Role of community health nursing in pandemics

SEMINAR ON ROLE OF
COMMUNITY HEALTH
NURSE IN MANAGING
PANDEMICS
Presented by:
Nisha Yadav
M.Sc. Nursing 2nd year
NINE, PGIMER
Chandigarh

At the end of class, students will be able to:
Understand the background and introduction
to pandemic and nursing
Understand the important factors in a
successful response
Describe key issues in managing pandemics
Describe the role of community health nurse
in managing pandemics
LEARNING OBJECTIVES

Background
Introduction
Important factors in a successful response
Key issues in managing pandemics
Role of community health nurse
Role of CHN to maintain and surge existing
services
Role of CHN to shield the vulnerable
OUTLINE

 Infectious diseases constitute the third leading
cause of death worldwide (WHO, 2017).
 Emerging global pandemics pose high risks for
individuals and communities.
 International mobility contributes to the
promulgation of new and reemerging pathogens that
frequently are resistant to current form of treatment
(Morens & Fauci, 2013).
BACKGROUND

 Nurses, the largest sector of healthcare workers in
every country, play a pivotal role in preparation for a
possible pandemic.
 According to World Health Organization (WHO), the
American Nurses Association (ANA) and other
healthcare organizations nurses’ role in a pandemic
begins even before a disease has an opportunity to
cause widespread devastation.
CONT..

 When a pandemic occurs community health nurses
at the local, state and federal levels have multiple
roles in:
Assessment
Planning
Implementing
Evaluating needs and resources for the different
populations being served.
 Community services play an important role in the
provision of palliative care during pandemics, such
as COVID-19.
INTRODUCTION

 It is important for community health nurses to
practice confidentially when they have knowledge
about an individual, family, communicable disease
outbreak, community level problem or any special
knowledge obtained in community health work
setting.
CONT..

consistent and timely
communication
between policy
makers and
healthcare providers
workforce training
and flexibility
continued delivery of
equipment and
supplies
access to
necessary support
services, such as
diagnostic tests.
IMPORTANT FACTORS IN A SUCCESSFUL
RESPONSE INCLUDE

Delay in
Early
identification
Unable to
recognize
pattern
Responses
and Policy
Options
KEY ISSUES IN MANAGING PANDEMICS

 Delay in Early identification
A key issue is the time delay in the early identification
of infections that pose a threat to potential
epidemics/pandemics.
 Unable to recognize pattern
A delay in such identification may lead to the
development of epidemics/pandemics and be an
impediment to the prompt initiation of treatment for
the infected individual, appropriate interventions and
protective devices, and efforts to curtail the spread of
the epidemic.
KEY ISSUES IN PANDEMICS

The World Health Organization Department of
Pandemic and Epidemic Diseases (PED) brochures
note that their work is implemented through a
multidisciplinary team that includes disease-specific
and public health experts with field experience
responding to outbreaks and emergencies under the
International Health Regulation, it is not clear how
nurse input is provided and communicated with the
team.
RESPONSES AND POLICY OPTIONS

RESULTS: Three interplaying themes were identified as follows:
(i) personal resources,
(ii) workplace resources and
(iii) situational influences.
The findings suggest that an effective epidemic outbreak
response would require further effort to reinforce the interplay
between individual nurses, healthcare institutions and the
governments.

 Early identification
To mitigate the delay, it is essential that the health care
professional who is the initial point of contact with the infected
person, likely the Community health nurse in many global
settings, communicate with the appropriate provider or agency
to initiate the next steps including following:
ROLE OF COMMUNITY HEALTH NURSE
Identification of the
pathogen
Initiation of
appropriate treatment
Prevention of further
dissemination

 Recognition of pattern
 Recognition of a pattern, alerting others as to the emerging
disease, and preventive services will aid in preventing further
diffusion of pathogens from isolated cases.
 Community health nurse Play a vital role in recognition of
pattern of pandemic

Facilitate community participation in
preparedness as well as during
emergency
Assess the local resources and funding
agencies required
Takes part in mass awareness program
ROLE OF COMMUNITY HEALTH NURSE IN
MANAGING PANDEMICS

Assures capacity to respond effectively
to pandemic or emergency
Minimizes vulnerability to effects of an
event
Restores system to functional level.
Education and Counseling to victims and
their family members

 Responses and Policy Options
 The World Health Organization Department of Pandemic and
Epidemic Diseases (PED) develops strategies, initiatives, and
mechanisms to address emerging and re-emerging epidemic
diseases to reduce impact on affected populations and limit
international spread. Community health nurse act a liaison in
implementation of these responses and policy actions

ROLE OF CHN IN MANAGING PANDEMICS

► PROTECT
healthcare
workers.
► INTERRUPT
the virus.
► MAINTAIN
existing
healthcare
services while
surging their
capacity.
► SHIELD
the most
vulnerable from
socioeconomic
shocks.
IMMEDIATE INVESTMENT IN COMMUNITY HEALTH SYSTEMS
WILL HELP ACHIEVE THE FOLLOWING GOALS:
Achieving these goals will require targeted actions at different
stages of the pandemic

Anticipation/early detection/containment
1. PROTECT
health workers.
• CHN will Coordinate with partners
and invest to rapidly produce,
deploy and restock PPE, including
masks, gloves, goggles, gowns,
hand sanitiser, soap and water,
and cleaning supplies.
• Ensure community health
workers are included in PPE
projections.

2. INTERRUPT the virus. • CHN will Standardise and
endorse a staffing and
readiness protocol for
CHWs responding to
pandemic
• Engage with governments
to quantify training needs
and invest to rapidly train
existing CHWs to
 Prevent
 Detect and
 Respond.

Leverage evidence-based behaviour
change strategies and widely accessible
mobile technologies to educate
communities regarding signs,
symptoms and transmission routes.
Lead skill building for personal
preventive measures such as social
distancing, hand hygiene,
coughing/sneezing into elbows and
wash interventions.
PREVENT

Organise hand hygiene
stations in communities
and health facilities and
mobilise local residents to
use them.
Support, lead or reinforce
community and facility-
based infection prevention
and control measures, such
as construction of triage
areas and use of PPE.
PREVENT

 CHN must ensure that all are subordinates are
following protocols designed to ensure the physical
safety and health of CHWs.
 Identify signs and symptoms in community members,
 support safe collection of samples in communities
and health facilities.
 Facilitate rapid transport of samples to laboratories
for analysis, thus reducing risks of nosocomial
transmission.
DETECT

► CHN must ensure CHWs should only be tasked with
responsibilities if they can be regularly supplied with
the key materials necessary to conduct those tasks
and protect themselves.
► Enter alerts into community events-based
surveillance systems
DETECT

 ► Communicate rapidly and effectively to residents
in pandemic areas, including delivering health
information in a tailored, context-specific and
relevant way while combating the spread of
misinformation.
 ► Support contact tracing, symptom reporting and
monitoring of contacts of patients with infectious
disease to ensure access to testing and treatment
for those who develop signs and symptoms.
RESPOND

3. MAINTAIN health services while
surging their capacity.
• Work with governments to ensure
Community health nurses are
designated as part of the
essential workforce.
• Invest in the national supply
chain to quantify demand and
coordinate distribution of
essential commodities and surge
supplies.

 Sustain routine primary healthcare services, for example,
vaccinations and integrated community case management of
young children with malaria, pneumonia or diarrhoea.
 Codesign workflow modifications necessary to continue
primary healthcare delivery while being responsive to
changing pandemic conditions and patient and health worker
safety.
ROLE OF CHN TO MAINTAIN AND SURGE
EXISTING SERVICES

 Introduce safe means of requesting and accessing care in the
event of community-level pandemic spread.
 Postpone non-essential services to alleviate capacity
constraints on existing health workforce.
 Monitor patients for clinical deterioration and support rapid
referral of individuals who require hospitalisation, reinforcing
links between the health system and communities
CONT.

 Harness digital technology to receive requests for care,
proactively check in with families, follow up with patients,
assess symptoms and establish care plans.
 Support preparation of health systems and communities for
the eventual introduction of vaccines and treatments,
including outreach to high-risk groups.
 Implement or support disinfection of high-risk surfaces in
communities using appropriate infection prevention and
control supplies and procedures.
CONT.

4. SHIELD the vulnerable. ► Support immediate cash
injections at the household level and
the creation of neighbourhood plans
to protect the most vulnerable.
► Work with governments and
funding partners to ensure that
budgets for CHWs incorporate
holistic support.

 Support self-isolation and monitor patients in the
community while ensuring delivery of food, social
and medical support.
 Combat misinformation, fear and mistrust by acting
as a bridge to the formal health system and national
authorities.
ROLE OF CHN TO SHIELD THE
VULNERABLE

Inspire positive behaviour change and
collective action.
Identify and educate at-risk populations
(elderly, immuno- compromised, those with
underlying conditions) to reduce their
exposure to infectious disease leading to
pandemic

Care/Service
provider
Communicator
Community
developer
Consultant
Educator
Facilitator
Policy
formulator
OTHER ROLES OF CHN IN MANAGING
PANDEMICS

ROLE OF CHN CONT..
 Pandemic or spread of communicable disease represent an
imbalance in the harmonious relationship between the
human, host and the environment.
 This state of imbalance provides the infectious agent an
opportunity to cause an outbreak.
 So to disrupt the agent host environment relationship, a
multisystem approach to be used by community health nurse

 Improve host resistance to infectioous agents and other
environmental hazards
ROLE OF CHN CONT..
improved hygiene, nutrition, and
physical fitness
Increased immmunization coverage
Provision of prophylaxis
Stress control and improved mental
health

 Improve safety of the environment
• Improved sanitation
• Provision of safe water and clean air
• Proper cooking and storage of food
• Control of vectors and animal
reservoir hosts

 Improve public health system
• Increased access to health care
• Adequate health education
• Improved surveillance system
 Facilitate social and political changes to ensure better health
for all people
Individual , organisational and community
action legislation

 Community health nurse has a important role in managing
pandemics through education , prevention, surveillance and
outbreak investigation
 Community health nurse can find infected individuals; notify
contacts; refer; administer treatments; educate the individual,
family community, professionals and population; act as
advocates and in general be state-of-the-art resources to
reduce the impact of pandemic in community.
CONCLUSION

 World Health Organization (n.d.) Pandemic and epidemic diseases.
Retrieved from: http://www.who.int/csr/disease/en/.
 Edmonson, C., McCarthy, C., Trent-Adams, S., McCain, C., &
Marshall, J. Emerging Global health issues: A nurse’s role. OJIN: The
Online Journal of Issues in Nursing, 22, doi:10.3912/OJIN.
 EIDR. Emerging infectious disease repository. EcoHealth Alliance
 U.S. Department of Health and Human Services (n.d.) Office of
Global Affairs, Office of Pandemics and Emerging Threats (PET).
http://www.hhs.gov/about/agencies/oga/about-oga/what-we-
do/policy-and-program-coordination/pandemics -emerging-
threats.html .
REFERENCES

Role of community health nursing in pandemics

Role of community health nursing in pandemics

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