ENUGU STATE UNIVERSITY OF SCIENCE AND

TECHNOLOGY

COLLEGE OF MEDICINE

FACULTY OF BASIC MEDICAL SCIENCES

DEPARTMENT OF NURSING SCIENCES

TOPIC :COMMUNITY AS A CLIENT OF CARE

By

Group 10 MEMBERS

DATE: August 31, 2023 .

GROUP MEMBERS

RAPHAEL LORDMORE UROKO 2020030193581 (group leader)

OGBE NNEOMA PEACE 2020030193700 (secretary)

ONYEISHI KELECHI SANDRA 2021030198199

ODEH CHIOMA JENNIFER 2020030195018

EZENWA CHIAMAKA DIVINE FAVOUR 2020030192101

CYRIACUS PRAISE CHINENYE 2020030193693

EKWEM NESOCHI ANGEL 2020030193694

Introduction ;

Community is typically defined as a group of people who share a common

location, culture, values, interests, or experiences. Here are a few key elements

of a community:

- Shared location: Communities are often geographically defined, like a

neighborhood, city, or country.

- Shared culture: Communities can be defined by shared language, traditions,

customs, and beliefs.

- Shared interests: Communities can also form around shared hobbies, activities,

or causes.

- Interdependence: Communities rely on each other for support, resources, and

services.

Types of community

1. Urban community – An urban community is a place-based community that

has its own unique structure and needs. Urban communities are densely-
 populated and often rely upon peripheral communities to provide food and

materials, while they offer services to other communities in return.

2. Suburban community – Suburban communities are less dense than urban

and often have high numbers of families and children. Their interests may

be focused on family planning, education, and cost of living pressures.

3. Rural community – Rural communities are often oriented around agrarian

lifestyles and have unique concerns such as access to healthcare and services

despite the fact they’re far from service providers. They also tend to, on

average, have a higher degree of conservative political leaning due to the

need to rely on self and neighbor over government.

Client is a person or group that receives services or products from a

professional or organization. Clients can be individuals, families, organizations,

or communities.

Care is showing kindness, support, and concern for someone’s well-being. It’s

about being there for them when they need it.

In the context of nursing, the term “community as a client” refers to viewing the

community itself as the recipient of nursing care. Instead of focusing solely on

individual patients, nurses recognize that the health and well-being of the entire

community are interconnected and play a significant role in individual health

outcomes.
When the community is seen as the client, nurses assess the community’s health

needs, identify health risks and disparities, and develop interventions and

strategies to promote the overall health of the community. This approach

involves working collaboratively with community members, organizations, and

resources to address health issues, implement health promotion programs, and

advocate for community health.

Nurses who view the community as a client may engage in activities such as

conducting community assessments, providing health education and preventive

care, coordinating healthcare services, facilitating access to resources, and

advocating for policies that improve community health. By considering the

community as a whole, nurses can contribute to the development of healthier

and more resilient communities.

Community health nurses works with clients at several levels

- Individual level: Providing care and support to individual clients, including

assessments, education, and interventions.

- Family level: Supporting and educating family members to help them better

care for their loved ones.

- Community level: Working with community organizations, policymakers,

and others to address population-level health needs and promote health equity.
- Systems level: Identifying and advocating for changes in health systems,

policies, and practices that can improve care for clients and communities.

- National level: Participating in national organizations and initiatives to

advocate for policies and practices that improve health outcomes for

populations across the country.

- Global level: Collaborating with international organizations and partners to

address health issues that affect populations around the world, such as

pandemics, health disparities, and access to care.

- Policy level: Working with policymakers to influence legislation and

regulations that impact health outcomes, such as access to healthcare, public

health initiatives, and health funding.

- Organizational level: Working within healthcare organizations and systems

to improve patient care, safety, and quality.

- Research level: Contributing to evidence-based practices through research

and evidence-informed decision-making.

- Education level: Educating and training other healthcare professionals and the

general public about health issues and best practices.

- Advocacy level: Promoting health equity and social justice through advocacy

and community organizing.

- Leadership level: Providing guidance and direction to healthcare teams and

organizations, and inspiring others to achieve shared goals.

- Innovation level: Using creativity and technology to develop and implement

new solutions to address healthcare challenges.

- Social justice level: Promoting equity, fairness, and social justice in

healthcare, including addressing systemic barriers and promoting inclusivity.

Principles of community as a client of care

PRINCIPLES OF COMMUNITY AS A CLIENT OF CARE

There are four main principles of community as a client of care:

empowerment, advocacy, collective responsibility, and community-based

participatory research.

1. EMPOWERMENT: The principle of empowerment is an important part of

the community as a client of care model. Empowerment means that the

community is given the tools and resources to make decisions about its own

health and well-being. This can involve providing education and information

about health issues, as well as empowering the community to advocate for itself

and make decisions about its own health. It's important to recognize that

empowerment is a process, and it takes time and effort to build capacity within

the community. This is often done through participatory approaches, such as

involving the community in health research and planning.

2. ADVOCACY: In the context of community as a client of care, advocacy is

about being an active voice for the community and its needs. This can involve a

variety of activities, such as raising awareness about health issues, educating

others about the community's needs, and advocating for policies and programs

that will benefit the community. Advocacy also involves building relationships

with decision-makers and policymakers, and working to build a sense of

empowerment and collective responsibility within the community. All of these

activities are done with the goal of improving the overall health and well-being

of the community.

3. COLLECTIVE RESPONSIBILITY: This principle is based on the idea

that health is not just an individual responsibility, but a shared responsibility.

This means that everyone has a role to play in improving the community's

health. This can involve things like working together to address health issues,

making decisions about health policies and programs, and supporting each other

in times of need. Collective responsibility also involves creating a sense of

community and connectedness, and building trust and respect within the

community.

4. PARTICIPATORY RESEARCH: Community-based participatory research

(CBPR) is a type of research that involves engaging the community in all stages

of the research process, from planning to data collection to dissemination.

CBPR recognizes that the community has valuable knowledge and expertise
that can be used to inform research and improve health. CBPR also recognizes

that the community should be involved in making decisions about how research

is conducted and how the findings are used. This approach is intended to create

a more equitable and beneficial relationship between researchers and the

community.

Goals and Means Of Practice in The Community:

-Status

Community health in terms of status, or outcome, is the most well-known and

accepted approach; it involves biological, emotional, and social parts. The

biological (or physical) part of community health is often measured by

traditional morbidity and mortality rates, life expectancy indexes, and risk factor

profiles. The question of exactly which risk factors are most important has been

a matter of ongoing disagreement.

-Structure

Community health, when viewed as the structure of the community, is usually

defined in terms of services and resources. Measures of community health

services and resources include service use patterns, treatment data from various

health agencies, and provider-to-client ratios. These data provide information,

such as the number of available hospital beds or the number of emergency

department visits to a particular hospital. The problems that can be found when
structure measures are used are serious. For example, problems related to access

to care and quality of care are well-known through stories reported in local

newspapers. Less well-known, but of equal concern, is the false belief that

simply providing health care improves health. Such problems require cautious

use of health services and resources as measures of community health.

A structural viewpoint also defines the characteristics of the community

structure itself. Characteristics of the community structure are commonly

identified as social measures, or correlates, of health. Measures of community

structure include demographics, such as socioeconomic and racial distributions,

age, and educational level. Their relationships to health status have been

thoroughly documented. For example, studies have repeatedly shown that health

status decreases with age and improves with higher socioeconomic levels.

-Process

The view of community health as the process of effective community

functioning or problem solving is well established. However, it is especially

appropriate to nursing because it directs the study of community health for

community action.

The role of a nurse in the community as a client

The role of a community nurse is to provide care for clients outside of clinical

hospital settings. Often, this can mean treating people in the comfort of their
own homes and assisting them with trips out in the community which may

include trips to the park, zoo, supermarket, surgery visits and accompanying

them on family holidays. This responsibility is not only beneficial to the client

but also reduces pressure on hospital services.

Community nurses play a vital role in delivering person-centered care to clients

and using their expertise and clinical judgement to make informed decisions to

improve the quality of care the client receives. Community nurses can carry out

a range of responsibilities during shift which may include:

 Monitoring the client’s airways, including tracheostomy management and

care

 Monitoring the client’s breathing, including invasive or non-invasive

ventilation management and care

 Medication administration

 Monitoring the client’s general health and wellbeing

 Monitoring medical stock

 Physiotherapy

 Following a prescribed plan

 Conducting safety checks on medical equipment

 Record keeping

 Managing infection prevention and control

 Communicating with clients, family and professionals regularly

  Supporting with tissue viability

 Delivering personal care and hygiene

 Moving and handling

 Carrying out elimination management

 Nutrition management

Enabling the client to meet their social goals and aspirations.

Community client and nursing practice

A community client refers to an individual, family or group of people who

reside within a specific community. Nursing practice in a community refers to

the delivery of healthcare services and interventions by nurses in a community

setting. It involves providing comprehensive and holistic care to individuals,

families, and populations within the community. It focuses on promoting and

maintaining health, preventing illness, and managing acute and chronic

conditions. In nursing practice, a community clients are the recipients of health

care services and interventions provided by nurses in various community

settings. Community nursing focuses on providing care, promoting health,

preventing illness, and managing chronic conditions in the community. Nurses

who work with community clients have a unique role in delivering holistic care

that considers the social, cultural, and environmental factors that influence

health. They collaborate with other healthcare professionals and community

organizations to address the specific needs of their clients and promote overall

well-being of the client.

Importance of community-clients in nursing practice

Community clients are of great importance in nursing practice for several

reasons.

Firstly, community clients allow nurses to provide care in a holistic and

comprehensive manner. By working with clients within their community, nurses

can gain a deeper understanding of the social, cultural, and environmental

factors that influence their health. This knowledge helps nurses tailor their care

plans to meet the specific needs and circumstances of their clients, leading to

more effective and personalized care.

Secondly, community clients enable nurses to focus on health promotion and

disease prevention. By working with clients in their community, nurses can

identify and address health risks and provide education and resources to

promote healthy behaviors. This proactive approach helps to prevent illness and

improve overall community health.

Thirdly, community clients help nurses build strong relationships and trust

within the community. By being present and accessible in the community,

nurses can develop meaningful connections with clients and their families. This
trust and rapport are vital in fostering open communication, ensuring client

engagement in their own care, and promoting positive health outcomes.

Overall, community clients play a crucial role in nursing practice by allowing

nurses to provide holistic care, focus on health promotion, and build strong

relationships within the community. Their importance lies in improving the

well-being of individuals and the overall health of the community.

Interventions that nurses use to address the unique needs of community

clients

Nurses use various interventions to address the unique needs of community

clients. Some of these interventions include:

1. Health Assessments: Nurses conduct comprehensive health assessments to

identify the specific health needs and risks of community clients. This helps in

developing individualized care plans.

2. Health Education: Nurses provide education and information to community

clients, empowering them to make informed decisions about their health. This

may include topics such as disease prevention, healthy lifestyle choices, and

medication management.
3. Care Coordination: Nurses collaborate with other healthcare providers and

community resources to ensure seamless and coordinated care for community

clients. This involves facilitating referrals, scheduling appointments, and

advocating for clients’ needs.

4. Health Promotion Programs: Nurses develop and implement health

promotion programs within the community, targeting specific health issues or

populations. These programs may include workshops, support groups, or

community-wide initiatives to improve overall health and well-being.

5. Medication Management: Nurses assist community clients in managing

their medications effectively. This may involve medication reconciliation,

education on proper administration, and monitoring for any adverse effects.

6. Chronic Disease Management: Nurses support community clients with

chronic conditions by providing ongoing education, monitoring, and assistance

in managing their condition. This may include regular check-ins, medication

adherence support, and lifestyle modifications.

7. Home Visits: Nurses conduct home visits to assess the living conditions,

safety, and social support systems of community clients. This helps in

identifying any barriers to health and developing appropriate interventions.

8. Advocacy: Nurses advocate for the rights and needs of community clients,

ensuring they have access to necessary healthcare services, resources, and

support. This may involve addressing social determinants of health, navigating

healthcare systems, and promoting health equity.

9. Referrals and Resource Linkages: Nurses connect community clients with

appropriate resources and services, such as social services, mental health

support, or community organizations. This helps clients access the

comprehensive care they need.

10. Follow-up and Support: Nurses provide ongoing follow-up and support to

community clients to monitor their progress, address any concerns or

challenges, and ensure continuity of care.

These interventions are tailored to the unique needs of community clients and

aim to promote their health, well-being, and overall quality of life.

Nursing process in a community as a client of care

APPLYING THE NURSING PROCESS TO A COMMUNITY AS A CLIENT

OF CARE

Community health nurses apply the nursing process to address needs of

individuals, families, vulnerable populations, and entire communities.

The community health nurse typically begins a community health needs

assessment by determining what data is already available.As previously

discussed in the “Community Health Concepts” section, national, state, county,

and local health needs assessments are widely available. Secondary analysis

refers to analyzing previously collected data to determine community needs.

Community health nurses may also engage in primary data collection to better

understand the community needs and study who may be affected by actions

taken as a result of the assessment. Primary data collection includes tools such

as public forums, focus groups, interviews, windshield surveys, surveys, and

participant observation.

Public forums are gatherings where large groups of citizens discuss important

issues at well-publicized locations and times. Forums give people of diverse

backgrounds a chance to express their views and enhance understanding of the

community’s specific needs and resources. Forums should be planned in a

convenient location with accessibility to public transportation and child care.

They should also be scheduled at convenient times for working families to gain

participation from a wide range of populations.

Focus Groups

Focus groups are a systematic method of data collection through small-group

discussions led by a facilitator. Participants in focus groups are selected to

represent a larger group of people. Groups of 6-10 people with similar

backgrounds or interests are interviewed in an informal or formal setting. Focus

groups should be scheduled at several dates and times to ensure a broad

participation from members of the community.

Interviews

Interviews are structured conversations with individuals who have experience,

knowledge, or understanding about a particular topic or issue. Key informant

interviews are conducted with people in key positions in the community and

have specific areas of knowledge and experience. These interviews can be

useful for exploring specific community problems and assessing a community’s

readiness to address those problems.

Windshield Surveys

A windshield survey is a type of direct observation of community needs while

driving and literally looking through the windshield. It can be used to observe

characteristics of a community that impact health needs such as housing,

pollution, parks and recreation areas, transportation, health and social services

agencies, industries, grocery stores, schools, and religious institutions.

Surveys

Surveys use standardized questions that are relatively easy to analyze. They are

beneficial for collecting information across a large geographic area, obtaining

input from as many people as possible, and exploring sensitive topics.Surveys

can be conducted face to face, via the telephone, mailed, or shared on a website.

Responses are typically anonymous but demographic information is often

collected to focus on the needs of specific populations.

Participant Observation

Participant observation refers to nurses informally collecting data as a member

of the community in which they live and work. This is considered a subjective

observation because it is from the nurse’s perspective. Informal observations are

made, or discussions are elicited among peers and neighbors within the

community.

IMPORTANCE OF A COMMUNITY AS A UNIT OF CARE

1.Connection and belonging

Togetherness is so central to our experience as humans; that feeling we are part

of something bigger can help give meaning to our lives. Finding others with the

same values, interests, and world views makes us realise that we’re not alone

and makes us feel valued. Indeed, belonging highlights why community is

necessary: being accepted into a group gives us a stronger sense of self and can

help us cope with negative experiences and feelings.

2.Influence

Sometimes we need an extra push to stop us from falling into unhealthy habits

or thoughts. Experiencing the positive influence of like-minded people is

another reason behind the importance of community. Studies confirm that our

overall health is partly determined by our ability to look after ourselves, but

sometimes we simply don’t feel capable of it. Communities can influence us

and motivate us to invest in our well-being and to bring positive changes to our

lives.

3.Sharing

Sharing activities, ideas and feelings reinforces not only our sense of self, but

also adds worth and value to the community. Indeed, the more the merrier

applies in this case! That’s not to mention the huge beneficial effect sharing can

have on mental health: higher engagement, positive emotions, and

empowerment are only some of the benefits. Sharing is caring.

4.Learning

Communities are usually built around common interests, but that doesn’t mean

they’re homogeneous. We can still find people within them who have different

views, experiences, or beliefs, and learning from them can help us reach

insights that we may not have reached on our own.

5.Acceptance

Developing community bonds with others who have different views may be

challenging, but it’s also an opportunity to practise acceptance. I had a personal

breakthrough when I read this article and understood that acceptance doesn’t

necessarily imply agreement.

“One of the main reasons behind the importance of community is that it can

help fight feelings of hopelessness and give us the certainty that we are safe.”

This valuable lesson can bring peace and relief. And there’s another side to

acceptance: self-acceptance. Community belonging helps us accept that

sometimes we’re strong and sometimes we’re vulnerable and that we need the

support of others to avoid unnecessary emotional struggles and pain.

6.More connections, more chances of success

The importance of community goes beyond the personal sphere and extends to

professional development. Since the pandemic begun we’ve seen a stronger

focus on supporting local businesses, so this is a good place to start networking

and building strong relationships. You never know where that could take your

business idea or professional life.