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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

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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
Q

Health Equity

A

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

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26
Q

Achieving health equity requires what?

A

Social justice

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27
Q

Social Justice

A

the fair and compassionate distribution of the fruits of economic growth

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28
Q

Health Disparity

A

a particular type of HEALTH DIFFERENCE that is closely linked with social or economic disadvantage

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29
Q

To improve health equity, we must address what?

A

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

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30
Q

How does equality, equity, and justice differ?

A

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
Q

The medical lens of health can always be traced back to …

A

the social determinants lens

32
Q

According to the APHA, Public health nursing is…

A

the practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences

33
Q

The foundation of public health nursing is based on…

A

public health and nursing science supporting one another

34
Q

How is public health nursing a population based practice

A

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
Q

The Client Unit of Care in PHN is ?

A

the population

36
Q

What are the principles of public health nursing

A
  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
Q

What are the essential components of nursing practice?

A
  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
Q

What are the Quad Council Competency Domains for Public Health Nurses (Skills they need)

A
  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
Q

What are some bodies of legal guidelines and ethics which guide PHN practice

A

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
Q

According to the Minnesota PHN Intervention Wheel there are ___ levels of practice and ___ public health interventions

A

3 levels of practice (individual/family, community, systems)

17 public health interventions

41
Q

What are the 4 interventions of screening and disease investigation

A

Surveillance

Disease and Health Event investigation

Outreach

Screening

42
Q

What are the 3 interventions of Case Management

A

Referral and follow up

Case management

Delegated functions

43
Q

What are the 3 interventions of health teaching

A

Consultation

Counseling

Health Teaching

44
Q

What are the 3 interventions of Community Collaboration

A

Community Organizing

Coalition Building

Collaboration

45
Q

What are the 3 interventions of policy development

A

Policy Development and Enforcement

Social Marketing

Advocacy

46
Q

Settings PH Nurses can be found in

A

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
Q

Public Health Nurses are ____ and/or ___

A

Generalists (covers all areas of public health) and/or Specialists (ex: Communicable disease, Environmental health, etc)

48
Q

What is public health

A

public health is the set of activities a society undertakes to monitor and improve the health of its collective members

49
Q

What are the 3 core functions of public health

A
  1. Assessment.
  2. policy Development
  3. Assurance
50
Q

Assessment

A

Systematic data collection on the population, monitoring the population’s health status, and making information available about the health of the community

51
Q

Policy Development

A

Efforts to develop policies that support the health of the population, including using a scientific knowledge base to make policy decisions.

52
Q

Assurance

A

Making sure the essential community oriented health services are available.

Making sure that a competent public health
workforce is available.

53
Q

What are some aspects of Assessment

A

Monitor Health

Diagnose and Investigate

54
Q

What are some aspects of policy development

A

Inform, Educate, Empower

Mobilize Community Partnerships

Develop Policies

55
Q

What are some aspects of Assurance

A

Evaluate

Assure competent workforce

Link to and provide care

enforce laws

56
Q

What does it mean that “Public health is not found in silos”

A

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
Q

Public Health Does not require ___ ___

A

rote memorization

58
Q

Where does the complexity of public health come in?

A

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
Q

Public health might seem like a straightforward discipline but the challenge comes in…

A

application / getting people to buy into it

60
Q

What are some examples of things the many layers of local and state public health departments do?

A

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
Q

Public health agencies are most successful and least noticed when…

A

their prevention measures work the best

62
Q

Florence Nightengale

A

Devoted life to prevention of needless illness and death through PREVENTION OF INFECTIONS and FOCUS ON ENVIRONMENTAL HEALTH

Reformer of hospital care

63
Q

Who is considered the founder of professional nursing via opening the first nursing school in 1860

A

Florence Nightingale

64
Q

Who is considered the pioneer in the use of statistics and policy in nursing?

A

Florence N

65
Q

Florence Nightingale used statistics to show hospital conditions in the Crimean war were deplorable which lead to what?

A

Public attention –> more funding for Army hospitals

Improved cleanliness, hygiene, and nutrition

Death rate of soldier decreases

66
Q

Lillian Wald

A

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
Q

Who coined the term Public health Nursing

A

Lillian Wald

68
Q

Who introduced “school nursing” to the US

A

Lillian Wald

69
Q

Who convinced the red cross to work with rural communities

A

Lillian Wald

70
Q

Lemuel Shattuck

A

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
Q

What laid the foundations for the Board of Health

A

Lemuel Shattuck Report

72
Q

Mary Breckenridge

A

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
Q

HP2030 allows you to look at what regarding public health?

A

How one community may differ from national data comparisons

N363: Practice of Nursing IV (16 decks)

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