Community Health Nursing Diagnosis and Nursing Care Plan

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Community Health Nursing Care Plans Diagnosis and Interventions

Community Health Nursing NCLEX Review and Nursing Care Plans

Community health nursing, also known as public health nursing, is one of the various specializations available in this professional field. Nurses who aspire to work in a setting other than a hospital and have greater control over their practice can choose to specialize in community health nursing.

A comprehensive approach to patient care is required in community health nursing. Its emphasis is on individuals, families, and groups within a particular area which focuses on the health promotion of an entire population while also preventing disease, disability, and mortality rates in a community.

Educating the community to maintain a healthy lifestyle is also one of the key objectives of community health nursing.

By taking into account the cultural beliefs, surroundings, lifestyle, and socioeconomic considerations, a community nurse should be able to adapt quickly and help people live healthier lives in their own environment.

Importance of Community Health Nursing

Community health nursing is paramount to the overall welfare and health of the population, as it enhances health outcomes and strengthens measures for disease monitoring and management.

Indeed, any healthcare system should be available to everybody. However, communities are dealing with a significantly large number of people of all ages who are unable to obtain or seek health care due to various reasons such as financial constraints.

Absence of insurance coverage, transport difficulties, inability to physically get to a doctor’s clinic or hospital, and a lack of understanding of where to go for healthcare are the other reasons why community members may not seek medical care.

As a result of a lack of access to health care, newborns, pregnant women, and other vulnerable groups have seen a significant increase in morbidity and mortality.

Underprivileged members of the community who do not have access to health care can be treated better through efficient community health nursing.

History of Nursing Involvement in the Community

Lillian Wald and Florence Nightingale were the first individuals to develop a system of health planning based on a study of the health requirements of the community they served. Nurses have also historically been active in putting other disciplines’ plans into action.

According to reputable organizations such as American Nurses Association (ANA) and American Public Health Association (APHA), community health nurses’ primary responsibility is to the community or population as a whole, and in order to fulfill this responsibility, nurses must recognize the need for comprehensive health planning.

Nurses should be involved in program planning for various reasons, in addition to professional organizations’ obligations. The majority of healthcare workers are nurses responsible for health programs where they learn a lot about what works and what does not. This experience aids in the identification of future problems that can be avoided, especially in a community.

Unlike any other healthcare provider, nurses spend more time in close touch with their patients than anybody else. They spend time in the community with clients, learning about their health, habits, needs, and what it’s like to be a member of that community firsthand.

Nurses are in a unique position to have access to vital information that may be used to plan and implement successful health programs as a result of their community involvement.

Nurses not only make up a substantial percentage of healthcare providers, but they also make up a significant fraction of healthcare consumers. Nurses are in a unique position to influence the development of population-based health programs as a result of this.

Principles of Community Health Nursing

Community Health Nursing (CHN) is an essential component of public health, and it is guided by a set of 12 principles, which include:

  1. Individuals, families, and communities’ identified needs are the foundation for CHN work. Its main goal is to expand the use of public health measures as part of the overall CHN approach.
  2. Goal attainment is facilitated by having an excellent comprehension of the agency’s goals and policies. Towards this goal, the mission statement engages Community Health Nurses to positively realize their work.
  3. Family is the main unit of service for CHN. The degree to which it can deal with its own challenges has an impact on its level of functioning. As a result, the most effective and accessible medium for CHN initiatives is the family.
  4. The efficacy of client care is strengthened by sensitivity to the client’s values, customs, and beliefs. Regardless of race, faith, color, or socioeconomic level, CHN services must be sustainable and accessible to all.
  5. Health education and counseling are integrated into the CHN’s. These foster and encourage community efforts to enhance people’s health by bringing concerns up for discussion.
  6. The achievement of goals is made easier when coworkers and members of the health team work together. Employees observe themselves on how their contributions benefit the entire organization.
  7. Evaluation of the degree to which CHN goals and objectives are being met can be performed on a regular and continuous basis. Through consultations, observations, and precise recording, clients are involved in the evaluation of their health program.
  8. To improve and maintain effective nursing practices in their context, a continuing staff education program and high-quality client services are required. The agency’s staff development programs take into account the professional interests and needs of Community Health Nurses.
  9. Maximizing the success of the Community Health Nurses’ activities by utilizing existing community resources. The ability to connect with existing community resources, both public and private, raises an understanding of what they require and what they are entitled to.
  10. The success of CHN programs is greatly determined by the active participation of the individual, family, and community in planning and making health care decisions. Participation in activities of organized community groups satisfies the needs and interests of the community.
  11. The task completed is guided and directed by the supervision of nursing services by qualified CHN employees. Employees’ ability to perform effectively and efficiently is enhanced.
  12. The basis for evaluating the progress of planned programs and activities, as well as a guide for future actions, is accurate recording and reporting. Community health records are used in studies and research as well as legal documents, thus, keeping accurate records is an essential responsibility of the community health nurse and community leaders.

Responsibilities of a Community Health Nurse

Community health nurses may have a distinct set of responsibilities due to the diversity of a community’s requirements. Clinics, churches, community health centers, non-profit organizations, private homes, and schools are just a few of the places where community health nurses work. Community health nurses have the following primary responsibilities:

  • Preventive care. One of the most important concepts of community health nursing is prevention. Community health nurses can help people who do not have access to preventive or screening services from a doctor or other healthcare practitioner by providing various health services. Vaccinations, cholesterol tests, and well-baby visits that improve health and prevent disease are some of the health services they provide at a little or free cost to the public.
  • Health trends monitoring. Particular health trends or illnesses have a different impact on each community. Rising rates of diabetes or hepatitis, for example, may affect just a percentage of the population, and community health nurses are trained to recognize and monitor these trends and risk factors. This data is utilized to educate and provide services specific to the community’s needs to prevent illness or disease from spreading.
  • Training and education. Community health nurses may create educational programs, presentations, and training materials to distribute to vulnerable members of the community after identifying significant concerns or trends affecting a particular location or population. As part of this program, nurses may work with schools, enterprises, elder centers, health clinics, and regional healthcare groups to communicate the information to the public.
  • Engagement in the underprivileged. Because public health nurses work so directly with people in a community, they are typically better able to comprehend the difficulties that affect different groups of people. As a result of their extensive understanding, they can advocate for those underserved by contacting local, state, and federal agencies to request further supplies, financing, and assistance for these groups.
  • Knowledge and Skills of a Community Health Nurse
  • Because community health nurses are responsible for a variety of tasks, they need to possess the following characteristics to succeed in their area.
  • Versatility. Nurses must be able to improvise and adapt rapidly to their circumstances. As typical duties might vary dramatically — one day it might be giving kids immunizations, and the next day might be presenting a lecture on malnutrition — it is essential to effortlessly switch between tasks.
  • Teamwork. The majority of the work of community health nurses involves collaboration with other healthcare organizations, community groups, and government leaders, although they may work independently. Nurses will be more productive if they learn to collaborate with others.
  • A BSN degree holder. The American Public Health Association (APHA) acknowledges a bachelor’s degree as the entry-level education required for public health nurses due to the intricacy of anticipating and addressing the health needs of a whole community. The APHA also recommends that BSN coursework include population health, finance, and healthcare policy in addition to preventive care methods.
  • Willingness and capacity to travel. There may be a frequent share of travel necessary depending on the area to reach the people. Traveling to rural, remote, or underserved places, in particular, may be prevalent. It is also possible that community health nurses will need to make arrangements with local organizations to meet them.

ADPIE Care Plan for Community Health Problems

The nursing process in a community involves health planning. It is a continual social process in which data in a certain area is collected and analyzed in order to establish a strategy for generating new ideas, meeting identified requirements, resolving health issues, and guiding changes in the delivery of health care.

The majority of nurses in the community are required to design strategies and actions for the entire community’s health needs, not just for the health of a single person. It involves the process of problem-solving which is centered on a certain group of people.

Assessments of communities are made, needs and problems are prioritized, goals are set, and methods for achieving them are developed. When planning care for a group or a population, the term program planning is frequently used to refer to the process of planning care for a community.

Community health nurses also conduct health assessments that collect a broader range of data than nurses in other fields. CHNs collect information on both individuals and families within the community.

They look at the data to see if it can be utilized to determine a population’s health, resources, or needs. They also look into how a range of community factors affect the health of the people who live there.

Collaborating with the members of the community to validate nursing diagnoses based on the assessment and enlisting community members’ support and cooperation in accomplishing change are all essential tasks. T

he program may not be successful if the community is not involved from the start. You will have a more successful program if you incorporate the community in the assessment and planning phases, just as you will have better adherence and outcomes from planning care with an individual client.

The nursing process in a community setting can be illustrated in the following scenarios:

Community Health Nursing Diagnosis

Community Health Nursing Care Plan 1

Altered health-seeking behaviors

Assessment: The older adults are expanding rapidly in ABC County, a suburban community. According to the records, there is only one taxicab service company in the area, which causes limited public transportation.

Nursing Diagnosis: Altered health-seeking behaviors related to insufficient transport services for senior citizens.

Desired Outcome:

Nursing Stat Facts
Nursing Stat Facts

The community, particularly the senior citizens, will improve their health-seeking behaviors through participation in organized health activities and programs.

Community Health Nursing InterventionsRationale
Conduct a comprehensive review of the health records in the communityEstablishing a baseline makes it easier to set realistic goals, which are the basis for effective planning.
Coordinate with the healthcare organizations and community leadersCollaboration with relevant organizations is necessary to have the resources required to put up health programs and activities.
Arrange home visits to selected senior citizens and identify the most significant health concerns that need to be addressed as soon as possible.Home visits can put an individual’s mind at ease and make them feel important in society. It will be expected that they will want to participate in the health initiatives that will be launched. Furthermore, identifying the most pressing health issues might assist community health nurses in prioritizing health-related programs and activities.
Form a community group that will be involved in the health initiatives that will be offered to the community’s senior citizens.Residents should also be involved in the planning and execution of community health programs to ensure that they are effective.
For the strategic location of the health programs and activities, work with the community or government leaders to choose the suitable location.To persuade the targeted demographic to actively engage in the planned healthcare activities, make sure the programs will be held in an accessible location in the community.
Collaborate with other healthcare professionals, such as licensed nutritionists or dieticians, to lead the nutrition education and counseling.One of the primary objectives in ensuring the health of the community’s senior citizens is to have a qualified nutritionist or dietician assess and assist them in achieving their dietary needs.
Arrange a community-based program offering social, recreational, and health-related services in strategic areas of the community.Almost every risk of disease, including heart disease, high blood pressure, and diabetes, can be reduced by engaging in recreational physical activities. It also improves mental health, which is just as important as physical health.
Organize health seminars to educate them about common health misconceptions and focus on the appropriate management and prevention of common diseases that affect the elderly.Due to a lack of basic information and access to healthcare, the older population has the greatest number of health misconceptions. Putting emphasis on health education will improve their medication adherence and a healthier lifestyle.

Community Health Nursing Care Plan 2

Risk of Cardiovascular Diseases

Assessment: According to figures from the District Health Department’s 2019 Annual Report, at least one person in every family in ABC County is obese, thereby increasing the risk of cardiovascular disease in the community.

The primary causes of this health concern are listed below:

  • Lack of information about sedentary lifestyles, poor nutritional habits, and overweight/obesity as cardiovascular disease risk factors
  • Lack of awareness of the risk factors, signs, and symptoms of cardiovascular diseases
  • Uninformed of the risks of future complications of obesity such as cardiovascular diseases
  • Limited access to fresh and nutritious food for everyone
  • Inactive support from the community groups and state leaders

Nursing Diagnosis: Risk of cardiovascular diseases related to obesity among the residents of ABC County as demonstrated in an obesity rate of 40.1% and record of being the second-highest mortality risk for cardiovascular disease at 203/100,000 in their District.

Desired Outcomes:

Knowledge regarding the effects of and prevention of obesity will be dispersed to the citizens of ABC County, and the number of residents who are able to verbalize the effects of and prevention of obesity will be increased by 30% by the end of the year.

The community will have at least 5% decrease in statistical numbers of obese individuals, as measured by BMI, and consequently a reduction in deaths from cardiovascular diseases related to obesity at the end of 2025.

Community Health Nursing InterventionsRationale
Assemble a diverse community committee to discuss how to make changes and build a strategy to address the community’s risk of cardiovascular disease.To collect more relevant information regarding the present health state of the population, the community should always be involved in the planning and assessment stages.
Organize cardiovascular tests for a specific group based on the data available, such as blood pressure monitoring for ages 18 and up, lipid panels for men and women over the age of 29, and fasting blood sugar, among other parameters.It is easier to set attainable expectations, which are the basis for effective planning, when the community nurses have a baseline in order.
Educate the people about the increased risk of heart attack, diabetes, and stroke associated with uncontrolled elevated set parameters and obesity.The best approach to inform the community about health threats and contributing factors is through health education.
In strategic areas of the community, put up a video presentation that shows the signs and symptoms of cardiovascular disorders, as well as emergency situations that necessitate immediate medical attention.One of the causes for delayed medical assistance is a lack of awareness of the signs and symptoms of emergencies such as myocardial infarctions and strokes.
In collaboration with community leaders and other health organizations, implement various behavior and social approaches to increase community physical activity. These programs may include forming walking groups and social networks that offer exercise support, worksite nutrition and physical activity programs, and the dissemination of free or discounted equipment that can help in weight reduction.The community’s willingness to lose weight will be strengthened even more if they have access to support groups and essential equipment.
Educate the community residents on how to properly use glucometers and blood pressure cuffs, as well as the appropriate weight for them, usual findings of blood pressure, and blood sugar screenings.Teaching the community about these essential health screening can help them stay on top of their health even while they are at home.
Seek the help of the community and possibly the state to make environmental modifications, such as creating clear, safe sidewalks and parks to make it easier for people to accomplish physical activities.As a result of these changes in the environment, the community will be encouraged to live a healthy lifestyle and exercise regularly in order to maintain a healthy weight.
Partnerships with community institutions to promote physical activity and a healthy lifestyle, such as putting up signs in elevators to encourage people to use the stairs, allowing more time per day for physical activity at school or at work, and providing healthier alternatives such as fruits and vegetables over unhealthy foods and beverages.Collaborations with various organizations are required to expand the scope of implementation and ensure the health programs’ long-term viability in the community.
Organize a counseling session with a healthcare professional to discuss dietary adjustments, proper exercise, and other lifestyle modifications, particularly for those with a family history of cardiovascular disease and obesity.Some people may find it demotivating to have non-modifiable factors for an illness, such as genetics. Setting up a one-on-one counseling session with a healthcare professional can help them attain their objectives.
At least once a week, organize weight-loss group activities like Zumba and dance classes.Participating in a group activity is more encouraging for the targeted population.

Nursing References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.  Buy on Amazon

Gulanick, M., & Myers, J. L. (2017). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.  Buy on Amazon

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.  Buy on Amazon

Disclaimer:

Please follow your facilities guidelines, policies, and procedures.

The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes.

This information is intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment.

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