COMMUNITY HEALTH

NURSING PROCESS

DR. MAHESWARI JAIKUMAR.

maheswarijaikumar2103@gmail.com
• Community health nurse is
responsible to provide general
and comprehensive public health
and nursing services to the
people at large in a defined
community.
• She is vested with the
responsibility of rendering
people to solve their health and
nursing care problems in their
place of living and work.
• This process of rendering care
can be done by making use of
NURSING PROCESS and
PRINCIPLES as applicable in the
community settings.
NURSING PROCESS
 DEFINITION
• Community Health Nursing Process
is a systematic, scientific, dynamic,
on-going interpersonal process in
which the nurses and the clients are
viewed as a system with each
affecting one and another and both
being affected by the factors within
the behaviour.
 DEFINITION
• “Community Health Nursing
Process refers to systematic
series of steps which are
followed by public health nurse
in community health and nursing
problems using community
approaches and resources”.
 ADVANTAGE
• Community Health Nursing
process is an effective tool to
help people solve their health
problems and meet their health
and nursing needs.
 STEPS
1. ESTABLISHING & MAINTAINING
WORKING RELATIONSHIP.
2. ASSESSMENT OF HEALTH NEEDS &
HEALTH PROBLEMS.
3. SETTING OBJECTIVES.
4. PLANNING AND IMPLEMENTING
INTERVENTIONS.
5. EVALUATION OF INTERVENTIONS.
STEPS IN NURSING PROCESS
I. ESTABILISHIBG & MAINTAINING
WORKING RELATIONSHIP
• Community health Nursing
process is helping community
people and families identify their
health problems and develop
competencies to solve their
health problems and meet their
health and nursing needs.
• This is enabled when the
community health nurse
establishes a good working
relationship with the families and
communities.

• Working relationship is
productive in nature.
• In “working relationship”
between community health nurse
and the community
people/families, there is a free
dialoguing and an attitude of trust
and confidence in the integrality
and capabilities of each other to
meet health and nursing goals.
• A working relationship between
a nurse and the community is
initiated and maintained by the
following means:

1.Knowing the client (community).

2. Communicating intensions and
nature of help and assistance
that would be extended.

3. Attentive listening and

responding in between.
4. Answering heir queries.

5. Considering their views.

6. Appreciating what is
worthwhile.

7. Empathetic attitude.
8. Meeting their immediate needs
and needs which are
considered important by
them.
 II. ASSESSMENT OF HEALTH
NEEDS & HEALTH PROBLEMS
• The community health nurse
comes to know the health needs
and problems of the community
as she explores the community.
• The problems could be a large
family size, malnutrition in
children, incomplete
immunization, anaemia in
pregnant and nursing mothers,
several morbidity conditons-TB,
malaria, diarhoea etc.,
• After obtaining the list of health
needs and problems, the
community health nurse needs
to prioritize the problems, as all
the problems cannot be dealt
with simultaneously.
• The priority is determined on the
basis of underlying criteria:

1. The nature of the problem, its

prevalence, impact and
prognosis.
2.Community’s perception of the
problem i.e., whether the
problem is felt by the community
and considers serious.

3. Preventive potential i.e.,

whether the problem can be
prevented or not.
 III. SETTING OBJECTIVES
• Once the problems are
prioritized, it is very important to
set up objectives relevant to
each of the problems identified.
 E.g., - Malnutrition
• To assess the
growth and
development of all
the under five
children in a defined
community to find
out malnourished
children.
• To get the medical examination
done for all the malnourished
children.

• To carry out prescribed

treatment and provide care to all
malnourished children.
• To do a regular monitoring of
nutrition status of all children.

• To enroll all children with

anganwadi for availing food
supplements.
• To educate mothers and
population in general about the
malnutrition and importance of
nutritious diet.
 IV. PLANNING AND
IMPLEMENTATION OF
INTERVENTIONS

• This is otherwise called the

ACTION PLAN.
• Once the objectives are
formulated it is necessary to
identify interventions to be
implemented to achieve the
objectives.
• Various actions are decided and
implemented as being most
effective in order to solve
particular problems (e.g.,
problem of malnutrition among
under 5)
• As the action is implemented,
the community health nurse
gives direct nursing care either
by herself or through ANM.

• She also helps the community to

develop their own resources and
mobilize outside resources also.
V. EVALUATION OF ACTION
PLAN
• Evaluation of interventions
determines the effectiveness of
actions implemented –
i.e.whether the desired results
intended are achieved or not.
• Evaluation also helps in finding
out the reasons for not achieving
the desired goal.

• This helps in making further

improvement ( feedback and re
plan, re implement and re-
evaluate)
• The effectiveness of intervention
depends upon its objectives and
is determined on the basis of the
following criteria:

1. Population coverage.
2. Utilization of services provided.

3. Outcomes in terms of reduction

in morbidity rates (increase in
life expectancy).
4. Change in knowledge, attitude
and practice, degree of
independence.
• Evaluation thus made is both
qualitative and quantitative.

• An effective evaluation strategy

has the following characteristics:
1. Well defined measurable
objectives.

2. Well defined action plan.

3. Has a base line statistical

information for comparison.
4. Observe changes in health
knowledge, attitudes and
practices.

5. Analyze and interpret the facts

(data) observed and recorded.
 PRINCIPLES OF COMMUNITY
HEALTH NURSING PROCESS
• Principles are rules for
community health practice or
actions.

• Theses provide guidelines to

function in the community
effectively & efficiently.
1. Community health nurse must
explore and know various
aspects of a defined
community to be able to plan
and implement health
services.
2. Community health nurse must
make a map of the community
showing the geographical
boundaries, important roads,
streets, housing networks,
church/temple/mosque,
school, post office. This helps
in plotting the house for care.
3. Community health nurse must
establish good working
relationship as it helps in
providing need based care.
4. Community health nurse must
know the health care delivery
system, health policies, health
goals, health actions, national
health care programmes while
rendering health services.
5. The community health nurse
should provide realistic health
services ( in terms of available
resources, funds).
6. community health nurse must
organize health services at
large for the community and
render the services to the
family which is the unit of
community.
7. Community health nurse must
continuously keep in touch
with the community and
provide wellness oriented
comprehensive services
continuously.
8. community health nurse must
work in collaboration with
other team members…
therefore she needs to know
the roles and responsibilities
of the other team members.
9. Community health nurse
educates in giving care to
individual, family and
community. The health
education should aim at
providing a comprehensive
health knowledge to the
community.
10. Community health nurse must
maintain proper health
records, registers . (These are
legal documents) These
records help in planning and
evaluation of the services.
11. The community health nurse
must evaluate her services to
find out achievement. Eg.,
population covered, actions
planned and recorded.
12. The community health nurse
must provide services to all
without any discrimination of
age, gender, colour, caste,
nationality, political
affiliation, religion, as every
individual has a right to
optimum health.
13. The community health nurse
must not interfere with
people’s religious, political
beliefs, but respect every one
without any prejudice.
14. Community health nurse
should work in close
consultation with employing
authority (Govt, public trust,
NGO).
15. Community health nurse
should develop and maintain
professional relationship with
health and health allies
agencies (Block Development
Office, Panchayats, Voluntary
Organizations).
16. Community health nurse must
never accept any bribe or gift
against professional ethics.
17. The community health nurse
must have an active
participation with the
community people in taking
care of their own needs and
health problems. (This can be
done by mass awareness
campaign).
18. The community health nurse
must be aware and closely co-
ordinate with the local formal
and informal leaders.
 THANK YOU

DR. MAHESWARI JAIKUMAR.

maheswarijaikumar2103@gmail.com