Community based

nursing

Key terms:
Community People and the relationships
that emerge among them as they develop and
use in common some agencies and institutions
and share a physical environment.
Community based occurs outside an
institution; services are provided to individuals
and families in a community.
Community based nursing the provision
of acute care and care for chronic health
problems to individuals and families in the
community.

Growing costs of hospital care

More services are being provided in

community based settings

Increasingly, nurses will engage in

what is called community
based nursing (CBN)

The main focus and aim of

CBN
In CBN the nurse focuses on illness care of
individuals and families across the life span.
The aim is to manage acute and chronic
health condition in the community, and the
practice is family centered illness care.
CBN is a philosophy that guides care in all
nursing specialties.

The main characteristic

features of CBN
Philosophy. Focus is on illness care
of individuals and families across the
life span.
Goal. Manage acute or chronic
conditions.
Service context. Family centered
illness care.
Community type. Human ecological.

The main characteristic

features of CBN

Client characteristics.
Individuals
Families
Usually ill
Culturally diverse
Autonomous
Able to define own problem
Involved in decision making

The main characteristic

features of CBN

Practice settings.
Community agencies
Home
Work
School
Interaction patterns. One to- one
Type of service. Direct illness care

The main characteristic

features of CBN
Emphasis
on
prevention.

primary
Secondary
Tertiary

levels

of

The main characteristic

features of CBN

Roles.
Client and delivery oriented.
Caregiver
Educator
Counselor
Advocate
Case manager
Group oriented.
Leader (disease management)
Change agent (managed care services)

The main characteristic

features of CBN

Priority of nurse activities.

Care management (direct care)
Patient education
Individual and family advocacy
Interdisciplinary practice
Continuity of care provider

Four key nursing modes in the

community
1. Community-Oriented
Nursing
Practice: a philosophy of nursing
care delivery that involves generalist
or specialist public health and
community health nurses providing
"health care" through community
diagnosis in order to create conditions
in which people can be healthy.

Four key nursing modes in the

community
2. Public
Health
Nursing
Practice:
promoting and
preserving the health of
populations. The goal is to
prevent disease and disability
and promote and protect the
health of the community as a
whole.

Four key nursing modes in the

community
3. Community
Health
Nursing
Practice:
to promote, preserve,
and maintain the health of the
population through the delivery of
personal
health
services
to
individuals, families, and groups.
Focus is on the health of individuals,
families, and groups and how their
health status affects the community
as a whole.

Four key nursing modes in the

community
4. Community-Based
Nursing
Practice:
a
setting-specific
practice
whereby
care
is
provided for "sick" individuals
and families where they live,
work, and attend school.

Challenges for the future

At present, the trend is to move more care
into community settings and to reduce the
number of hospital days for "sick" clients
Reasons:
community care is often much less
expensive than hospital care
care in the community is usually more
appealing to people who prefer to remain
at home rather than be treated in a
hospital