Community and Public Health Nursing Community and Public Health Nursing 5tH editioN Edited by david Sines Professor of Community Health Care Nursing, Pro Vice Chancellor, Faculty of Society and Health, Buckinghamshire New University, Uxbridge, Middlesex, UK Sharon Aldridge-Bent Senior Lecturer, Community Health Care Nursing, Faculty of Society and Health, Buckinghamshire New University, High Wycombe, UK Agnes Fanning Head of Academic Department, Primary Care and Public Health, Faculty of Society and Health, Buckinghamshire New University, High Wycombe, UK Penny Farrelly Senior Lecturer, Faculty of Society and Health, Buckinghamshire New University, High Wycombe, UK Kate Potter Senior Lecturer and Course Leader Specialist Community Public Health Nursing, Faculty of Society and Health, Buckinghamshire New University, High Wycombe, UK Jane Wright Senior Lecturer, Specialist Community Public Health Nursing, Faculty of Society and Health, Buckinghamshire New University, High Wycombe, UK This edition first published 2013 © 2013 by John Wiley & Sons, Ltd © 1995, 2001 by Blackwell Science Ltd for first and second editions © 2005 by Blackwell Publishing Ltd for third edition Registered Office John Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK Editorial Offices 9600 Garsington Road, Oxford, OX4 2DQ, UK The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK 111 River Street, Hoboken, NJ 07030-5774, USA For details of our global editorial offices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell The right of the author to be identified as the author of this work has been asserted in accordance with the UK Copyright, Designs and Patents Act 1988. 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No warranty may be created or extended by any promotional statements for this work. Neither the publisher nor the author shall be liable for any damages arising herefrom. Library of Congress Cataloging-in-Publication Data Community health care nursing (Sines) Community and public health nursing / edited by David Sines, Sharon Aldridge-Bent, Agnes Fanning, Penny Farrelly, Kate Potter, and Jane Wright. – 5th edition. p. ; cm. Preceded by: Community health care nursing / edited by David Sines, Mary Saunders, Janice Forbes-Burford. 4th ed. 2009. Includes bibliographical references and index. ISBN 978-1-118-39694-0 (paper) I. Sines, David, editor of compilation. II. Title. [DNLM: 1. Community Health Nursing–Great Britain. 2. Public Health Nursing–Great Britain. 3. Primary Health Care–Great Britain. WY 106] RT98 610.73′43–dc23 2013026529 A catalogue record for this book is available from the British Library. Wiley also publishes its books in a variety of electronic formats. 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Cover design: Sarah Dickinson Set in 10/13pt Trump Mediaeval by SPi Publisher Services, Pondicherry, India 1 2013 Contents Notes on Contributors xii 1 the Context of Primary Healthcare Nursing 1 The changing context of service provision 1 The changing face of the community healthcare workforce 4 The primary care vision for the next decade 8 The impact of primary care policy changes on the role of the primary care nurse 14 The scope of primary care nursing practice within the context of a changing workforce 15 Conclusion 19 2 Community development and Building Capacity 22 Introduction 22 The current context for community development practice 23 Defining the terms 24 Defining community 24 Defining social capital 25 Defining empowerment 26 Defining capacity building 27 Defining community development 27 Defining community engagement 28 The role of community health professionals 29 Conclusion 34 3 Multi-Sector Working and Self-Management, Community Health Care 37 Introduction 37 Context for multi-sector working in the United Kingdom 38 Key drivers for multi-agency working 41 Examples of multi-sector working and self-management initiatives 43 Dementia 44 Obesity 45 Asthma 47 Concluding reflections 48 4 Moving Care Closer to Home 53 Hospital provision: A brief history of the last 50 years 53 Health care: What does it mean? 58 Selective definitions of health 58 Universal definitions of health 59 vi Contents Caring and nursing: Where are we now? 61 Nursing at the interface between paid and unpaid care 63 Public health and care closer to home 65 Conclusion 68 5 evidence-Based Practice and translational Research Applied to Primary Health Care 71 Introduction 71 Evidence-based practice 72 Designing the study 73 Translational research 73 Overview 73 Experiments, randomised controlled trials and quasi-experiments 74 Health impact assessments 75 Surveys 76 Case studies 77 Different methodologies and methods give you new insights 77 Participatory approaches for community research 78 Participatory appraisal 78 Data collection methods 79 Data management, analysis and interpretation 79 A multi-method evaluation of a clinical educational innovation 80 Example of PA 81 General research issues 81 Validity, reliability and generalisability 81 Presentation and dissemination 82 The internet or world wide web (www) 83 Research proposals 83 Ethical issues 84 IRAS 85 The NHS research passport 85 Ethics committees 86 Conclusion 87 Acknowledgments 88 Further reading 88 Journals 88 Ethics 89 Funding 89 Statutory body 89 6 integrating the Children’s Public Health Workforce 91 Introduction 91 Health indicators 92 The policy context 95 The role of the specialist community public health nurse 97 The HCP 97 Contents vii Delivering the HCP 101 Pregnancy and the first 5 years of life 101 The recommended schedule: pregnancy (Universal Services) 101 The recommended schedule: pregnancy progressive services (Universal Plus and Universal Partnership Plus) 102 The recommended schedule: birth to 6 months (Universal) 102 The recommended schedule: birth to 6 months (progressive services) (Universal Plus and Universal Partnership Plus) 102 Recommended schedule: 6 months to 1 year (Universal) 103 Recommended schedule: 6 months to 1 year (progressive services) (Universal Plus and Universal Partnership Plus) 103 Recommended schedule: 1–5 years (Universal Services) 103 Recommended schedule: 1–5 years (progressive services) (Universal Plus and Universal Partnership Plus) 103 The recommended schedule: 5–11 years (Universal Services) 104 The recommended schedule: 5–11 years (progressive services) (Universal Plus and Universal Partnership Plus) 104 Recommended schedule from 11 to 16 years (Universal Services) 105 Recommended schedule from 11 to 16 years: progressive services (Universal Plus and Universal Partnership Plus) 106 Recommended schedule: 16–19 years (Universal Services) 106 Recommended schedule: 16–19 years (progressive services) (Universal Plus and Universal Partnership Plus) 107 The practitioner’s role in safeguarding and child protection 108 The practitioner role in improving emotional health and well-being 109 Conclusion: future development and challenges for practice 110 7 Community Children’s Nursing 113 Introduction 113 Early days 114 The NHS 115 NHS at home: Community children’s nursing services 118 Children with acute and short-term conditions 119 Children with LTCs 123 Children with disabilities and complex conditions, including those requiring continuing care and neonates 125 Technology dependence 127 Continuing care 128 Neonates 128 Children with life-limiting and life-threatening illness, including those requiring palliative and end-of-life care 128 Conclusion 130 8 Public Health Nursing (Adult): A Vision for Community Nurses 135 Introduction 135 The vision for health reform: the policy context 138 viii Contents The public health outcomes framework (2012) 140 Improving the determinants of health 140 Health improvements 141 Health protection 141 Healthcare public health and preventing premature mortality 142 Health promotion versus public health 143 An upstream approach 145 Health protection 145 Community nursing and public health 146 Conclusions: the future 149 9 Caring for the Adult in the Home Setting 151 End of life 152 The policy context 152 Managing LTCs in the community 154 Case Study based upon complexities of patient care in the home setting 155 Maximising health and well-being: helping people to stay independent 158 Working with people to provide a positive experience of care 158 Adult safeguarding 159 Measuring impact of service through patient feedback 160 Delivering high-quality care and measuring impact 160 Building and strengthening leadership 161 Ensuring we have the right staff, with the right skills in the right place 161 Technology 164 Informal carers 164 Supporting positive staff experience 165 Conclusion 166 10 General Practice Nursing in Context 169 Introduction 169 Origins 170 The advent of contemporary general practice nursing 172 Practice nursing roles and functions 174 Core skills for the GPN 174 Education 175 Scheduled care 176 Unscheduled care 178 Chronic disease management 179 Asthma management 180 Hypertension 180 The future 181