Comm Test 2: Public Health Nursing Flashcards
- individuals in the community, focused on illness, phn manage acute and chronic conditions, individual visits home visits= 1:1 interaction , focus on secondary and tertiary, disease management
community-focused nursing (CFN)
- aggregates and the population goal is prevention, at risk clients, can talk about own concerns, the way think about treating a group instead of individual, primary
community-oriented nursing (CON)
- program planning like edu, looking at dev policies, research, using to assess the behavior and health of person in the community, more of an administrative funding= state funding, Johnson county public health= johnson county funds
- gov money more of a set agenda that you have to deal with Ex: scoliosis screenings in school but not required only 2-3 have is it cost worthy was cut
public health nursing
- boundaries are fluid, funding is usually by the entity no tax money, same types of things but your agenda with input from community
Community health
- way we think and have thought of public health in the past, and how we think now *thinking up stream late 80-90s
- why wait till they are sick then edu on how to not come back
- put more edu primary some secondary interventions 1st to see if that makes a difference on how sick they get
- keep them form getting as sick as they possibly can
River of Disease
- how all other components affect A. “The Wheel” B. Levels of prevention C. Public health nursing competencies- core values of phn D. Early intervention E. Use of health belief model F. Use of health promotion models and theories- Nola Pender G. Risk management principles
Thinking Upstream
-assessment looking holistically, long term affects
The Wheel”
more of a situation where you build it they will come, give info to be healthier hopefully they will use it
Use of health belief model-
- who’s at risk, if identify self or us identify give info to address the risk Ex: drinking is health detriment if used in excess will see in the hospital , now we see it as how do we keep them out of the hospital =should be primary care providers, clinics
Risk management principles
- HP 2020 & LHIS
- Intervention- formulate to prevent
- Essential Services
- core functions of phn
- public health defined
Process of Public Health Nursing- process
core functions of public health nursing
assessment
policy development
assurance
competent health care work
educate and empower people
mobilize community partnerships
assurance
making sure that services are available Ex: when you move into this community another phn will come to visit you, forwarding records, giving report to new phn,
Assurance-
to take proper care of someone with certain disease Ex: teach CNA on a communicable diseases
A. competent health care work-
- identify other things that are coming up, assuring that it is there
C. mobilize community partnerships
A. data collection Ex: breathing issues at senior center
B. monitoring health status
C. identifying problems
D. Inform community about data findings Ex: senior center in certain town
E. report data findings to that population
F. Evaluation- reassessment, quality, how well it worked, any aspect of public health services
assessment
making an emergency preparedness plan, will enforce laws that are related to health and safety, research for new info and solutions, PHN have to have data and scientific knowledge to back it up
Ex: active tb and have small children they have to enforce that is endangerment to the child, they will go in and inform and tell them they must get treatment to stay in home
Policy Development-
- Monitor health status to identify community health problems.
- Diagnose and investigate health problems and health hazards in the community.
- Inform, educate, and empower people about health issues.
- Mobilize community partnerships to identify and solve health problems
- Develop policies and plans that support individual and community health efforts.
- Enforce laws and regulations that protect health and ensure safety.
- Link people to needed personal health services and assure the provision of health care when otherwise unavailable.
- Assure a competent public health and personal health care workforce.
- Evaluate effectiveness, accessibility, and quality of personal and population-based health problems.
- Research for new insights and innovative solutions to health problems.
Essential Public Health Services
levels of prevention- interventions, what phn is doing
primary
secondary
tertiary
Focused on health promotion and protection. This type of prevention/intervention occurs before one becomes ill or is aware of illness. People who are the recipients of are generally healthy individuals
Primary level of intervention
Focused on identifying disease early and performing preventative interventions. This type of prevention/intervention occurs in at risk populations. People who are the recipients may not be ill at this point, but have potential to become ill due to gender, genetics, age, lifestyle, etc
Secondary-
-Focused on rehabilitation and restoration. This type of prevention/intervention occurs after one has been diagnosed or treated for a particular disease or illness. People who are ill or in the recovery state of disease. Goal is to minimize recurrence of disease or illness and to limit severity of the disease
Tertiary
Goals and objectives for the health of the US by decade
-where we want to be
Guiding Factors for Public Health
Healthy People 2020
Infectious disease- cholera
Inadequate and/or unsafe hospitals
Little technology- penicillin made, syphilis study
Experienced-based education for health care professionals
Stage 1 1800-1900
economic influences on health care
Acute infections- typhoid, influenza
Trauma
Specialty hospitals- marine hospital service
Medical advances- family planning
Social Security
Shift to science-based education: center of disease control, world health organization
Stage 2 1900-1945
economic influences on health care
Increase in chronic disease- aids, legionnaire disease,
Growing number of facilities- WIC
Durable technology- small pox eradication, polio vaccine
Specialties – MD, etc..
New types of health care professionals
Stage 3 1945- 1984
economic influence on health care
Emerging infections Old disease recurrence Computers- genome project Super drugs Primary care Multidisciplinary teams- healthy people 2000 Managed care
Stage 4 1984- Present
economic influence on health care
Factors Affecting Resource Allocation in Health Care
uninsured
poor
access to care
rationing
- insurance has to accept everyone no exclusions, no preexisting condition
- physicians, clinics, and health care providers must have a set schedule of fees for reimbursement Ex: one doc charges more than another
- No one makes a profit on routine care- annual checkups, required screenings
- Everyone must take responsibility for modifiable factors of health
What are the critical factors that determine the success of Universal Health Care?
- Monitor health status to identify community health problems
- Diagnose and investigate health
problems and health hazards
in the community - Evaluate effectiveness, accessibility, and quality of personal
and population-based health services
Assessment phn
- Develop policies and plans that support individual and community health efforts
- Enforce laws and regulations that protect health and ensure safety.
- Research for new insights and innovative solutions to health problems
Policy Development phn
- Link people to needed personal health services and assure the provision of health care when otherwise unavailable
2. Assure a competent public health and personal health care workforce
3. Inform, educate, and empower people about health issues
4. Mobilize community partnerships to identify and solve health problems
Assurance phn
member of the workforce or a dependent of this work, likely to be in low paying jobs, part-time or temporary, or jobs at a small business
- They cannot afford to or employers do not offer, age and good health status may not perceive the need for the insurance
uninsured factor affecting resource allocation in health care
not always uninsured, working class at low income jobs, income is below poverty level, and have a mortality rate nearly 3 times that of middle class - poor health= low edu levels, unemployment, or low occupational status, low wages, child or over 65, and being a member of a minority
poor factors affecting resource allocation in health care
Medicaid does provide access but aren’t getting health services needed like private insurances
- Inability to afford health care, insurer doesn’t not approve cover or pay for care, client has preexisting conditions, physicians refusing to accept insurance plan - lack of transportation, communication problems, childcare needs, lack of time or information, refusal of services by providers, lack of after hours of care, long office waits, and distance to care
access to care
factor affecting resource allocation in health care
refusal to accept a certain insurance and potential decrease in the acceptable quality of services offered, we have changed from reaction type of care to prevention type of care
Ex: if public health department has only a certain number of vaccine to give to the general public, when sparse will take the highest risk first
High risk- immunocompromised, older adult, certain disease
Rationing
factors affecting resource allocation in health care
Example: Education to prevent falling into the “River of Disease”.
Example: Assessment for a disease or illness to determine risk. This is performed on persons in the general public.
primary prevention
Example: Screenings, screenings, screenings.
Example: Teaching how to screen self or others for a particular disease.
Example: Prevent complications by administering medication or other treatments
secondary prevention
Example: Referrals to support services such as PT, OT, etc…………
Example: Provide education about disease management, means of preventing complications.
Example: Teach one to identify signs/symptoms of exacerbation and remission of a diagnosed disease or illness.
tertiary prevention
