12/19/96 L1121

COMMUNITY HEALTH NURSE 2

DEFINITION: This is advanced professional nursing with primary orientation in the promotion and maintenance of the physical and psychosocial health of individuals and families within the community.*

An employee in this class performs as an area nurse coordinator or a program nurse coordinator within a state health center* responsible for the direction, coordination, and provision of a variety of community health services. Employes in this class may function in other capacities that are similar in nature and comparable in scope and complexity to area or program nurse coordinator responsibilities. The area nurse coordinator* has responsibility for the coordination and continuity of all program services within a community health service area.* The area nurse coordinator directs the work efforts of professional and non-professional nursing personnel within the community health service area by coordinating the continuity of nursing services and insuring that program goals are attained. Work involves continually assessing the status and patterns of health care utilization of individuals and families within the community to insure that appropriate services are provided. The employee is responsible for reporting on the health service activities* that are performed within the community health service area in order that necessary program planning, evaluation, and modification can be effected. The Program nurse coordinator* is a select job that may be structured within a county or group of counties where specialized program* coordination is needed. The program nurse coordinator has responsibility for the coordination and continuity of all component functions of one or more programs within multiple community health service areas. This responsibility involves the planning, implementation, coordination, and evaluation of a program(s) at the local level and recommending modifications when necessary to enhance the direct delivery of health services to the community. The program nurse coordinator is a resource person who provides nursing expertise in a particular program (i.e. child health, crippled children, communicable disease) to the other professional and non-professional nursing personnel within the state health center. Work further involves continually monitoring all services of the assigned program(s) throughout the community health service areas to insure the accomplishment of program objectives and attainment of program goals. Employes in this class perform in the same variety of settings and have the same direct nursing service responsibilities (e.g. home visit services) for a specific geographical territory as the lower level nurse. Liaison services typically involve representing the agency on local health boards and committees by participating in the planning and evaluation of other community agency programs. Employees identify learning needs, make training recommendations, and provide ongoing orientation and on-the-job education for subordinate professional and non-professional personnel. Employees also participate in and evaluate the effectiveness of staff development programs to further enhance professional and community health nursing skills. Work assignments are received in the form of oral and written instructions and employes exercise independent judgment regarding the application of professional nursing practices. Work is reviewed by a professional nursing supervisor through observation, reports, and conferences for quality and adherence to established standards in the application of professional nursing practices.

EXAMPLES OF WORK: Directs or coordinates the provision of community health nursing services to insure the continuity of care and the attainment of program goals within an assigned area.

Plans, prioritizes, coordinates, and evaluates the clinic services, home visit services, health education programs, and liaison services within the assigned area of responsibility.

Observes and assesses the health status of individuals and families within the community and reviews records and reports to insure that appropriate nursing services are provided through effective nursing care, health education and referral.

Coordinates the provision of nursing services based on referrals from individuals, families and other community resources.

Coordinates in the assigned area of responsibility the planning for community follow-up of individuals and families referred from various health care resources.

Reports on health service activities for the assigned area of responsibility in order that necessary planning, evaluation, modifications, and improved continuity of services can be affected.

Coordinates and participates in nursing case conferences with professional and non-professional personnel within the assigned area of responsibility to insure the continuity of nursing care.

Plans and assesses immediate and long-term goals for the assigned area of responsibility.

Provides direct nursing services through home visits, clinics, and community and liaison services, which are in addition to the primary coordinative responsibilities.

Insures that the development, implementation, review and modification of family centered nursing care plans are accomplished.

Insures that health promotion and maintenance are provided through teaching, guidance and counseling to individuals, families, and groups within the community.

Orients new employees to the community health nursing program and specific assignments within the community health service area.

Insures that actual and potential safety and health hazards within the health center, clinic, and the home are identified and appropriate action taken to eliminate them.

Explains and interprets to individuals, families, and other groups the policies, rules and regulations, procedures, philosophy and objectives as they relate to the health care system.

Promotes the development of collaborative and cooperative relationships with other community agencies and groups engaged in the planning, implementation, and evaluation of health services.

Assists the nursing supervisor in the evaluation of the accomplishment of goals and objectives in relationship to the community health nursing program.

Represents the agency as a community health nursing resource on local boards and committees for the improvement of community health programs.

Initiates, conducts and evaluates epidemiological surveys, health research activities, special studies and projects.

Participates in departmental or inter-disciplinary committees which influence or determine policies affecting nursing practice.

Coordinates the observational experiences for affiliate nursing students.

Participates in and evaluates the effectiveness of staff development programs to further enhance professional and community health nursing skills; and recommends continuing education programs to further enhance the competence of the nursing staff.

Prepares and submits records and reports in accordance with rules and regulations.

Performs related work as required.

REQUIRED KNOWLEDGES, SKILLS, AND ABILITIES: Knowledge of the theories and practices of professional nursing.

Knowledge of the theories and practices of professional community health nursing.

Knowledge of the principles and practices involved in organizing and directing the work of others.

Knowledge of the purpose and functions of other health care and social organizations in the community.

Knowledge of current developments in the field of community health nursing. Skill in the application of professional community health nursing practices. Skill in application of basic nursing practices and methodology.

Skill in directing and instructing professional and non-professional nursing personnel in the application of nursing practices and methodology.

Skill in maintaining records and preparing reports, i.e., nursing care plans, individual and family records.

Skill in the application of techniques utilized in interviewing, observing, recording and reporting signs and symptoms of the individual's and family's actual or potential health status.

Skill in providing guidance to individuals and families for health promotion and maintenance.

Ability to promote and maintain continuity of care within an assigned area.

Ability to make independent judgments in relation to the nursing care of individuals and families.

Ability to make independent judgments in resolving a variety of lifethreatening health problems.

Ability to plan and assess immediate and long-term goals for the assigned area of responsibility.

Ability to insure that staff utilization is proper for the needs of the assigned area.

Ability to plan and coordinate the activities of the professional and nonprofessional nursing personnel in the assigned area.

Ability to evaluate both the educational needs of staff and staff development programs.

Ability to develop and maintain effective working relationships with other employees.

Ability to establish and maintain effective communications with individuals, families and other members of the community.

Ability to identify actual or potential health and safety hazards.

Ability to recognize patterns and trends in the health care delivery system.

Ability to express ideas clearly and concisely, both orally and in writing.

Ability to understand and follow oral instructions.

Ability to recognize the limitations of one's capabilities and to seek help and/or guidance when necessary.

Ability to acquire new knowledges, skills and techniques required to maintain currentness in community health nursing practice.

Ability to develop the capacity to initiate, conduct, and evaluate surveys, research activities, and special projects.

MINIMUM EXPERIENCE AND TRAINING: Two years of community health nursing experience and a bachelor's degree in nursing, including or supplemented by the required number of credit hours of community health nursing education, accredited by the National League for Nursing (a master's degree in nursing or public health accredited by the National League for Nursing or the American Public Health Association may be substituted for one year of community nursing experience;

or

Any equivalent combination of experience and training.

NECESSARY SPECIAL REQUIREMENT: Possession of a current license to practice as a Registered Nurse issued by the Pennsylvania State Board of Nursing; or possession of a non-renewable temporary practice permit issued by the Pennsylvania State Board of Nursing.

CONDITION OF EMPLOYMENT: Employes possessing nonrenewable temporary practice permits must obtain licensure as a Registered Nurse within the one (1) year period as defined by the Pennsylvania State Board of Nursing.

 

Allocation Terms (COMMUNITY HEALTH NURSING)

1 Community: Any particular geographical area where nursing services are provided to individuals, families, and groups where referrals and collaboration occur with health care organizations; and where coordination and cooperation exists with social and other organizational disciplines and resources.

2 Community Health Service Area (CHSA): An assigned territorial jurisdiction that is a small county (50,000 - 200,000 pop.) or an equivalent major sub-division of a county, where nursing services are delivered in the community to individuals, families, and groups with actual or potential health problems.

The assigned territorial jurisdiction (CHSA) varies depending upon the identified and anticipated health needs of the community; demographic characteristics; availability of health care resources; and the philosophy, goals, and objectives of the nursing services and the agency.

Since there are such great variances in geographical size and population density, the information provided is only a relative measure of scope for jobs in Community Health Nursing.

Examples of CHSA Structures:

1 - Inter-city urban area with a high population density and availability of many health care resources.

2 - Remote rural area with a sparce population and availability of few health care resources.

3 State Health Center: A facility located in the local community (county) where a variety of health services are coordinated and provided either directly or by prompt referral within the particular geographical area. The primary objective of the State Health Center is to promote the highest standards of health care services, by preventing health problems and teaching health promotion within the community.

The state Health Center serves as the headquarters within the community for the local administration of State Community Health Services.

4 Clinic: An organized health service directed to a group of individuals for a specifically identified health care need which is conducted in a variety of settings; generally following the pattern of patient intake, patient interview, provision of services (assessment, diagnosis, treatment (i.e. teaching, counseling, guidance and physical care), and evaluation) and determination of necessary follow-up activities.

5 Home Visit: Direct nursing services provided to individuals within the home by utilizing a family centered approach in the assessment, diagnosis, treatment, and evaluation, and determination of necessary follow-up activities.

6 Community Services: Health services conducted within the community that are directed to a group of individuals with a specifically identified health care need. Such health services primarily include planned educational activities and participation on community advisory boards and committees.

7 Family Centered Approach (Nursing Care): The provision of community health nursing services (i.e. teaching, counseling, guidance, and physical care) to an individual(s) who is recognized and cared for, not as a single entity, but as part of a family unity by performing family evaluation, providing family orientation, and coordinating family assistance.

8 Program: Any of the major component services that are authorized by the Department of Health for administration within the State Community Health Centers (i.e. Child Health, Adult Health, Crippled Children, Communicable Disease, Chronic Respiratory).

9 Program Services: Encompasses all of the following:

1 . Clinic services for diagnosis, treatment, health education, and referral.

2. Home visit services for diagnosis, treatment, health education, and referral.

3. Community services for group health education.

4. Liaison services with community groups for the purpose of health care continuity.

10 Activities: The component elements of each program service (health service and/or direct nursing service).

Examples

Clinic Services Activities - interviewing patients; observing patients; assisting physicians; documenting patient records; administering medications; administering immunizations; counseling patients and families; initiating referrals; directing ancillary personnel.

Home Visit Services Activities - interviewing patients; observing patients; assessing total family health status; documenting patient records; developing nursing care plans; administering treatment; teaching and counseling patients and families; demonstrating and instructing physical care methods; initiating referrals.

Community Services Activities - conducting health educational programs to community groups (speaking before groups and presenting audio-visuals and literature); explaining inter-agency cooperative methods (e.g. referrals) to other organizations; interpreting state community health services to community organizations, professional groups, and community leaders.

Liaison Services Activities - communicating and consulting with health care, social, educational, and religious organizations to promote health care continuity and planned follow-up care; cooperating with state and local agencies on surveys and emergencies; participating in community projects, activities, and meetings; representing the agency on local health screening programs; encouraging other organizations to make appropriate referrals to the state health center.

11 Staff Nurse: A professional nurse who has the responsibility for the delivery of nursing services to individuals and families within the community, focusing on prevention of disease and promotion and maintenance of health.

Clinic Staff Nurse - A role of the professional staff nurse when designated to perform specific nursing services and record maintenance functions within a clinic.

Clinic Charge Nurse - A role of the professional staff nurse when designated as nurse in charge on the onsite organized delivery of health services within a clinic.

12 Area Nurse Coordinator: A professional nurse who has the responsibility for the delivery of all the nursing services within a community health service area. This nurse has limited-scale program responsibility that involves the entrustment of the operational aspects of the programs within the assigned geographical area (CHSA) which encompasses the following component function:  

Program Implementation

(a) Implement Program Services by Performing:

- Staff Orientation

- Staff Scheduling

- Site Preparation

- Supply Requisitioning (Availability)

- Community Resource Contacts

- Media Contacts

- Program Service Administration

(b) Evaluate Activities of Each Program Service by Utilizing:

- Observation

- Data Collection

- Data and Operational Assessment

- Documentation Review

- Problem Resolution

- Coordinative Communication

- Reporting (Documentation of Data and Findings)

13 Program Nurse Coordinator: A Professional nurse who has the responsibility for the comprehensive coordination of one or more programs within multiple community health service areas. In jobs that involve the responsibility for only one program, the program must be of a major  magnitude encompassing the following intensity within the program services:

1 . Prioritization, direction, and evaluation of four or more  clinic sessions conducted per month for the same health service (e.g. Child Health Conference); or two or more clinic sessions conducted per month for different health care services (i.e. Orthopedic Clinic, Cardiac Clinic, Cleft Palate Clinic). 

2. Prioritization, ordination, evaluation, and identification of available resources for all home visit services which originate from families; clinic sessions; educational sessions; and health care, social, and other organizations; that identify needs for numerous or varied health care services.

3. Prioritization, ordination, presentation, evaluation, and identification of available resources for all group health education sessions, averaging one session per month, which originate from need determination; families; clinic sessions; and health care, social, and other organizations; that identify educational needs on numerous or varied health care topics.

4. Prioritization, ordination, and evaluation of liaison services with numerous or varied community groups. 

 

In jobs that involve the responsibility for more than one program, the programs may of a minor magnitude encompassing the following intensity within the program services:

1. Direction and evaluation of one or more  clinic sessions conducted per month for the same health care service (e.g. Child Health Conference). 

2. Prioritization, coordination, evaluation, and identification of available resources for all home visit services which originate from families; clinic sessions; educational sessions; and health care, social, and other organizations; that identify needs for limited and similar health care services.

3. Presentation, evaluation, and identification of available resources for group health education sessions, averaging four sessions per year, which originate from need determination; families; clinic sessions; and health care, social, and other organizations; that identify educational needs limited and similar health care topics.

4. Provision and evaluation of liaison services with community groups on a limited  basis.

The program nurse coordinator has full-scale program responsibility that involves the entrustment of the evaluative, planning, and coordinative aspects of a program(s) at the local level (county(s)) which encompass the following component functions: 

Program Need Evaluation

(a) Observation

(b) Data Collection

(c) Assessment (Feasibility/Benefits/Results)

(d) Need Identification

(e) Recommend Findings (Modifications)

Program Plan Development

(a) Define and/or Apply Goals

(b) Determine Program Services

(c) Determine Program Service Composition (Activities)

(d) Determine Appropriate Utilization of Budgetary Resources

(e) Determine Site Location (s)

(f) Identify Media Sources

(g) Seek and Coordinate Community Resource Cooperation

(h) Maintain and Evaluate Records

(i) Determine Staff Development

Needs/Objectives/Methods

Program Implementation

(a) Implement Program Services by Performing:

- Staff Orientation

- Staff Scheduling

- Site Preparation

- Supply Requisitioning (Availability)

- Community Resource Contacts

- Media Contacts

- Program Service Administration

(b) Evaluation Activities of Each Program Service by Utilizing:

- Observation

- Data Collection

- Data and Operational Assessment

- Documentation Review

- Problem Resolution

- Coordinative Communication

- Reporting (Documentation of Data and Findings)

Program Continuity

(a) Coordinate Program Services and Professional Nursing Staff by Performing

- Continuity Planning

- Coordinative Communication

- Documentation Review

- Problem Resolution

- Combined Program Service Assessment

 

Commonwealth Equivalent PSG ST09