Exam 1 Flashcards
What is the mission of public health?
“to generate organized community effort to address the public interest in health by applying scientific and technical knowledge to prevent disease and promote health”
What is public health?
“What we, as a society, do collectively to assure the conditions in which people can be healthy”
What is the government’s special function in public health?
“to see to it that vital elements are in place and that the mission is adequately addressed”
What are the public health core functions at all levels of government?
- Assessment
- Policy development
- Assurance
What is the Community Health Improvement Process (CHIP)?
A major outcome of the Institute of Medicine’s committee. A method for improving the health of the population on a community-wide basis. The method brings together key elements of the public health and personal health care systems in one framework.
What are the primary features of public health nursing as a specialty?
Population focus, community orientation, health promotion and disease prevention emphasis, and population-level concern and interventions, which frequently are at the level of public policy, such as anti-smoking laws, the requirement of immunizations for entry to school, and seat belt legislation.
What are the eight principles of public health nursing?
- The client or “unit of care” is the population.
- The primary obligation is to achieve the greatest good for the greatest number of people or the population as a whole.
- The processes used by public health nurses include working with the client(s) as an equal partner.
- Primary prevention is the priority in selecting appropriate activities.
- Selecting strategies that create healthy environmental, social and economic conditions in which populations may thrive is the focus.
- There is an obligation to actively reach out to all who might benefit from a specific activity or service.
- Optimal use of available resources to assure the best overall improvement in the health of the population is a key element of the practice.
- Collaboration with a variety of other professions, organizations, and entities is the most effective way to promote and protect the health of the people.
Regarding the core public health functions implemented at all levels of government, what does ASSESSMENT refer to?
Assessment refers to systematically collecting data on the population, monitoring of the population’s health status, and making available information about the health of the community.
Regarding the core public health functions implemented at all levels of government, what does POLICY DEVELOPMENT refer to?
Policy development refers to the need to provide leadership in developing policies that support the health of the population; it involves using scientific knowledge in making decisions about policy.
Regarding the core public health functions implemented at all levels of government, what does ASSURANCE refer to?
Assurance refers to the role of public health in making sure that essential community-wide health services are available, which may include providing essential personal health services for those who would otherwise not receive them.
Assurance also refers to ensuring that a competent public health and personal health care workforce is available.
What is frequently viewed as the feature that distinguishes public health nursing from other specialties?
Its setting
The use of which characteristics of public health are a more useful approach?
A focus on populations that are free-living in the community, an emphasis on prevention, a concern for the interface between the health status of the population and the living environment (physical, biological, sociocultural), and the use of political processes to affect public policy as a major intervention strategy for achieving goals.
According to the 1985 Consensus Conference sponsored by the Nursing Division of the U.S. Department of Health and Human Services, what are specialists in public health nursing defined as?
Specialists in public health nursing are defined as those who are prepared at the graduate level, either master’s or doctoral, “with a focus in the public health sciences”. This is still true today.
What is population-focused practice?
Population-focused practice is the focus of specialists in public health nursing. This focus on populations and the emphasis on health protection, health promotion, and disease prevention are the fundamental factors that distinguish public health nursing from other nursing specialties.
What is a population defined as?
A population is defined as a collection of individuals who share one or more personal or environmental characteristics.
The term population may be used interchangeably with the term aggregate.
How can a historical approach can be used?
A historical approach can be used to increase understanding of public health nursing in the past, as well as its current dilemmas and future challenges.
How can the history of public health nursing be characterized?
The history of public health nursing can be characterized by change in specific focus of the specialty but continuity in approach and style of the practice.
What is public health nursing a product of?
Public health nursing, referred to in the text as population-centered nursing, is a product of various social, economic, and political forces; it incorporates public health science in addition to nursing science and practice.
Federal responsibility for health care until the 1930s…
Federal responsibility for health care was limited until the 1930s when the economic challenges of the Depression permitted reexamination of local responsibility for care.
Who designed and implemented the first program of trained nursing?
Florence Nightingale
Who founded the first district nursing association in England?
William Rathbone
What increased the need for trained nurses in the US, especially in public health nursing?
Urbanization, industrialization, and immigration.
What did increasing acceptance of public roles for women permit?
Increasing acceptance of public roles for women permitted public health nursing employment for nurses, as well as public leadership roles for their wealthy supporters.
Who was the first trained nurse in the US, who was salaried as a visiting nurse?
Frances Root. She was hired in 1887 by the Women’s Board of the New York City Mission to provide care to sick persons at home.
When were the first visiting nurses’ associations founded?
The first visiting nurses’ associations were founded in 1885 and 1886 in Buffalo, Philadelphia, and Boston.
Who established the Henry Street Settlement?
Lillian Wald established the Henry Street Settlement, which became the Visiting Nurse Service of New York City, in 1893. She played a key role in innovations that shaped public health nursing in its first decades, including school nursing, insurance payment for nursing, national organization for public health nurses, and the United States Children’s Bureau.
When was school nursing founded and what was its purpose?
Founded in 1902 with the vision and support of Lillian Wald, school nursing sought to keep children in school so that they could learn.
Which insurance company established the first insurance-based program?
The Metropolitan Life Insurance Company established the first insurance-based program in 1909 to support community health nursing services.
When was the National Organization for Public Health Nursing founded and what did it provide?
The National Organization for Public Health Nursing (founded in 1912) provided essential leadership and coordination of diverse public health nursing efforts; the organization merged into the National League for Nursing in 1952.
What happened to official health agencies between 1900 and 1940?
Official health agencies slowly grew in numbers between 1900 and 1940, accompanied by a steady increase in public health nursing positions.
What is the Sheppard-Towner Act of 1921?
The innovative Sheppard-Towner Act of 1921 expanded community health nursing roles for maternal and child health during the 1920s.
Who established the Frontier Nursing Service?
Mary Breckinridge established the Frontier Nursing Service in 1925, which influenced provision of rural health care.
How was it for African-American nurses seeking to work in public health nursing?
African-American nurses seeking to work in public health nursing faced many challenges, but ultimately had significant impact on the communities they served.
What have characterized the specialty since at least the 1910s?
Tension between the nursing role of caring for the sick and the role of providing preventive care, and the related tension between intervening for individuals and intervening for groups have characterized the specialty since at least the 1910s.
As it attempted to remedy some of the setbacks of the Depression, what established a context in which public health nursing services expanded?
The Social Security Act
What were the effects of World War II?
The challenges of World War II sometimes resulted in extension of nursing care and sometimes in retrenchment and decreased public health nursing services.
By mid-twentieth century, what led to examination of the goals and organization of public health nursing services?
By mid-twentieth century, the reduced prevalence of communicable diseases and the increased prevalence of chronic illness, accompanied by large increases in the population more than 65 years of age, led to examination of the goals and organization of public health nursing services.
Between the 1930s and 1965, what did organized nursing and community health nursing agencies sought to establish?
Organized nursing and community health nursing agencies sought to establish health insurance reimbursement for nursing care at home.
What did the implementation of Medicare and Medicaid programs in 1966 establish?
Implementation of Medicare and Medicaid programs in 1966 established new possibilities for supporting community-based nursing care but encouraged agencies to focus on services provided after acute care rather than on prevention.
What have the efforts to reform health care organization focused on?
Efforts to reform health care organization, pushed by increased health care costs during the last 40 years, have focused on reforming acute medical care rather than on designing a comprehensive preventive approach.
What did the 1988 Institute of Medicine report document?
The 1988 Institute of Medicine report documented the reduced political support, financing, and impact that increasingly limited public health services at national, state, and local levels.
What impact did the federal policy changes in the late 1990s have?
In the late 1990s, federal policy changes dangerously reduced financial support for home health care services, threatening the long-term survival of visiting nurse agencies.
What have brought renewed emphasis on prevention to nursing?
Healthy People 2000, Healthy People 2010, and recent disasters and acts of terrorism have brought renewed emphasis on prevention to nursing.
When conducting a health assessment interview, what should we always ask the client?
When conducting a health assessment interview, always ask if the client has recently traveled out of the US or to one of the border areas along the US-Mexico perimeter. People who travel abroad may bring back diseases that are hard to diagnose. In addition, people often cross the border into Mexico to fill a prescription for medicine because it is often less expensive than in the US. Unfortunately, many times the medications brought back have been relabeled and are out of date.
Who’s goal is global health?
Global health is a collective goal of nations and is promoted by the world’s major health organizations.
What is necessary to achieve global health?
Global health cannot be achieved without using the constructs of global health diplomacy: addressing and finding solutions to physical, environmental, fiscal, economic, political, safety, educational, and trade issues.
How does the fall of political and economic barriers between countries affect global health?
As the political and economic barriers between countries fall, the movement of people bak and forth across international boundaries increases. This movement increases the spread of various diseases throughout the world.
What role do nurses play in the identification of potential health risks at US borders?
Nurses play an active role in the identification of potential health risks at US borders, with immigrant populations throughout the US, and as participants in global health care delivery.
What is essential for understanding the health of specific populations?
Understanding a population approach is essential for understanding the health of specific populations.
What does universal access to health care for the world’s populations rely on?
Universal access to health care for the world’s populations relies on strong primary care.
The major organizations involved in world health are…?
The major organizations involved in world heath are:
- Multilateral
- Bilateral and non-governmental or private voluntary
- Philanthropic
What is the health status of a country related to?
The health status of a country is related to its economic and technical growth. More technologically and economically advanced countries are referred to as developed, whereas those that are striving for greater economic and technological growth are termed lesser developed. Many lesser-developed countries shift financial resources from health and education to other internal needs, such as defense or economic development, and this shift does not help the poor.
What is the global burden of disease (GBD)?
The global burden of disease (GBD) is a way to describe the world’s health. The GBD combines losses from premature death and losses that result from disability. The GBD represents units of disability-adjusted life-years (DALYs)
What do critical global health problems include?
Critical global health problems still exist and include communicable diseases such as tuberculosis, measles, mumps, rubella, and polio; maternal and child health; diarrheal diseases, nutritional deficits; malaria; and AIDS.
What have also become global health concerns?
Natural and man-made disasters have become global health concerns.
What three dimensions do most definitions of community include?
Most definitions of community include three dimensions:
- networks of interpersonal relationships that provide friendship and support to members
- residence in a common locality
- shared values, interests, or concerns
What is the definition of a community?
A community is defined as a locality-based entity, composed of systems of formal organizations reflecting societal institutions, informal groups, and aggregates that are interdependent and whose function or expressed intent is to meet a wide variety of collective needs.
Is a community practice setting sufficient reason for stating that practice is oriented toward the community client?
No. A community practice setting is insufficient reason for stating that practice is oriented toward the community client. When the location of the practice is in the community but the focus of the practice is the individual or family, the nursing client remains the individual or family, not the whole community.
What is population-centered practice targeted to?
Population-centered practice is targeted to the community– the population group in which healthful change is sought.
What is the definition of community health?
Community health is defined as the meeting of collective needs through identification of problems and management of behaviors within the community itself and between the community and the larger society.
What do most changes aimed at improving community health involve?
Most changes aimed at improving community health involve, out of necessity, partnerships among community residents and health workers from a variety of disciplines.
What does assessing community health require?
Assessing community health requires gathering existing data, generating missing data, and interpreting the database.
What are five useful methods of collecting data?
Five methods of collecting data useful to the nurse are:
- Informant interviews
- Participant observation
- Secondary analysis of existing data
- Surveys
- Windshield surveys
What is the biggest challenge in assessment?
Gaining entry or acceptance into the community is perhaps the biggest challenge in assessment.
What is usually the relationship between the nurse and the community when collecting data?
The nurse is usually an outsider and often represents an established health care system that is neither known nor trusted by community members, who may react with indifference or even active hostility.
What does the planning phase include?
The planning phase includes analyzing and establishing priorities among community health problems already identified, establishing goals and objectives, and identifying intervention activities that will accomplish the objectives.
What happens after high-priority problems are identified?
Once high-priority problems are identified, broad relevant goals and objectives are developed; the goal is generally a broad statement of the desired outcome while the objectives are precise statements of the desired outcome.
What are intervention activities?
Intervention activities, the means by which objectives are met, are the strategies that clarify what must be done to achieve the objectives, the ways change will be effected, and the way the problem will be interpreted.
What does implementation mean?
Implementation, the third phase of the nursing process, means transforming a plan for improved community health into achieving goals and objectives.
What is evaluation?
Simply defined, evaluation is the appraisal of the effects of some organized activity or program.
What is the expected growth of the national health spending in the years between 2010 and 2019?
In the years between 2010 and 2019, national health spending is expected to grow at an average annual rate of 6.1%, reaching $4.5 trillion by 2019.
By 2012, what programs are expected to account for over half the health care purchased in the US?
Medicare, Medicaid and the Children’s Health Insurance Plan.
Which entity reported that the number of uninsured rose to 46.3 million in 2008, from 45.7 million in 2007?
The US Census Bureau
What happens with the uninsured in terms of preventive care, diagnosis and treatment?
The uninsured receive less preventive care, are diagnosed at more advanced disease states, and, once diagnosed, tend to receive less therapeutic care in terms of surgery and treatment options.
A recent study found that as many as 27,000 deaths in 2006 were the result of a lack of insurance.
What did a study in 2007 found in regards to shortages of primary health care providers?
A study in 2007 found that 56 million people in the US lacked adequate access to primary health care because of shortages of primary health care providers in their communities.
Who have the greatest barriers to access?
Those who are poor, minority group members, and non-English speakers have the greatest barriers to access.
Among the 18 million who received care in community health centers in 2007…
- one out of every five clients were low-income, uninsured individuals
- one in four were low income and members of minority populations
- one in seven were rural residents.
What is globalization?
Globalization is a process of change and development across national boundaries and oceans, involving economics, trade, politics, technology, and social welfare.
How is primary health care defined?
Primary health care, the focus of the public health system in the US, is defined as a broad range of services, including, but not limited to, basic health services, family planning, clean water supply, sanitation, immunization, and nutrition education.
The US and primary health care
The US, as a WHO member nation, has endorsed primary health care as a strategy for achieving the goal of health for all in the twenty-first century.
How does emphasis on the social and physical environment affect Healthy People 2020?
The emphasis on the social and physical environment moves Healthy People 2020 from the traditional disease-specific focus to a more holistic view of health consistent with a public health frame of reference.
