Quality clinical experience is a basic need of current health practices, and nursing researches have implemented various practices in the past couple of decades to ensure a target based approach which gives both qualitative and quantitative results. It is important to understand the right application of the different approaches applied to the nursing practices, as it will help to obtain the right approach depending upon the various social, economic, environmental and behavioral differences.
In order to implement a focused solution to the health needs, there are concepts like community and aggregate nursing which help to concentrate on a specific target population so that the results obtained are not only quick but are also measurable.
Community & Aggregate based practices have a dual effect on the nursing standards, on one hand it helps to provide choice to the patients, secures better care, involves one service approach and applies advanced nursing skills on the other hand it helps the staff to work in a better environment, enjoy more freedom and play enhanced clinical roles. In this paper we will look at the conceptual difference and inter-linkage between community and aggregate nursing and will have a quick review of their application in the current health care practices.
Community and Aggregate Nursing: A definition
Nursing environment faces different kinds of requirements based on specific population that is being handled. Community nursing is a practice which develops an indirect service delivery which is able to effectively work together towards the health benefit of a certain population which is expected to provide quality assurance and enhanced health planning. The community based nursing involves various health care practices including assessment of patient needs known as “epidemiological investigation”, however all these include an operation based on a target population with the help of collective effort towards the betterment of the entire selected population.
Aggregate nursing again is an approach to create quality health care units, however this time the approach is more from an individual perspective, the methods of delivery are applied according to the individual needs, and therefore there are lot of times when both community and aggregate practices fall in the same bracket. The planning and identification of the care which is provided remains similar to the previous over here however the involvement of family and community during the planning phase is not as evident as it is in the community based practice, we will see the conceptual difference between these two in the next section.
Aggregate and Community nursing: different in a similar way
There are times when it is said that aggregate based approach is itself a different type of community based approach and in order to understand this, we can look at the concept of population and sub-population. In case of a community based approach the planning is done while targeting specific groups and design interventions keeping in mind the expected result on the community, group and family. Now in this case the data which is looked at during the planning phase involves not only the impact on the patient but on the entire community.
Community Based Approach (Group) - Community - Sub-Group - Aggregate (Individual)
Now in the above discussion we have seen that how community based approach looks at the entire group while planning the care but now when we are discussing the aggregate based approach we will talk about a sub-group and to explain it better, multiple sub-groups (aggregates) together form a community. Now it is easy to understand that the aggregate based approach is conceptually a further sub-divided community, in order to create a more concentrated focus towards a smaller population.
Aggregate Based Approach: A case study
In order to understand the fine boundary that subdivides community and aggregate based approaches, let’s look at this case study where common a nursing team is looking after pregnancy cases and related care. Now there are in total 23 patients who are being considered as a community and there is a focused approach to study and develop common practices to satisfy the healthcare needs of the entire community. However there is a further sub-division of this community as there is high-risk aggregate subgroup where the members of the community are underweight and need special care. Hence there will be an aggregate based approach which will be effective in order to specifically benefit the nutrition needs of the aggregate (sub-group).
From the above discussion, it is clear that focus is the deciding factor and determines as to whether community or aggregate nursing approaches will work in a specific scenario. It is easy to infer that Aggregate is basically a smaller part of a community which needs to be treated in a specialized way and needs more individual attention then the others. As a difference both of these approaches involve planning and health care activities however the concept of community based nursing directly works to show a collective impact on the community however in case if there is a smaller group that needs a specialized approach, aggregate based approach will be more effective.
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