LEGISLATIVE FRAMEWORK
International legislation.
The concept of community care was initiated by the WHO in 1980 with the re-evaluation of the concept of health as mentioned in the Alma Ata meeting: balance between biological, economic, environmental, social and financial, environmental, cultural-educational and political factors.
In 1988, at the European Nursing Conference, strategies were established to improve the functions and socio-economic status of nurses and recommendations were made to foster the development of community nursing. The recommendations relate to: moving nursing out of the hospital into the community; nurses' participation in groups that support health development; serving as a patient resource instead of a health care provider; nurses' participation in planning and evaluation programs; increased participation of nurses in the leadership and management of primary care teams; greater responsibility for decision-making within primary care teams, health care teams and cost/efficiency analysis; transforming the nurse into a frontline worker who lives in a local community, gets to know people and their families, visits homes, schools, places of work and recreation; systematically evaluates outcomes to improve quality of care; moving from the biomedical model (treating the patient) to the holistic model of care (nursing); more activity and involvement in seeking out clients instead of waiting for their requests for consultation; participation in medical research and development of health care programmes; development of common standards for ethics and quality control in nursing activities; development of professional nursing associations; promotion and maintenance of health and prevention of disease; involvement of individuals, families and the community in care and empowering them to take responsibility for their own health; active concern to reduce inequities in access to health services and to meet the health needs of the whole population; multidisciplinary and multisectoral collaboration; professional autonomy for nursing managers.
The WHO Regional Office for Europe has accepted the ecological orientation of community medicine, recognising the implications of the human habitat in promoting health. In 1992 WHO created a network of 11 health regions to assist changing health strategies and to stimulate health policy development in line with the principles of community health care: shift from centralised health policy-making to community initiative: partnership and citizen control; equity for health (women, children, elderly, unemployed, migrants, disadvantaged population); community participation: empowering people to take responsibility for their own health; intersectoral work (medical, nursing, social work, clergy, etc.).
Since 1993, when around 100 communities in Europe were first involved, community nursing continues to develop progressively on our continent. The Regional Office for Europe based in Copenhagen has set up operational divisions to implement community health risk assessment and prevention programmes.
Romanian legislation
The process of training of community nurses was initiated in our country as a result of the influence of a complex of socio-economic, political and cultural factors, which imposed essential changes in the educational management of nurses.
In 2006, the law was issued to regulate the services and activities in the field of community healthcare in Romania. According to this law, community health care comprises the set of health activities and services organised at community level to solve the medical-social problems of the individual, in order to maintain him/her in his/her own living environment and which are provided in an integrated system with social services. Community health care is an integrated set of health programmes and services focused on the basic needs of healthy and sick people, delivered in an integrated system with social services. Community health care programmes and services are carried out in accordance with the policies of the Ministries of Health, Labour, Social Solidarity and Family, the National Authority for Persons with Disabilities, the National Agency for Family Protection, other institutions and local authorities with responsibilities in this field.
THE MISSION OF COMMUNITY NURSING
The World Health Organization states that community health nursing is a synthesis of nursing practice, public health practice, health promotion and primary health care.
The purpose of community nursing is to support individuals, families and the community in achieving optimal health; to provide and promote lifestyles through education, public awareness and community activities.
Community nursing practice extends into the areas of disease prevention, health improvement, health advocacy (decision support), empowerment and research.
Community nursing actions are carried out to promote the optimal level of health of individuals and the community by promoting the right to information, health advocacy and self-determination.
The role of community nurses according to the WHO Strategy is as follows:
- Community and family health - initiatives related to maternal and child health, school health, disease control, health of the elderly population, disease prevention.
- Health promotion - building partnerships in the community to identify community needs related to issues and support decision making
- Health education - addresses the need for learning to be supported through written materials, presentations, group work, media, counselling and more.
- Prevention (diseases and accidents, alleviation of suffering) - prevention and spread of communicable diseases, strategies to promote safety and prevent accidents.
- Early identification of community problems and appropriate interventions - specific populations (infants, preschoolers, children), early interventions vulnerable individuals with hearing, vision problems, tracking child development, identifying parent knowledge and preventing falls in the elderly.
MISSION OF THE MASTER
The master's program in community nursing aims to deepen knowledge in the field of community nursing, with the mission:
• Acquire during training additional theoretical knowledge that will enable a scientific understanding of the community nursing process. This enables individual responsibility for nursing work to be assumed after graduation from the Masters programme.
• Acquiring during training the communication skills necessary to apply care according to the specific individual, family or community to which it belongs.
• Acquiring during training a broad range of general and individualized care techniques and identifying specific skills for the field of community nursing
• Acquiring during training attitudes and behaviours towards the individual being cared for, their carers and colleagues in the care team; acquiring respect for life, society and its positive values.
• Providing the opportunity to apply acquired knowledge in practice.