Community as

a client

Tamar Avedissian RN, MSN, PhD

03/13/2025

• WHO defined the community as “a

group of people, often living in a
defined geographical area, who may
share a common culture, values and
norms and are arranged in a social
structure according to relationships
which the community has developed
over time. Members of the community
gain their personal and social identity
by sharing common values and norms
that have been developed by the
Communit community in the past and may be
y modified in the future”

SAMPLE FOOTER TEXT 2

03/13/2025

• Blum (1974) defined community differently and categorized it

based on their interactions (such as between schools, social
services and governmental agencies)

• Nurses working in communities know that society consists of

many different types of communities
+ E.g. a group to support smoke free environment
+ E.g. an area with water pollution may bring the people of
that area together

• Because the type of communities differ, nurses must plan

community interventions that consider their specific
characteristics

Communit
y (cont’d) • In most definitions community includes people, place and
function

SAMPLE FOOTER TEXT 3

03/13/2025

• The community is the client when the nursing

focus is on the collective or common good of
the population instead of on individual health

• Population-centered practice seeks healthful

change for the whole community’s benefit

• E.g. the nurse would help an individual disabled

worker become independent in activities of
daily living. The nurse would become involved
with promoting vocational rehabilitation
Communit services in the community and seek reasonable
y as client employment policies for all disabled workers

SAMPLE FOOTER TEXT 4

03/13/2025

• TB can be affecting an individual, promoting

interventions to mitigate TB at the national
level is population-centered care

• An individual may be a smoker, but without

proper programs and policies the individual
may not be able to change the habit of
smoking

• Think about sedentary lifestyle of a patient

you are taking care of, how can you think at
the population level to help this patient
change the habit?
Examples
SAMPLE FOOTER TEXT 5
03/13/2025

Viewing the community as a client

means commitment to 2 concepts:

1. COMMUNITY 2. PARTNERSHIP FOR

HEALTH COMMUNITY HEALTH

SAMPLE FOOTER TEXT 6

03/13/2025

Status:
Communit • Vtal statistics (live births, neonatal deaths, maternal deaths,
infant deaths)

y health • Incidence and prevalence of leading causes of mortality and

morbidity
• Health risk profiles of selected aggregates
• Functional ability levels

Structure:
• Health facilities (hospitals, nursing homes, school health
services…)
• Health manpower (physicians, nurses, social workers, dentists…)
• Health resource use patterns (bed occupancy, clinic visits…)

Process:
• Commitment to community health to sustain the community
(local government)
• Awareness of self and others to set realistic goals for the
community (neighborhood help organizations)
• Effective communication (accurate transmission of information)
• Conflict containment
• Partcipation (active involvement of population)

SAMPLE FOOTER TEXT 7

03/13/2025

Guide for • Healthy People 2020  2030

• Healthy People 2020 (HP2020) tracks approximately
nurses to 1,300 objectives organized into 42 topic areas, each of
which represents an important public health area.
improve • Attain high-quality, longer lives free of preventable

the health disease, disability, injury, and premature death;

of
• Achieve health equity, eliminate disparities, and
improve the health of all groups;

community • Create social and physical environments that promote

good health for all; and
• Promote quality of life, healthy development, and
healthy behaviors across all life stages.

SAMPLE FOOTER TEXT 8

03/13/2025

• 3 main characteristics of a successful

Community partnership:
partnership • Being informed: community member
s and professional partners must be aware
of their rights and responsibilities
• Flexibility: community member and
professional partners must recognize the
unique and similar contributions that
each can make
• Negotiation: distribution of power must
be negotiated at every stage of the
change process
SAMPLE FOOTER TEXT 9
03/13/2025

Partnerships involving
Alert !!! nurses working with
community organizations
offer one of the most
effective means for
interventions because they
actively involve the
community and build on
existing community
strengths

Because they know they

have to start with the
people

SAMPLE FOOTER TEXT 10

03/13/2025

• Follow guidelines
+USPSTF
+WHO
+CDC
+APHA
Strategies
+AHA
to
improve
communit • Follow evidence-based
practice
y health
SAMPLE FOOTER TEXT 11
03/13/2025

Community
assessment

Community- Evaluating
community
Community
nursing
focused health
intervention
diagnosis

nursing
process
Implementing Planning for
in the community
community health

SAMPLE FOOTER TEXT 12

03/13/2025

• Gather data systematically, develop a database,

then interpret the data, analyze the problem
• Gaining entry into the community is the
hardest part
+ What are the geographic boundaries of the
community?
+ Which people are members of this community?
+ What characteristics do the members have in
common?
Communit • Demographic data

y • Racial data
• Vital statistics
assessme • Surveys
nt • Informant interviews
• Focus groups
SAMPLE FOOTER TEXT 13
• Participant observation
03/13/2025

• Boundaries: What defines the boundary? Roads, water, railroads? Does the area have a name? A
nickname?

Each community has its • Housing and zoning: What is the age of the houses? What kind of materials in the construction? Describe the
own characteristics. These housing, including space between houses, general appearance and condition, and presence of central heating, air
conditioning, and modern plumbing.
characteristics, along with
demographic data, provide • Open space: Describe the amount, condition, use of open space. Is the space used? Safe? Attractive?
valuable information in • Commons: Where do people in the neighborhood congregate? Who congregates there and at what hours during
understanding the the day?
population that lives within
• Transportation: How do people get from one place to another? Is public transportation available? If so,
the community and the
what kind and how effective? How timely? Personal autos? Bikes, etc.?
health status, strengths
and limitations, risks, and • Social service centers: Do you see evidence of recreation centers, parks, social services, offices of doctors and
vulnerabilities unique to dentists, pharmacies?
the "population of • Stores: Where do residents shop? How do they get to the shops? Do they have groceries or
interest." Once you have sources of fresh produce? Is this a "food desert"?
defined a "community of
• Street people and animals: Who do you see on the streets during the day? Besides the people, do you see
interest" to assess, a animals? Are they loose or contained?
windshield survey is the
equivalent of a community • Condition of the area: Is the area well kept or is there evidence of trash or abandoned cars or houses? What
kind of information is provided on the signs in the area?
head-to-toe assessment.
• Race and ethnicity: What is the race of the people you see? What do you see about indices of ethnicity?
The best way to conduct a Places of worship, food stores, restaurants? Are signs in English or other languages? (If the latter, which ones?)
windshield survey is to • Religion: What indications do you see about the types of religion residents practice?
have a designated driver
and at least one other • Health indicators: Do you see evidence of clinics, hospitals, mental illness, substance abuse?
passenger to scan the • Politics: What indicators do you see about politics? Posters, headquarters?
outline and take notes.
• Media: Do you see indicators of what people read? If they watch television? Listen to the radio?

• Business and industry: What type of business climate exists? Manufacturers? Light or heavy industry? Large
SAMPLE FOOTER TEXT 14
employers? Small business owners? Retail? Hospitality industry? Military installation? Do people have to seek
03/13/2025

• Community nursing diagnoses

language must be at the
aggregate level, and the defining
characteristics must be
observable and measurable at
the aggregate level
+NANDA
Communit +Omaha system classification used
y nursing by home care nurses

diagnosis
SAMPLE FOOTER TEXT 15
03/13/2025

• Problem-Prioritizing: After identifying the

problems and stating the diagnoses, there is a
need to prioritize the problems based on pre-
determined criteria and scoring sheets:
+ Community awareness of the problem
+ Community motivation to resolve the problem
+ Nurses’ ability to influence problem solution
+ Availability of expertise
+ Severity of the outcomes if problem is

Planning unresolved
+ Speed to which the problem can be resolved
for
communit • Establish goals and objectives:
+ Goals are broad statements
y health + Objectives are specific

SAMPLE FOOTER TEXT 16

03/13/2025

Small interacting groups,

Implementi formal and informal,
ng in the mediating structures, early
community adopters

Lay advisors

Mass media

Health policy

SAMPLE FOOTER TEXT 17

03/13/2025

Evaluating Evaluating the process and the

outcome
communit
y health Decide if the cost in money and time
interventi were worth it
on
Results must be compared to
baseline information collected before
the intervention
With evaluation, the entire process is
open for renegotiation

SAMPLE FOOTER TEXT 18

03/13/2025

THANK YOU 
SAMPLE FOOTER TEXT 19