Chapter 2 Flashcards
the Canadian constitution requires provinces to provide comparable levels of __________________ for comparable _________________
public service
taxation
the federal government encourages ________________ by contributing money and giving conditions under which that money is received
equalization
Canada health act passes in ____________ and reinforces 5 central points across provincial healthcare systems. state them
1984
publicly administered comprehensive universal portable accessible
Canada has a national, universal health insurance program, with the first policy implemented at the provincial level in Saskatchewan, where in 1947 Tommy Douglas introduced legislation to institute _______________, or publicly funded ________________, in that province…it was not until 10 years later in 1957 that similar legislation, the hospital insurance and diagnostic services act (HIDS) was passed by the government of Canada
medicare
healthcare
because provincial and territorial wealth varies, the federal governments involvement has been necessary to ______________ services across provinces and territories. Since 1957 the federal government has done that in 2 ways: first by contributing _____________ (in effect, transferring money from weather to poorer provinces and territories) and by stipulating specific ________________ the provinces and territories must meet in order to receive the money
equalize
money
conditions
in 1983 the Canada health act supported and lobbied fro by Canadian nurses associated established criteria and conditions in respect of insured health services and extended health care services provided under provincial law that must be met before a full cash contribution may be made: five central points- name them
publicly administered comprehensive universal portable accessible
federal: the public health agency of Canada was established in 2004 to strengthen __________________ in the country as a response to the ____________ crisis
public health
SARS
the PHAC concentrates the resources necessary to advance public health _______________ and _______________
nationally
internationally
_______________ and _________________ also have plans and committees to deal with disease prevention and health promotion
provinces
territories
hile there are differences in organization and delivery, each province and territory provides ___________________, __________________ and _________________ services
primary health care
public health
home care
the ________________________ was established in September 2004 to strengthen public health in Canada
public health agency of Canada (PHAC)
the PHAC brings together scientists, researchers, policy makers, and public health professionals including doctors and nurses and epidemiologists. they are committed to the well being of ____________ and the Canadian population as a _______________
communities
whole
____________________ is defined as accessible, acceptable, affordable health care and encompasses the determinants of health and their influence on health and well being
primary health care
primary care providers include?
physicians nurses dentists pharmacists dieticians midwives optometrists
________________ refers to services accessed at the first point of contact with the health system
primary care
most Canadians access _________________ through a GP who is reimbursed on a fee for service basis
primary care
while the largest group of primary care providers in Canada is ____________, other primary care providers include?
physicians nurses nurse practitioners dentists chiropractors pharmacists dieticians midwives optometrists public health nurses
___________________ augments medicare by ensuring that health promotion, illness and injury prevention and health protection services are among the essential health services that are universally accessible to individuals and families
public health
public health infrastructure has been eroded in recent decades as a result of increased _______________ and decreased ______________
complexity
funding
home care
________________ is defined as a wide range of health services delivered at home and throughout the community to recovering, disabled, chronically, or terminally ill persons in need of medical, nursing, social or therapeutic treatment and or assistance with the essential activities of daily living
a vital part of Canadian health care, every jurisdiction offers publicly funded _______________ to its constituents
home care
a central strategy for all CHNs is developing _____________ and community _____________
leadership
influence
attributes that support community and public health nursing practice include: ____________________ practice; _________________ culture; and ______________ policy
management
organizational
government
creating and articulating a clear purpose and vision is critical and to do that effectively, nurses/CHNs must be ale to see the long _________, incorporating multiple aspects of the broader environment, communities, _____________ environment and the larger health and social systems
view
political
1947: Saskatchewan gets _______________ under Tommy Douglas
medicare
summarize 2/4 federal initiatives in the development of health promotion and give one rational for each the illustrates their importance on an international level
Lalonde report (1974): acknowledged the limitations of the funded medical/treatment system. presented a vision for health promotion. identified 4 determinants of health, with an emphasis on lifestyle and environment. led to a global reconceptualization of health promotion
Epp report (1986): expanded the definition of health promotion, incorporated some of the tenets of primary health care and emphasized social/environmental/political dimensions of health. formed the basis for the Ottawa charter of health promotion
Ottawa charter of health promotion (1986): international document identifying the prerequisites for health, strategies for promoting health, and outcomes of the strategies. acknowledges that caring for ones self and others is conducive to health. identifies caring, holism, and ecology as essential concepts in health promotion
Population health template and population health promotion model (2001 and 1996): resources developed to put population health and health promotion into action. used nationally and internationally in program planning, community development and resource allocation.
Population health template and population health promotion model (2001 and 1996)
resources developed to put population health and health promotion into action. used nationally and internationally in program planning, community development and resource allocation.
international document identifying the prerequisites for health, strategies for promoting health, and outcomes of the strategies. acknowledges that caring for ones self and others is conducive to health. identifies caring, holism, and ecology as essential concepts in health promotion
Ottawa charter of health promotion (1986)
epp report
expanded the definition of health promotion, incorporated some of the tenets of primary health care and emphasized social/environmental/political dimensions of health. formed the basis for the Ottawa charter of health promotion
Lalonde report (1974)
acknowledged the limitations of the funded medical/treatment system. presented a vision for health promotion. identified 4 determinants of health, with an emphasis on lifestyle and environment. led to a global reconceptualization of health promotion
discuss three Canadian values that are reflected in the current medicare system
social justice: all members of society ,including the most vulnerable, are entitled to free health care in Canada
equity: all Canadians are viewed equally and without discrimination in terms of universal health care coverage
community: all members of society contribute through taxation to provide everyone in the community with access to health care regardless of ability to pay
1947: Medicare:
- first policy of public healthcare implemented in _________________________
- Tommy Douglas (‘father of Medicare’) and Cooperative Commonwealth Federation
- Not until 10 years later in 1957 that similar legislation, the _______________________________________________________(HIDS) was passed by the government of Canada which provided for the federal governments payment of half the costs of insurance plans if key criteria were met
Saskatchewan
hospital insurance and diagnostic services act
Current: national,____________________ health insurance program
universal
Canada Health Act:
- Federal funding was provided as long as provincial health insurance plans met the 5 criteria:
1. ) ______________ administered (accountable to the public)
- ) ___________________ (must cover necessary in-hospital, medical and surgical-dental services)
- ) _____________ (available to all)
- ) _______________ (available after a max of 3 months of residency, and no extra charge for care out of province)
- ) _______________ (no user fees HCP must be reimbursed adequately)
publicly comprehensive universal portable Accessible
the Canada health act has ensured that Canadians have access to healthcare regardless of their ability to__________ and where they___________!!
pay
live
the Canada health act Reflects the values of ________________,____________ and________________. It is held up as a symbol of the values that represent Canada. It articulates a social contract that defines healthcare as a basic ______________
social justice
equity
community
right
Health_______________,_______________ of disease and injury, health _______________ and home health were not emphasized in the Canada health act
-These services were left unprotected by federal legislation; therefore each______________ determines what is covered to what extent
promotion
prevention
protection
province
2006: CNA spoke up and stated that health_____________, funding to address_________________ of health and support for control of ____________ costs were as important as wait times and fears about financial sustainability
promotional
determinants
drug
today public health systems in Canada continue to be confronted by ideologies that favor __________________, _______________________ and ______________ outcomes which tend to overshadow health promotion and prevention values, strategies and activities
efficiency
effectiveness
short term
____________________:a process of enabling people to increase control over and to improve their health. Enabling people to increase control over and improve their health transcends ‘healthy lifestyle’ or ‘health choices’ and focuses on the personal and social resources that are available, accessible and so forth
health promotion
Effective chronic disease prevention and management will require broad policy options, including amending the ___________________________; promoting interdisciplinary_________________ and supporting further integration of public health,_______________ and other sectors of the healthcare system. _______________ care and community______________ health services are areas that need to be strengthened within the Canada health act
Canada health act teamwork homecare palliative mental
1974 Lalonde Report
-presented a vision for health promotion services as critical component of Canada’s health care services
-identified 4 determinants of health:
_________________
____________________
__________________
_________________
-this was the first acknowledgement that health was influenced by social, economic, environmental conditions (where people lived, worked and played)
the Lalonde report was considered revolutionary by the global community and led to a reconceptualization of health _______________
environment human biology lifestyle healthcare system promotion
1986: Epp Framework: Achieving health for all which is a framework for health promotion
- expanded on _____________ definition of health promotion
- incorporated: primary health care and emphasized the role of broad social, environmental and political determinants of health
- the document concluded with a slander of strategies that focus on _______________ responsibility for health or blaming the victim while ignoring the social and economic determinants
- formed the basis for the _____________________
Lalondes
individual
ottawa charter
1986: The Ottawa Charter
- emerged from the first international conference on health promotional hosted in Ottawa
- identified ________________ for health, strategies for promoting health and outcomes of those strategies
- this marked a dramatic shift in health promotion
- determinants identified: peace, shelter, income, and food = broader view of health, focused on _____________________ factors rather than providing illness care and identifying risk factors, it switched to an inclusive approach that also focused on socioenvironmental factors
- caring for ones self and others is conductive to health
- _______________, _________________ and ecology are essential concepts in health promotion
pre-requisites
socioeconomic
caring
holism
governments have a responsibility for the health of their people and equity in health is an expression of _________________
social justice
primary health care
________________________= accessible, acceptable, affordable healthcare
- Other tenets of PHC include: basis in research, continuum of services from promotive to rehabilitative, identification of health education, proper nutrition, disease prevention and control, and maternal and child health care as minimum services
- recognizes importance of interdisciplinary approaches for success
- emphasis on community participation and empowerment
- encompasses the determinants of health and their influence on health and well-being
- CHN’s have participated in primary health care and are well prepared to play a leadership role
____________________ reform began at a national level and sought to move toward an integrated systems approach which would more broadly provide the full spectrum of health services in communities or neighborhoods. It was envisioned that health promotional and disease and injury prevention services would be enhanced as the focus shifted “upstream” with the implementation of primary health care
primary care
public health ensures:
-health_______________,_____________ and injury prevention, and health _______________ services are among the affordable, acceptable and essential health services that are “universally accessible to individuals that live in the community”
promotion
illness
protection
severe problems in public health in Canada include: disparities among _______________ and regions, severely inadequate and decreasing _______________, critical human resource issues, development of public health policies without consideration of relevant ____________
provinces
funding
data
funding of public health services depends largely on ______________ governance and delivery structures
provincial
standards for public health are inconsistently developed across_______________. The development of standards has been influenced by many factors, including legislation, mandates, leadership and history
canada
problem: as care shifts to the home, they shift beyond the boundaries of public _________________. All of the provinces offer a package of basic services, but there are significant provincial variations in the degree to which services are publically funded vs privately funded and this results in significant inequity in accessing publicly funded home care across different regions of the country
insurance
Community health nursing is in a______________ position today
The undervaluing mirrors the diminished funding and resources of previous decades
there is relative_____________ of CHNs
vulnerable
invisibility
there is visible decline in community health nursing _____________
key issues that have been identified include: need for stronger discipline specific communities of practice and more opportunities to meet with peers to discuss and solve professional issues; substantial concern regarding leadership within health units and management skills at the senior management level; lack of career paths and opportunities for advancement
the areas most cited as needing attention were organizational culture, a sense of being _____________ and appreciated, the quality of leadership, the quality of supervision and management and access to ongoing education and training
leadership
valued
CHNs must be able to see the long view and be able to articulate a clear _________________ and vision in order to incorporate multiple aspects of the communities, the political environment and the larger health and social systems
purpose
• The following attributes of nurse leaders contribute to effectiveness:
o ______________________ and listening skills
o Resilience, persistence and hardiness
o Comfort with ambiguity, uncertainty and _________________
o Willingness to take _______________
o Working from a foundational moral ________________
o Confidence in own values and ________________
o Self confidence, self awareness, social awareness
o ___________________
o Cultivation of professional and personal _____________
communication
complexity
risks
framework
beliefs
knowledge
supports
Within the context of community health nursing practice, important organizational supports that positively influence practice include a work culture that:
o Values the unique and combined contribution of _________
o Deliberately establishes _______________ and mentoring plans
o Has a clear vision engendering __________________
o Has stable ______________ and access to necessary resources to accomplish work
staff
leadership
commitment
funding
Collaborative leadership at a national level will be strengthened by developing intersectoral relationships, promoting community health solutions across sectors and addressing the wider _________________________
__________________ is consistently identified as contributing to leadership developmen
determinants of health
mentoring
numerous reports at the provincial and federal levels have recommended reforms to the healthcare system (_________________________, which made 47 recommendations for both the immediate future and the next 20 years)
Romanow commission report
demands on limited ____________ health and ________________ health care nursing services have challenged the community health system
home
primary
CHNs practice at the intersection of public policy and private lives and are thus in a position to include political advocacy and efforts to influence healthy ______________ _____________ in their practice
public policy
CHNs are well positioned and morally obligated to act and provide
leadership
______________: a resource for everyday life encompassing social and personal resources as well as physical capacities.
health
The emphasis on personal and social resources moves us into the idea of_________________
community
_______________________ is defined as: Equitable access to health and health services, public participation, appropriate technology, intersectional collaboration, and reorientation of the health care system to promotion of health and prevention of disease and injury.
primary health care
in the early 20th Century, health departments were dissolved after a local emergency was over. which statement below characterizes the social attitude of the era?
- public health was the responsibility of doctors
- visiting nurses were responsible for community health
- the state was not responsible for health care
- women should not be working outside of the family
the state was not responsible for health care
what was the primary reason for the establishment of school health programs?
- prevent ill children from becoming dependent citizens
- promote the health of all children
- provide food for children who lived in poverty
- treat sick children so they could work and contribute to the family income
promote health of all children
