Approaches in chn

community health nursing II - unit IV

1. Community Health Nursing II U nit IV Approaches In Community Health Nursing PREPARED BY KRUPA MATHEW.M, ASSISTANT PROFESOR

2. APPROACHES Community Health Nurses use various approaches to provide care in the community. Some of them are Epidemiological approach Problem solving approach Evidence based approach

3. Epidemiological approach Epidemiology is the basic science of preventive and social medicine. It began with Adam and eve both tried to investigate the qualities of “forbidden fruit”. The Greek physician Hippocrates father of epidemiology the first person to have examined the relationship between the occurrence disease and environmental influences. epidemiology epi means=among, demos= people, logos=study.

4. DEFINITION The study of the distribution and determinants of health-related states or events in specified population and the application of the study to control of health problems (J.M. Last 1988)

5. AIMS OF EPIDEMIOLOGY T he ultimate aims of epidemiology can be concluded into two followings points To eliminate or reduce the health problem or its consequences T o promote the health and wellbeing of society as a whole.

6. USES OF EPIDEMIOLOGY I nvestigation of causation of disease. S tudy of the natural history and prognosis of diseases. D escription of the health status of the populations. I t includes proportion with ill health, change over time, change with age etc E valuation of the interventions. P lanning health services, public policy and programs.

7. Epidemiological approaches

8. ASKING QUESTIONS Epidemiology has been defined as “a means of learning or asking questions… and getting answers that lead to further questions”. for example the following questions could be asked.

9. HEALTH EVENTS

10. HEALTH ACTIONS

11. MAKING COMPARISONS T his approach is to make comparisons and draw inferences. This may be comparison of two (or more groups)- one group having the disease (or exposed to risk factor) and the other groups not having the disease (or not exposed to risk factor) or comparison between individuals. By making comparisons, the epidemiologist tries to find out the crucial differences in the host and environmental factors between those affected and not affected. C omparison may be made between different populations at a given time e.g . rural with urban population, between sub group of population e.g. male with female population, between various periods of observation e.g. different seasons

12. Definition A systematic approach to defining the problem and creating a vast number of possible solutions without judging these solution. “Problem solving is a cognitive processing directed at achieving a goal where no solution method is obvious to the problem solver ” PROBLEM SOLVING APPROACH

13. PROBLEM-SOLVING PROCESS

14. EVIDENCE BASED PRACTICE APPROACH Definition Evidence: It is something that furnishes proof or testimony or something legally submitted to ascertain in the truth of matter. Evidence based practice: It is systemic inter connecting of scientifically generated evidence with the tacit knowledge of the expert practitioner to achieve a change in a particular practice for the benefit of a well- defined client / patient group. (French 1999). Evidence based nursing: It is a process by which nurses make clinical decisions using the best available research evidence, their clinical expertise and patient preferences

15. NEED FOR EBP For making sure that each client get the best possible services. Update knowledge and is essential for lifelong learning. Provide clinical judgement. Improvement care provided and save lives.

16. GOAL OF EBP Provide practicing nurse the evidence based data to deliver effective care. Resolve problem in clinical setting. Achieve excellence in care delivery. Reduces the variations in nursing care and assist with efficient and effective decision making

17. Steps in ebp Many methods are used to conduct EBP in community health nursing one of the common method is PICO method P – Patient Population Of Interest I – Intervention Of Interest C – Comparison Of Interest O – Outcome Of Interest Step 1: Defining the patient (Population Of Interest) Step 2: Identifying the intervention or process of interest Step 3: Examining the comparison of interest Step 4: Outcome of interest Step 5: Time frame

18. Example : Does the incidence of protein energy malnutrition among infants (p) of village A decrease (O) with administration of nutrition balls ( I ) for 6 months compared to infants of village b (c)

19. Advantages of EBP Provide better information to practitioner Enable consistency of care Better patient outcome Provide client focused care Structured process Increases confidence in decision-making Generalize information Contribute to science of nursing Provide guidelines for further research Helps nurses to provide high quality patient care

20. Disadvantages of EBP Not enough evidence for EBP Time consuming Reduced client choice Reduced professional judgement/ autonomy Suppress creativity Influence legal proceedings Publication bias

21. Thank you