Community - Super Fun Vocab Flashcards
Incidence
The number of new cases or events in a population at risk during a specified time
Risk
The probability that an event will occur
Prevalence
- Total number of cases of the disease in the population at a given time, or the total number of cases in the population, divided by the number of individuals in the population
- Prevalence = a / (a + b)
Epidemic
- Spreading rapidly and extensive by infection and affecting many individuals in an area of a population at the same time: an epidemic outbreak of influenza
Morbidity
- A diseased condition or state
- The incidence or prevalence of a disease or of all diseases in a population
Mortality
- The state or condition of being subject to death
Rate
- The frequency of a health event in different populations at certain periods of time
Proportion
- Ratio in which the denominator includes the numerator
3 components of epidemiologic triangle
o Host
o Agent
o Environment
Epidemiology
- The study of the distribution and factors that determine health-related states or events in a population, and the use of this information to control health problems
Lillian Wald
Began visiting the poor on New York’s lower East side (1893)
Established the Henry Street settlement house & later the Visiting Nurse Association of New York City
By 1905 public health nurses were providing almost 48,000 visits to more than 5000 patients
Wald is considered a leader in the development of public health nursing
Metropolitan Life Insurance began using nursing services in early 1900 with demonstrated declines in mortality rate
Ended in 1921 after concerns by American Medical Association
3 core functions of public health
- Assessment – comprehensive
o Systematic data collection on the population
o Monitors population’s health status
o Makes information available about the health of a community
o IPLANs – IL plan for local assessment of need - Policy and development
o Efforts to develop policies that support the health of the population
o Uses scientific knowledge and data from needs assessment
o Example: No smoking in restaurants - Assurance
o Making sure that essential community health services (programs) are available
o WIC – food nutrition and assistance, FCM (family case management – pregnant and uninsured), Immunization clinics, etc.
Differentiate between community-oriented and community-based nursing
Community-oriented
- Primary focus is health care of either the community or a population of individuals, families and groups
- More broad
- Goal: preserve, protect, promote or maintain health
- Aim is to promote the quality of life
- Further divided into Public Health Nursing and Community Health Nursing
Community-based
- CB nursing focuses on illness care
- Because of growing costs of hospital care, more services are being provided in community-based settings
- Aim is to manage acute and chronic conditions in the community
- Examples: home health, hospice, assisted living
Mary Breckenridge
Established Frontier Nursing Service in 1925
PHN care provided on horse back in Appalachian sections of southeastern Kentucky
Elizabethan Poor Law
1601: guaranteed care for the poor and vulnerable
The Shattuck Report
Landmark report issued in 1850 by the Massachusetts Sanitary Commission recommended
◦ Establishment of state health depts. and local boards of health
◦ Sanitary surveys, collection of vital statistics
◦ Environmental sanitation
◦ Food, drug and communicable disease control
◦ Well-child care and health education
◦ Smoke & alcohol control
◦ Town planning
◦ Teaching preventive medicine in medical schools
Florence Nightengale
Had vision to train nurses
1850 – studied nursing in Germany
Began with district (home) nursing
Became involved with hospital nursing during the Crimean War (1854)
◦ With trained nurses, she documented decreased mortality rates
◦ Set the framework for evidenced-based nursing
◦ Believed nursing should promote health, prevent illness, emphasized proper nutrition, rest, sanitation and hygiene
Private insurance - different types
- HMOs
o Low cost, all care coordinated by a PCP, care may be less fragmented, low co-pay if any, cost effective if you have a lot of medical bills and have a PCP in a large system with good access to specialists
o Low choice, specialty referrals must be coordinated by PCP, no ability to go out of network - PPOs
o No PCP, clients have more choices, may go out of network with penalty fee
o More expensive, less care coordination, expenses can be substantially higher if out of network - Catastrophic insurance
o Fee for service policy
o Low monthly premiums, high deductibles
o Client assumes more responsibility for his/her own health care costs
10 essential public health services
- ASSESSMENT
- Monitor health
- Diagnose & investigate
- POLICY DEVELOPMENT
- Inform, educate, empower
- Mobilize community partnerships
- Develop policies
- ASSURANCE
- Enforce laws
- Link to/provide care
- Assure competent workforce
- Evaluate
- Research
Define the concept of community
- People in relationships with others
- Can be bounded by geographical setting
- Common values or interests or purpose
- Emotional, geographical or functional relationships
- (Book – 3 dimensions: people, place, function)
6 key data collection methods
- Epidemiologic, quantitative data (CDC, state, insurance company, hospitals…)
- Informant interviewing (users & stakeholders) – directed talks with selected members of a community to find out more information about an issue – direct method of collecting data
- Participant observation (sitting in the ED) – observations made by experiences in the community
- Windshield surveys (see text, page 220) – “community head to toe assessment”
- Secondary analyses of existing data (BRFSS – behavioral risk factor surveillance survey) – nurse is using previously gathered data and analyzing it
- Surveys – report data from a sample of persons (used less often because more time and effort involved)
Identify and describe the 3 levels of preventive interventions, citing examples of each
Primary - health promotion and specific protection
- Annual examination – and see above
Secondary – early diagnosis and prompt treatment
- Pap smears, mammogram
- Screening for something specific
Tertiary – Rehabilitation
- Diabetic education referred by PCP
- Activities to manage disease, because it is already present
Learning styles
3 domains of learning – each domain has specific behavioral components that form levels (a hierarchy of steps), each level building on the previous
- Cognitive (thinking)
o Includes memory, recognition, understanding and application
o Learners master each level of cognition in order of difficulty and move from simple to complex
o Applying information learned
- Affective (feeling)
o Includes changes in attitudes and the development of values
o Focus is on what the learner thinks, values and feels - Psychomotor (acting)
o Performance of skills
o Examples: giving an injection, performing a bed bath
6 basic principles of effective education
- Message – sending a clear message to the learner
- Format – selecting the most appropriate learning format
- Environment – creating the best possible learning environment
- Experience – organizing positive and meaningful learning experiences
- Participation – engaging the learner in participatory learning
- Evaluation – evaluating and giving objective feedback to the learner
Define and differentiate between educational goals, objectives and outcomes
Goals: what you want to achieve through the educational process
- One or two sentences at most – clear and concise
Objectives: what do you do to achieve that goal (what you’re going to teach & how you’re going to teach it)
- Generally task-oriented
- Incorporate different methodology (powerpoints, videos, etc.)
Outcomes: things that you want the learner to be able to verbalize when you’re done – need to be measurable
- Active verbs: (e.g., identify, explain, discuss, etc.)
- Upon completion of the program, the participant will ….
Risk assessment
- Typically non-invasive
- Generally a survey or questionnaire
- Identifies a risk: low, medium, high
Medication Management of Hypertension
Diuretics: sometimes called “water pills” because they work in the kidney and flush excess water and sodium from the body.
Beta-blockers: reduce nerve impulses to the heart and blood vessels. This makes the heart beat slower and with less force. Blood pressure drops and the heart works less hard.
ACE inhibitors : Angiotensin converting enzyme (ACE) inhibitors prevent the formation of a hormone called angiotensin II, which normally causes blood vessels to narrow. The ACE inhibitors cause the vessels to relax and blood pressure goes down.
Angiotensin antagonists : shield blood vessels from angiotensin II. As a result, the vessels become wider and blood pressure goes down.
Calcium channel blockers (CCBs): keeps calcium from entering the muscle cells of the heart and blood vessels. This causes the blood vessels to relax and pressure goes down.
Alpha-blockers: reduce nerve impulses to blood vessels, which allows blood to pass more easily, causing the blood pressure to go down.
Alpha-beta-blockers: work the same way as alpha-blockers but also slow the heartbeat, as beta-blockers do. As a result, less blood is pumped through the vessels and the blood pressure goes down.
Nervous system inhibitors: relax blood vessels by controlling nerve impulses. This causes the blood vessels to become wider and the blood pressure to go down.
Vasodilators: directly open blood vessels by relaxing the muscle in the vessel walls, causing the blood pressure to go down.
Act FAST Campaign
(For strokes)
F = Face = Does one side of the face droop?
A = Arms = Downward drift of one arm when both arms are raised?
S = Speech = Is speech slurred or strange?
T = Time = If you observe any of the above signs, call 911 immediately
