals select those actions that fulfill their goals.
Example- respecting a patient’s right to self-determination
o Nonmaleficence
No harm is done when applying standards of care.
o Beneficence
Maximize possible benefits and minimize possible harms.
o Distributive justice
Fair distribution of the benefits and burden in society is based on the needs and
contributions of its members.
o Advocacy
Nurse plays the role of informer, supporter and mediator for the patient.
Nurses act as advocates for communities and populations through efforts to
change health care systems and improve quality of life.
Example- nurses working to promote access to clinics for individuals
who live in rural communities.
- Evidence-Based Practice
o EVP
Involves using best practices, expert opinion, and client preferences to change the
delivery of client care and improve client outcomes.
o Data
Quality- data collected from research to measure whether bias was minimal
Quantity- the number of studies, participants, or strength of effect.
Consistency- whether the results are repeatable.
Data is also classified to determine the strength of the information.
o In the Community
EBP improves public health as nurses develop policies to improve the health of
specific groups, provide new solutions for groups of people (assessment), provide
information to communities (policy development) and evaluate the effectiveness
of the health care environment for groups (assurance)
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The Task Force on Community Preventative Services produces a guide that
reviews health promotion and disease prevention guidelines compared to the
available evidence. Then, they determine whether the evidence is strong enough
to implement an intervention.
Nurses must consider several factors when applying evidence to practice: cost,
benefit, satisfaction, safety, and patient specific factors.
- Health Promotion and Disease Prevention
o Health Promotion
Healthy People national health goals are derived from scientific data and trends
collected during the prior decade.
Based off of major risks to the health and wellness of the United States
Population.
Serves as a measure for quality of health.
Objectives include the following focus areas
Access to health services, adolescent health, chronic kidney disease,
disability, genomics, global health, health-related quality of life and well-
being, hearing disorders, nutrition and weight status, older adults, oral
health, preparedness, family planning, food safety, mental health,
medical product safety, LGBT health, substance abuse, and sleep health.
o Disease Prevention
Primary Prevention- prevention of the initial occurrence of disease or injury
Nutrition education, family planning, sex education, smoking cessation
education, communicable disease prevention education, education about
health and hygiene issues to specific groups, safety education, prenatal
classes, providing immunizations, advocating for access to health care,
healthy environments.
Secondary prevention- early detection and treatment of disease with the goal of
limiting severity and adverse effects.
Community assessments, disease surveillance, screenings, cancer,
diabetes mellitus, hypertension, TB, lead exposure, genetic disorders,
control of outbreaks of communicable diseases.
Tertiary prevention- reducing the limitations of disability and promoting
rehabilitation following health alterations.
Rehabilitation, nutrition counseling for management of a specific
disease, exercise rehabilitation, case management, physical and
occupational therapy, support groups.
Chapter 2- Factors Influencing Community Health
- Culture
o The Office of Minority Health has requirements for culturally and linguistically
appropriate services (CLAS).
o Language assistance and information to a client in their preferred language throughout
the delivery of health care.
o Congruency between culture and health care is essential to the well-being of the client; it
is important to assess cultural beliefs and practices when developing a care plan.
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