Community and Public Health Nursing

David Sines is Professor of Community Healthcare Nursing and Pro Vice Chancellor and Executive Dean for the Faculty of Society and Health at Buckinghamshire New University, Buckinghamshire, UK.Sharon Aldridge-Bent is Senior Lecturer in Community Health Care Nursing at Buckinghamshire New University, Buckinghamshire, UK.Agnes Fanning is Head of Academic Department of Primary Care and Public Health at Buckinghamshire New University, Buckinghamshire, UK.Penny Farrelly is a Senior Lecturer in Specialist Community Public Health Nursing at Buckinghamshire New University, Buckinghamshire, UK.Kate Potter is Senior Lecturer in Specialist Community Public Health Nursing at Buckinghamshire New University, Buckinghamshire, UK.Jane Wright is a Senior Lecturer in Specialist Community Public Health Nursing at Buckinghamshire New University, Buckinghamshire, UK.

• Notes on Contributors xii 1 The context of primary healthcare nursing 1The changing context of service provision 1The changing face of the community healthcare workforce 4The primary care vision for the next decade 8The impact of primary care policy changes on the role of the primary care nurse 14The scope of primary care nursing practice within the context of a changing workforce 15Conclusion 192 Community Development and Building Capacity 22Introduction 22The current context for community development practice 23Defining the terms 24Defining community 24Defining social capital 25Defining empowerment 26Defining capacity building 27Defining community development 27Defining community engagement 28The role of community health professionals 29Conclusion 343 Multi-Sector Working and Self-Management, Community Health Care 37Introduction 37Context for multi-sector working in the United Kingdom 38Key drivers for multi-agency working 41Examples of multi-sector working and self-management initiatives 43Dementia 44Obesity 45Asthma 47Concluding reflections 484 Moving Care Closer to Home 53Hospital provision: A brief history of the last 50 years 53Health care: What does it mean? 58Selective definitions of health 58Universal definitions of health 59Caring and nursing: Where are we now? 61Nursing at the interface between paid and unpaid care 63Public health and care closer to home 65Conclusion 685 Evidence-Based Practice and Translational Research Applied to Primary Health Care 71Introduction 71Evidence-based practice 72Designing the study 73Translational research 73Overview 73Experiments, randomised controlled trials and quasi-experiments 74Health impact assessments 75Surveys 76Case studies 77Different methodologies and methods give you new insights 77Participatory approaches for community research 78Participatory appraisal 78Data collection methods 79Data management, analysis and interpretation 79A multi-method evaluation of a clinical educational innovation 80Example of PA 81General research issues 81Validity, reliability and generalisability 81Presentation and dissemination 82The internet or world wide web (www) 83Research proposals 83Ethical issues 84IRAS 85The NHS research passport 85Ethics committees 86Conclusion 87Acknowledgments 88Further reading 88Journals 88Ethics 89Funding 89Statutory body 896 Integrating the Children’s Public Health Workforce 91Introduction 91Health indicators 92The policy context 95The role of the specialist community public health nurse 97The HCP 97Delivering the HCP 101Pregnancy and the first 5 years of life 101The recommended schedule: pregnancy (Universal Services) 101The recommended schedule: pregnancy progressive services (Universal Plus and Universal Partnership Plus) 102The recommended schedule: birth to 6 months (Universal) 102The recommended schedule: birth to 6 months (progressive services) (Universal Plus and Universal Partnership Plus) 102Recommended schedule: 6 months to 1 year (Universal) 103Recommended schedule: 6 months to 1 year (progressive services) (Universal Plus and Universal Partnership Plus) 103Recommended schedule: 1–5 years (Universal Services) 103Recommended schedule: 1–5 years (progressive services) (Universal Plus and Universal Partnership Plus) 103The recommended schedule: 5–11 years (Universal Services) 104The recommended schedule: 5–11 years (progressive services) (Universal Plus and Universal Partnership Plus) 104Recommended schedule from 11 to 16 years (Universal Services) 105Recommended schedule from 11 to 16 years: progressive services (Universal Plus and Universal Partnership Plus) 106Recommended schedule: 16–19 years (Universal Services) 106Recommended schedule: 16–19 years (progressive services) (Universal Plus and Universal Partnership Plus) 107The practitioner’s role in safeguarding and child protection 108The practitioner role in improving emotional health and well-being 109Conclusion: future development and challenges for practice 1107 Community Children’s Nursing 113Introduction 113Early days 114The NHS 115NHS at home: Community children’s nursing services 118Children with acute and short-term conditions 119Children with LTCs 123Children with disabilities and complex conditions, including those requiring continuing care and neonates 125Technology dependence 127Continuing care 128Neonates 128Children with life-limiting and life-threatening illness, including those requiring palliative and end-of-life care 128Conclusion 1308 Public Health Nursing (Adult): A Vision for Community Nurses 135Introduction 135The vision for health reform: the policy context 138The public health outcomes framework (2012) 140Improving the determinants of health 140Health improvements 141Health protection 141Healthcare public health and preventing premature mortality 142Health promotion versus public health 143An upstream approach 145Health protection 145Community nursing and public health 146Conclusions: the future 1499 Caring for the Adult in the Home Setting 151End of life 152The policy context 152Managing LTCs in the community 154Case Study based upon complexities of patient care in the home setting 155Maximising health and well-being: helping people to stay independent 158Working with people to provide a positive experience of care 158Adult safeguarding 159Measuring impact of service through patient feedback 160Delivering high-quality care and measuring impact 160Building and strengthening leadership 161Ensuring we have the right staff, with the right skills in the right place 161Technology 164Informal carers 164Supporting positive staff experience 165Conclusion 16610 General Practice Nursing in Context 169Introduction 169Origins 170The advent of contemporary general practice nursing 172Practice nursing roles and functions 174Core skills for the GPN 174Education 175Scheduled care 176Unscheduled care 178Chronic disease management 179Asthma management 180Hypertension 180The future 18111 Occupational Health Nursing 184OHNs as specialist practitioners 184Historical perspective 185Provision of OH services in the United Kingdom 189The changing nature of UK workplaces 191Changing work patterns 192Workplace practices 193The domains of OH nursing practice 193The professional domain 194The environmental domain 197The educational domain of practice 197Public health strategies 198Specialist community public health nursing: Part 3 of the register maintained by the NMC 19812 Caring for the Person with Mental Health Needs in the Community 201Introduction 201Background: Why bother with community mental health nursing? 202Clinical profile: John 203Recovery: Conceptual explanation 203Development of therapeutic relationship 205Assessment of needs 206Instilling hope 207Promoting life beyond distress 208Promoting connectedness 209Promoting personal responsibility 209Principles of community mental health nursing 210Examining experience with service users 210Linking experiences 210Acknowledging service users’ wishes 211Working together 211Therapeutic presence 211Risk assessment and management 212Conclusion 21313 Caring for the Person with Learning Disabilities in the Community 216Introduction 216People with learning disabilities 217The number of people who have learning disabilities 218Service principles in learning disability services 220Moving forward 224The health of people with learning disabilities 226Physical health 227Mental health 228What community nurses for people with learning disabilities do? 230The future role of community nursing services for people with learning disabilities 233Conclusion 23614 Leadership: Measuring the Effectiveness of Care Delivery 241Introduction 241Influences on leadership 242Government policies 245Front-line staff 247Spend some time looking at these four scenarios 251Measuring the effectiveness of delivery 253Conclusion 25415 Social Innovation and Enterprise 257Introduction 257What is social innovation? 258Research on social innovation 259Characteristics of a social innovator 260Social innovation and community health 261Commissioning 263Approaches to social innovation 264Social innovation as a concept 265Conclusion 26816 Adult Vulnerability in the Community 271Introduction 271Adult safeguarding 271Definitions of abuse of adults 272Legal framework of adult safeguarding 274Mental Capacity Act 2005 274Recent adult safeguarding guidance 275Domestic violence 276The prevalence of domestic violence in the United Kingdom 277Effects of domestic violence 277Contextual issues 278Substance and alcohol misuse 279Conclusion 28117 End-of-life Care 285Whole systems approach 286Assessment: The foundation to providing good care 288Symptom management 289Beyond the management of physical symptoms 290Advance care planning 290Advance statement/Preferred priorities for care 291Advanced decisions to refuse treatment (ADRT) 292Assisted suicide 292Do not attempt resuscitation orders 293Care in the last days of life 294Models of interdisciplinary working: The road to successful end-of-life care 295Community nurses: The lynchpins of successful end-of-life care in the community 295Death of a child 296Dementia 297Care of the bereaved 298Conclusion 299Case study 30018 Interprofessional Learning and Teaching for Collaborative Practice Community 305Introduction 305Inter-professional education and collaborative practice 305Learning theory 308Teaching and learning in practice 314Responsibilities for teaching and learning of all members of the team 315Team leader 315Community practice teacher 316Mentor 316Associate mentor 316Learner 316Sign-off mentor 317Mastering mentorship 317Adult safeguarding: an example 318Conclusion 31819 User Involvement, Self-Management and Compliance 322The modern PPI system 323The rationale for greater user involvement 324The patient as co-producer 332Co-production cannot be realised without support 334Conclusion 335Acknowledgement 336Index 338

“I would recommend this book to student nurses, community and district nurses and anybody with a passion for public health nursing. Clear, concise and structured it is a book I have found beneficial for my own learning.”  (Nursing Times, 24 April 2015)“Thorough, comprehensive, and up-to-date with the latest policy guidelines Community and Public Health Nursing is an invaluable resource for novice and experienced practitioners, and for all healthcare professionals who work in the primary care and community setting, including practice nurses, nurse practitioners, district nurses, community staff nurses, health visitors, school nurses, walk-in centre nurses and sexual health nurses.”  (Newbooks.lib, 9 September 2014)