S4: Skill Lab Manual

Community clinical practice is a grass root approach of practice that is applied
in communities to promote and protect the health of the population. The clinical
practice focuses on the health needs and directed towards all groups of community
members

Community clinical practice nursing takes place in a wide variety of settings which
includes promoting health, preventing illness, maintaining health, restoration,
coordination, management, and evaluation of care of individuals, families, and
communities. In the community settings, care focuses on maximizing individual
potential for self-care regardless of any injury or illness. The client assumes
responsibility for health care provision.

The purpose of this clinical practice is to introduce the associate student nurse
to community setting. A major focus of this course is to introduce the student to
think critically and discuss the role of community health care associate nurse within
a national environment. Associate student nurses will be exposed to the cultural
diverse population. Students will enhance critical thinking skills by planning and
implementing services in the vulnerable population community.

In this practicum, the student will identify a community health project focusing on
a plan to improve or maintain the health of a targeted population. The project will
involve identifying the problem, population, analyzing data, formulation a community
health diagnosis, plans for implementation, by taking into consideration barriers,
social, and cultural consideration) and evaluation of the project.

4.1 Orientation of the students in Community clinical practice

Before the associate student nurse goes for the practice, it is helpful to understand
how to approach different types of people of different ages, behavior, lifestyle and
contextual background. Therefore, the teacher will hold a briefing session to the
students on:

– Playing a participatory process among stakeholders to encourage information
   sharing and increase awareness on health needs in the community

– Community health-care team building comprising representatives from the
    community or members of stakeholder organizations

– Conducting the assessment process concurrently with other functions
    throughout the course of the community health-care interventions and
     programs

– Identifying community people’s health-care needs (individuals, families,
   groups in the community), which lays a strong foundation for other functions

– Collecting up-to-date information, representing both the people’s perspectives/
    experiences

– Attendance in community setting is encouraged and compulsory

– The students need to understand the community contexts

– There are readings that have to completed so as to adequately participate in
    assignments

– In order to complete this course successfully, the students have to participate
   in all course activities like homework, course project, self–reflections, etc.

– Students are expected to engage in course activities and submit work by due
    dates and times.

The associate student nurse needs to follow the steps below for community
placement to improve the health promotion.

4.2 Steps for Community Nursing Diagnosis

Step 1: Assessment

Assess a targeted population in the community to see what needs exist. This
is done by searching health data for the specific population. Interviews may be
conducted among the community members from the population, select and define
the community by noting its history. What makes the community thrive today,
describe the physical environment of the community, capture a picture of your
selected community. What are the vital health needs of the community? Think about
socioeconomic status. What illness or diseases are present in that community? Do
members in that community have easy access to primary care? What are the most
prevalent health problems in that community?

Characteristics of the assessment process:

– A participatory process among stakeholders to encourage information sharing
   and increase awareness on health risks and problems in the community

– Community health-care team building comprising representatives from the
   community or members of stakeholder organizations

– Conducting the assessment process concurrently with other functions
    throughout the course of the community health-care interventions and
    programs

– Identifying community people’s health-care demands (individuals, families and
    groups in the community) which lays a strong foundation for other functions

– Collecting up-to-date information, representing both the people’s perspective/
    experiences and academic perspective.

Step 2: Community Diagnosis

Formulate a community health nursing diagnosis related to this health need, based
on this data, survey results and community input. After conducting the survey and
community assessment, what are the strengths and needs of that community?

Step 3: Plan the community intervention

This includes analyzing data collected and reviewing evidence-based interventions.
The intervention must be based on data showing the intervention that has been
done in the past somewhere and was effective. Planning will also include reflecting
on barriers, social and cultural considerations. The student should ask him/herself
if this will have a positive health impact in the designated population, whether the
goals are realistic and whether there will be any need for spending money.

Step 4: Implementation

The student creates an educational presentation describing how the program
would be implemented, present the plan to the teacher to see if the plan will be
implemented.

Step 5: Evaluation

States how to evaluate the intervention and how the evaluation will impact the
population

4.3 Student Responsibility

– Attendance in community setting is encouraged and compulsory
– The students need to understand the community contexts
– There are readings that have to completed so as to adequately participate in
    assignments

– In order to complete this course successfully, the students have to participate
   in all course activities like homework, course project, self–reflections, etc.

– Students are expected to engage in course activities and submit work by due
    dates and times

4.4 Reporting the community placement

At the end of the community placement, students will be required to submit certain
assignments from each course to demonstrate that they have met the objectives of
the program. All assignments should be submitted in time and feedback also given
in time for proper progression of students.

CONCLUSION
The program for the associate nurse requires intensive theoretical and practical
package simultaneously. To learn the basic theory, there is need to understand
the concept of professional behavior and develop the dexterity to perform practical
skills to prepare for clinical placement is a large undertaking.

The complexity of learning in the clinical environment is challenging, the student
needs to learn to think critically in applying theory to a variety of individuals in
unique contexts as well as developing the ability to care for individuals. They also
learn to work with other members of the health care team, again in a variety of
settings.

The students in this program are expected to undergo clinical experience assigned
to them enthusiastically using the nursing process approach as well as current
trends and issues in nursing profession.
It is hoped that this clinical manual will provide the information and tools to prepare
well and participate in a productive, enjoyable clinical learning experience.