Community Nursing Flashcards
Which specific groups does the federal government cover you
FNIHB, Canadian forces, veterans, inmates, and refugees
principles of health act
Universality accessibility comprehensiveness of services portability public admiration
role of provinces regarding health care
legislate, organize and deliver services
benefit of Community health centres
improving access to health care
what is Canada known for
leader in health promotion movement
medical model definition of health
absence of disease
WHO definition of health
Holistic, physical, mental and social well-being
Ottawa charter definition of health
health is a resource aspiration, satisfy needs, coping
what are the 3 levels of prevention
1-education, prevent disease/injury2-check for problems (screening)3-tx
healthy public policy
intent of having a positive effect on or promoting health
protective factors
variable that assist in managing the stressors associated with being at risk
Lalonde report
health promotion”health field concept”individual blame on health
alma-ata declaration
what are the per-requisites for health (Ottawa charter)
basic needs/rightspeace, resourcessocial justice, equitystable ecosystem, income
what are the 3 strategies of Ottawa charter
advocate, enable and mediate
what are the 5 actions of Ottawa charter
healthy public policy supportive environment community action personal skills reorient health services
Epp Report and 3 focuses
“Health for all”-reduce differences btwn groups (income)-reduce risk for injury/disease-enhance coping
what are the 3 health promotion mechanisms of Epp report
self care mutual aid healthy environments
what are the 3 implementation strategies of Epp report
public participation community health services healthy public policy
what are the 3 health promotion approaches
biomedical behavioural socio-environmental
biomedical health promotion approach
3 levels of prevention biological and physical
behavioral health promotion approach (ex)
change risk behaviors to promote health-smoke pack graphics
population health promotion approach (6)
determinants of health evidence-based upstream investments collaborate public involvement accountability
what are the aspects of “strengthening community action” strategy from Ottawa Charter
community development capacity building community mobilization empowerment
main concern of health protection
maintenance of health- immediate health risks
Summative evaluations
assess program outcomes or follow-up on the results of the program activities
Community health index
summary of the health indicators of a community
Community forums (pro)
low cost and capturing the perspectives of a large number of people
Focus groups and key-informant methods (con)
limit the number of persons expressing their perspectives
Surveys (con)
expensive and technically demanding
Adequacy
the extent that the program addresses the entire health concern defined in the assessment
progress evaluation
monitor program activities
purpose of program planning
facilitates how resources are used so that they will have the most impact
Formative program evaluation (ex)
Quality assurance audits
The Program Logic Model
Utilizes a diagram, Involves stakeholders, Shows linear linkages towards outcomes (effective?)
The interactive stage
describes the health concern using past and present data to project future population needs
what is an important component of the initial planning phase
Relevance
Relevance
The program is suitable to meet the needs of the target group
what are major sources of information for program evaluation
program clientsprogram recordscommunity indicators
health program
activities to address health concerns and builds on patient strengths
what are the 4 steps of the health program management process
assessingplanningimplementationevaluation
what are the 2 types of program planning
strategic and operational
strategic program planning
matching patient health needs, strengths and resources
operational program planning
uses a specific objective related to plan (smaller scale and more detailed)
what are the 2 models of program planning
logic model and precede-proceed model
precede-proceed model
comprehensive but complex with 9 phases
what is included in the logic model
situation inputs (resources)outputs (program activities)outcomes
what are the 2 assumptions of the precede-proceed model
multiple factors affect healthcollaboration is needed for change
who is involved in the assessment step of program planning
key stakeholders
community health nursing
individual clients in the community (umbrella term)
population health
Health outcomes of a population(determinants and indicators)
what strategies do population health use
protection, prevention, and promotion
what is the role of the public health nurse
promotion, protection and prevention among populations
public health
health care of communities and populations (broad)- activities
what is the goal of public health
improve health of all people
primary health care
comprehensive social justice and equity, universally accessible to people in a community collaboration
social justice
ensuring fairness and equity in health services so that vulnerable individuals in society have easy access to health care
what has increased life expectancy
Improvement in control of infectious diseases through immunizations and sanitation
what are sub-populations called
aggregates
Canada’s health goals
(1) basic needs(2) belonging and engagement(3) healthy living(4) a system for health.
upstream thinking
macroscopic, big-picture population focus (determinants, factors)
downstream thinking
is a microscopic, individual curative focus
community
people and the relationships between people who commonly share agencies, institutions, and a physical environment
difference between equality and equity
equality- everyone gets the sameequity- eliminate disparities (fair)
what are the 5 principles of primary health care
accessibilityhealth promotionpublic participationintersectoral collaborationappropriate techonology
Current Priorities to Improve Integrated Health Care for Canadians
1) accessibility-rural/remote
2) supporting health workers
3) mental health and substance use
4) modernizing
determinants of health- modifiable (6)
social supports and coping skillseducation and literacyemployment/ working conditionsphysical environmentshealthy behaviourschildhood experiences
Community Health Nursing Standards of Practice -client focused (5)
promotionpreventionmaintenance/restorationcapacity buildingaccess and equity
Community Health Nursing Standards of Practice -nurse focused (3)
evidence informed responsibility/accountability professional relationships
determinants of health- non modifiable (6)
biology and genetic endowmentrace/racismgendercultureaccess to health servicesincome and social status
7 teachings
Respect-buffaloLove-eagleCourage-bearHonesty- sabe (Bigfoot)Wisdom-beaverHumility-wolfTruth-turtle
how many reserves in MB (accessibility)
63 reserves in MB, 23 are not accessible by road
which aboriginal people live in Manitoba
Ojibway, Cree, Oji-Cree Saulteaux and dene
what is Bloodvein’s economy
fishing, trapping, wild rice harvesting, commercial businesses band office
Drum
sign of healing (only hear mother’s heartbeat while in the womb)
sweet grass
medicine, hair of earth mother, purification of mind/body/spirit, blesses us
sage
women’s medicine purification of mind/body/spirit
how does sage affect the body
mind- open to new learningeyes -see good in all peoplemouth -speak truthheart- love all peoplethink- goodness and wellness
Cedar
male property invite the good spirits
Tobacco
offerings ceremonies wellness grieving
difference between the north and south
north- nursing station, isolatedsouth- health centre, run by bands, accessible
band council resolution
laws
ex of overcrowding
12-15 people living in an 800 square foot house
who pays for medical travel
Non-insured Health Benefit Program of ISC
transportation improvement
hover craft can travel at night unlike helicopters
advanced scope of practice
draw blood, perform x-rays, suture wounds perform ECGs
hospice care
respite and comfort at end of lifereduce pain and suffering
who does case management deal with
individual clients
purpose of case management
reduce health care spending maintain and improve the quality of client care
Occupational health histories
current and past jobsexposures to specific agents (onsite and other environments)relationships between the symptoms and activities at workfactors that increase risk to agents
what are the roles of the public health nurse
advocateleaders and consultants referral sourcedirect primary caregivers
what roles facilitate the provision of continuity of care to clients
discharge planner and referral agent
what are the 8 CHN functions
what is included in care and counselling
risk assessment & responseoutreach (barriers and stakeholders)
what is included in continuity of care
referrals discharge planning
what is included in health education
literacy and health literacy assessment
what are the 5 key components of case management
coordinating carecontinuity of care changes in patient conditionevaluate care deliveredfinancial implications of care plan
credentials for community nurses (besides RN)
public health- bachelor degreeparish- RN with pastoral care and social sciencestelenurse- RN more knowledge and assessment skillsoutreach- RN with community experience
what are the 3 types of thinking of PHN
upstream, midstream and downstream
midstream thinking
change in the local/organizational levelmaterial world-improve housing
downstream thinking
treatment focused on individual
epidemiology
population health and factors and use this info to control health problems
prevalence
existing cases/total population
web of causality
interrelationship of multiple factors that interact to influence health.
epidemiological triangle
categorizes factors as agent, host, or environment but not the interactions between them
Levels of prevention
actions taken to improve health outcomes
goal of clinical trial
evaluate the effectiveness of an intervention (causality)
what type of action is best for a population related to improving health
one that addresses all 3 levels of prevention
Sensitivity
the extent a test identifies those individuals who have the condition
Positive predictive value
proportion with a positive test who have the disease (probability that an individual with a positive test has the disease)
Validity
accuracy of a test or measurement or how closely it measures what it claims to measure (sensitivity and specificity)
endemic
constant presence in the environment
What is the importance of sensitivity
when early treatment is important when identification of every case is important
what factor to look at with description of disease patterns
the size of the population at risk for the disease
what are predictive values affected by
the level of disease in the screened population the sensitivity and specificity of the test
incidence rate
new cases in a population at risk (those without the disease)
difference between descriptive and analytical epidemiology
descriptive- person, place, timeanalytical- how and why
epidemiological process
define-current statsdescribesearch- factorsdetermine/analytical
history of epidemiology
hippocrates- influences on healthpasteur- pasteurization/germ theorylister- antiseptic surgerykoch- specific organisms (TB)
who is the father of epidemiology
john snow (cholera and water pump)
difference between morbidity and mortality
morbidity- sick mortality- death
what are ratios used for
estimate risk
agent, host, environment of epi triangle
agent- the thing that caused the diseasehost- living thing(s) that is infectedenvironment- where (social/physical factors)
life course approach
early factors influence health later in life longitudinal studies (lifespan studies)
natural history of disease
prepathogenesis- primary preventionpathogenesis- 2nd/3rd prevention
screening can diagnose diseases (T/F)
F-not diagnostic- need referrals
what are the main types of epi studies
descriptiveanalyticalecologicalexperimental intervention
purpose of epi studies (descriptive, analytical, ecological, experimental)
Des- trends, who is at riskanal- hypothesiseco- group dataexper- prevention, policies
how to measure the process dimension of community health
community awareness
how to measure the structure dimension of community health
manpower, resources and facilities
what is the emphasis of process dimension
health promotion, primary prevention
Data generation
developing data that do not already exist from community members
focus group
a group from the community to share their beliefs, opinions, and experiences about a selected topic
factors of a community
people, place and time, and function
what is the nurses role when the community is a client
provide prevention and early intervention programs for the total population
what phase does evaluation begin in
during the planning phase
data generation examples
community knowledge and beliefsvalues, goals and concerns
what are the 3 dimensions of community health
status, structure, process
what is the goal of community oriented practice
ongoing health promoting changes
how to measure the status dimension of community health
vital statisticsprevalencelife expectancy
what is a coalition
multiple groups that work together because they share a common concern
what is the difference between capacity building and asset mapping
capacity- focus on strengths to improve communityasset mapping- identify assets (structures) of the community
difference between sustainability and competence
sustainability- buy in competence- knowledge of resources
secondary analysis
uses previously gathered data
what are the 4 steps of the planning phase
analyzeprioritizegoals/objectivesinterventions
what are the 4 steps of the community nursing process
assess, plan, implement, evaluate
difference between the change agent and change partner
agent- gather and analyze facts, implement programspartner- teaching, advocate
The reciprocity principle
society must support individualscommunities comply with public health interventions
The harm principle
Restriction of freedom of some is justified in order to prevent harm to others
The principle of least restrictive means
discuss before using full authority
who is considered nursing’s first moral leader and community-oriented nurse
Florence nightingale
What developed as a response to the technological advances in health care science?
Ethic of care (differentiate nursing from medical practice)
what is the goal of virtue ethics
to enable persons to flourish as human beingscharacter development
Consequentialism
results/purposesfocuses on the outcome
Deontology
Utilitarianism
greatest good, least harmfocus on the outcome
Social justice
the fair distribution of everythingeliminate disparities between social groups
Equity
the fulfillment of each individual’s needs as well as the individual’s opportunity to reach full potential as a human being
A feminist ethic of care
strengthens relationships and solves problems addresses inequalities due to gender, race, and class.
Ethics
knowledge of moral lifereflection on what one ought to do
what are the ethical principles
beneficencenon-maleficenceautonomydistributive justice
morals vs morality
morals- societal norms about what constitutes right or wrongmorality- obligations to self and others
ethical distress
unable to do the right thing
