untitled

of persons and environments through caring, and the
mission of the Christine E. Lynn College of Nursing
(Florida Atlantic University College of Nursing
Philosophy and Mission, 1994/2003).
The model’s initial conceptual framework also
grew out of the political reality that some concepts
that were readily understood and valued by persons
in the wider community must be used in order to
secure funding. The result was a proposal for a
demonstration project to develop a framework for
nursing as primary health care and early interven-
tion (Parker, 1996). This proposal expressed the
ideal, or the major components of the faculty nurs-
ing focus statement, and the political and practical,
which are the principals of the World Health
Organization (WHO) principles of primary health
care (1978). Another blend of ideal and practical
was the political reality and hope that such a
demonstration project, if successful, would be
embraced by the administration and the faculty of
the College of Nursing as well as the community
being served.
The concepts and relationships of the model
briefly set forth as part of the proposal for funding
have continued to be the guiding force for the com-
munity practice. Through various participatory-
action approaches, including ongoing shared
reflection, intuitive insights, and discoveries, the
Community Nursing Practice Model has evolved
and continues to develop. The education of univer-
sity students and the conduct of student and faculty
research are integrated with nursing and social
work practice. Throughout the early development
and ongoing refinement of the model, there has
been nurturing of collaborative community part-
nerships, evaluation and development of school
and community health policy, and development of
enriched community.
The model has been used as a framework for
curriculum development for a master’s program
in advanced community nursing at Naresuan
University, Phitsanulok, Thailand. The faculty of
nursing at Mbarara University of Science and
Technology, Mbarara, Uganda, has used the model
to develop study of advanced community nursing
and to design and operate the first school-based
community nursing center in Uganda. Today, ten
years after the initial proposal for the demonstra-
tion project was funded, the Community Nursing
Practice Model guides a diverse, complex, and
transdisciplinary practice of nursing and social
work in four school-based community wellness

centers serving children and families from diverse

multicultural communities and is accepted by local

communities and providers as essential to the

health care system. In 2004, more than 10,000 per-

sons received primary health care and an additional

12,000 participated in various health-promotion

activities. This year also more than 100 undergrad-

uate, master’s, and doctoral students studied nurs-

ing practice and research and eight nursing faculty

practiced and conducted research guided by the

model. An academic center, The Quantum Founda-

tion Center for Innovation in School and Commu-

nity Well-Being that provides a home for this

integrated practice is also an outcome, as are

ongoing proposals to fund integrated practice and

scholarship. The model is featured in a major com-

munity nursing text (Clark, 2003). The practice

received the 2001 award for Outstanding Faculty

Practice from the National Organization of Nurse

Practitioner Faculties.

The Community Nursing

Practice Model

Essential values that form the basis of the model are

1) respect for person; 2) persons are caring, and

caring is understood as the essence of nursing; 3)

persons are whole and always connected with one

another in families and communities. These essen-

tial or transcendent values area always present in

nursing situations, while other actualizing values

guide practice in certain situations.

The principles of primary health care from the

World Health Organization (1978) are the actualiz-

ing values. These additional concepts of the model

are 1) access; 2) essentiality; 3) community partici-

pation; 4) empowerment, and 5) intersectoral col-

laboration. These also guide health care and social

service practice. Concepts of practice that have

emerged include transitional care and enhancing

care. The model illuminates these values and each

of the concepts in four interrelated themes: nurs-

ing, person, community, and environment, along

with a structure of interconnecting services, activi-

ties, and community partnerships (Parker and

Barry, 1999). An inquiry group method has been

An inquiry group method has been

designed and is the primary means of

ongoing assessment and evaluation.

CHAPTER 25 Developing a Community Nursing Practice Model 391