Logo Logo

FUNDAMENTAL OF COMMUNITY HEALTH NURSING

Course dashboard

Click here to access Unit one Content..


Topic One: foundation of nursing

Terminologies

NURSING :  is defined as the diagnosis and treatment of human responses to actual or potential health problems but according to Virginia Herderson( 1958) Nursing  is  the unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge. And to do this in such a way as to help him gain independence as rapidly as possible.

Nurse:  A person who nourishes, fosters and protects; a person prepared to take care of sick, injured and aged people. as defined by Robinson (1982).

History of Nursing: In most ancient civilizations, women were responsible for nurturing, nourishing and providing care to children and ill family members. Nursing was also a community service that preserved and protected the family.
Uprichard (1973) described the early history of nursing using three images:
1.The folk image- The Nurse as Mother ,nurse was generally a member of the family or, if not, then a member of the community who demonstrated a special skill in caring for others
2.The religious image- Nurse as God’s Worker , In the Bible, a woman named Phoebe is identified as the first deaconess, a word meaning servant or helper. Deaconess cared for widows, orphans, and the sick. Olympias, a woman of Constantinople, set up a hospital to care for the sick. In the middle Ages, the traditional role of the religious groups in caring for the ill was continued by various orders of monks and nuns.
3.The renaissance image- The Renaissance saw the decline of monastic orders and the rise in individualism and materialism. There was a radical change from the image of the selfless nurse that had developed in the early Christian period and the Middle Ages. Care of the ill was delegated to servants and those unable to find any other means of support.

Topic One: Summary
◦Nursing is an ancient profession that has evolved alongside human civilization.
◦Religion heavily influenced this evolution. Many early hospitals were tied to organized religion.
◦During the industrial revolution, scientific methods became more important.
◦Florence Nightingale is the founder of modern nursing. She established the first school for nurses that provided theory-based knowledge & clinical skill-building and encouraged the belief that there is a body of nursing knowledge distinct from medical knowledge.

An individual with a certificate becomes a community nutrition technician, Diploma- community nutrition officer and degrees- nutritionists/dieticians

Registration is with the Kenya Nutritionist and Dietitian Institute (KNDI)- Regulatory body


  • Management is also defined as the process by which resources are mobilized, combined and coordinated to effectively to achieve organizational objectives.
  • It is a process that utilizes organizational resources in the most effective and efficient manner, in order to attain stated organizational objectives.

Efficiency and Effectiveness

  • Efficiency in management refers to optimal utilization of organization resources with minimal wastage. It is also the relationship between achieving objectives and consumption of resources.
  • Effectiveness refers to attaining specific organizational goals that are timely and challenging. It is also an outcome measure of the interventions that improve peoples health under ordinary circumstances and in ordinary settings.

    • Management versus Administration
  • Administration is part of management work but more concerned with execution.
  • A manager is said to be performing administrative work when he/she is involved in interpreting policies of the organization and putting into plans and having those plans implemented.
  • At every level of management, managers perform some work which involves execution or “doing” which is one that completes the administrative process.
  • Therefore administration is the total of planning, organizing, controlling, coordinating and also operating work.


    • Course dashboard

    Click here to access Unit Two Content..


    Topic 1: Nursing Theories

    • Grand theories – have the broadest scope & present general concepts and propositions. Are complex. This limits the use of grand theories for directing, explaining, & predicting nursing in particular situations.

    Middle-range theories- address specific phenomena & reflect practice. They  are more narrow in scope than grand theories & offer an effective bridge between grand theories and nursing practice.
     
    NURSING PRACTICE THEORY (prescriptive theory): has the most limited scope & level of abstraction. Are  developed for use within a specific range of nursing situations & have a more direct impact on nursing practice than do theories that are more abstract. 
    ◦They provide frameworks for nursing interventions and predict outcomes and the impact of nursing practice.
    ◦At the same time, nursing questions, actions, and procedures may be described or developed as nursing practice theories.
    ◦The day-to-day experience of nurses is a major source of nursing practice theory.

    How do nurses use theory in everyday practice?

    1. To Organize patient data
    2. To Understand patient data
    3. Analyze patient data
    4. Make decisions about nursing interventions
    5. Plan patient care
    6. Predict outcomes of care
    7. Evaluate patient outcomes

    Tasks;

    Q. what are the Current trends that influence nursing theory?


    NURSING THEORISTS

    Florence Nightingale


    • >Focused on the relationship of patients to their surroundings
    • >Emphasized on the importance of observing the patient and recording information
    • >Importance of cleanliness
    • >Health and recovery from illness is related to environment
    • She linked health with five environmental factors:
    1. Pure or fresh air.
    2. Pure water.
    3. Efficient drainage.
    4. Cleanliness.
    5. Light, especially direct sunlight

    Virginia Henderson


    ◦According to Henderson: The “Unique function of the nurse… is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or a peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge.”
    —Nurse’s role = substitute for the patient, a helper to the patient or a partner with the patient


    Other Nursing theorists ( read and make short notes ) are:

    1. Hildegard Peplau,
    2. Martha Rogers,
    3. Dorothea Orem,
    4. Imogene King,
    5. Betty Neuman,
    6. Sister Calista Roy,
    7. Jean Watson,
    8. Madeleine Leininger,






    Course dashboard

    Click here to access Unit Three Content..


    Topic 1: PROFESSINALISM IN NURSING

    At the end of this unit, the learner should be able to:

    1. Define the terms used in this unit
    2. Outline the characteristics of a proffessional nurse
    3. Explain  the importance of proffesionalism 
    4. Outline the difference between a proffesion and an occupation 
    5. State the roles of a professional nurse
    6. Give an overview of the various Nursing proffeional bodies internationally and nationally and their various functions.
    Definitions
    Profession – is a calling that requires special knowledge, skill & preparation i.e an occupation that requires extensive education.
    Professionalism:  is knowing what to do, how to do it, when to do it, and doing it.” Is a set of attributes, a way of life, a responsibility and commitment.

    Characteristics of a Profession:
    •A profession utilizes in its practice a well-defined & well –organized body of specialized knowledge.
    •A basic profession requires an extended education of its members, as well as a basic liberal foundation.
    •A profession has a theoretical body of knowledge leading to defined skills, abilities and norms & strives to enlarge this body of knowledge by entrusting its practioners to institutions of higher learning.
    •A profession provides a specific service.
    •Members of a profession have autonomy in decision-making and practice, thus attracts individuals of intellectual & personal qualities who exalt service above personal gain & who recognizes their chosen occupation as a life work.
    •A profession strives to compensate its practioners by providing freedom of action opportunity for continuous professional growth & economic status.
    • A Profession through standards & a code of ethics  enhances practice responsibility. 

    Importance of  Professionalism
    •Ensures quality of patient care
    •Enhances Use of best evidence in practice
    •Encourages Competence and safety in a changing world
    •Enhances Collegial working relationships with other disciplines
    • Ensures Sharing of the limited resources

    Comparison between A Profession &
     occupation


    Occupation

    Profession

    Training may occur on

    job

    Education takes place in

    College and university

    Length of training varies

    Education is definite and

    prolonged

    Value, beliefs and Ethics are

    not Prominent features of

    preparation

    Value beliefs, and Ethics are

    integral part of preparation

    Commitment & personal

    identification may vary

    Commitment & personal identification strong

    Works are supervised

    Works are autonomous

    Guided decision making

    Decisions based on science or theoretical constructs


    Roles of a Professional nurse
    Caregiver/ Care provider - This is the traditional & most essential role where a Nurse Functions as nurturer, comforter, & provider ( “Mothering actions” )

    Teacher - Provides information and helps the client to learn or acquire new knowledge and technical skills, Encourages compliance with prescribed therapy. Promotes healthy lifestyles, Interprets information to the client.

    Counselor - Helps client to recognize and cope with stressful psychologic or social problems; to develop an improved interpersonal relationships and to promote personal growth. Provides emotional, intellectual to and psychologic support.

    Change agent-  The nurse acts as a change agent when assisting others, that is, clients, to make modifications in their own behavior. Nurses often act to make changes in a system, such as clinical care, if it is not helping a client return to health. Nurses are continually dealing with change in the health care system.

    Client advocate - A client advocate acts to protect the client. In this role the nurse may represent the client's needs and wishes to other health professionals, such as relaying the client's wishes for information to the physician. They also assist clients in exercising their rights and help them speak up for themselves.

    Manager - Makes decisions, coordinates activities of others, allocate resource & Evaluate care and personnel. Plans & gives direction, develop staff, monitors operations, give the rewards fairly and represents both staff and administrations as needed.

     Researcher - Participates in identifying significant researchable problems & Must be aware of the research process, language of research,  & sensitive to issues related to protecting the rights of human subjects.


    PROFESSIONAL BODIES

    Professional body is made up of members of the profession. The following are professional bodies in Kenya.

    1.National nurses association of Kenya (NNAK)
    2.ICN consisting of 128 National Nurses Associations - world wide
    3.Nursing Council of Kenya NCK

    Role of professional bodies

    • >Controls the profession on: Education and qualification,  Registration and legal definition, Government policies & Employment policies.

    • >Organization and management of nursing services

    • >Development of unique body of knowledge

    • >Relationships with other professions

    • >Support services for professionals


    NURSING COUNCIL OF KENYA (NCK)


    NCK was established by the Nurses Act, Chapter 257 of the laws of Kenya which was enacted as an Act of Parliament to make provision for the training, registration, enrolment & licensing of nurses, to regulate their conduct and to ensure their maximum participation in the health care of the community (Nurses Act 1985).

    Membership of the council

     2 ex-official

     Director of Medical Services and the Chief Nursing officer.

     One person

    ...responsible for education.

     Two persons

    ...representing religious organizations providing health services in Kenya.

     Two persons

    ...representing nursing associations (one from NNAK and one from KEPNA  (Kenya Progressive Nurses Association).

     Four persons

    nominated by the outgoing council to represent:

    General nursing, midwifery, and community health                                                         

     Eleven elected members

    ...who may be involved in clinical practice, nursing education and
       administration. They must be registered nurses as follows: Three registered nurses, three midwives, three community health nurses and two psychiatric nurses.

    Functions of the Nursing Council 
    •Establishing &  improving the stds of professional nursing & of health care within the community
    •Prescribing & regulating syllabuses of instruction and courses of training for persons seeking registration or enrolment under the Act
    •Recommending to the Minister institutions to be approved for the training of persons seeking registration or enrolment under the Act
    •Prescribing & conducting examinations for persons seeking registration or enrolment under the Act.
    •Prescribing badges, insignia or uniforms to be worn by persons registered, licensed or enrolled under the Act
    •Control  the conduct of person registered, licensed or enrolled under the act, and to take such disciplinary measures as may be necessary to maintain a proper standard of conduct among such persons
    •Maintain/control standards for nursing care, qualified staff, facilities, conditions & environment of health institutions
    •Directing & supervising the compilation & maintenance of registers, rolls and records required to be kept under sections 12, 14 and 16
    Advising the Minister on matters concerning all aspects of nursing

    N:B- functions of the Nursing Council are carried out through committees. Council meets every 3 months
    The Education Standing Committee-  Deals with all issues that relate to nursing education such as: Designing nursing programmes, syllabus & national curriculum according to the health needs of the community, Scrutiny of institutional curriculum to see whether they meet the minimum standards for producing a safe practitioner &  Formulating training materials like education policies, guidelines and procedures and log books for recording clinical practice learning.
    The Standards & Ethics Committee -  This committee Initiates & maintains stds of nursing education & practice, Coordinates council visits to health institutions for the purposes of monitoring the quality of nursing education or quality of care being offered to patients and clients respectively.
    Registration & Licensing Standing Committee- Meets every month & deals with registration, enrolment & licensing of nurses for nursing practice.
    Investigations Standing Committee- Investigates all cases of professional misconduct, negligence, malpractice and impropriety.
    Finance Standing Committee- deals with all financial issues of the Council in relation to income and expenditure.
    Disciplinary Committee- Deals with disciplinary cases recommended by the investigations standing committee. It is independent of the full council.
    The Nursing Council Secretariat- All activities of the Nursing Council are coordinated by the Secretariat.

    TASK
    Read & make notes on ICN (International Council of Nurses) & NNAK (National  Nurses Association  of  Kenya)





      









    Course dashboard

    Click here to access Unit Three Content..


    Topic 1: PROFESSINALISM IN NURSING

    Ethics and Legalities in Nursing

    Code of Ethics:  A formal statement of the ethical obligations & duties of every person entering the nursing profession. it  Provides guidelines for professional nursing behavior.

    Ethical Principles

    •Autonomy- self determination, independence, self reliance.
    •Beneficence - Duty to do good
    •Nonmaleficence- prevent from harm
    •Confidentiality- Keep privileged information private
    •Fidelity - Duty to be faithful to one’s commitments
    •Justice- Seeks fairness

    Legal Aspects of Nursing in Kenya
    •As a nurse you are liable to the national laws as well as professional ethics related to your practice.

    Examples of Offences

    NEGLIGENCE -  charged with this offence if you do not provide the expected care to a patient or client in the field you were trained in.

    MISCONDUCT - Includes stealing drugs or hospital property, forgery or fraud, coming on duty while drunk, fighting while on duty or use of abusive language.

    MALPRACTICE - Remember you are a trained nurse. If you provide substandard care to patients you will be charged of malpractice. In addition, if you also perform procedures that are out of your scope of practice you may be charged with malpractice.

    IMPROPRIIETY - As a nurse the profession binds you to conduct yourself professionally while on duty or off duty.

    Topic 1: Hospital Organization

    Def: It is an institution for the care, cure and treatment of the sick and wounded also for the study of diseases and for the training of doctors and nurses.

    Functions of a Hospital
    Patient Care: Care for the sick and the injured and restoration of the health of a diseased person without any discrimination.
    Diagnosis and treatment of diseases:
    Medical Education and Training: Provides professional and technical education for health personnel
    Medical and Nursing Research: It provides the basis for scientific investigations into causes, diagnosis, treatment and nursing management of diseases and hospital administration


    CLASSIFICATION OF HOSPITALS

    Each hospital is distinct in its characteristics as it differs in structure, functioning, performance and the community it serves. They are therefore classified according to:


    Length of stay of patient
    Short – term/acute care - Patient stays for a short term for treatment of the disease, acute in nature e.g. pneumonia.


    Long – term/chronic care - Treat diseases or conditions chronic in nature e.g. TB, cancer


    clinical basis
    They are licensed as general hospitals. Treat all kinds of diseases but major focus on severe medical conditions like heart diseases.


    ownership
    This category includes: Public, Voluntary, Private, or Corporate – Public limited company , under companies act


    size Classification is adopted according to bed strength (capacity)


    Objectives
    Teaching/Research - a hospital to which a college is attached for medical/nursing/dental/pharmacy education. The main objective is to teach based on research


    General - Provide treatment for common diseases and conditions, provide active medical and nursing care for more than one category of medical discipline.


    Specialized Hospitals - Provide medical/nursing care primarily for only one discipline or specific diseases or conditions of one system


    Isolation Hospitals - Admit patients suffering from infections or communicable diseases requiring isolation


    HOSPITAL DEPARTMENTS

    OUTPATIENT (OPD)/ CASUALTY - It is the point of contact between hospital and community. Its activities influence those of all other departments.
    MEDICAL UNIT - They admit patients for treatment other than surgery and certain exceptions. The services are further subdivided into subspecialties e.g. cardiology, neurology, nephrology, dermatology etc.
    MATERNITY/ OBSTETRIC UNIT - Serves to provide care for the expectant mother and her newborn.
    PEDIATRIC UNIT - The clients in this unit are aged between 1 day old and 15 years. New Born Unit (NBU) is part of this unit.
    RADIOLOGY/ X –RAY - It provides diagnostic services for inpatient, outpatient and casualties.
    PATHOLOGY/LABORATORY - Primary function is assisting in diagnosis of diseases and treatment. Specimen examined include stool, urine, sputum, blood, cerebrospinal fluid, tissues and bone marrow.
    PHARMACY - The functions include stocking of drugs and medical supplies, distribution of drugs to departments
    LAUNDRY - Ensures availability of microbe – free washed linen
    DIETARY - Preparation of nutritionally adequate meals
    CENTRAL STERILE SUPPLY SERVICES DEPARTMENT(CSSD)-
    It stores, sterilizes, maintains and issues instruments, materials and garments which are required to be sterilized. Air condition in this department is essential to avoid contamination through air.





    order by votes Up vote 18 Down vote Instead of using a plugin with unnecessary Kbytes, all you need is a simple function like this (see explanation in comments):