Community Health Nursing
Community Health Nursing tests the health care delivery system, epidemiology, levels of prevention and the nurse's role in family and community care.
Core rules
- Levels of prevention: primordial (health policy and promotion), primary (immunisation and health education before disease occurs), secondary (early diagnosis and prompt treatment, including screening), tertiary (disability limitation and rehabilitation).
- Incidence is new cases in a period divided by the population at risk; prevalence is all existing cases at a point divided by the total population.
- Rural hierarchy in India: sub-centre, now upgraded as Health and Wellness Centre, then Primary Health Centre, Community Health Centre and district hospital. The ASHA is a community link worker, not a nurse.
- Cold chain: oral polio vaccine at −20 °C, most other vaccines at +2 to +8 °C; DPT, hepatitis B and Td must never be frozen.
- Bag technique: place the bag on a plastic sheet on a clean surface, perform hand hygiene, use clean inner contents, disinfect equipment after the visit.
- Infant mortality rate = infant deaths under 1 year in a year ÷ live births in the same year × 1000.
Worked example
A block records 2000 live births and 40 infant deaths in one year. IMR = (40 ÷ 2000) × 1000 = 20 per 1000 live births. Reasoning: the denominator is live births, not mid-year population; using total population would give a figure that cannot be interpreted.
Traps that cost marks
- Confusing incidence with prevalence.
- Freezing vaccines that must stay at +2 to +8 °C, which destroys DPT.
- Writing birth rate where infant mortality rate is asked.