Exam 1 Flashcards
Systematic data collection, analysis, and monitoring of health problems and needs in population (includes monitoring the population health status and providing/disseminating information about the health of the community)
Assessment
Refers to a group of individuals living within the same geographical area, such as a town or neighborhood or a group of individuals who share some other common denominator such as ethnicity or religious orientation
Community
A collection of individuals who share one or more personal or environmental characteristics. They share at least one characteristic such as age, gender, ethnicity, residence, or a shared health issue such as HIV/AIDS or breast cancer. The common denominator or shared characteristic may or may not be a shared geography or other link recognized by the individuals within that population.
Population
Manage acute or chronic conditions among individual clients and families. Care is family centered and the setting is community based. Setting specific practice, care is provided where people live, work, and attend school.
Community based nurses
Aim to prevent disease and disability; promote, protect, and maintain health. Focus is on “health care” of individuals, families, and groups in community as a whole. Provide healthcare to promote quality of life. Do community diagnosis, health surveillance, monitoring and evaluation of community and population as well as coordination of healthcare, disease prevention, health promotion, health education.
Community oriented nurses
The first public health nurse and is the founder of public health nursing (established the Henry street settlement house in 1893 and the visiting nurse service of NYC)
Lillian Wald
Made contributions to public health nursing and was the founder of the frontier nursing service
Mary Breckinridge
The founder of modern day nursing and is known for her work to improve care on the battlefield during the Crimean War and in hospitals
Florence Nightingale
Provides 10 year measurable public health objectives. Vision: “A society in which all people achieve their full potential for health and well being across the lifespan”. Mission: “To promote and evaluate the nation’s efforts to improve the health and well being of its people”.
Healthy People 2030
To be the premier health promotion, prevention, and preparedness agency in the US and a global leader in public health
CDC
Health outcomes of a group of individuals, including the distribution of such outcomes within the group
Population health
A skill the nurse develops in learning to respect individual dignity and preferences, as well as acknowledging cultural differences
Cultural competency
An understanding that awareness about one’s own culture is an ongoing process, and an acknowledgment that we must approach others as equals, with respect for their prevailing beliefs and cultural norms
Cultural humility
Categorizes groups of people based on superficial criteria such as skin color, physical characteristics, and parentage
Race
Includes shared geographical origin, language or dialect, religious faith, folklore, food preferences, and culture
Ethnicity
Conditions and circumstances in which people are born, grow, live, work, and age. Circumstances are shaped by a set of forces beyond the control of the individual; economics and the distribution of money, power, social policies, and politics at the global, national, state, and local levels
Social determinants of health
A testing of groups of individuals who are at risk for certain conditions (they’re usually asymptomatic, this isn’t a diagnostic test). This is a key component in secondary prevention.
Screenings
The ability of the instrument to give consistent results on repeated trials
Reliability (consistency or repeatability)
The degree to which the instrument measures what it is supposed to measure
Validity (accuracy)
The thinking domain- thinking through information and be able to comprehend it (1/3 of the domains of learning)
Cognitive
The feeling domain- involves the client’s feelings regarding values, attitudes, and beliefs (2/3 of the domains of learning)
Affective
The doing domain- the physical or mental activities required to learn skills (domains of learning)
Psychomotor
The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions
Health literacy
Strategic plan to improve a community’s health. Assesses health by collecting data, analyzing data, using data.
Community Assessment
Health status- biostatistics (mortality, morbidity, other indicators of health), structure of the community (demographics, culture, services and resources available, environment), competence (effective community functioning), effective community functioning/community competence (commitment to the community, conflict containment and accommodation (working together), participation interaction, decision making, management of the relationships with society, participation (use of local services), self/other awareness, effective communication)
Components of community assessment
Gather information, identification of areas in need of improvement, document needs and gaps in service, provide baseline data, identify potential resources, help to establish a vision and goals and strategies to meet community needs, build consensus and buy in to change, increase a community’s readiness and ability to change by promoting collaboration among partners, identify benchmarks to measure progress in meeting goals, provide information for problem and asset identification and policy formulation, implementation, and evaluation
Community assessment uses
Needs versus assets, maximize on strengths, community based participatory research, asset mapping/assessment (people, places, systems, focuses on effectiveness not deficiencies, empowers people, builds working together and relying on one another, uses everyone’s talents), community based participatory research (CBPR) (engagement of community members as full partners in an assessment, collaborative (interest, knowledge, expertise)
Concepts of community assessments
Comprehensive assessment (collection of data about populations living in a community, look at assets, unmet needs and opportunities for improvement), population focused assessment (larger group or aggregate, shares at least one similar characteristic/issue, can focus on a specific age group, gender or health issue), setting specific assessment (focused on specific setting), problem or health issue based assessment (focus on specific problem or health issue, analysis of data determines who is at risk), health impact assessment (provide advice to community on optimizing its health by identifying the potential effects on the health of a population and the distribution of those effects within the population), rapid needs assessment (measure present and potential public health impact of an emergency), primary community assessment (windshield survey)
Types of assessments
When the nursing focus is the collective or common good of the population not individual health, highlight the complexity of the change process. The nursing goal is to improve the health of the collective, usually an ongoing series of healthy changes, not a fixed state- most effectively achieved through partnerships. Nurses may work with individuals; families; other interacting groups, aggregates, or institutions; or within a population (direct nursing care can be part of population focused community health practice- but the resulting changes/goals are intended to affect the whole community).
Community as a client
The process that helps communities to understand how to move from where they are to where they would like them to be. It’s a multistep process (defining the problem, creating a plan, feedback, evaluation), planning occurs at all levels (local, state, federal, global), is one of 10 essential public health services and should occur in every community. Building community capacity can increase quality of life, promote long term community health, and increase community resilience. Health people 2020 provides a tool for community health planning.
Community program planning
Process evaluation (investigates the process of delivering the program or technology and looks at alternative delivery procedures), includes detailed information on how the program actually worked, any changes made to the program, and how those changes have impacted the program. Summative evaluation occurs at the end of the program (evaluation of the objectives and the goal).
Types of program evaluations
Establish who should participate, develop questions, put a budget in place, decide on an internal or external evaluation, determine data collection methods, collect data, analyze and interpret data, communicate findings to stakeholders, use to show evidence for, or improve, the program.
Nine steps to program evaluation
The study of health related trends in populations for the purposes of disease prevention, health maintenance, and health protection. Used to monitor disease trends (examines numeric indicators of the occurrence of diseases or conditions, how long they last, and comparing that to historical trends assets with the management).
Epidemiology
Number of new cases in the population at a specific time
Incidence
Number of existing cases in the population at a specific time
Prevalence
Number of people exposed to a specific agent who develop the disease/total number of people exposed. The number of people that become ill or die from a disease
Attack rate
The physical, infectious, or chemical factor that causes the disease (chemical agents include drugs and toxins, physical agents include noise and temperature, infectious agents include viruses and bacteria)
Agent (1/3 epidemiology triangle)
Living being that an agent or the environment influences
Host (2/3 epidemiology triangle)
The setting or the surrounding that sustains the host (physical environment includes geography, water/food supply, presence of reservoirs/vectors, social environment includes access to health care, high risk working conditions, poverty)
Environment (epidemiology triangle)
Condition occurs when the rate of disease exceeds the usual (endemic) level of the condition in a defined population
Epidemic
Condition occurs when an epidemic occurs in multiple countries or continents (such as COVID)
Pandemic
Particles transmitted by air to susceptible host via droplets or particles
Airborne
Bacterial, viral, parasitic infection of food
Food infection
Toxins produced through bacterial growth, chemical contamination, or disease producing substances
Food intoxication
Fecal contamination of water
Waterborne
Via a carrier, such as a mosquito or tick
Vector borne
Transmission of infectious agent from infected host to susceptible host via direct contact
Direct contact
Protection due to the immunity of most community members making exposure unlikely
Herd immunity
Natural defense mechanisms of the body to resist specific antigens or toxins
Natural immunity
Develops through actual exposure to the infectious agent
Acquired immunity
Production of antibodies by the body in response to infection or immunization with a specific antigen
Active immunity
Transfer of antibodies to the host either transplacentally from mother to newborn or through transfusions of immunoglobulins, plasma proteins, antitoxins
Passive immunity
Involves a combination of nursing knowledge with social and public health sciences (the goal is to promote health and prevent diseases). Scientific discipline, community oriented, population focused, mission is to organize community efforts to use scientific and technical knowledge to prevent disease and promote health. Policy/enabling environment (national, state, local laws), organizational (organizations and social institutions), community (relationships between organizations), interpersonal (families, friends, social networks), individual (knowledge attitudes, behaviors).
Public health nursing
To protect the health of the citizens residing in its county, municipality, township, or territory
Local public health department
Identify educational needs. Establish educational goals and objectives. Select appropriate educational methods. Implement the educational plan. Evaluate the educational process.
Educational process steps
An approach to providing the highest quality of healthcare in all settings to improve health outcomes. The conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual clients.
Evidence based practice
Lack of resources (including time, funding, computers, knowledge), reluctance to accept findings, resistance to questioning of long established practices, client noncompliance with recommended interventions
Barriers to using evidence based practice
Anticipatory action taken to prevent the occurrence of an event or to minimize its effect after it has occurred. There are three levels: primary, secondary, tertiary.
Prevention
Changes community norms, community attitudes, community awareness, community practices, and community behaviors. It’s directed toward entire populations within the community or occasionally toward populations at risk or populations of interest.
Community level practice
Changes organizations, policies, laws, and power structures within communities. The focus is on the systems that impact health, not directly on individuals and communities.
Systems level practice
Changes knowledge, attitudes, beliefs, practices, and behaviors of individuals. This practice is directed at individuals, alone or as part of a family, class or group.
Individual based practice
Describes and monitors health events through ongoing and systematic collection, analysis, and interpretation of health data for the purpose of planning, implementing, and evaluating public health interventions (1/17 wheels of intervention)
Surveillance
Systematically gathers and analyzes data regarding threats to the health of populations, ascertains the source of the threat, identifies causes and others at risk, and determines control measures (2/17 wheels of intervention)
Disease and other health event investigation
Locates populations of interest or populations at risk and provides information about the nature of the concern, what can be done about it, and how services can be obtained (3/17 wheels of intervention)
Outreach
Identifies individuals with unrecognized health risk factors or asymptomatic disease conditions in populations (4/17 wheels of intervention)
Screening
Locates individuals and families with identified risk factors and connects them with resources (5/17 wheels of intervention)
Case finding
Assists individuals, families, groups, organizations, and/or communities to identify and access necessary resources in order to prevent or resolve problems or concerns (6/17 wheels of intervention)
Referral and follow up
Optimizes self care capabilities of individuals and families and the capacity of systems and communities to coordinate and provide service (7/17 wheels of intervention)
Case management
Direct care tasks a registered professional nurse carries out under the authority of a health care practitioner as allowed by law. Delegated functions also include any direct care tasks a registered professional nurse entrusts to other appropriate personnel to perform. (8/17 wheels of intervention)
Delegated functions
Communicates facts, ideas, and skills that change knowledge, attitudes, values, beliefs, behaviors, and practice of individuals, families, systems, and/or communities (9/17 wheels of intervention)
Health teaching
Establishes an interpersonal relationship with a community, system, family, or individual intended to increase or enhance his or her capacity for self care and coping. Counseling engages the community, system, family, or individual at an emotional level. (10/17 wheels of intervention)
Counseling
Seeks information and generates optional solutions to perceived problems or issues through interactive problem solving with a community, system, family, or individual. The community, system, family, or individual selects and acts on the option best meeting the circumstances. (11/17 wheels of intervention)
Consultation
Commits two or more persons or organizations to achieve a common goal through enhancing the capacity of one or more of the members to promote and protect health. (12/17 wheels of intervention)
Collaboration
Promotes and develops alliances among organizations or constituencies for a common purpose. It builds linkages, solves problems, and/or enhances local leadership to address health concerns. (13/17 wheels of intervention)
Coalition building
Helps community groups to identify common problems or goals, mobilize resources, and develop and implement strategies for reaching the goals they collectively have set. (14/17 wheels of intervention)
Community organizing
Pleads someone’s cause tracts on someone’s behalf, with a focus on developing the capacity of the community, system, individual, or family to plead their own cause or act on their own behalf. (15/17 wheels of intervention)
Advocacy
Uses commercial marketing principles and technologies for programs designed to influence the knowledge, attitudes, values, beliefs, behaviors, and practices of the population of interest. (16/17 wheels of intervention)
Social marketing
Places health issues on decision makers’ agendas, acquires a plan of resolution, and determines needed resources. Policy development results in laws, rules, regulations, ordinances, and policies. Compels others to comply with the laws, rules, regulations, ordinances, and policies created in conjunction with policy development. (wheels of intervention)
Policy development/enforcement
The sustainable goals are to end poverty and hunger, ensure good health and well being, achieve gender equality, ensure clean water and sanitation, ensure affordable and clean energy, promote decent work and economic growth, build industry innovation and infrastructure, reduce inequalities, make cities and communities sustainable, ensure sustainable consumption and production, take action on climate change, preserve oceans, protect ecosystems, promote peaceful societies, and strengthen global partnerships
World Health Organization
