CHNC Standards
CHNC Standards
CHNC Standards
Contact Information
Community Health Nurses of Canada
182 Clendenon Avenue
Toronto, ON, M6P 2X2
[email protected]
Funding for this publication was provided by the Public Health Agency of
Canada. The opinions expressed in this publication are those of the authors
and do not necessarily reflect the official views of the Public Health Agency
of Canada.
Canadian Community Health Nursing
Professional Practice Model
& Standards of Practice
Table of Contents
1 Acknowledgements
2 Foreword
24 Appendices
Appendix A: Methodology: Development of the Practice Model and Standards of Practice . . . 24
Appendix B: Examples of Service Delivery Models Used in Community Health Nursing . . . .26
Appendix C: Determinants of Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Appendix D: Examples of Management Practices . . . . . . . . . . . . . . . . . . . . . . . 28
Appendix E: Examples of Theories and Conceptual Frameworks . . . . . . . . . . . . . . . 29
Appendix F: Community Health Nursing by Area of Practice . . . . . . . . . . . . . . . . 30
Appendix G: Relationship between Standards and Competencies . . . . . . . . . . . . . . . 31
Appendix H: Health Promotion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
33 References
List of Figures
Figure 1. Key Aspects of Nursing Knowledge (metaparadigm)
Figure 2. History of Community Health Nursing
Figure 3. Population Health Promotion Model
Figure 4. The Jakarta Declaration
Canadian Community Health Nursing
Professional Practice Model & Standards of Practice
Acknowledgements
The identification of the components of the Community Health Nurses of Canada (CHNC)
Professional Practice Model and the Canadian Community Heath Nursing Standards of Practice
was made possible by CHNC and its Board of Directors; the CHNC Certification, Standards and
Competency Standing Committee and the Standards Review Revision Project Team; the CHNC
Education/Professional Development Standing Committee and the Practice Model Project Team.
Funding for this work came from the Public Health Agency of Canada and in-kind support from the
Winnipeg Regional Health Authority. The Community Health Nurses of Canada would like to thank
the following CHNC members for their generous contribution of time and expertise to this work.
Review of the literature: Claire Betker, Barbara Mildon and Jane Underwood
A special thank you to the nearly 500 dedicated community health nurses from across Canada who
allowed us to “hear their voice” by responding to the standards survey.
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Canadian Community Health Nursing
Foreword
2
Professional Practice Model & Standards of Practice
Introduction
The components of the CHNC practice model incorporate many of the concepts that were embedded
in the original model that was developed in 2003i. Professional practice models include the structure,
process and values that support nurses’ control over the delivery of nursing care and the environment in
which care is delivered.ii
The Client
(Individuals, Families, Groups, Communities, Populations, Systems)
Community health nurses support the health and well-being of individuals, families, groups, communi-
ties, populations and systems. Community health nurses practice in health centres, homes, schools and
other community-based settings. Using a capacity building and strength-based approach, they provide,
coordinate or facilitate direct care and link people to community resources. They view health as a
dynamic process of physical, mental, spiritual and social well-being. Health includes self-determination
and a sense of connection to the community.
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Canadian Community Health Nursing
Code of Ethics
The Code of Ethics has been developed by nurses for nurses to assist them to practice ethically and to
work through ethical challenges that arise in their practice with individuals, families, groups, communi-
ties, populations and systems.
The Canadian Nurses Association’s Code of Ethics for Registered Nurses is a statement of the ethical
values of nurses and of nurses’ commitments to persons with health-care needs and persons receiving care. It
is intended for nurses in all contexts and domains of nursing practice and at all levels of decision-making. iii
• Promote, protect and preserve the health of individuals, families, groups, communities, and
populations in the settings where they live, work, learn, worship and play in an ongoing and / or
episodic processiv
• Consider and address the impact of the determinants of health within the political, cultural and
environmental context on health
• Support capacity building approaches focused on client strengths and client participation
• Protect and enhance human dignity respecting social, cultural, and personal beliefs and
circumstances of their clients
• Advocate and engage in political action and healthy public policy options to facilitate healthy living
• Incorporate the concepts of inclusiveness, equity and social justice as well as the principles of
community development
• Participate in knowledge generation and knowledge translation, and integrate knowledge and
multiple ways of knowing
• Engage in evidence informed decision making
• Work at a high level of autonomy
• Practice with an emphasis on teamwork, collaboration, consultation and professional relationships.
Standards define the scope and depth of practice by establishing criteria for acceptable nursing practice.v
They represent the desirable and achievable levels of performance expected of nurses in their practice
and provide criteria for measuring actual performance.vi
A variety of service delivery approaches that integrate community health nursing process into practice
are used. These include, but are not limited to:
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Professional Practice Model & Standards of Practice
Community health nursing roles and activities continually evolve to meet the health needs of the dif-
ferent population groups. Service delivery is focused on preventive, curative, social and environmental
aspects of care; is responsive to community needs; and takes into consideration stewardship of resources
for making services efficient and effective. (See Appendix B – Examples of Service Delivery Models Used in
Community Health Nursing)
Determinants of Health
The determinants of health are the individual and collective factors and conditions affecting health sta-
tus. The determinants of health extend beyond the community health nurses practice environment and
scope of influence. The determinants of health influence community health nursing practice because
of the profound impact they have on the health of the client (individuals, families, groups, communi-
ties, populations and systems). Community health nurses support the client by advocating for change to
address the determinants of health. (See Appendix C – Determinants of Health)
Competencies are the integrated knowledge, skills, judgment and attributes required of a registered
nurse to practice safely and ethically. Attributes include, but are not limited to attitudes, values and
beliefs.vii,viii
Government Support
Community health nursing in Canada is usually funded by government resources and influenced by
government policies. Decisions about funded services, resources, performance standards and policies
that affect community have an impact on the ability of community health nurses to deliver care. The
nursing community can work with governments and advocate for decisions that optimize health in the
community.
Management Practices
Management practices refer to the decision making structures and processes within community organi-
zations and agencies. Effective management practices: promote the realization of autonomous practice;
enable community health nurses to practice to the full scope of their abilities; and encourage commu-
nity health nurses to incorporate evidence and research into their practice.
Community health nurses value a management approach that recognizes their contribution both
informally and formally. Examples of rewards include but are not limited to: celebration of successes;
certification; promotion and professional advancement or remuneration. (See Appendix D – Examples of
Management Practices)
Professional relationships recognize the strengths and contributions of others and require effective com-
munication, consultation, collaboration and partnerships with clients, team members, professionals and
other organizations.
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Canadian Community Health Nursing
Professional regulatory standards demonstrate to the public, government and other stakeholders that
a profession is dedicated to maintaining public trust and upholding the criteria of its professional
practice. ix
Figure 1. Key Aspects of Nursing
Knowledge (metaparadigm)
Theoretical Foundation
6
Professional Practice Model & Standards of Practice
Introduction
The Canadian Community Health Nursing Standards of Practice (the Standards) represent a vision for
excellence in community health nursing. The Standards define the practice of a registered nurse in the
specialty area of community health nursing. They build on the generic practice expectations of regis-
tered nurses and identify the practice principles and variations specific to community health nursing in
Canada. The Standards apply to community health nurses who work in the areas of practice, education,
administration and research.
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Canadian Community Health Nursing
Community health nursing acknowledges its roots and traditions, embraces advances, and recognizes
the importance of the need to continually evolve as a dynamic nursing specialtyi. (see Figure 2. History
of Community Health Nursing)
Community health nurses view health as a dynamic process of physical, mental, spiritual and social
well-being. Health includes self-determination, realization of hopes and needs, and a sense of connec-
tion to the community.i Community health nurses consider health as a resource for everyday life that is
influenced by circumstances, beliefs and the determinants of health. The determinants of health are fac-
tors and conditions that affect health status and include social, cultural, political, economic, physical and
environmental health determinants. Additional determinants of health specific to aboriginal populations
have also been identified. (See also Appendix C – Determinants of Health)
A Glossary of Terms, which further describes relevant concepts and terms related to community health
nursing practice can be found at http://chnc.ca/nursing-publications.cfm.
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Professional Practice Model & Standards of Practice
N DA R D N DA R D N DA R D N DA R D N DA R D N DA R D N DA R D
S TA S TA S TA S TA S TA S TA S TA
Health Professional
Prevention
1
Maintenance,
Health
Promotion 2 and Health
Protection
3 Restoration
and
4 Professional
Relationships 5 Capacity
Building 6 Access
and Equity 7 Responsibility
and
Accountability
Palliation
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Canadian Community Health Nursing
Standard 1:
Health Promotion
b. Uses a variety of information sources including community wisdom to access high quality data and
research findings related to health at the international, national, provincial, territorial, regional and
local levels to plan programs and services.
c. Seeks to identify the root causes of illness, disease and inequities in health.
d. Considers socio-political issues that may underlie individual, family, group, community, population
or system problems. (See Appendix C- Determinants of Health)
e. Recognizes the impact of specific issues such as political climate, will, values and culture, historical
context, client readiness, and social and systemic structures on health.
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Professional Practice Model & Standards of Practice
h. Identifies strategies for change that will make it easier for people to make healthier choices.
i. Collaborates, along with other sectors, with the individual, family, group, community or population,
to support them to overcome health inequities and take responsibility for maintaining or improving
their health by increasing their knowledge, influence and control over the determinants of health.
j. Understands and uses social marketing, media and advocacy strategies, in collaboration with others,
to raise awareness of health issues and place issues of social justice and health equity on the public
agenda.
k. Applies relevant theories and concepts (e.g. Stages of Change Theory,xix; Self-Efficacy Theory,xx
Assets and Strengths xxi, Community Mobilizationxxii) to shift social norms and change behaviours
in partnership with others while working on enabling factors to overcome barriers in the social and
physical environment.
l. Uses a client centered approach to help the individual, family, group, community and population to
identify strengths and available resources to access health and take action to address their needs
m. Evaluates and modifies population health promotion programs as needed in partnership with
the individual, family, group, community, population or system in partnership with individuals,
employers and policy makers.
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Canadian Community Health Nursing
Standard 2:
Prevention and Health Protection
a. Participates in surveillance activities; analyzes and utilizes this data to identify and address health
issues within a population or community.
b. Recognizes patterns and trends in epidemiological data and service delivery and initiates strategies
to improve health.
c. Recognizes the differences between the levels of prevention (primary, secondary, tertiary) and
selects the appropriate level of intervention.
d. Facilitates informed decision making for protective and preventive health measures.
e. Helps individuals, families, groups, communities, populations or systems identify potential risks to
health including contributing to emergency and/or disaster planning, being knowledgeable about
specific emergency / disaster plans and promoting awareness of the plan(s) amongst individuals,
families, groups and communities.
f. Uses harm reduction principles grounded in the concepts of health equity and social justice, to
identify and reduce or remove risk factors in a variety of environments and settings including
homes, neighbourhoods, workplaces, schools and street.
g. Provides prevention and protection services for the individual, family, group or community to
address issues such as communicable disease, injury, chronic disease, physical environment (e.g. clean
air, water, land) and community emergencies or disasters.
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Professional Practice Model & Standards of Practice
k. Practices in accordance with legislation and regulation relevant to community health practice (e.g.
public health legislation, child protection legislation and provincial/territorial/federal regulatory
frameworks). In addition, when relevant, practices in accordance with complementary sub specialty
standards e.g. occupational health nursing; parish nursing.
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Canadian Community Health Nursing
Standard 3:
Health Maintenance, Restoration and Palliation
a. Assesses the health status and functional competence of the individual, family, group, community,
population or system within the context of their environmental and social supports.
b. Develops mutually agreed upon plans and priorities for care with the individual, family, group,
community, population or system.
c. Identifies a range of strategies including health promotion, health teaching, disease prevention and
direct clinical care strategies along with short and long-term goals and outcomes.
d. Maximizes the ability of an individual, family, group, community, population or system to take
responsibility for and manage their health needs according to resources and personal skills available.
e. Supports informed decision making; acknowledges diversity, unique characteristics and abilities; and
respects the individual, family, group, community or population’s specific requests.
f. Adapts community health nursing techniques, approaches and procedures to health challenges and
the challenges related to equity in health in a particular community situation or setting.
g. Uses knowledge of the community to link with and refer to community resources or develop
appropriate community resources as needed.
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Professional Practice Model & Standards of Practice
h. Facilitates maintenance of health and the healing process for the individual, family, group,
community, population or system in response to significant health emergencies or other community
situations that negatively impact health.
i. Evaluates outcomes systematically and continuously in collaboration with the individual, family,
group, community, population or system including other health practitioners and inter-sectoral
partners.
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Canadian Community Health Nursing
Standard 4:
Professional Relationships
a. Builds a network of relationships and partnerships with a wide variety of individuals, families,
groups, communities, organizations and systems (e.g. community and volunteer service
organizations, businesses, faith communities and with health professionals and other sectors) to
address health-related issues and support health equity.
b. Uses a holistic and comprehensive mix of community and population based strategies such as
coalition building, inter-sectoral collaboration, partnerships and networking to overcome health
inequities.
c. Assesses individual, family, groups, community and system beliefs, attitudes, feelings and values about
health and health inequities and their potential effect on the relationship and intervention.
d. Recognizes her or his personal beliefs, attitudes, assumptions, feelings and values about health and
their potential effect on interventions/strategies.
e. Is aware of and uses culturally relevant communication strategies when building relationships.
Communication may be verbal or non-verbal, written or graphic. It may involve face-to-face,
telephone, group, print or electronic methods.
f. Respects, trusts and supports or facilitates the ability of the individual, family, group, community,
population or system to identify, solve and improve their own health issues.
g. Involves the individual, family, group, community, population or system as an active partner,
applying community development principles, to identify relevant needs, perspectives and
expectations.
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Professional Practice Model & Standards of Practice
h. Recognizes and promotes the development of health enhancing social support networks as an
important determinant of health.
j. Promotes and supports linkages with appropriate community resources when the individual, family,
group, community, population or system is ready to receive them (e.g., hospice or palliative care,
parenting groups).
l. Negotiates an end to the relationship, in a professional manner, when appropriate (i.e., when the
client demonstrates readiness and assumes self-care, when the goals for the relationship have been
achieved, or based on the direction of the organization/employer).
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Canadian Community Health Nursing
Standard 5:
Capacity Building
a. Works collaboratively with the individual, family, group, community, population or system
(including other health care providers) to identify needs, strength, available resources and strategies
for action.
Figure 4. The Jakarta Declarationxv
b. Uses community development principles and
facilitates action to support the priorities of The Jakarta Declaration identified the
the Jakarta Declaration (See Figure 4) following priorities;
1. Promote social responsibility for health
c. Engages the individual, family, group, 2. Increase investments for health
community, population or system in a development
consultative process from a foundation of 3. Consolidate and expand partnerships for
equity and social justice. health
4. Increase community capacity and
d. Recognizes and builds on the readiness of empower the individual
the individual, family, group, community or 5. Secure an infrastructure for health
system to participate and act. promotion.
f. Understands group dynamics and effectively uses facilitation skills to support group development.
g. Helps the individual, family, group, community or system to participate in issue resolution to
address their determinants of health.
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Professional Practice Model & Standards of Practice
h. Helps groups and communities to gather available resources that support taking action to address
their health issues.
i. Actively shares knowledge with other professionals and community partners and appreciates the
importance of collaborative team work.
j. Supports the individual, family, group, community, and population to advocate for themselves.
l. Applies principles of social justice and advocates for those who are not yet able to take action for
themselves.
m. Uses a comprehensive mix of strategies to address unique needs and to build individual, family,
group, community, population or system capacity.
o. Actively works with community partners including health professionals to build capacity for health
promotion.
p. Evaluates the impact of change on the health outcomes of the individual, family, group, community,
population or system.
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Canadian Community Health Nursing
Standard 6:
Access and Equity
a. Assesses and understands the capacity of the individual, family, group, community, population or
system.
b. Assesses, in collaboration with partners, the norms, values, beliefs, knowledge, resources and power
structures of the client (individual, family, group, community, population or system).
d. Collaborates with colleagues and with other members of the health care team and community
partners to promote effective working relationships that contribute to comprehensive client care
and optimal client care outcomes.
e. Collaborates with individuals, families, groups, communities, populations or systems to identify and
provide programs and methods of delivery that are acceptable to them and responsive to their needs
across the life span.
g. Supports the individual, family, group, community and population’s right to choose alternate health
care options.
h. Advocates for equitable access to health and other services and equitable resource allocation.
i. Mobilizes resources to support health by coordinating and planning care, services, programs and
policies.
j. Refers, coordinates or facilitates access to services in the health sector and other sectors.
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Professional Practice Model & Standards of Practice
k. Adapts practice in response to the changing health needs of the individual, family, group,
community, population or system.
l. Uses strategies such as home visits, outreach and case finding to overcome inequities and facilitate
access to services and health-supporting conditions for potentially vulnerable populations (e.g.,
persons who are ill, elderly, young, poor, immigrants, isolated or have communication barriers).
m. Analyzes and addresses the impact of the determinants of health on the opportunities for health for
individuals, families, groups, communities, populations and systems.
n. Advocates for healthy public policy and social justice by participating in legislative and policy-
making activities that influence determinants of health and access to services.
o. Takes action with and for individuals, families, groups, communities, populations and systems at the
organizational, municipal, provincial, territorial and federal levels to address service gaps, inequities
in health and accessibility issues.
p. Monitors and evaluates changes and progress in access to relevant community services that support
the determinants of health.
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Canadian Community Health Nursing
Standard 7:
Professional Responsibility and Accountability
a. Assesses and identifies risk management issues and takes preventive or corrective action
individually or in partnership to protect individuals, families, groups, communities, populations, and
organizations from unsafe, unethical, illegal or socially unacceptable circumstances.
b. Identifies ethical dilemmas about whether responsibility for issues lie with the individual, family,
group, community, population, or system or with the nurse or the nurse’s employer.
c. Makes decisions using ethical standards and principles, taking into consideration one individual’s
rights over the rights of another, individual or societal good, allocation of scarce resources, and
quantity versus quality of life.
d. Seeks help with problem solving, as needed, to determine the best course of action when
responding to ethical dilemmas, risks to human rights and freedoms, new situations and new
knowledge.
f. Advocates for societal change to support health for all based on the concepts of health equity and
social justice.
g. Uses current evidence and informatics (including information and communication technology) to
identify, generate, manage and process relevant data to support nursing practice.
h. Identifies and acts on factors which affect practice autonomy and delivery of quality care.
i. Participates in the advancement of community health nursing by mentoring students and new
practitioners.
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Professional Practice Model & Standards of Practice
l. Appreciates and develops teamwork skills that contribute proactively to the quality of the
work environment by identifying needs, issues and solutions, using conflict resolution skills and
collaborative decision making.
m. Provides constructive feedback to peers as needed to enhance community health nursing practice.
n. Documents community health nursing activities in a timely and thorough manner (includes
telephone advice and work with individuals, families, groups, communities, populations and
systems).
o. Advocates for effective and efficient use of community health nursing resources.
p. Uses reflective practice to continually assess and improve personal community health nursing
practice.
q. Seeks professional development experiences that are consistent with: current community health
nursing practice; new and emerging issues; the changing needs of the population; the evolving
knowledge of the impact of inequities or social injustices; determinants of health; and emerging
research.
s. Identifies desired outcomes and related indicators in collaboration with individuals, families, groups,
communities, populations, systems or the workplace.
t. Uses available resources to systematically evaluate the achievement of desired outcomes including
the availability, acceptability, efficiency, and effectiveness for quality improvement in community
health nursing practice and the work environment.
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Canadian Community Health Nursing
Appendices
Appendix A:
Methodology: Development of the
Practice Model and Standards of Practice
Practice Model
The process to identify and describe the components of the practice model was guided by a project
management team and included:
The Expert Group of 20 members of CHNC represented varied community health nursing expertise
and included frontline nurses, managers, consultants, directors, educators, researchers and senior decision
makers.
Based on the results the literature review, environmental scan and the focus groups, the consulting
team developed a draft list of components of the practice model (with definitions) for an electronic
survey. Using a modified Delphi approach, Expert Group members responded to two rounds of surveys.
Additional feedback was obtained from the Expert Group in a series of teleconferences. The Project
Management team submitted the final report to the CHNC Board of Directors.
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Professional Practice Model & Standards of Practice
Based on the results of the literature review, environmental scan(s) and focus groups, the consulting
team developed a draft list of standards for the survey. The survey was designed to gather quantitative
feedback to measure the level of agreement for each of the statements and to provide qualitative feed-
back. The Standards Revision Project team members met three times with the consultants to provide
direction and clarity.
A modified Delphi process was conducted to solicit widespread feedback about the Standards. Using a
snowball sampling methodology, community health nurses from across Canada were invited to par-
ticipate. The invitation was distributed by email to all past and present members of the CHNC (using
the membership data base) and to a list of 210 names that was developed by the Project Team and the
consultants. Recipients of the email were encouraged both to complete the survey and to forward the
survey invitation to other interested people. After the survey was closed, the preliminary results were
reviewed by the project team. This review resulted in the survey being resent to CHNC contacts in
some provinces/ territories and practice domains to increase the response rate in those underrepre-
sented areas.
A total of 443 surveys were completed. The results indicated a very high level of agreement with
each of the standards (all but 3 having greater the 85% agreement). All comments and edits that were
received from the survey were considered and the Project Team provided regular feed back throughout
the revision process. Feedback from the Project Team was obtained via teleconference meetings and
email. The final draft was reviewed by the Standards Revision Project Team before it was sent to the
CHNC Board of Directors.
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Canadian Community Health Nursing
Appendix B:
Examples of Service Delivery Models
Used in Community Health Nursing
Common service delivery models include, but are not limited to:
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Professional Practice Model & Standards of Practice
Appendix C:
Determinants of Health
Health is influenced by economic, social and environmental conditions. "The determinants of health,
are the individual and collective factors and conditions affecting health status."xxv
The identification of what determines health is an evolving area. This list has come from the various
sourcesxxx, xxxi, xxxii and community health nurses should seek further reading to maintain their expertise
in the area of health determinants. The following are some of the most commonly recognized determi-
nants of health or factors that can shape a person’s health:
Additionally the National Aboriginal Health Organization has identified the following aboriginal
specific determinants of healthxxxiii
• Colonization • Cultural continuity • Poverty
• Globalization • Territory • Self determination
• Migration • Access
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Canadian Community Health Nursing
Appendix D:
Examples of Management Practices
The following are examples of management practices that support organizations to fully realize the
potential of their community health nursing resource.
• Participatory Management
• Shared Governance
• Transformational Leadership
• Nursing Practice Council
• Approach using Professional Practice Leaders (e.g. Clinical Nurse Specialist)
• Quality, Evaluation and Continuous Improvement
• Change Management Approach
• Reflective Practice
• Action Research
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Professional Practice Model & Standards of Practice
Appendix E:
Examples of Theories
and Conceptual Frameworks
Theories and conceptual frameworks that pertain to community health include, but are not limited to:
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Canadian Community Health Nursing
Appendix F:
Community Health Nursing
by Area of Practice
• Combines knowledge from primary health care (including the determinants of health), nursing
science and social sciences
• Focuses on prevention, health restoration, maintenance or palliation
• Focuses on clients, their designated caregivers and their families (within the context of groups,
communities, populations and systems)
• Integrates health promotion, teaching and counselling in clinical care and treatment
• Initiates, manages and evaluates the resources needed for the client to reach optimal well-being and
function
• Provides care in the client’s home, school or workplace
• Has a nursing diploma or a degree (a baccalaureate degree in nursing is preferred) and is a member
in good standing of a professional regulatory body.
• Combines knowledge from public health science, primary health care (including the determinants
of health), nursing science, and the social sciences
• Focuses on promoting, protecting, and preserving the health of populations
• Links the health and illness experiences of individuals, families, and communities to population
health promotion practice
• Recognizes that a community’s health is closely linked to the health of its members and is often
reflected first in individual and family health experiences
• Recognizes that healthy communities and systems that support health contribute to opportunities
for health for individuals, families, groups, and populations
• Practices in increasingly diverse settings, such as community health centres, schools, street clinics,
youth centres, and nursing outposts, and with diverse partners, to meet the health needs of specific
populations
• Has a baccalaureate degree in nursing and is a member in good standing of a professional regulatory
body for registered nurses.
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Professional Practice Model & Standards of Practice
Appendix G:
Relationship between
Standards and Competencies
Source – A. Moyer presentation 2007, Updated 2010 (with permission of the author)
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Canadian Community Health Nursing
Appendix H:
Health Promotion
Health promotion is the process of enabling people to increase control over and to improve their health.
Health is seen as a resource for everyday life.xiv
a. Build Healthy Public Policy to ensure that policy developed by all sectors contributes to health-
promoting conditions (e.g., healthier choices of goods and services, equitable distribution of
income).
b. Create Supportive Environments (physical, social, economic, cultural, spiritual) that recognize the
rapidly changing nature of society, particularly in the areas of technology and the organization of
work, and that ensure positive impacts on the health of the people. (e.g., healthier workplaces, clean
air and water).
c. Strengthen Community Action so that communities have the capacity to set priorities and make
decisions on issues that affect their health (e.g., healthy communities).
d. Develop Personal Skills to enable people to have the knowledge and skills to meet life's challenges
and to contribute to society (e.g., life-long learning, health literacy).
e. Reorient Health Services in a health promotion direction, beyond the provision of clinical and
curative services, embracing an expanded mandate which is sensitive and respects cultural needs,
supports the needs of individuals and communities for a healthier life, and opens channels between
the health sector and broader social, political, economic and physical environmental components.
• Peace
• Shelter
• Education
• Food
• Income
• Stable ecosystem
• Sustainable resources
• Social justice
• Equity
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Professional Practice Model & Standards of Practice
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List of Figures
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