COMMUNITY---Week # 1 Flashcards
Healthy People 2020 Initiatives (5)
1) Establish Measurable Objectives
2) Consult with health care expects locally/nationally to collect data
3) National Health goals are derived from scientific data and trends collected during the prior decade
4) Guides Nurses in developing health promotion strategies to improve individual / community health
5) Measure for quality of health–helps nurses develop health promotion strategies
PRIMARY PREVENTION deals with the ________ population
Well
Important facts about DORTHEA DIX
- 1st generation of mental asylums
What does the (WHO) World Health Organization do?
Provides daily information regarding the occurrence of internationally important diseases.
Establishes world standards for antibiotics / vaccines
The “3rd” major change to healthcare in the 21st century is “Increased use of technology”. What are the three main types of technology?
1) Medical devices
2) Health Information Tech (HIT)
3) Telehealth
Describe the “shift of care” (1900-1999)
1910– (Home care focused) 90% of nursing care provided in patients home (by their family with visits from doctor/nurse
1950–(Hospital care focused) Nursing students were utilized as hospital staff
1980 – (Home care focused) D/C from hospitals occurred faster d/t increased cost of hospitalization using DRG’s (Diagnostic Related Grouping)
**care was transferred to community nurses
“3” components that make up the Epidemiological Triangle
1) AGENT—physical, infectious or chemical factor that causes the disease
2) HOST—the living being that an agent or environment influences
3) ENVIRONMENT—the setting/surrounding that sustains the host
principles of Epidemiology in practice (6)
1) Assessment
2) Planning and Interventions
3) Health Promotion
4) Outbreaks
5) Environment
6) Evaluation
Equation for PREVALENCE
Number of EXISTING CASES in the population at a specific time divided by POPULATION TOTAL x 1,000 = _______ per 1,000
Health indicators
describes the health status of a community and serve as targets for the improvement of a community’s health.
Important Facts about CLARA BARTON
- Founded American Red Cross (1881)
* Civil War -care for soldiers
(STRATEGIES) to implementing community health programs (7)
1) Good assessment
2) Accurate interpretation of data
3) Collaboration with community partners
4) Effective communication
5) Sufficient resources
6) logical planning
7) skilled leadership
Define “RATE”
The primary measurement used to describe either the occurrence or the existence of a specific state of health or illness
What are the “three” major changes to Health care in the 21st century?
1) Development of patient / client-centered care
2) Patients have personal responsibility for their health
3) Increased use of technology
Define “ATTACK RATE”
Number of people exposed to a specific agent who develop the disease divided by total number of people exposed
What is Nonmaleficence?
- Not willfully harming a patient
* no harm done when applying the standards of care
What are the preventative services for Health promotion and disease prevention (5)
1) Education and counseling
2) Immunizations
3) Preventative Medications
4) Lifestyle changes
5) Actions to prevent a potential disease or disability
What is Beneficence?
- being proactive in promoting the clients best interest
- maximize possible benefits
- minimize possible harm
Important fact about FLORENCE NIGHTINGALE
- Promotes self care / preventative care
- Environmental theory
- Crimean War (1854)-treated soldiers
- 1st statistician (Reviewing data)
What are the principles guiding community health nursing (5)
1) Ethics
2) Advocacy
3) evidence base practice
4) Quality
5) Professional Collaboration/communication
what are the methods of data collection for community assessment? (5)
1) WINDSHIELD SURVEY
2) INTERVIEWS
3) OBSERVATIONS
4) EXISTING DATA
5) CONSTRUCTED SURVEYS
The “1st” major change to healthcare in the 21st century is “DEVELOPMENT OF PT/CLIENT CENTERED CARE”…What are the “5” things we (nurses) take into consideration when caring for our patient?
1) Cultural
2) Personal Preferences
3) Values
4) Families
5) Lifestyle
What is “GLOBAL HEALTH”
Health issues and concerns that transcend national boundaries and may best be addressed by cooperative actions and solutions.
People may also define health differently based on their culture, role in life or even what is possible in their environment.
Physical, mental and social wellbeing and not just the absence of disease.
When evaluating the “PLACES” component of the community assessment…what are the “5” things that evaluated?
1) PHYSICAL (geography, housing)
2) ENVIRONMENTAL (Geography, climate, pollutants)
3) SOCIAL SYSTEMS (Religious, education, transportation, etc)
4) HUMAN SERVICES (# of hospitals, police stations, libraries)
5) POWER SYSTEM (who makes the decisions/laws)
Important facts about LILLIAN WALD
- 1st Public Health Nurse
* Socioeconomic & educational component to health
Equation for INFANT MORTALITY RATE
Number of infant deaths before 1 year of age in a year divided by NUMBER OF LIVE BIRTHS in the same year x 1,000 = ________ per 1,000
What are the patient / client care “benefits” from INCREASED USE OF TECHNOLOGY ? (6)
1) Improved Coordination
2) Evidence based
3) Eliminate paperwork
4) Reduce error
5) expanded access
6) decreased cost
What is fidelity?
*honouring commitments to clients
Describe “EXISTING DATA” (community assessment)
Strengths?
Limitations?
USE OF EXISTING DATA TO ASSESS PROBLEMS
STRENGTH—database of prior concerns—ability to trend health issues over time
LIMITATIONS—possibility that data might not represent current situation
Equation for INCIDENCE
Number of NEW CASES in the population at a specific time divided by POPULATION TOTAL x 1000 = _______ per 1,000
Describe “WINDSHIELD SURVEY”
Strengths?
Limitations?
DESCRIPTIVE APPROACH THAT ASSESSES SEVERALCOMMUNITY COMPONENTS BY DRIVING THROUGH A COMMUNITY.
STRENGTHS—provides descriptive overview of the community
LIMITATIONS—Need a driver—time consuming—results based only on visualization-no input from community members
Medicaid provides coverage for _________________
for individuals of low socioeconomic status and children.
*funded by federal and State governments
Examples of TERTIARY PREVENTION interventions (2)
1) DISABILITY LIMITATIONS
2) REHABILITATION
3) SUPPORT GROUPS
How do community nurses keep the populations “safe” (11)
1) Prevent Epidemics
2) Protect environment, workplace, food, water
3) Promote Healthy behavior
4) Monitor health status
5) mobilize community resources
6) Health promotion, disease prevention, risk reduction
7) Respond to disasters
8) Assure public of trained personnel
9) Reaching out to those at high risk
10) injury prevention through interventions
11) Influence policies that effect change
What is distributive Justice
Distribution of the benefits / burden in society.
*Everyone gets their fair share
When collecting data for the community assessment, it is essential to combine several methods of data collection. Relying only on one or two key pieces can result in an incomplete assessment (TRUE) OR (FALSE)
TRUE
What are the PUBLIC HEALTH “Benefits” from the increased use of Technology? (5)
1) Increased prevention
2) Earlier detection of infectious disease
3) Better tracking of chronic disease
4) Better health evaluation measures
5) Accurate assessments of disease and disability burden in the community
Define “Health Promotion
action or effort that supports the well being of the individual, groups and communities by decreasing risk of illness and injury
TERTIARY PREVENTION deals with the _________
People that already have the illness
Examples of SECONDARY PREVENTION interventions (2)
1) EARLY DIAGNOSIS—screening tests (ie, breast exam, pap smear, case findings)
2) ADEQUATE TREATMENT
Describe “OBSERVATIONS” (community assessment)
Strengths?
Limitations?
OBSERVATION OF FORMAL OR INFORMAL COMMUNITY ACTIVITIES
STRENGTHS—indication of community priorities—environmental profile—ID of power structures
Healthy People is Coordinated by _______________
US Department of Health and Human Services
Equation for CRUDE MORTALITY RATE
Number of deaths divided by population total x 1,000 =_______________ per 1,000
What are the roles of the Community Health nurse?
4
1) Interact with and establish community partners serving the community at large
2) Witness the interaction between the community program and the response of the client to the services.
3) identify future services
4) Coordination, continuity of care, evaluating outcomes
Action taken prior to the onset of disease which removes the possibility that disease will ever occur
PRIMARY PREVENTION
Public Health Achievements (1900-1999)
Vacc. Vehemently Work IN Cardiac Stroke
Food Fluoride To Mothers Family
- Vaccinations
- Vehicle Safety
- Workplace Safety
- Decreased infectious diseases
- Decreased Cardiac Disease
- Decrease Stroke Death
- Food Safety
- Fluoridation in water
- Tobacco = HAZARD
- Mother / Baby (healthier)
- Family Planning
What are the “4” parts of Medicare??
PART A— hospital, home, hospice care and limited skilled nursing care
PART B– medical/diagnostic services, mh services, preventative care
PART C– a combination of Part A & Part B–typically provided through a private insurance
PART D – RX med coverage
__________ and ____________ rates are used to measure the existence of a particular disease, and allows the nurse to compare the rate of disease from one population to another
INCIDENCE AND PREVELANCE
“2” main components of a community assessment?
People
Places
Define “PANDEMIC”
When an EPIDEMIC occurs in multiple countries or continents
overall death rate is known as __________
CRUDE MORTALITY RATE
An action which halts the progress of a disease at its incipient stage and prevents complications
Secondary Prevention
What is Autonomy?
- Individuals right to make his or her own decision-actions which fulfill their goals
Upstream thinking
use to focus on interventions that promote health or prevent illness, as opposed to medical treatment models that focus on care after they are ill.
GOALS (6) of the PPACA
“Patient Protection and Affordable Care Act”
Affordable insurance coverage Access to primary care Lower costs Coverage up to 26 years of age Ban lifetime limits Cover preventive care
Report notifiable communicable diseases to_____________________
State Depart of Health
Healthy People started in __________ and is completed every _____________
1979
10 years
Define “Community Health Nursing”
A systematic process of delivering care to improve the health of the entire community
What is accountability?
accepting responsibility for ones own actions
The “2nd” major change to healthcare in the 21st century is “The patients’ responsibility for their own health”..What are the “4” things that THE PATIENT IS RESPONSIBLE FOR?
1) Be an active participate
2) Review their own health records
3) Monitoring drugs (and their side effects)
4) Educating themself
EPIDEMIOLOGY
the study of health related trends in populations for the purposes of disease prevention, health maintenance and health protection
Describe “INTERVIEW” (community assessment)
Strengths?
Limitations?
DIRECT DISCUSSION WITH COMMUNITY MEMBERS FOR THE PURPOSE OF OBTAINING IDEAS AND OPINIONSN FROM KEY INFORMANTS
STRENGTHS— minimal cost—reading/writing of participants not required
LIMITATIONS—built in bias—meeting time & place
Define “Community’
group of people and institutions that share geographic, civic and/or social parameters
Types of services covered by Medicaid
- In and Out Patient care
- Lab | Radiology
- Home health services
- Vaccines
**Family Planning
- Pregnancy care
- <21 - Early and periodic screening, diagnosis and treatment
When evaluating the “PEOPLE” component of the community assessment…what are the “5” things that evaluated?
1) Demographic (distribution, mobility, density)
2) Social (marital status, education, crime rate, occupation, recreation)
3) Biological (health/disease status, race, age, gender
4) Cultural (Language, religion, spirituality, values)
5) Vital Stats (birth/death rate)
define “ENDEMIC”
Constant prescence of a disease or infectious agent within a given area (or group) without importation from outside
Describe the Epidemiological Process (7)
1) Assessment –
2) Formulate theory using gathered information
3) Narrow down possibilities by gathering more info
4) Make a plan
5) Put plan in action
6) Evaluate plan to determine level of success
7) Report and Follow up
SECONDARY PREVENTION deals with the ________ population
AT RISK
Determinants of Health
factors that influence the clients health
- nutrition
- stress
- education
- education
- environment
- finances
Systems thinking
studies how an individual, or unit, interacts with other organizations/systems.
**Useful in examining cause and effect
Define “RISK”
Probability or likelihood that a disease or illness will occur in a group of people who presently do not have the problem
_______________ is responsible for administration of the Medicaid program
State health agency
What is Epidemiology used for…?
1) used to provide interventions for targeted groups
2) Numerical info about the impact of disease and death of populations
3) it provides a broad understanding of the spread, transmission, and incidence of disease and injury
(BARRIERS) to implementing community health programs (7)
1) Poor assessment
2) Incomplete data
3) Not including community partners
4) Poor communication
5) Poor resources
6) Lack of planning
7) Poor Leadership
Define “Epidemic”
An outbreak that occurs when there is an increased incidence of a disease beyond that which is normally found in the population
Mortality rates provide information about __________
Cause of death
Population-based practice. the synthesis of nursing and public health within the context of preventing disease and disability and promoting and protecting the health of the entire community
Public Health nursing
_________ is the physical, infectious, or chemical factor that causes a disease
THE AGENT
Epidemiological triangle
___________ is the living being that an agent or the environment influences.
THE HOST
Epidemiological triangle
__________________ is the setting or surrounding that sustains the host
THE ENVIRONMENT
EPIDEMIOLOGICAL TRIANGLE
EPIDEMIOLOGICAL TRIANGLE
Name —“2” PHYSICAL AGENTS
“2” CHEMICAL AGENTS
“2” INFECTIOUS AGENTS
“2” PHYSICAL AGENTS:
- ---noise - ---temperature
“2” CHEMICAL AGENTS
- --drugs - --toxins
“2” INFECTIOUS AGENTS
- --viruses - --bacteria
EPIDEMIOLOGICAL TRIANGLE
(7) Types of Susceptible Host(s):
“O GAG PIE”
O-ccupation
G-ender
A-ge
G-enetics
P-hysiological state
I-mmunological status
E-thnicity
Difference between “INCIDENCE” and “PREVALENCE”
INCIDENCE is the # of NEW CASES and PREVALENCE involves the # of EXISTING CASES
Probability or likelihood that a disease or illness will occur in a group of people who presently DO NOT have the problem
RISK
Examples of “Primary Prevention”
1) nutrition education
2) family planning / sex education
3) smoking cessation
4) safety education (seat belts, helmets)
