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N363: Practice of Nursing IV > Exam 1: Population and Public Health Nursing > Flashcards

Exam 1: Population and Public Health Nursing Flashcards

1
Q

Currently, on average, how do per person healthcare expenditures in the US compare to other countries and what is the average?

A

We have the highest cost per capita at around 8000$ on average

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2
Q

National Health Expenditures per Capita is projected to do what by 2023?

A

Double in cost per person to use healthcare

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3
Q

Why is the per capita cost of healthcare contradictory for the US?

A

Despite high healthcare expenditure costs, we have lower quality of care than other countries and have the highest infant mortality rate (1 out of 1000)

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4
Q

How does patient care differ from population health?

A

Patient care focuses on treatments for specific diseases and conditions, downstream symptoms of issues, medical and biological determinants of sickness, patients and healthcare providers, purchasers, and payers

Population health focuses on wellness, prevention, and health promotion; upstream causes of health problems; social determinants of health and community conditions; all people; partnerships between health and sectors such as education transportation and housing

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5
Q

What is the idea of upstream and downstream when it comes to healthcare

A

The idea is that we are so focused on downstream problems when the problems are coming from upstream (the community rather than individual issues) and we should be focused there

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6
Q

Population Health

A

The health outcomes of populations - so a distribution of health outcomes across a DEFINED GROUP

*These groups are often based on geographic populations like nations, states, neighborhoods, but can also be other groups like employees, ethnic groups, disabled persons, prisoners, or any other defined group.

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7
Q

Improving population health requires that healthcare providers and organizations…

A

look beyond their own systems and partner with other organizations, entities, and professionals

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8
Q

The important thing to understand about population health is…

A

there are populations with their own health (ex: faculty v student populations) and they are often a defined group either geographically or by some other definition.

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9
Q

What are the 3 levels of healthcare practice

A

Community Level

Population (Aggregate) Level

Individual or Family Level

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10
Q

Community Level

A

Broad

Contains and is composed of different populations

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11
Q

Population (Aggregate) Level

A

A group sharing a defined set of characteristics or shared characteristics

ex: Men 65+, Women 16-24, Infants

Populations are composed of individuals and families, but the population then composes and exist within a community

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12
Q

What level of healthcare practice would Broome county fall into?

A

Community

It is made up of populations within the county each having their own individuals and families

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13
Q

What determines health (Percentages %)?

A

Genetics - 20%

Health Care - 20%

Social, Environmental, Behavioral Factors - 60%

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14
Q

Social Determinants of Health

A

The economic and social conditions that influence the health of individuals, communities, and jurisdictions as a whole

They are system level factors so they can be hard to address

ex: your choice to go to the gym is influenced by these things outside your control

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15
Q

What are the main social determinants of health

A

Safe Affordable Housing

Quality Education

Job Security

Social Connection and Safety

Living Wage

Access to Transportation

Availability of Food

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16
Q

Health is ___ than health care

A

more

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17
Q

Health is tied to the …

A

distribution of resources

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18
Q

The choices we make are…

A

shaped by the choices we have

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19
Q

High Demand + Low Control = ___ ___

A

Chronic Stress

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20
Q

Chronis Stress can be ___

A

deadly (Cortisol response)

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21
Q

What can cause telomeres to shorten

A

chronic stress - this causes actual physiologic changes in the body

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22
Q

HPA Axis

A

Hypothalamic Pituitary Adrenal Axis system

Controls release of cortisol, the stress hormone that can hurt us when chronic or in large amounts

Hypothalamus (releasing factor) –> Anterior pituitary (ACTH through blood) –> Adrenal Cortex —> Cortisol

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23
Q

What are the factors that determine the magnitude of the HPA Axis response

A
  1. Novelty to the individual
  2. Unpredictable nature
  3. PERCEIVED threat to person
  4. Sense of loss of CONTROL
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24
Q

Where you work, live, and play …

A

impacts your health!

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25
Health Equity
when all people have the opportunity to "attain their full health potential" and no one is disadvantaged from achieving this potential because of their social position or other socially determined circumstance
26
Achieving health equity requires what?
Social justice
27
Social Justice
the fair and compassionate distribution of the fruits of economic growth
28
Health Disparity
a particular type of HEALTH DIFFERENCE that is closely linked with social or economic disadvantage
29
To improve health equity, we must address what?
the root causes of disparities - this means GOING BEYOND ASKING WHO is at greater risk for disease to ASKING WHY some populations are at greater risk
30
How does equality, equity, and justice differ?
Equality assumes everyone benefits from the same supports - this is equal treatment (ex: everyone gets a box to stand on regardless of height) Equity means everyone gets the supports they need via "affirmative action" - everyone gets amounts of boxes based on height in order to see over a fence Justice is when causes of inequality (systematic barriers) are removed (ex: there is now a see through fence)
31
The medical lens of health can always be traced back to ...
the social determinants lens
32
According to the APHA, Public health nursing is...
the practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences
33
The foundation of public health nursing is based on...
public health and nursing science supporting one another
34
How is public health nursing a population based practice
focuses on entire populations grounded in the ASSESSMENT of the populations health status considers the broad determinants of health focuses on all levels of prevention, with an emphasis on primary prevention intervenes at multiple levels - community, systems impacting community health, individuals and families that comprise communities collaborates with a variety of other professions and stakeholder groups
35
The Client Unit of Care in PHN is ?
the population
36
What are the principles of public health nursing
1. Unit of care is the Population (not just the individuals) 2. Achieve the greatest good for the greatest number 3. Health promotion and protection !!! are priorities 4. Select strategies that create health environmental, social, and economic conditions 5. Actively reach out to all who might benefit 6. Use available resources 7. Collaborate with other professions and organizations
37
What are the essential components of nursing practice?
1. Health Promotion (Individual to population level; attaining optimal health) 2. Risk Reduction (Reduces person's risk for disease) 3. Health Protection (Person's ability to protect against disease)
38
What are the Quad Council Competency Domains for Public Health Nurses (Skills they need)
1. Analysis and Assessment 2. Policy Development/Program Planning 3. Communication 4. Cultural competency 5. Community Dimensions of Practice 6. Public Health Science 7. Financial Management and Planning 8. Leadership and systems thinking
39
What are some bodies of legal guidelines and ethics which guide PHN practice
State nurse practice acts Education, License, Certification Standards of Practice Code of Ethics Public Health Laws (Mandatory Reporting) Civil Laws (Surveillance, Investigations, Confidentiality) Criminal Laws (Prisons)
40
According to the Minnesota PHN Intervention Wheel there are ___ levels of practice and ___ public health interventions
3 levels of practice (individual/family, community, systems) 17 public health interventions
41
What are the 4 interventions of screening and disease investigation
Surveillance Disease and Health Event investigation Outreach Screening
42
What are the 3 interventions of Case Management
Referral and follow up Case management Delegated functions
43
What are the 3 interventions of health teaching
Consultation Counseling Health Teaching
44
What are the 3 interventions of Community Collaboration
Community Organizing Coalition Building Collaboration
45
What are the 3 interventions of policy development
Policy Development and Enforcement Social Marketing Advocacy
46
Settings PH Nurses can be found in
Local and state health dept Homes Schools Prisons Factories/Large employment firms Parishes, Churches, Synagogues, Mosques Child care Facilities Non profit relief organization (i.e. red cross) nail salons, barber shops
47
Public Health Nurses are ____ and/or ___
Generalists (covers all areas of public health) and/or Specialists (ex: Communicable disease, Environmental health, etc)
48
What is public health
public health is the set of activities a society undertakes to monitor and improve the health of its collective members
49
What are the 3 core functions of public health
1. Assessment. 2. policy Development 3. Assurance
50
Assessment
Systematic data collection on the population, monitoring the population’s health status, and making information available about the health of the community
51
Policy Development
Efforts to develop policies that support the health of the population, including using a scientific knowledge base to make policy decisions.
52
Assurance
Making sure the essential community oriented health services are available. Making sure that a competent public health workforce is available.
53
What are some aspects of Assessment
Monitor Health Diagnose and Investigate
54
What are some aspects of policy development
Inform, Educate, Empower Mobilize Community Partnerships Develop Policies
55
What are some aspects of Assurance
Evaluate Assure competent workforce Link to and provide care enforce laws
56
What does it mean that "Public health is not found in silos"
It involves so many other aspects and other stakeholders like nursing, social scientists, tech people, etc It is not just one idea, in order to solve PH issues we need to come together with multiple disciplines to solve problems
57
Public Health Does not require ___ ___
rote memorization
58
Where does the complexity of public health come in?
The technical pieces like biology of disease, economics of development and measurement of disease burden are important but not overly complex The complexity comes in asking new questions or old questions in new ways - thinking about the world and our relationship to health in ways that we are not used to
59
Public health might seem like a straightforward discipline but the challenge comes in...
application / getting people to buy into it
60
What are some examples of things the many layers of local and state public health departments do?
Protect the health of citizens Surveillance Outbreak Investigation Quarantine Mandated reporting of specific diseases Report cause of death to state health departments and the CDC and prevention Natural and Manmade disaster preparedness Oversee public sanitation Safety of the water supply Laboratory testing of water samples Inspection of sewer systems Health related mandates Food safety Provide direct health care like vaccines, well baby checks, and prenatal care
61
Public health agencies are most successful and least noticed when...
their prevention measures work the best
62
Florence Nightengale
Devoted life to prevention of needless illness and death through PREVENTION OF INFECTIONS and FOCUS ON ENVIRONMENTAL HEALTH Reformer of hospital care
63
Who is considered the founder of professional nursing via opening the first nursing school in 1860
Florence Nightingale
64
Who is considered the pioneer in the use of statistics and policy in nursing?
Florence N
65
Florence Nightingale used statistics to show hospital conditions in the Crimean war were deplorable which lead to what?
Public attention --> more funding for Army hospitals Improved cleanliness, hygiene, and nutrition Death rate of soldier decreases
66
Lillian Wald
1885- Founded Henry Street Settlement Believed nurses should not only care for the sick in their homes but teach prevention, and address SOCIAL CONDITIONS
67
Who coined the term Public health Nursing
Lillian Wald
68
Who introduced "school nursing" to the US
Lillian Wald
69
Who convinced the red cross to work with rural communities
Lillian Wald
70
Lemuel Shattuck
Wrote the Massachusetts Lemuel Shattuck Report which established permanent boards of health in MA These reports began collecting and recording vital statistics and promoted sanitary measures to prevent disease This then spread to other localities (the movement)
71
What laid the foundations for the Board of Health
Lemuel Shattuck Report
72
Mary Breckenridge
Established the Frontier Nursing Service in 1925 to provide nursing for underserved populations in remote mountains of Kentucky Still exists and educates midwives to this day
73
HP2030 allows you to look at what regarding public health?
How one community may differ from national data comparisons

N363: Practice of Nursing IV (16 decks)

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