COMMUNITY BASED NURSING

Community Based Nursing

Community Based Nursing

Introduction

A field of nursing that is a blend of primary health care and nursing practice with public health nursing. The community health nurse conducts a continuing and comprehensive practice that is preventive, curative, and rehabilitative. The philosophy of care is based on the belief that care directed to the individual, the family, and the group contributes to the health care of the population as a whole. The community health nurse is not restricted to the care of a particular age or diagnostic group. Participation of all consumers of health care is encouraged in the development of community activities that contribute to the promotion of, education about, and maintenance of good health. These activities require comprehensive health programs that pay special attention to social and ecologic influences and specific populations at risk.

In today's environment of health care reform, federal, state and private market forces are calling for the development of community based, competent comprehensive, convenient and accessible health care delivery systems. A community-based, population-focused approach to planning, delivering and evaluating nursing care has never been more important, thus professional nursing needs to realign its allegiance and accountability by shifting from the historical emphasis of the profession to respond to these trends. Community based nursing is changing dramatically in response to new federal reimbursement methodology. Prospective Payment Rules are just being drafted for the new systems which are expected to curtail services or even jeopardize survivability.

All sectors of the health care delivery system will continue to shift, necessitating shifts in nursing practice to accommodate new practice settings, policies, reimbursement policies and expanding roles. The nursing profession has changed its definition and priorities for public health nursing practice significantly since 1996. Four major developments have shaped this landmark change: a) publication of the scope and standards of public health nursing practice (ANA with input from ACHN, APHA), b) efforts to encourage baccalaureate nursing education programs to better prepare nurses for population-focused nursing practice, c) programs to educate public health nurses in core public health functions and population- focused nursing practice and d) development of a public health intervention model and evidence-based practice guidelines for public health nursing.

Discussion

Community based nursing/home health is defined as a philosophy of nursing that guides nursing care provided for individuals and families wherever they are, including where they live, work, play or go to school. The practice is characterized by an individual and family-centered orientation, the development of partnerships with clients and an appreciation of the values of the community. CBN/home health nursing is applied to all nurses who practice in the community whether or not they have had preparation in public health nursing. Major role activities include case management, patient education, individual and family advocacy and an interdisciplinary approach.

Demographic changes and a rapidly growing elderly and chronically ill population have shifted the emphasis of health services from merely disease prevention to health promotion. The argument that hospital-based care and medical services alone are not enough to maintain people's health ...