Chapter 1 Key Terms

Question 1

aggregate

Answer 1

is a collection of individuals
who have one or more personal or environmental characteristics
in common.

Question 2

assessment

Answer 2

refers to systematically collecting data on the
population, monitoring the population’s health status, and
making information available about the health of the
community.

Question 3

assurance

Answer 3

refers to the role of public health in ensuring that
essential community-oriented health services are available,
which may include providing essential personal health services
for those who would otherwise not receive them. It also refers to making sure that a competent public
health and personal health care workforce is available. Fielding
(2009) subsequently made the case that it also should mean that public health officials should be involved
in developing and monitoring the quality of services
provided.

Question 4

capitation

Answer 4

a payment
arrangement in which insurers agree to pay providers a fixed
sum for each person per month or per year, independent of the
costs actually incurred.

Question 5

community-based nursing

Answer 5

is a setting-specific practice whereby
care is provided for clients and families where they live, work, and attend
school. The emphasis of community-based nursing practice is acute and
chronic care and the provision of comprehensive, coordinated, and continuous
services. Nurses who deliver community-based care are generalists or
specialists in maternal/infant, pediatric, adult, or psychiatric/mental health
nursing.

Question 6

Community Health Improvement Process (CHIP)

Answer 6

a method for
improving the health of the population on a community-wide
basis. The method brings together key elements of the public
health and personal health care systems in one framework.
(The major outcome of the committee’s work)

Question 7

community health nurses

Answer 7

nurses providing secondary or tertiary
care in a home setting, school nurses, and nurses in clinic
settings (in fact, any nurse who does not practice in an institutional
setting) could fall into the category of

Question 8

cottage industry

Answer 8

The massive organizational changes occurring in the health
delivery system present a unique opportunity to establish new
roles for nurse leaders who are prepared to think in population
terms. The movement can be thought of as
the “industrialization” of health care, which operated very
much like a cottage industry or a small business for a very
long time.
(the trend toward the use of private capital in financing
health care, particularly institution-based care and other
health-related businesses.)

Question 9

integrated systems

Answer 9

the development

of partnerships, alliances, and other linkages across settings

Question 10

levels of prevention

Answer 10

Primary Prevention
Using general and specific measures in a population to promote health and
prevent the development of disease (incidence) and using specific measures
to prevent diseases in those who are predisposed to developing a particular
condition.
Example: The public health nurse develops a health education program for
a population of school-age children that teaches them about the effects of
smoking on health.

Secondary Prevention
Stopping the progress of disease by early detection and treatment, thus reducing
prevalence and chronicity.
Example: The public health nurse develops a program of toxin screenings
for migrant workers who may be exposed to pesticides and refers for treatment
those who are found to be positive for high levels.

Tertiary Prevention
Stopping deterioration in a patient, a relapse, or disability and dependency by
anticipatory nursing and medical care.
Example: The public health nurse develops a diabetes clinic in which nursing
care including educational programs for nutrition and self-care are provided
for a defined population of adults in a low-income housing unit of the
community.

Question 11

managed care

Answer 11

Although populations have historically been the focus of
public health practice, specifically defined populations are
becoming a focus of the “business” of managed care; therefore
more managed care executives are joining public health practitioners
in becoming population oriented. Their focus is on using such epidemiological and statistical strategies
to develop databases and analytical approaches to making
decisions at the level of a defined population or subpopulation
enrolled in a particular care delivery organization or those covered by a particular insurance company. A population focused
approach to planning, delivering, and evaluating
various aspects of care delivery is increasingly being used in an
effort to achieve better outcomes in the population of interest
and has never been more important.

Question 12

policy development

Answer 12

refers to the need to provide leadership
in developing policies that support the health of the population,
including the use of the scientific knowledge base in
making decisions about policy.

Question 13

population

Answer 13

is a collection of individuals
who have one or more personal or environmental characteristics
in common. Members of a community who can be defined
in terms of geography (e.g., a county, a group of counties, or
a state) or in terms of a special interest or circumstance
(e.g., children attending a particular school)

• first sentence was the definition for aggregate as well. The second sentence was stated specifically for this definition.

Question 14

population-focused practice

Answer 14

problems are defined (by assessments
or diagnoses), and solutions (interventions), such as
policy development or providing a particular preventive service,
are implemented for or with a defined population or subpopulation

Question 15

public health

Answer 15

the role is protecting and promoting health, as well as

preventing disease and disability, is extremely important.

Question 16

public health core functions

Answer 16

The committee
stated that the mission of public health was “to generate
organized community efforts to address the public interest in
health by applying scientific and technical knowledge to prevent
disease and promote health.”The government has a special function “to see to it that
vital elements are in place and that the mission is adequately
addressed.” TO CLARIFY THE GOVERNMENT’S ROLE IN FULFILLING THE MISSION, THE REPORT STATED THAT ASSESSMENT, POLICY DEVELOPMENT, AND ASSURANCE are the public health core functions
at all levels of government.

Question 17

public health nursing

Answer 17

is a specialty because it has a distinct
focus and scope of practice, and it requires a special knowledge base. The following characteristics distinguish public health
nursing as a specialty:
• It is population-focused. Primary emphasis is on populations
whose members are free-living in the community as opposed
to those who are institutionalized.
• It is community-oriented. There is concern for the connection
between the health status of the population and the
environment in which the population lives (physical, biological,
sociocultural). There is an imperative to work with
members of the community to carry out core public health
functions.
• There is a health and preventive focus. The primary emphasis
is on strategies for health promotion, health maintenance,
and disease prevention, particularly primary and secondary
prevention.
• Interventions are made at the community or population level.
Target populations are defined as those living in a particular
geographic area or those who have particular characteristics
in common and political processes are used as a major intervention
strategy to affect public policy and achieve goals.
• There is concern for the health of all members of the population/
community, particularly vulnerable subpopulations.

” They engage in population-focused
practice, but can and do often apply the Council of Linkages
concepts at the individual and family level”

Question 18

Quad Council

Answer 18

developed levels of skills to be attained by public health nurses for each of the competencies.
(It is a coalition of public health nursing organizations)

Question 19

subpopulations

Answer 19

within the larger population, such as high-risk infants under
the age of 1 year, unmarried pregnant adolescents, or individuals
exposed to a particular event such as a chemical spill.