Exam 3 Flashcards
Refers to meeting the basic health needs of a community by providing readily accessible health services.
Primary health care
Defined as one “designed and built to improve the quality of life for all people who live, work, worship, learn, and play within their borders—where every person is free to make choices amid a variety of healthy, available, accessible, and affordable options”
Healthy place
Implies providing accessible services to promote the health of populations most at risk for health problems (e.g., the poor, the young, older adults, minorities, the homeless, and immigrants and refugees).
Equity
Focus on providing community members with a positive sense of health that strengthens their physical, mental, and emotional capacities.
Health promotion and disease prevention
Well-informed and motivated community members participate in planning, implementing, and evaluating health programs.
Community participation
The coordinated action by all parts of a community, from local government officials to grassroots community members
Multisectoral cooperation
Affordable social, biomedical, and health services that are relevant and acceptable to individuals’ health, needs, and concerns.
Appropriate technology
The key models for community practice include the following:
Locality development is a process-oriented model that emphasizes consensus, cooperation, and building group identity and a sense of community.
Social planning stresses rational-empirical problem solving, usually by outside professional experts. Social planning does not focus on building community capacity or fostering fundamental social change.
Social action aims to increase the problem-solving ability of the community with concrete actions that attempt to correct the imbalance of power and privilege of an oppressed or disadvantaged group in the community.
Community includes three factors:
people, place, and function
Other Principles Useful in Developing a Healthy Community…
-The whole is greater than the sum of the parts. Change in one part affects the other parts.
-Collaboration is central to development of a healthy community.
-All systems have feedback loops. Information from one area is fed back to the whole. This feedback provides an opportunity for change or “course correction.”
Greatest good for greatest number
Utilitarianism
Distributing resources & burdens equitably among members of a society and ensuring vulnerable groups are included in equitable distribution of resources.
Communitarianism
Community health is reflected in
Health behaviors of and subsequent outcomes for its residents. Ability of community as a system to support healthy individuals.
Individuals have dynamic interactions with social and environmental features of communities
the socio-ecological model
The Nurse’s Role in the Community
-Establish credibility and trust
-Gatekeepers- community leaders who create opportunities for nurses to meet diverse community members
-Stakeholders- anyone with personal or occupational interest in a community’s outcomes
-Community health workers- community members from diverse backgrounds who receive training to perform health outreach work
Community assessment is to take a detailed stock of a community
-Focuses from the inside and from the outside
-Sometimes called community needs assessment
-Requires clinical judgment
-Requires critical appraisal of multiple types of data
Why complete a Community Assessment?
To learn more about the following: Community assets (aka, strengths), Community needs (aka, areas for improvement), Locating confirmation data to address a recognized community problem
Public health nurses (PHNs) are ideal assessment leaders
Primary sources of data
Participant observation—windshield survey; key informants; focus group; photovoice; spatial data—geographic information systems
An assessment of community features relevant to public health through visual observation to identify the health of a community
windshield survey
The Seven A’s
awareness, access, availability, affordability, acceptability, appropriateness, adequacy
Planning, Implementation, or Evaluation?
Analyzing and establishing priorities among health problems identified through nursing diagnosis. Establishing goals and objectives. Identifying activities to accomplish objectives.
Planning
Planning, Implementation, or Evaluation?
Enacting the plan for improved community health using identified goals and objectives.
Implementation
Planning, Implementation, or Evaluation?
Measuring the success of the program and determining community satisfaction with outcomes.
Evaluation
Actions taken on behalf of communities, systems, individuals, and families to improve or protect health status.
Interventions
A PHN may use any or all of the interventions.
Changes community norms, community attitudes, community awareness, community practices, and community behaviors. It is directed toward entire populations within the community or occasionally toward populations at risk or populations of interest. An example of community-level practice is a social marketing campaign to promote a community norm that serving alcohol to under-aged youth at high school graduation parties is unacceptable. This is a community-level primary prevention strategy.
Community level practice
The goal of community-level practice is to increase the knowledge and attitude of the entire community about the importance of immunization and the consequences of not being immunized. These strategies will lead to an increase in the percentage of people who obtain recommended immunizations for themselves and their children.
Changes organizations, policies, laws, and power structures within communities. The focus is on the systems that impact health, not directly on individuals and communities. Conducting compliance checks to ensure that bars and liquor stores do not serve minors or sell to individuals who supply alcohol to minors is an example of a systems-level secondary prevention strategy practice
Systems level practice
The goal of systems-level practice is to change the laws, policies, and practices that influence immunization rates, such as promoting population-based immunization registries and improving clinic and provider practices.
Changes knowledge, attitudes, beliefs, practices, and behaviors of individuals. This practice level is directed at individuals, alone or as part of a family, class, or group. Even though families, classes, and groups are comprised of more than one individual, the focus is still on individual change. Teaching effective refusal skills to groups of adolescents is an example of individual secondary prevention strategy level of practice.
Individual level practice
The goal of individual/family-level strategies is to identify individuals who are not appropriately immunized, identify the barriers to immunization, and ensure that the individual’s immunizations are brought up to date.
True or False?
No one level of practice is more important than another; in fact, many public health priorities are addressed simultaneously at all three levels.
True
· Define the three Levels of Prevention
o Primary (well populations)
o Secondary (early stages)
o Tertiary (seeks to prevent worsening of crisis)
True or False?
The nursing process is used at all levels of practice: Assessment, Diagnosis’, Planning, Implementation, evaluation.
True
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.
Surveillance
Systematically gathers and analyzes data regarding threats to the health of populations, ascertains the source of the threat, identifies cases and others at risk, and determines control measures.
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.
Outreach
Identifies individuals with unrecognized health risk factors or asymptomatic disease conditions in populations.
Screening
Locates individuals and families with identified risk factors and connects them with resources.
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.
Referral & follow up
Optimizes self-care capabilities of individuals and families and the capacity of systems and communities to coordinate and provide services.
Case management
Are 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.
Delegated functions
Communicates facts, ideas, and skills that change knowledge, attitudes, values, beliefs, behaviors, and practices of individuals, families, systems, and/or communities
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. Engages the community, system, family, or individual at an emotional level.
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.
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.
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.
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.
Community organizing
Pleads someone’s cause or acts 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.
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.
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.
Policy development
Compels others to comply with the laws, rules, regulations, ordinances, and policies created in conjunction with policy development.
Policy enforcement
Identify the steps and principles that guide community health education.
o Conduct a thorough needs assessment:
§ Prioritize the needs. Consider the learner’s knowledge, skill, motivation, and available resources.
o Develop goals and objectives
§ Goals: broad, long-term expected outcomes.
§ Objectives: Specific, short term criteria to be met.
Learning strategies for children and individuals with little knowledge about a health-related topic
Pedagogy
Learning strategies for adults, older adults, and individuals with some health-related knowledge about a topic
Andragogy
Essential in presenting written, audio, or visual information.
Cultural competence
Barriers to learning
Low health literacy and lack of motivation to learn
Adults are motivated to learn when:
§ They think they need to know something.
§ The new information is compatible with their prior life experiences.
§ They value the person(s) providing the information.
§ They believe they can make any necessary changes that are implied by the new information.
Have a defined membership and a specific purpose. They may or may not have an official place in the community’s organization.
formal groups
The ties between members are multiple, and the purposes are unwritten yet understood by members. These groups often form spontaneously when participants have a common interest or need.
informal groups
