Exam 01 Flashcards
Chapters: 1, 2, 11, 17, 19, Skills Lab
population
collection of individuals who have 1+ personal/environmental characteristcs in common
community
group of people that share something in common (location, interests, values). usually several things in common
health services pyramid layers (bottom to top)
BOTTOM: population-based health care services
clinical preventive services
primary healthcare
secondary healthcare
TOP: teritary healthcare
What is true about the bottom-most layers of the health services pyramid?
The greater the effectiveness of the services in the lower tiers, the greater the capability of higher tiers to contribute efficiently to health improvement
Primary prevention
promote health and prevent development/incidence of disease
Secondary prevention
stopping progress of disease by early detection and treatment
Tertiary prevention
stopping deterioration in a patient, relapse, or disability/dependency
Three core functions of PHN + definitions
Assessment: monitor health status to ID community health problems
Policy development: community partnerships, education, policies and plans
Assurance: ensuring people have access to health services
Ten services of PHN
1) monitor health status to ID community health problems
2) diagnose and investigate health problems and hazards in the community
3) inform, educate, and empower people
4) mobilise community partnerships to ID and solve health problems
5) develop policies and plans supporting individual and community efforts
6) enforce laws/regulations protecting health
7) link people to needed health services and ensure provision of healthcare
8) ensure competent public and personal health care workforce
9) evaluate effectiveness, accessibility, and quality of personal/public health services
10) research for new solutions to health problems
why is PHN an area of specialisation? (5 points)
Population focused (not institutionalized)
Community oriented (connection between health status and environment)
Health and prevention focused (primary and secondary prevention)
Interventions made at community/population level
Concern for health of all members, especially vulnerable subpopulations
Who founded the first district nursing association in England?
William Rathbone
Who began nursing in warfare and founded nursing as a profession?
Florence Nightingale
Who is the Henry Street Settlement/Public Health Nursing founder?
Lillian Wald
Who founded the Red Cross in the civil war?
Clara Barton
Who was the first school nurse?
Lina Rogers
Who founded the Frontier Nursing service and what was its purporse?
Mary Breckinridge, pioneer of nurse-midwifery
What was the Metropolitan Life Insurance Company’s involvement in PHN?
Funded PHN d/t importance of preventive healthcare for those under their insurance
Key features of 7 eras of public health: Colonial America
based on Elizabethan Poor Law of 1601
Key features of 7 eras of public health: American Revolution
lack of organisation and enforcement of PH efforts
Key features of 7 eras of public health: Industrial Revolution
Increased urbanization, counties cared for their members
Exception: federal gov’t provided healthcare for merchant seamen and immigrants
Key features of 7 eras of public health: Mid-19th century
Increasing complexity of medical care called for skilled caregivers; Clara Barton and Florence Nightingale
Key features of 7 eras of public health: Early 20th century
National Organization for PHN established in 1912. Lina Rogers, Lillian Wald, Met Life insurance company. Concern that feds were too involved in medicine
Key features of 7 eras of public health: Later 20th century
Social security act expanded oportunities for PH, as people could reture without poverty. Switch to medical model where specific diseases were funded rather than comprehensive services. Rise of chronic illness post war as people were living longer; hospital was place of preferred care
Key features of 7 eras of public health: National Health Insurance until now
Medicaid founded, but did not cover preventive services
Healthy People Initiatives aim to promote health and prevent disease through evidence-based strategies, fostering collaboration across sectors and advancing health equity.
Affordable Care Act of 2010 expanding healthcare access for all, focus on prevention for total prevention
What was the federal government’s involvement in maritime trade and public health?
Federal government aimed to secure America’s maritime trade by providing healthcare for seamen and traders, protecting seacoast cities from epidemics via quarantine orders etc. Key for $$
What were the beginnings of school nursing?
In 1902, >20% of children were absent at any one time.
Focus was on screening children and keeping ill children out of school, not making sure they returned
Lina Rogers made home visits and surveilled children to help them recover and return to school, instructing parents on care and reducing absenteeism by 90%
Why is it important to have community partnerships?
Help collect accurate and relevant data
Investment of community members in the success of assessment and projects
Primary sources of data
collected directly through interaction with community memebrs
Secondary sources of data
collected from existing reports on the community (census, statistics, numerical reports, mortality and morbidity info)
What are the three parts of a community?
A system made up of people, place, and function
7 As of community health
Aware
Accessible
Available
Afford
Acceptable
Adequate
Appropriate
What does client-centered care recognize the client as?
the source of control and full partner in providing care based on preferences, values, needs of client
What does ADPIE stand for?
assessment, diagnosis, planning implementation, evaluation
10 assumptions underlying the intervention wheel
- PHN requires knowledge and skills in both nursing and public health
- PHN focuses on populations
- PHN considers determinants of health
- PHN is guided by priorities ID through community assessment
- PHN emphasizes prevention
- PHN intervenes at all 3 levels of practice
- PHN uses nursing process (ADPIE) at all levels of practice
- PHN uses a common set of interventions regardless of setting
- PHN contributes to the achievement of the 10 essential services
- PHN is grounded in a set of values and beliefs
3 levels of practice in the intervention wheel
Individual
Community
System
What are the five colours in the intervention wheel?
Red, green, blue, orange, yellow
Red wedge interventions (4)
surveillance, disease and health event investigation, outreach, screening
Green wedge interventions (3)
referral and follow up, case management, delegated functions
Blue wedge interventions (3)
Health teaching, counselling, consultation
Orange wedge interventions (3)
Collaboration, coalition building, community organising
Yellow wedge interventions (3)
advocacy, social marketing, policy development/enforcement
Cornerstones of PHN (7)
- focus on health of entire pop
- reflects comm priorities/needs
- establish caring relationships
- encompasses mental, physical, emotional, social, spiritual, environmental aspects of health
- promotes health through strats based on epidemiological evidence
- collab w comm resources to achieve, but can work alone if needed
- sources authority from nurse practice act
Educational domains (3)
Cognitive, Affective, PsychomotorC
Cognitive learning domain
includes: memory, recognition, understanding, reasoning, application, and problem solving
Affective learning domain
includes changes in attitudes and development of values
Psychomotor learning domain
includes performance of skills requiring neuromuscular coordination, emphasizing motor skills
SMART acronym (objective setting)
specific, measurable, achievable, relevant, time-specific
7 Skills of an effective educator
- gains attention of learners, helps them understand info presented is important and helpful
- communicates objective of instruction
- asks learners to recall previous knowledge to link new knowledge
- presents material in clear, organised, simple manner specific to learners’ strengths, needs
- helps learners apply the info
- encourage demonstration of learned info
- provides feeedback to learners
pedagogy
learning strategies for children, individuals with minimal knowledge about health related topic
andragogy
learning strategies for adults, individuals with some health-related knowledge
How to teach chilren
- concrete examples and word choices
- objects and devices
- repetitive health behaviours –> games
Health Belief Model components (6)
perceived susceptibility
perceived severity
perceived benefits
perceived barriers
cues to action
self-efficacy
stages of change/transtheoretical model (six stages of change)
precontemplation
contemplation
preparation
action
maintenance
termination
socio-ecological model
healthcare/bx are a function of individual, interpersonal, organisational, community, and population factors
THEREFORE
interventions must be specific to each of these levels.
CHANGE IS COMPLEX!
Five ways people are motivated to change
social incentives
immediate rewards
sense of control
highlighting progress, not decline
progress monitoring
Sociecological model levels of environment surrounding individual
outermost: public policy
community
organisational
interpersonal
individual knowledge
Vision screening purpose
early ID of learning barrier from visual problems
Procedure of vision screening
ask if student wears glasses/contacts (not readers), screen with glasses if applicable
stand 10-20 ft away from chart, heels on taped line, eye level chart
screen at smallest line that can be read, cover LEFT eye and test RIGHT eye, then switch
Vision passing criteria
PASS: can read 3/4 sumbols on a line AND missing no more than 2 when there are 5-8 symbols in a line. Move up one line evry time a student does not pass a line
FAIL: 2-line difference between two eyes, 20/50 or less, s/sx of squinting, inability to track
Send letter to parents/guardians with screening results
Reason for no visual screening
if child is receiving regular vision management
What charts are used for visual screening?
Lazy E for up to 2nd grade and for non-readers
Snellen chart for readers
Hearing screening purpose
done to assess children for hearing loss, the most common birth disorer.
Influences dev of speech, language, cognitive, psychosocial abilities
When do you do hearing screenings?
preK –> grade three, grade 7, 11
Hearing screening procedure
tell student to raise hand when they hear a tone from headphones, even if very soft
Red is Right, Blue is left, face student away from you
TEST DEVICE: 1000 Hz, volume between 40-60 dB, hold tone for 1-2 sec. If child doesn’t respond to testing tone, reinstruct and test again until child responds
SCREENING LEVEL: lower volume to 20 dB. Test at frequencies 1000 Hz and 4000 Hz, both ears. When child makes 2 correct responses, move to next frequency/ear. If 2 wrong responses, raise volume by 5 dB until 2/4 correct on each ear
Hearing screening passing criteria
PASS: 2 correct responses at each frequency
FAIL: <2 responses out of 4 presentations; mark as REFER – needs medical follow up. Rescreening at the same screening, later in the same day, and within 2 weeks of screening
Reason for no screening
has regular hearing management outside of school
Epipen administration instructions
Most common reason: food allergy
Call 911!
Blue to the sky, orange to the thigh
push into thigh firmly until it clicks, hold for 3 s
Remove injector, save and take to hospital
can give a second dose w/in 5-15 min as needed
Lice characteristics
- feed on human blood via scalp
- do not carry disease
- can only live 48 hours off humans
- transmitted: head-to-head contact
- nits are the eggs
- dirty hair does not increase likelihood of getting lice
Lice management in school setting
screen children if they have symptoms or staff raise concern. No need for wide-spread screening. Keep it confidential
If lice found: educate student on avoiding head-to-head contact, avoid sharing personal items, return student to class next period
No lice found: educate on prevention, return student to class next period
Allow students to remain in classes even with live lice or nits on heads
Notify parents of need for screening, treatment
Lice treatment
Pediculicides OTC, follow directions
prescription if OTC does not help
Comb out dead/live live using a nit comb
Scabies location and transmission
skin-to-skin contact
itching in palms, worse at night, rash throughout body (reaction to scabies and waste under skin)
Oregon poison center number
1 800 222 1222
