Community Nursing In South Africa

COMPETENCIES – COMMUNITY HEALTH NURSING

  1. Nature of specialization: Community Health Nursing /Public Health Nursing Internationally the trend is to use the terms Community Nursing and Public Health Nursing as synonyms. The focus of Community Health/ Public Health Nursing is on communities, populations, groups and families, as opposed to Primary Care Nursing where the focus is
    mainly on individuals within a family. A Community/ Public Health Nurse Specialist is a Professional Nurse, who has specialized
    competencies in measuring the health status and determining the health needs of communities and groups; in order to strategically plan, develop and implement intervention strategies, taking into consideration measureable national and international health indicators. A Community/ Public Health Nurse Specialist mainly works within a multidisciplinary team, which includes policy makers, community representatives and
    other members of the health team. An additional qualification in Community Health Nursing is registrable as such with the
    South African Nursing Council.
  2. Context
    Communities comprise groups of people with common characteristics (such as age, geographical boundaries; life stages, living conditions) and who often share goals and contexts. Examples may include groups of school children, elderly people, infants, pregnant women, people suffering from malnutrition, all the inhabitants of a town or
    geographical area etc.
  3. Continuum
    Co-ordinates, collaborates and manages activities in the planning and provision of relevant and evidence based comprehensive health care within the context of communities and groups.
  4. Competency overlaps
    Generic competencies in the domains of professional practice, ethics, legal frameworks, leadership and management, quality of care and research; as well as critical cross-field outcomes including problem solving, teamwork, communication skills, social responsibility and others, are relevant for all specialist fields in nursing. These include
    aspects of the following:

COMPETENCIES

  1. DOMAIN 1: PROFESSIONAL, ETHICAL & LEGAL PRACTICE
    1.1. Professional
    Practice subdomain
    1.1.1. Functions effectively within the multidisciplinary,
    interdisciplinary and trans-disciplinary team within an
    appropriate leadership model.
    1.1.2. Accepts accountability for own professional judgment,
    actions, outcomes of care and continued competence, in accordance with legislative and competency frameworks.
    1.1.3. Recognizes and practices within the professional parameters
    of a Specialist Community Health/ Public Health Nurse.
    1.1.4. Consults with and/or refers to appropriate others when
    necessary.
    1.1.5. Leads and participates in activities related to improving access
    to and quality of health service delivery at all levels of care.
    1.2. Ethical Practice sub-domain
    1.2.1. Identifies and addresses ethical issues based on professional
    values and relevant codes of conduct, taking into consideration the diverse ethical value systems of communities.
    1.2.2. Demonstrates professional integrity and ethical conduct in
    response to health sector marketing strategies.
    1.2.3. Actively informs the social justice agenda (including client
    safety and human rights) through lobbying and advocacy for
    policy changes.
    1.3. Legal Practice subdomain
    1.3.1. Advocates for and influences policy and health legislation
    specific to Community Health/ Public Health issues.
    1.3.2. Practices in accordance with relevant professional and civil
    legislative frameworks.
    1.3.3. Practices in accordance with relevant policies, procedural
    guidelines, protocols and national imperatives.

DOMAIN 2: COMMUNITY/PUBLIC HEALTH PRACTICE
2.1. Health Promotion & Prevention sub-domain
2.1.1. Collaborates with stakeholders to promote and facilitate
community participation, involvement and development
in health care.
2.1.2. Facilitates community empowerment programs.
2.1.3. Identifies, develops and facilitates health promotion
programs to address public health issues at
informational, empowerment and health promotional
levels.
2.2. Assessment, monitoring and evaluation sub-domain
2.2.1. Plans, develops and implements health measurement
intervention strategies to assess health status of groups and communities, with the aim of identifying and prioritising health needs.
2.2.2. Within a team approach, utilises a wide range of assessment strategies to gather accurate, relevant, objective and subjective data required for planning, practice and measurement purposes within the Community Health/ Public Health field.
2.2.3. Analyses and utilises evidence based information to guide
and influence intervention strategies, to improve health and health care delivery.
2.3. Planning and implementation subdomain
2.3.1. Within a team approach, apply critical thinking and reasoning skills to contribute towards relevant and measureable comprehensive health care, taking into consideration national and international benchmarks and
indicators.

Using relevant community based and community
empowerment frameworks to facilitate sustainable, cost
effective and efficient public health interventions, in line
with health trends and priorities.
2.3.3. Responds appropriately and timeously, within a relevant
team approach, to unexpected or rapidly changing
situations and emergency situations impacting on health.
2.4. Therapeutic
Communication and
Relationships
2.4.1. Initiates and develops enabling relationships within
communities and groups.
2.4.2. Demonstrates effective interpersonal and
communication skills and strategies on all levels of
interaction and service rendering.
2.4.3. Maintains a relationship that respects diverse cultural
and social boundaries.
2.4.4. Facilitates access to information and health resources
that will sustain healthy communities.

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  1. DOMAIN 3: PERSONAL DEVELOPMENT AND QUALITY OF CARE
    3.1. Quality Improvement
  2. 3.1.1. Promotes dissemination reviews, community care programs and health services against best practices of health and other relevant indicators and standards.
    3.1.2. Participates in planning and facilitating quality improvement strategies, to improve the quality of community care and services.
    3.1.3. Participates in developing and implementing responsive service standards relevant to community service.
    3.1.4. Ensures and accounts for the cost effective use of health facilities and resources.

3.1.5. Participates in the planning and implementing of appropriate Disaster Plans to protect the safety, health and security of communities.
3.1.6. Facilitates the accurate keeping of records and health information, optimally using health information systems and strategies.
3.1.7. Promotes the dissemination, use, monitoring and review of community care programmes and health services against best practices of health and other relevant indicators.
3.1.8. Participates in developing, implementing and adapting service standards relevant to community service.
3.1.9. Ensures and accounts for the cost effective use of health services and resources.
3.2. Continuing Personal Development subdomain
3.2.1. Undertakes regular review of own practice, by engaging in reflection as well as personal and peer review through critical examination, evaluation and review.
3.2.2. Assumes responsibility for lifelong learning, own professional development and maintenance of competence.
3.2.3. Participates in unilateral and multidisciplinary teaching
and learning.

  1. DOMAIN 4: LEADERSHIP AND MANAGEMENT
    4.1. Acts as a mentor and coach for the community and multidisciplinary team.
    4.2. Assumes leadership roles in the implementation of community health services and community development
    projects.
    4.3.
    4.4. Defines clearly the contributions and expectations required of team members, as a team leader and team

member within a facilitating, empowering, collaborating
and enabling framework.
4.5.
4.6. Leads in and/or participates in the development, review
and modification of practice policies, procedures and
protocols.
4.7. Contributes to national policy and protocol development
that relates to delegation of responsibilities specific to
Community Health Nursing.
4.8. Applies appropriate project management and business
skills to ensure quality and cost effective community care
services.
4.9. Advocates for and acts within span of control to create a
positive working environment.
4.10. Adapts leadership style and approaches to specific
situations within Community Health.
4.11. Leads in a manner that inspires respect and confidence
from others.
4.12. Prioritises work load, manages time effectively and
allocates resources to optimise outcomes.
4.13. Provides leadership in the development and
implementation of advanced practice education and
professional development of learners and colleagues in
the workplace.
4.14. Uses the change process to influence the introduction of
innovations and adaptations to advance field of practice.
4.15. Acts as an effective role model for students and within
the care team.
4.16. Acts as a resource in the Community Health field for
students, members of the health team, policy makers and
the community.

member within a facilitating, empowering, collaborating
and enabling framework.
4.5.
4.6. Leads in and/or participates in the development, review
and modification of practice policies, procedures and
protocols.
4.7. Contributes to national policy and protocol development
that relates to delegation of responsibilities specific to
Community Health Nursing.
4.8. Applies appropriate project management and business
skills to ensure quality and cost effective community care
services.
4.9. Advocates for and acts within span of control to create a
positive working environment.
4.10. Adapts leadership style and approaches to specific
situations within Community Health.
4.11. Leads in a manner that inspires respect and confidence
from others.
4.12. Prioritises work load, manages time effectively and
allocates resources to optimise outcomes.
4.13. Provides leadership in the development and implementation of advanced practice education and professional development of learners and colleagues in the workplace.
4.14. Uses the change process to influence the introduction of innovations and adaptations to advance field of practice.
4.15. Acts as an effective role model for students and within the care team.
4.16. Acts as a resource in the Community Health field for students, members of the health team, policy makers and the community.

4.17. Uses a range of supportive strategies, such as precepting and mentoring, when supervising and/or monitoring delegated care.
4.18. Applies appropriate project management and business skills to ensure quality and cost effective Community Care services.

  1. DOMAIN 5: RESEARCH
    5.1. Analyses a range of epidemiological research methods, with regard to their appropriateness for investigating, preventing and control of health priorities in the country, or within a specific group or community.
    5.2. Analyses and critically interpret research findings to influence a systematic approach to health improvements.
    5.3. Reviews and evaluates research reports.
    5.4. Implements relevant research outcomes
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