Role of Community Health Nurse in Health Planning, Implementation and Evaluation
Community health nursing is a community-centered approach to health service provision with the aim of health promotion, and prevention of disease, premature death and disability among members of a community (Clark, 2009). Health promotion, prevention and treatment of health disorders, rehabilitation, evaluation, and research are the fundamental elements of nursing practice in community health programs. The nurse in the community setup serves as an educator, care provider, advocate, manager, leader, collaborator, and researcher. The community settings in which the nurse works includes homes, schools, ambulatory care settings, and occupational health environments. Community health nursing requires nurses to develop partnerships with all the stakeholders in health provision. Community health nursing is practiced starting with planning, implementation, and evaluation. In the three procedures of health care provision the nurse plays a pivotal role in various health care teams responsible for the implementation of different programs.
Community Health Planning
Assessment of community health needs provides essential information for planning health programs (Racher & Annis, 2008). The role of the community health nurse is to maintain a periodic assessment of the public health situation in the community. This role makes a CHN a useful member of the health programs planning team. The community health nurse should maintain proper reports and records by developing quality guidelines that are fundamental for community health. The CHN does this by profiling the community in terms of population demographics, community health status, community specific factors influencing health, current nursing or health programs, community perception or opinions on community health needs and services, and national and local priorities. The assessment role of a CHN provides fundamental information necessary for the planning of health programs in specific communities. From the profile of the community, priorities for health services can be identified. The nurse participates in periodic planning meetings with the entire health care team for the purposes of planning, implementation, and evaluation of community health projects.
Quality planning and record keeping enables the nurse to respond promptly in situations involving implementation and monitoring of aspects of family and the general community. Planning is defining factor in the success of community health practice. This is due to the dynamic nature of population demographics, patterns of disease, reforms in health systems, and health care costs. These considerations have shifted focus of health delivery to initiatives for health promotion based on community oriented- health care planning. The health needs of individuals and communities are diverse. Community health nurse provides fundamental elements of information to the health care planning team based on continuous assessment of community health situation. The evolving care demands require planning that produces high quality, innovative, and cost-effective community health programs.
Implementation of Community Health Care Programs
Education (capacity building), provision of clinical services, and participation in research are some functions through which a community health nurse contributes to the implementation of health programs (Meadows, 2009). Due to his/her rapport, knowledge and proximity to the community, the health nurse is able to help the health teams in rolling out various programs that require mobilization and close contact with the community. The community health nurse provides an avenue for feedback to the health managers. The nurse serves as a contact and mediator between the community and health management authorities. The roles of the community health nurse can be outlined in the framework of health promotion, prevention, and protection (Hecker, 2009). In the delivery of services for health promotion, the PHN builds public policy for quality health, creates supportive environments, reorient health services, and strengthens community action for health.
The prevention functions comprise participation in reproductive and family health, prevention of chronic health disorders, nutrition and food security education, and, sexual and mental health. For health protection the CHN participates in initiatives for environmental health, emergency health, and prevention of communicable diseases. The basic role of the nurse in the implementation of health programs is advocacy, education, and actual implementation of specific program activities. The nurse leads the health provision team in the community. Apart from family health programs and counseling, the nurses participate in research activities and transportation of clinical research samples. They facilitate the creation of healthy health home and occupational environments. The nurses help physicians plan and conduct special clinics in the community.
Evaluation of Community Health
Monitoring and evaluation of implemented community health programs is a significant role of the community health nurse (Rall & Meyer, 2006). Through periodic research the CHN is able to monitor the performance of health services in the community. The CHN uses indicators developed by the relevant health team to score the performance of running or completed programs. Program evaluation is necessary for planning future services and streamlining running programs so to stick to the intended purpose. The CHN plays this role by engaging the community to provide relevant information about the programs. The information about the effectiveness of the programs provided by the community health nurse provides the basis for the determination of the impact of the programs on communities. Program evaluation provides the basis for program modification and replication. The design and implementation of future health programs rely on the effectiveness of earlier programs. Therefore, the planning process takes into account the evaluation information of completed health programs.
Health planning, implementation, and evaluation are the critical procedures in health provision at the community. Counseling and education are prime health promotion duties of a community health nurse. These are functions that require adequate health planning in which the community heath nurses are the primary participants. In order to contribute sufficiently in the process of planning, the community health nurse must conduct continuous appraisal of the dynamic situation of health factors in the community. Periodic evaluation provides the health nurse with an insight into the effectiveness of the health work in the community. The community nurse functions as an essential member of the health team. The nurse has to build a professional relationship with the health and members of the community. Family health and, maternal and child health are two examples of teams in which the community health nurse is a fundamental member. The focus of community health nursing is the provision of health care services that are based on disease prevention and health promotion initiatives.
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