Exam 1 Flashcards
Public Health
Goal is to organize community efforts that will use scientific and technical knowledge to prevent disease and promote health.
How do i keep the community healthy?
E.g., driving and there are plows and seatbelts
-mall portion of the health care budget in the U.S. that is used for this prevention and population-focused speciality. (Basically Their money is limited. You don’t get a lot of money. That’s usually the first place they cut. All our money is spent on chronic care. Very little spent on prevention)
Benefits from Public Health
Dramatic increase in life expectancy
• Decreased number of deaths from stroke, coronary heart disease, and
cancer
• Declines in death rates of adults and children
• Population-focused PH approaches could help prevent up to 70% of
early deaths in America, compared to only 10% for medical treatment.
What are the 3 Public Health Core Functions
Assessment
Policy Development
Assurance
describes public health in America. These functions provide a framework for defining the services to be provided by the public health system.
Assessment
Collection data
systemic data collection on the population, monitoring the population’s health status and making information available about the health of the community
◦ Monitor health status to identify community health problems
◦ Diagnose and investigate health problems and health hazards in the community
Characteristics of Public Health Nursing
- it is population-focused
-it is community-oriented - it is health and prevention focused
Interventions are performed at the community and/or population level - Concern for the health of all members of the population or
community, particularly vulnerable populations - The nurse often reaches out to those who might benefit from
a service or intervention
Primary
Promote health and prevent disease from developing
E.g., immunizations, handwashing teaching, cover sneeze
Secondary
Screening, early detection of disease
Screen before symptoms
Tertiary
Treat
Attempt to limit the progression of the disease
“They already have it
Quad Council
The Quad Council are made up of four public health nursing organizations and has established core competencies
These competencies reflect an agreement that the public health nurse requires preparation at the baccalaureate level.
Healthy People 2030
Eliminate preventable disease, disability, injury, and premature death
Set healthy goals for the entire nation
Set up health objectives for the nation
What are the Core Objectives?
Baseline only
Target met or exceeded
Improving
Little or no detectable change
Getting worse
Baseline only
We dont yet have data beyond the initial baseline data, so we dont know if we’ve made progress
Target met or exceeded
We’ve achieved the target we set aAt the beginning of the decade
Improving
We’re making progress toward meeting our target
Little or no detectable change
We haven’t made progress or lost ground
Getting worse
We’re farther from meeting our target than we were at the beginning of the decade
Developmental Objectives
Developmental Objectives represents high-priority public health issues that are associated with evidence-based interventions but dont yet have reliable baseline data.
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Developmental Objectives: Developmental objectives are important public health issues that don’t have enough data yet to measure their impact, even though there are proven ways to address them. Whether or not they become main goals in Healthy People 2030 depends on if we can collect reliable data on them.
Research Objective
Research objectives represent public health issues with a high or economic burden or significant disparities btwn population groups… but they aren’t yet associated with eveidence based interventions
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Research objectives focus on public health issues that have a big impact on health or money, or show big differences between different groups of people, but don’t yet have proven ways to address them. These objectives may be added to Healthy People 2030 as we learn more about them and find effective interventions.
In simple terms, both developmental and research objectives are important public health issues, but the distinction lies in whether there is enough data and proven interventions to address them. Developmental objectives need more data, while research objectives need to find effective ways to tackle the issue before they can become core goals in Healthy People 2030.
Social Determinants of health
Conditions in which people are born, grow, live, work, and age…influences their health status
Factors include education, economic status, social support, transportation, neighborhood, and physically environment and employment
Addressing social determinants of health is key to improving health of populations
Challenges for Community and Public Health Nursing in the Twenty-first Century
• Helping eliminate health disparities in underserved populations
• Demonstrating cultural competence
• Planning for community change
• Contributing to a safe and healthy environment
• Responding to emergencies, disasters, and terrorism
• Responding to the global environment
Florence Nightingale
Crimean War1854
•accepted an assignment to lead a group of nurses who
were sisters from various Catholic and Anglican orders to
the Crimea to work at the Barracks Hospital in Scutari
• Despite deplorable conditions, the army doctors at first refused her assistance.
• Eventually, the doctors, in desperation, called for her help.
• Purchased medical supplies, food, and linen; set up a kitchen; instituted laundry services; initiated social
services; spent up to 20 hours each day providing nursing care
/
She bought supplies and bought her own people; so The sheets were dirty, nobody cleaned anything. They weren’t going about nutrition, hand washing, sunlight. And she realized, hey, these are simple changes that we can make.And she actually went in and started making these changes. She actually has the roots of public health nursing. She sent the framework for current nursing.So while she was there, you think about, this was political activism. The first nursing school was established. She was honored as the foundation for professional nursing.She introduced principals of asepsis and infection control. She came up with a way to transcribe doctor’s orders, came up with a plan to have patient records.
- established 1st nursing school in England
Honored as the founder of professional nursing services,
- Introduced principles of asepsis and infection control, a
system for transcribing doctor’s orders, and a system to
maintain patient records
◦ Contributions to nursing research
◦ Kept careful statistics—documented a decrease in the death rate of soldiers from 42% to 2% as a result of health care reforms that emphasized sanitary conditions
Who created the Frontier Nursing Services (FNS)
Mary Breckinridge
Lilian Wald
In the 1880s, she developed a viable practice for public health nursing which is called The Henry Street Settlement, Lower East Side of NYC
- provide well baby care, health education, disease prevention, and treatment of minor illnesses
- nursing practice formed the basis for public health nursing in the U.S
- Developed the first nursing service fr occupational health ( Metropolitan Life insurance Company)
- Visting Nurse
- School nursing: • They didn’t have school nurses back then. And when somebody was sick, a child was sick, you went home. There was a lot of infectious diseases then.
• If I sent you home, I never checked that you didn’t come back. So she was like, what is going on? So they decided to set up school nurses.
- Occupational Health Nursing
Metropolitan Life Insurance Company
Developed by Lilian Wald
Prevention of diseases in workers to promote productivity
Sliding scale fee
History of Lilian Wald
One of her assignments were to go out and walking in the tenements ; she used to do classes for the immigrants. They were very, very poor that lived in the tenements. And one day she was getting a class and one of her usual mommies didn’t come. And she gave the class, and also the little girl comes running and crying, there’s something wrong with my mother can you help? And she left and the mother delivered the baby, but she was still bleeding Nobody changed anything. And she just couldn’t believe the horrible conditions. And she’s looking around, how many people were in this little tenement? Nobody changed anything. And she just couldn’t believe the deplorable conditions. And she’s looking around, how many people were in this little tenement?The rats, the roaches, the bugs crawling up. And she just couldn’t believe it and she realized, you know, we’ve got to start making changes. So she called that her baptism by fire. She couldn’t believe a family of 7 were in one tiny room… THAT WAS her START
• she started sending people to help the kids and to see what was going on with them
◦ Lead to babies being well,So she really was amazing. From her we have well baby care, health education, disease promotion. She was a champion for public health nurse.
She formed for housing reform,, world peace, rights of women, children, advocate for immaigrnts
◦ Fought for civil rights
◦ She has a place in the lower east side and it’s still there
◦ She came up with a playgraound
‣ They used to throw or empty their toilets on to the street where children play so she created a safe playground
Mary Breckinridge
Rural Nursing 1925
Established Frontier Nursing Service
• Rural nursing: There’s no medical care. Who’s delivering that baby? How many babies do you have? How many babies do you have? Oh, you’ve got the most. You’re going to help me deliver. That’s how they decided. So if I had the most babies, that was the person that would run around, to the whole town and help anybody else that was delivering.
• Yep. It sure is. Mary Breckenridge lost her own two children to different diseases as young children. And she said she wanted to help make a difference. So she brought about this royal frontier nursing where they can go out and actually help people. So the person that was training, it was much better to have a trained nurse than just somebody that happened to have four children delivering a baby, right?
Henry Street Settlement
Created by Lilian Wald
• Henry: buy this little house and decided hw to help these sick kids; nurses would spend the night with these kids; And the nurses would come back and say, it is so infested with rats and roaches. These kids sleep right through them, crawling on them, going in and out their ears, their nose.Like they came back so disgusted. We got to do something, right? So that’s what she got so involved with making changes and reform.
Henry Street Settlement provided home visits, health education, and medical care to those in need.
Through her work at the Henry Street Settlement, Lillian Wald became a pioneering figure in public health nursing and social work. She advocated for social justice and healthcare reform, leaving a lasting impact on the field of public health and inspiring others to address the social determinants of health in underserved communities.
Diagnostic Related Groups (DRGs)
Are a classification system used by hospitals to group patients with similar diagnoses and medical needs together for the purpose of billing and reimbursement. Each DRG has a predetermined payment rate based on the average costs associated with treating patients in that group.
For example, if a patient is diagnosed with an inflamed appendix and the expected length of stay in the hospital is three hours, the hospital is reimbursed based on that predetermined time frame regardless of the actual length of stay. This means that the hospital receives the same payment whether the patient stays for three hours or longer.
If a patient can be discharged earlier than expected due to their good health and quick recovery, the hospital still receives the same payment for the anticipated duration of care. This can create incentives for hospitals to provide more efficient and effective care in order to optimize their financial outcomes within the constraints of the DRG payment system.
National Association of School Nurses (NASN)
Provides the general guidelines and support for all schoool nurses
- standards of professional practice
-Professional performance standards
So there are standards for home care nurses, standards for school nurses. No matter where you work, you’re still following the nurse practice act, okay?
So don’t let someone tell you, oh, it’s okay. You can do that. If a nurse can’t do that, a nurse can’t do that, okay? So keep those things in mind.
Standards of Practice for School Nurses
The American Academy of Pediatrics (AAP) guidelines state that school nurses should ensure the following:
- tht children get the health care they need, including emergency care in the school
- that the nurse keeps track of the state-required vaccines
- that the nurse carries out the required screening of the children based on state law
- that children with health probs. Are able to Learn in the classrooms
What are the eleven criteria for school nurses?
- Develop school health policies and procedures
- Evaluate their own nursing practice
- Keep up with nursing knowledge
- Interact w/ the interdisciplinary healthcare team
- Ensure confidentiality
- Consult with other to give complete care
- Use research findings in practice
- Ensure the safety of children, including when delegating care to other school personnel
- Have good communication skills
- Manage a school health program efficiently
- Teach others about wellness
Things don’t need to be told. Guess what, if a child has HIV, the whole school does not need to know.….If the child is in fifth grade, do I need to tell the teacher? No, it’s none of his or her business. If we’re talking kindergartners and the kid is a biter, or the other kids are biting, that might be a conversation…..But other than that, all children, any bleed, anything universal precautions. Nobody’s touching blood. So those are things to kind of, so confidentiality’s a big deal.
What are the educational Credentials of School Nurses
The National Association of School Nurses (NASN) reccomend that school nurses have a bachelor’s degree in nursing and a special certification in school nursing
However, there is NO general law regarding the educational background of school nurse; some stated hire LPNs
What are the roles and functions of School Nurse?
Give care to children as:
- direct caregivers
-dispense meds
- educators
- counselors
Coordinate the health of many students in their schools with the health care that children receive from their own health care providers
School Nurses and Healthy People 2020
They wanna make sure children stay healthy and make sure they get their vaccinations , safety gear, nutritious foods, and decreasing the number of days absent (due to illness like asthma etc. )
1 nurse out every ____children is recommended
1 out of every 750 children
One nurse is really not enough.. who is that nurse responsible for in the school?—- EVREYONE IN THE BUILDING, t is not just the student,— also the faculty, and visitors (if a visitor gets a MI, you are responsible)
Primary Prevention in the School
Prevent childhood injuries
Substance abuse prevention education
Disease prevention education
Required vaccinations for schoolchildren
Secondary Prevention in the school
Emergency plan and emergency equipment
Giving medication in school
Assessing and screening
Indentification of child abuse or neglect
Communicating with/ health care providers
Efforts to prevent suicide
*Violence at school
Tertiary Prevention in the Schools
Children with asthma
Children with diabetes
Children who are autistic
Children with DNR orders
Homebound children
Pregnant teenagers and teen mothers
Scope of Occupational Health Nursing
Occupational Health Nursing is a speciality practice that focuses on the promotion, prevention, and restoration of health within the context of a safe and healthy work environment ; involves prevention of adverse health effects from occupational and environmental hazards
These nurses usually work in traditional manufacturing, industry, service, health care facilities, construction sites, and government settings
Occupational Safety and Health Act (1970)
OSHA
Safe work place
A federal agency improves worker health and safety by establishing standards and regulations and by educating workers.
Sets exposure standards and is responsible for enforcement of safety and health legislation.
Academic education is generally at the graduate level as a ____
Occupational Health Nurse
however, many nurses with an associate degree in
nursing or BSN work in occupational health
Role as a occupational nurse
Okay, so we do promotion help promotion at workplaces, which is important you should have a whole team that works there Injuries that can happen at work. We need to teach them about their workplace hazards and doing a natural walkthrough What are you seeing that somebody else isn’t seeing? I like a better idea of challenges about
Go down to the warehouse and injure your back. What are they doing? What’s happening now? So you want to decrease the risk of occupation from those who want to promote levels of prevention We want to prevent injuries It’s preventing actual injury the nursery for their type of work they’re doing
Optimally a team approach is used; core team members
include occupational health nurse, occupational physician, industrial hygienist, safety professional
• Services provided range from those focused only on work-
related health and safety problems to a wide scope of services that includes primary care
Worker Assesment
Occupational Nurses does worker assesment which do a traditional hxs and physical assessment, emphasizing exposure to occupational hazards
Workplace Assessment
Occupational nurses do worksite walk-through
Healthy People 2030 Occupational nursing
Identifies the national health objectives aimed at reducing the risk of occupational illnesses and promoting safety. Health education and health protection strategies are proposed to address the needs of large population groups such as the American workforce
Primary prevention Occupational Nurse
Promote health
Identify hazards
Immunizations
Secondary prevention occupational nurse
Screenings
Referral to counseling
Tertiary prevention occupational nurse
Restore health and assit to maximum level of functioning
