Exam 1 Flashcards
protection, promotion, optimization of health and abilities, prevention of illness and injury, alleviation of suffering thru dx and treatment of human response, AND advocacy in care for individuals, families, communities, populations
nursing
art and science of prolonging life, promoting health and preventing disease thru organized community efforts
public health nursing
healthy people in healthy communities
vision of public health
what level of nursing as a staff nurse in public health focusing on individual/family, within community or institution
BSN
what level of nursing to be a public health nursing specialist with a primary focus on the population, to clients within the community
MSN
school nursing, hospice, home health, occupational health, disaster preparedness, forensics, faith community, rural health
certifications/specialities
- expertise in nursing and public health
- assesses health status of populations using data
- analyzes collected data (needs, strengths)
- partners with people to determine need
- participated with community to iD expected outcomes
ANA definition of public health nursing
philosophy of nursing service delivery (care thru community diagnosis, health surveillance, eval population health status)
community-oriented nursing practice
setting specific practice where care is provided to sick (LTC, outpatient clinic)
community based nursing practice
- nursing + public health theory
- focus of practice is health of community as whole and how it impacts individuals
public health nursing practice
- collect vital stats (birth, death, marriage)
- control sanitary conditions
- control communicable diseases
- provide lab services (STD, lead)
- protect maternal and fetal health (vulnerable pop)
- educate public (nutrition, mental health)
mandated PH services
- assessment (data collection and monitoring)
- policy development and implement
- assurance (making sure essential health services are available)
core functions PH
district nursing
-1859, Liverpool, England
- WM Rathbone, Florence Nightingale
- to instruct families in care of ill members @ home
district nursing in US
- 1877- NY City Mission began
- 1887- spread to Boston + Phil w focus on poor
- 1893- Lillian Wald began dn in NYC (Henry St. Settlement), Red Cross, 1st to use term PHN
frontier nursing
- horseback, going to rural and remote Apps to provide nursing
PHN 1920s
- Mary Breckenridge started frontier nursing service region of KY–> dec infant and maternal mortality
- introduced first nurse midwife
- FNS still active today
PHN 1930S and 40s
- health and welfare of public
- school nurses going to students’ houses to see them; able to get more resources for family
- also infants, TB, STD
PHN 1970S- present
- service to total community
- focus on primary prevention
Primary Care Medical Home Attributes
- access to care
- accountability (for quality of care),
- comprehensive (all info, care, and services needed)
- continuity (improving health over time)
- coordination + integration (helping pts navigate system to meet their needs)
- pt + fam centered
Roles of nurses
advocate, evaluator, planner, provider, consultant, educator, counselor, manager, coordinator
Public Health Advocate Steps
- do hw, look for where is need
- connect w partners- collective power
- make message compelling
- make most of opportunities to influence
- be confident, fearless, relentless
WHO definition of health
state of complete physical, mental, and social well being, and not only absence of disease or infirmity
characteristics of community’s health
- status (outcomes, physical/emotional/social determinants [suicide, crime, morbidity, mortality])
- structure (services + resources [what makes up community such as access to care])
- process (how community functions such as politics)
Community Health Needs Assessment
- part of ACA requiring non-profit hospitals to conduct every 3 years
- ID where there is a need
Community Health Improvement Plan
- counties and other government agencies develop this post needs assessment
- IL: IPLAN
MAPP
Mobilizing for Action thru Planning + Partnerships
GDP
- gross domestic product
- indicator of how country is doing (economic health)
quality indicators
- if we are giving quality care
- insurance companies look at
- ex: readmission rates, pressure injury rates
factors affecting resource allocation
- uninsured (don’t seek primary prevention, seek care when very sick…cost of their care higher, inc risk hospitalization of mortality)
- access to services (proximity, transport, access to insurance, language)
- rationing (services, nurses, providers sometimes withhold services)
two factors that have greatest effect on longevity
behavior, lifestyle
two factors that have the greatest effect on development of illness
environment, genetics
1st developmental stage PH
- 1800-1900
- Infectious epidemics/medical care unregulated
- care of fam in home
2nd developmental stage PH
- 1900-1945
- trauma/shift to science based training
3rd developmental stage PH
- 1945-1984
- inc in c diseases, inc in medical specialties
4th developmental stage PH
- 1984- present
- inc infectious/managed care
factors influencing health care costs
- inflation, demographic changes, tech, c illness, treat illness vs. prevention, “defensive med”
defensive medicine
over-ordering services
barriers healthcare
money, time, already caring for someone else who is sick, education
medicare
65+
medicaid
pregnant, blind, lower income, taking care of someone with a disability, disability
health departments county funds come from
property taxes
federal funding comes from
grants, special programs
block grants
fed. gov. gives $ to local government w general provision to how it can be spent
private support financing healthcare types
- insurance (HMO have to get referral from primary), employers, individuals, managed care
primary level intervention
- intervene before illness
- risk factors (diet, activity, smoke, alc), education, vax, car seats
secondary level intervention
- screening, slow progression of disease
- BP, blood sugars, BMI, vision screening
tertiary level intervention
- treating disease, stopping relapse + further deterioration
- rehab, medical interventions
cost containment
keeping price same or lower
portability
- transferring of health coverage
- ex: when changing/lost job
US Dept of Health and Human Services (preventive, health protection, health promotion)
- preventive: HTN, STD, immunizations
- protection: toxins, OSHA, fluoride, EPA
- promotion: smoking cessation, stress, substance abuse, screenings, maternal and fetal care
State Health Agencies
- establish health codes, regulation of insurance industry
Local level governments
- funded by tax dollars
- responsibility of county/city gov
federally qualified health centers
-safety net providers
- community health centers, public housing, homeless health care, migrant health centers
Human Genome Project
- 1988-2003, under direction of Dr. Francis Collins
- mapped all 25,000 genes in human DNA
Precision healthcare
- purpose: improve safety, quality, effectiveness of healthcare for all US citizens
- linking clinical and genetic info for individualized healthcare
polygenic risk score and disease
- can be used to determine if individual is at inc risk fir developing certain disease
single gene vs complex disease
- single gene- can be traced to one gene (CF)
- complex- many genes effected, environment also plays role (CAD)
Genetic Information Nondiscrimination Act of 2008
prohibits discrimination based on genetic makeup (by employers, insurance))
Biostatistics
- predictor of healthcare delivery
- censuses, demographics, vital stats, rates (freq), ratio (comparisons), risks
