Comprehensive Analysis: Primary Health Care Nursing in Australia

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This essay delves into the crucial role of nurses in primary health care (PHC), specifically focusing on health promotion strategies within the context of the Ottawa Charter. It begins by defining PHC and outlining the diverse roles of nurses, including health promotion, treatment, and patient education, with a particular emphasis on the care of older adults. The essay distinguishes between primary care and PHC, highlighting the broader scope of the latter, which is aligned with the World Health Organization's principles. The core of the essay explores the application of the Ottawa Charter's strategies, such as building healthy public policy, creating supportive environments, strengthening community action, developing personal skills, and reorienting healthcare services, to prevent chronic diseases among the elderly population. The discussion emphasizes the nurses' role in implementing these strategies through assessments, patient education, and advocacy. The essay concludes by reiterating the importance of nurses in promoting health outcomes and preventing illness through the effective application of PHC principles and strategies.
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Running head: PRIMARY HEALTH CARE NURSING
PRIMARY HEALTH CARE NURSING
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1PRIMARY HEALTH CARE NURSING
Introduction
Primary healthcare comprises of a wide-ranging health service providers including
General Practitioners (GPs), healthcare professionals, pharmacists, dentists, Aboriginal health
workers, midwives and nurses (general practitioner nurses, community nurses and nurse
practitioners) who deliver primary healthcare services across private, public and non-government
health sectors (Health.gov.au, 2019). Primary healthcare service aims at providing a continuous,
comprehensive and person centred care to facilitate an enhanced and quality care to the patients
for promoting their health. Primary health care can be provided in community based settings
such as in community health, general practices, and local and non-government settings
(Health.gov.au, 2019). The services provided under the primary health care include screening
and prevention, treatment and management, early intervention and health promotion. The nurses
involved in providing primary health care practices within a wide range of settings includes
community base settings, Residential aged care, General Practice, domiciliary settings and many
more. This paper focuses on nurses roles in health promotion in the primary health care and
discusses on the importance of health promotion strategies according to the Ottawa Charter for
Health Promotion.
Discussion
The key features of the nurses in Primary Health Care focuses on the following areas-
health promotion, healthy aging, rehabilitation and palliation, population and public health,
policy development and advocacy, treatment of ill people, child and family care and illness
prevention. The recent research of Australian general practice settings suggests and identifies the
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2PRIMARY HEALTH CARE NURSING
role of primary healthcare nurses as a patient carer, educator, improvement agent, quality
controller and a problem solver. Nurses must understand the health needs of the patients by
comprehensively understanding their concerns and implement the appropriate care strategies
through a patient centred and holistic approach to care (Smolowitz et al., 2015).
There is a significant difference noticed in the relationship between primary care and
primary health care. Although these two terms are used interchangeably in the clinical settings,
these two terms are different and describes two different concepts. Primary care implicates
narrower concept of family-doctor services delivered to the patients, whereas, primary health
care is considered to be a broader term derived from the core principles enunciated by the World
Health Organization. It is based on the approach taken towards health policy and service that is
delivered to individuals and population-level “Public health-type” functions (Muldoon, Hogg &
Levitt, 2006).
Primary health care is the first level of contact that focuses on protecting and promoting
public health in communities by employing socially accepted methods at a cost that can be
afforded by both the community and the country. It forms an integral part of the country’s
healthcare system by developing strategies that benefits the patient population and community as
a whole (Who.int, 2019).
The nurse role selected is the early intervention and implementing health promotion
strategies in the primary health care. This is because nurses are the first level of contact in the
primary healthcare. The nurses working in the healthcare sectors are responsible for delivering
quality services to the patients. After the patients are admitted to the hospital, nurses are
responsible to do complete analysis of the patients through assessments by monitoring the
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patient’s vitals and carrying out essential and effective measures to combat with the health
concerns of the patients (Yakuwa, Neill & Mello, 2018). Disease prevention and health
promotion by early diagnosis of the physical abnormalities of the patients and monitoring the
vitals and collecting both subjective and objective data falls under the responsibility of the nurses
in the primary health care to facilitate an effective delivery of an enhanced nursing care, thereby,
improving patient’s health outcomes and increasing their satisfaction. Nurses working in the
primary health care should have adequate knowledge and possess skill set required to provide an
enhanced nursing care. The nurses must have knowledge and must be able to comprehensively
understand the interpretation of the patients vitals recorded in order to implement intervention
strategies addressing the patient’s problem (Fukada, 2018).
The services of the primary health care are directed to a particular population group like
the older people, young adolescents, maternity and child care, people who have a low socio
economic status, Aboriginal and Torres Strait Islander people and people who are from culturally
diverse groups (Health.gov.au, 2019). The target group chosen for this essay is older people. The
characteristics of the target group are accessed and it is found that the most common issue
associated with the target group is chronic diseases which have shown the maximum prevalence
among the aged population. Therefore, identifying the roles of nurses is important in the primary
healthcare to facilitate intervention strategies in the treatment plan and health promotion
intervention.
The aged adults are more susceptible to chronic diseases as age is a major risk factor in
the developing chronic illnesses like cardiac diseases, diabetes and other comorbidities (Salive,
2013). Aged adults with chronic conditions have different physical and mental needs according
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to their preferences and severity of the disease and therefore should be given the right care
according to their needs on priority basis (Lukewich, Edge, VanDenKerkhof & Tranmer, 2014).
Nurses have the primary role of conducting assessments and recording all the vital signs that
indicates the severity of the patient’s condition which will help to guide the treatment process.
Besides, conducting assessments and documenting the patient’s major signs and symptoms
through a comprehensive analysis and assessments by accessing patient’s history, nurses must
also build a nurse-patient relationship for understanding the patient’s current health condition
and concern through an effective communication that will lead to the delivery of an enhanced
nursing care and promote patient’s health (Da Silva et al., 2018). The aged adults are more
susceptible to chronic diseases due to various risk factors and therefore needs serious attention in
terms of medical treatment.
The Ottawa Charter for Health Promotion states that health promotion is a process that
enables individuals to increase their control over health and improving it. Health promotion
means to enhance the quality of life by attaining a complete physical, mental and social
wellbeing and in order to achieve a higher quality of life, individuals must realize their
aspiration, satisfy their needs and cope with the environmental changes (Betterhealth.vic.gov.au,
2019). Health should be perceived as a positive concept that gives emphasis to social and
personal resources and also on physical capacities (Betterhealth.vic.gov.au, 2019).
The strategies for health promotion according to the Ottawa Charter for Health Promotion
are:
Healthy public policy building: It is considered as one of the primary key solutions for
improving health. The policies must be checked and monitored for the adverse effects on health
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5PRIMARY HEALTH CARE NURSING
and if found to be negatively impacting health, strategies must be implemented for changing
them (Who.int, 2019). Healthy Public Policy is required to ensure safety of the people (Who.int,
2019). Initiatives must be taken for reducing chronic diseases due to various factors. Community
based strategies can be effective in addressing the effects of chronic diseases on health and the
strategies must outline the necessary changes that are needed to be incorporated in their lifestyle
to promote health and prevent diseases. Nurses have an important role in this area by advocating
and notifying on behalf of the clients, their families and community to promote an effective
public health policy.
Creating a supportive environment: Health promotion strategies also include creating a
supportive environment to ensure that everyone lives in an environment that is safe and
encouraging (Who.int, 2019). Nurses play an important role in creating supportive environment
by promoting a healthy lifestyle and motivating them to engage and participate in the community
programs that will promote their health by adopting and bringing into effect certain changes in
their lifestyle that contributes to their wellbeing. The policy designed and implemented must
create supportive environment that results into taking appropriate measures to health promotion
by working through partnerships in the community level. Nurses have a role in encouraging and
establishing primary health care plans for promoting health of the patients and prevent the
prevalence of chronic diseases among them.
Strengthening community action: There is a need to strengthen community action in the
decision making procedures that is important for determining their needs and requirements
(Who.int, 2019). Nurses must focus on the implementation of the strategies to control over the
health issues faced by the community in order to eradicate the chances of developing chronic
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diseases. Some community programs can be arranged and implemented for changing the
community factors that influence the occurrence and frequency of chronic diseases among the
targeted age group.
Development of personal skills: Personal skills development are important in controlling
their lives by making them participate effectively in the process for decision making for
themselves impacting their lives and contributing to their promotion of health. Health promotion
supports both personal as well as social development by providing information about health and
improving skills required for effectively managing and preventing diseases among the population
(Who.int, 2019). Nurses, therefore, should make people aware of their health and impart
knowledge among them so that they can implement the strategies to prevent the occurrence of
chronic illnesses thereby promoting their health.
Re-orientation of healthcare service for preventing illness and promoting health: The
responsibility of promoting health and prevent chronic illnesses must be shared among the
individuals, healthcare professionals, community groups, the health service institutions and
governments where all the stakeholders are working together as a team towards promoting health
and prevent the frequency of chronic illnesses among the targeted age group. The health care
sectors must increasingly work towards providing health services for facilitating the delivery of
effective strategies for health promotion among the targeted age group. Healthcare services must
aim at providing curative services for promoting the health by considering ad respecting all the
sensitive aspects of the community like cultural needs (Who.int, 2019). This mandate must
support individual needs and communities for an enhanced quality of life. Reorienting the health
services also needs a strong attention to both professional training and education as well as to the
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health research leading to a change in the nature and organization of the health services that
focuses on the comprehensive needs of the patients as a whole individual (Who.int, 2019).
Conclusion
From the above essay, it can be concluded that, nurses being the first level of contact in
the primary health care services, must effectively manage and prevent illnesses by designing
intervention strategies for health promotion of the patients through assessments and monitoring
of the patient’s vitals. The nurses working in clinical settings must possess competencies and
appropriate skill set to validate their problem solving attitude towards patient’s issues. Nurses,
through their enhanced skills and advocacy must reach an effective and improved health
outcome among the patient population by implementing the above health promotion strategies.
The services provided by the nurses under the primary health care include screening and
prevention, treatment and management, early intervention and health promotion targeting various
age groups. However, this essay has identified the nurse’s role in providing primary healthcare
services to the target group by aligning with Ottawa Charter health promotion strategies for
prevention of chronic diseases.
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References
Betterhealth.vic.gov.au. (2019). Ottawa Charter for Health Promotion. Retrieved 6 September
2019, from https://www.betterhealth.vic.gov.au/health/servicesandsupport/ottawa-
charter-for-health-promotion
Da Silva, R. B., Brault, I., Pineault, R., Chouinard, M. C., Prud’homme, A., & D’Amour, D.
(2018). Nursing practice in primary care and patients’ experience of care. Journal of
Primary Care & Community Health, 9. doi: 10.1177/2150131917747186
Fukada, M. (2018). Nursing competency: definition, structure and development.
Yonagoactamedica, 61(1), 001-007.doi: 10.33160/yam.2018.03.001
Lukewich, J., Edge, D. S., VanDenKerkhof, E., &Tranmer, J. (2014). Nursing contributions to
chronic disease management in primary care. JONA: The Journal of Nursing
Administration, 44(2), 103-110. doi: 10.1097/NNA.0000000000000033.
Muldoon, L., Hogg, W., & Levitt, M. (2006). Primary care (PC) and primary health care (PHC).
What is the difference?. Canadian Journal Of Public Health, 97(5), 409-11. Retrieved
from https://www.ncbi.nlm.nih.gov/pubmed/17120883
Health.gov.au. (2019). Department of Health | Primary Health Care in Australia. Retrieved 6
September 2019, from
https://www1.health.gov.au/internet/publications/publishing.nsf/Content/NPHC-
Strategic-Framework~phc-australia
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9PRIMARY HEALTH CARE NURSING
Salive, M. E. (2013). Multimorbidity in older adults. Epidemiologic reviews, 35(1), 75-83. doi:
10.1093/epirev/mxs009
Smolowitz, J., Speakman, E., Wojnar, D., Whelan, E. M., Ulrich, S., Hayes, C., & Wood, L.
(2015). Role of the registered nurse in primary health care: meeting health care needs in
the 21st century. Nursing Outlook, 63(2), 130-136. doi: 10.1016/j.outlook.2014.08.004
Who.int. (2019). The Ottawa Charter for Health Promotion. Retrieved 6 September 2019, from
https://www.who.int/healthpromotion/conferences/previous/ottawa/en/
Who.int. (2019). WHO called to return to the Declaration of Alma-Ata. Retrieved 6 September
2019, from https://www.who.int/social_determinants/tools/multimedia/alma_ata/en/
Yakuwa, M. S., Neill, S., & Mello, D. F. D. (2018). Nursing strategies for child health
surveillance. Revistalatino-americana de enfermagem, 26.doi:10.1590/1518-
8345.2434.3007
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