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Discuss factors influencing health care reform.
Concepts for Lecture
1. Escalating health care costs, expanding technology, changing pat-
2. Nurses, professional organizations, and consumers influence health
care reform.
In 1991, the ANA published Nursing’s Agenda for Health Care
Reform, which set forth the ANA’s recommendations for health care
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2
Describe various community-based frameworks, including integrated health
care systems, community initiatives and coalitions, and case management.
Concepts for Lecture
1. Various approaches are emerging to address community health, in–
cluding integrated health care systems, community initiatives and
coalitions, managed care, case management, and outreach programs
using lay health workers.
C
HAPTER
7
COMMUNITY NURSING AND CARE CONTINUITY
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UGGESTIONS FOR
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LASSROOM
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CTIVITIES
•
Discuss Nursing’s Agenda for Health Care Re-
form. Ask the students to identify which items on
the agenda have been implemented and which
are yet to be addressed.
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UGGESTIONS FOR
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LASSROOM
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CTIVITIES
• Have the students explore their community of
origin for examples of community initiatives,
coalitions, and outreach programs and report
findings to the class.
S
UGGESTIONS FOR
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LINICAL
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CTIVITIES
CHAPTER 7 / Community Nursing and Care Continuity 35
Community coalitions bring together individuals and groups for
the shared purpose of improving the community’s health. The coali-
tions may focus on single or multifaceted problems.
Case management tracks a client’s needs and services through a
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3
Differentiate community health care settings from traditional settings.
Concepts for Lecture
1. Traditionally, community services have been provided in county and
state health departments (public health nursing), in schools (school
nursing), in workplaces (occupational nursing), and in homes (home
2. More recent settings for community nursing practice include nurse–
managed community nursing centers, parish nursing, and telehealth
centers.
Nurse–managed community nursing centers provide primary
care to specific populations and are staffed by nurse practitioners and
S
UGGESTIONS FOR
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LASSROOM
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CTIVITIES
• Invite nurses who practice in the roles of par-
ish nurse or in a nurse-managed or telehealth
center to discuss these roles.
and share observations with the group.
36 CHAPTER 7 / Community Nursing and Care Continuity
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4
Differentiate community-based nursing from traditional institutional-based
nursing.
Concepts for Lecture
1. As in traditional institutional-based nursing, community-based nurs-
ing (CBN) is nursing care directed toward specific individuals.
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5
Discuss competencies community-based nurses need for practice, including
the Pew Health Professions Commission recommended for health competen-
cies for future health practitioners.
Concepts for Lecture
1. Community-based health care (CBHC) is a primary health care sys-
tem that provides health-related services in places where people
spend their time, for example, in the home, in shelters, at work, at
aged care insurance provider, or a specific medical need or category.
2. To be truly effective, a CBHC system needs to provide easy access
to care, be flexible in responding to the care needs that individuals
and families identify, promote care between and among health care
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6
Explain essential aspects of collaborative health care: definitions, objectives,
benefits, and the nurse’s role.
Concepts for Lecture
1. The ANA’s (1992) operational definition of collaboration is a colle-
gial working relationship with another health care provider in the
provision of client care.
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UGGESTIONS FOR
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LASSROOM
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CTIVITIES
• Invite nurses working in a variety of commu-
nity-based health care settings to discuss the
goals, purposes, and roles of the nurse in these
settings.
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UGGESTIONS FOR
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LASSROOM
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CTIVITIES
•
Invite nurses working in a variety of community-
based health care settings to discuss the goals,
purposes, and roles of the nurse in these settings.
• Discuss the characteristics of an ideal health
care system as written in 1992 with the reality
of the health care system today.
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UGGESTIONS FOR
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LASSROOM
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CTIVITIES
• Have the students discuss how they believe
mutual trust and respect can be developed
within their class and how this might relate to
the development of collegial working relation-
ships in the clinical area.
2. The collaborative role of the nurse occurs with peers, with other
health care professionals, with nursing professional groups, and with
legislators
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7
Describe the role of the nurse in providing continuity of care.
Concepts for Lecture
1. Continuity of care is the coordination of health care services by
health care providers for clients moving from one health care setting
to another and between and among health care professionals. It en-
2. Discharge planning is the process of preparing a client to leave one
level of care for another. Effective discharge planning involves on-
going assessment to obtain comprehensive information about the cli-
3.
Health care teaching is often required for clients to understand their situ-
ation, to make health care decisions, and to learn new health care behav-
iors. Prior to discharge, it is essential that the client and caregiver
S
UGGESTIONS FOR
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LASSROOM
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CTIVITIES
• Invite a panel of home care coordinators to
discuss the services provided and funding re-
quirements for the home care agencies.
for their clients.
• Obtain permission for students to observe a
health team or family conference.
• Assign students to assist a nurse to provide