Nursing 109

N109: Foundations in Nursing Practice Study Guide

Chapter Seven: Community-Based Nursing Care Learning Objectives • Discuss the Healthy People 2020 report and the impact of government systems and regulations on the individual. • List and discuss the levels of prevention. • Discuss community health systems. • Discuss the impact of epidemiology and communicable disease on the community. • Describe factors that influence community care. • Describe tools the nurse can use to assess the community. • Develop a plan of care related to community care using the nursing process. A community is broadly defined as a group of interacting people, possibly living in close proximity, who share some common values. Community is attributed with social cohesion within a shared geographical location, generally in social units larger than a household. 7.1 Historical Perspectives Nursing care had been administered in homes for much of history until the 20th century, when nursing care shifted to primarily a hospital setting. Somewhat of a shift back to the home setting began in the 1980s because of the concern about costs, fragmentation of healthcare, and access to a quality healthcare system. In the 1960s and 1970s, patients stayed in the hospital for seven to ten days for uncomplicated conditions or surgery. Today there are numerous outpatient settings including ambulatory care, surgical and dialysis centers, rehabilitation centers, walk-in clinics, physician’s offices, and in the home care. Community Health Nursing vs. Community-Based Nursing Community health nurses are predominantly responsible to the community population as a whole, while community-based nurses provide home care and focus on the individual and family within a community. The community-based nurse must teach clients and families to manage equipment and be responsible for complex self-care. 7.2 Healthy People 2020 The Healthy People initiative was established in 1990 and provides science-based, tenyear national objectives for improving the health of all Americans. For three decades, Healthy People has established benchmarks and monitored progress over time in order to: • Identify nationwide health improvement priorities • Increase public awareness and understanding of the determinants of health, disease, and disability and the opportunities for progress

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