Final Flashcards
what do healthy communities have
- clean safe environment
- conservation of nature and resources
- access to affordable food, water, housing, recreation, transportation
- education
- good economy, jobs
- sense of community
- culture, religious beliefs
- health public policy
community definition
a group of people with diverse characteristics who are linked by social ties, share common perspectives, and engage in joint action in geographical locations or settings
different nursing positions in the community
- NPs
- nurse leaders/ knowledge coordinators
- communicable disease specialists
- public health nurses
- nursing support services
- home care nurses
- harm reduction coordinators
- outreach (street) nurses
maslow’s hierarchy of needs
is informed by the Blackfoot nation
from bottom to top:
1. physiological needs
2. safety needs
3. belongingness and love needs
4. esteem needs
5. need to know and understand
6. aesthetic needs
7. self actualization
8. transcendence
individual
one person
family
two or more
shares emotional, physical, financial support
group or aggregate
groups within a population
ex. youth with diabetes
population
a large group of people who have at least 1 characteristic in common and reside in a community
society
the systems that incorporate the social, political, economic, and cultural infrastructure to address issues of concern
characteristic of community health nursing
- CHNs promote, protect, and preserve the health of individuals, families, groups, communities, populations
- are where people live, work, learn, play
- in a continuous process
- view health as a resource and focuses on capacity
- work at a high level of autonomy
- combine specialized nursing, social and public health sciences with experiential knowledge
structural determinants of health
the socioeconomic and political context that a person is born into and lives in
- governance -> how the government is run
- economic, social, and public policies
- social and cultural values that communities place on health
can lead to unequal distribution of material and monetary resources -> impacts someones socioeconomic position
socioeconomic position factors
- education
- occupation
- income
- gender
- race, ethnicity
- social class
impacts intermediary determinants
intermediary determinants
- housing
- income to by food
- psychosocial factors -> support systems
- biological factors -> genetic predispositions
has an impact on the types of health systems that are in the community
both of these impact the overall health of the community
action areas of the Ottawa charter
- building health public policy
- creating supportive environments
- strengthening community action
- developing personal skills
- reorienting health services
biomedical approach to health
focus only on the absence of disease or disability
goal to decrease morbidity and mortality rates
focuses solely on the individuals disease-> target population is primarily high risk individuals with physiological risk factors
behavioural approach to health
focus of the physical/function ability and physical/emotional well being
focuses on the individual as a whole person, not just the disease
addresses behavioural risk factors, provides education and social marketing
goal is to decreases behavioural risk factors, improve lifestyles, create healthy public policies
socio-environmental approach to health
goes beyond physical/emotional well being to include social well being at individual and community levels
health is viewed as a resource for daily living rather than a state of being
addresses psychosocial risk factors and socio-environmental risk conditions
Ottowa charter strategies, emprnowerment strategies, community development
goals include improved personal perception of health, social networks, community group action to create equitable distribution of power/resources
creation of healthy public policies related to social equity and environmental sustainability
social inequities
- class
- race/ethnicity
- immigration status
- gender
- sexual orientation
institutional inequities
corporations and businesses
government agencies
schools
laws and regulations
non-for-profit organizations
upstream approach
improve community conditions
laws, policies, regulation the create community conditions supporting health for all people
all community/ policy focus, macro levels of employment, education, universal health care
midstream approach
addressing individuals social needs
includes patient screening question about social factors -> use data to inform and provide referrals
social workers, community health workers, and community organizations provide direct support to meet patients social needs
community and organizational level
downstream approach
providing clinical care
medical interventions
individual focus, treatment, care, surgery, meds, rehab
what makes Canadians sick
50% your life -> SDOH
25% your health care -> access
15% your biology -> genetics
10% your environment -> air quality, infrastructure
SDOH has a huge impact on a persons health
intersectionality
refers to how sources of discrimination overlap and reinforce each other
also refers to how we have many identities what intersect and make us who we are
health equity
removes obstacles to good health so everyone had a fair chance
health inequities
are systemic, avoidable, and unfair
equality for equity
equality is like giving everyone the same size bike
equity is giving everyone their own bike that suits their needs
structural violence
social exclusion, oppression and lack of agency lead to invisible marginalization and exploitation
social justice
a fair and equitable division of resources, opportunities, and privileges in society
Ottawa charter
regards health promotion as the over arching concept
the process of enabling people to increase control over and improve their health
health promotion
broader than disease prevention
emphasis on:
- participation
- empowerment
- equity
- build healthy public policy
- create supportive environments
- strengthen community action
- develop personal skills
-reorient health services
is multi-sectoral -> incorporates community development and policy work
is often political in nature -> addresses structural and systemic inequities
Community health nurse roles
- provides essential health services in the community
- considers the SDOH
- focuses on health promotion, disease prevention, and protection
- focus is on the client as an equal partner
- promotes coordination of care and inter-professional collaboration
CHNC
community health nurses of canada
the national voice of CHNs
CHN model of professional practice
the client is at the centre: could include individuals, group, families, communities, population, and systems
3 sections include:
- community organizations -> professional relationships, management, delivery structure
- system -> SDOH, government support
- community health nurses and nursing practice -> code of ethics, theory foundation, standards, values and principles
three areas of practice under the CHNC
public health nurses
home health nurses
primary/ family care nurses
hierarchy of standards for CHN
bottom to top (widest to most specific)
provincial standards -> most important, override every other standard
CHNC standards -> will always include CNA code of ethics
HH, PH, FH competencies
CHNC standards of practice
- health promotion (more focus on PHN)
- prevention and health protection
- health maintenance, restoration, and palliation (more focus on HHN)
- professional relationships
- capacity building (build the clients ability to help themselves without the support of a nurse)
- health equity
- evidence informed practice
- professional responsibility and accountability
standards 4,5,6,7,8, help to achieve 1,23
how long it takes to not be considered a novice in community nursing
a RN with two or more years experience in community nursing, anything less is considered a novice
public health nurses
focus on promoting, protecting, and preserving the health of populations
home health nurses
focus on prevention, maintenance, restoration, and palliation
focus on families, care givers, and individuals
primary care or family practice nurses
focus on preventative screening, health education, assessment, tx of minor illness or injury
healthy child development
is at the core of community development because children are essential to a healthy and sustainable community
schools and health
research has shown that school settings have a positive impact on most of the health behaviours and outcomes of the population
schools are where::
- children and youth learn, play, and love
- adults work and engage
- families and neighbourhoods gather
BC adolescent health survey
happens every 5 years -> next one is in 2028
gathers data on:
- background info on youth completing the survey
- behaviour and health profile: physical health, nutrition, injuries, mental health, sexual health, substance use
- risks to health development: poverty, loss, violence, discrimination
- support for healthy development: family, school, community, youth resiliency
- gives opportunity for youth to suggest topics and ask questions
BC adolescent health survey: Okanagan findings 2024
Okanagan youth are less likely to be sexually active and drink alcohol than in previous years
less likely to report positive mental health
increase in the % of youth who were injured and needed medical attention
males are more likely to report positive health and well-being
highlighted the importance of feeling connected to family, culture, school, and community
the human early learning partnership (HELP) at UBC
HELP is dedicated to improving the health and well-being of children through interdisciplinary research and mobilizing knowledge
HELP has multiples surveys to collect data -> includes the EDI and MDI
EDI (early development instrument)
the 5 scales:
- physical health and well being
- language and cognitive development
- communication skills and general knowledge
- emotional maturity
- social competence
kindergarten age school children
looks for areas of vulnerability and to use the data to adapt programs to suit it
who uses the data from HELP and EDI
- early childhood coalitions
- early child development works
- school representatives
- ministries of children and family development, education and health researchers
health concerns addresses in school settings
- unintentional injuries -> leading cause of death in children 1-19
- communicable diseases
- unhealthy weights
- mental health issues
- risky behaviours
CHN and PHN role in schools
there is a need for an expanded health-promotion role for the PHN in schools -> but its not always happening
Pan struggle to work within a broad scope of practice that is consistent with the socio-environmental and SDOH approaches
Comprehensive school health promotion (CSHP or CSH)
is an internationally recognized framework for supporting improvements in students educational outcomes while addressing school health in a planned, integrated, holistic way
healthier students are better learners, and better educated individuals are healthier
CSHP = HPS
health promoting school (HPS)
is a school that constantly strengthens its capacity as a healthy setting for living, learning, and working
CSHP = HPS
CHN role in healthy promoting schools (HPS)
HPS in a high dose are shown to change behaviours -> CHNs can be involved in this work
PHNs are usually asked to sit in on the school’s health promotion committee
4 pillars of comprehensive school health (CSH)
- social and physical environment
- teaching and learning
- healthy school policy
- partnerships and services
CHN and the community
- community as the client: nurse is the expert and care is often directed by policy, using epidemiological date
- community as a partner: the community its the expert on what they require, partnership is focused, looks at community strengths and what is meaningful to the community
a CHNs approach will depend on the method of working with the community -> client or partner
Community development steps
occurs when the community is engaged in social change
CHNs and health care providers partner with the community to make change
- define the indue
- initiate the process
- plan community conversations
- talk, discover, and connect
- create asset map
- mobilize community
- plan and implement
community capacity building
promotes a positive view and works with community strengths
works to help communities become strong based on strengths, perspectives, opposed to communities being defined by their weaknesses
asset mapping
identify the community assets
can include people, businesses, institutions, not for profits, community physical characteristics
the nursing process and the community
assessment, planning, intervention, evaluation (APIE)
assessment:
- identifies strengths, resources, assets, capacities, opportunities
- clarifies health concerns
- consideres SDOH
- looks at politics, economics, and social factors
plan:
- programs
- redesign existing services
intervention
- advocate
- build capacity
- create sustainability
- facilitate knowledge, relationships
- provide resources
- education
-social marketing
- enforcement
evaluation
- is there a change within the community
- should be empowering, supportive, positive change
prerequisites for health
- peace
- shelter
- education
- food
- income
- stable eco-sytem
- resources
- equity
- social justice
SDOH basically
primary prevention
stops disease or injury before is occurs
vaccines
secondary prevention
reduces the impact of disease or injury
BP monitorization
tertiary prevention
manages existing disease or injury
HIV management medication
primary care
refers to the first point of contact of an individual with the health care system
family physicians, NPs, and midwives
it is a PART of primary health care
primary health care
recognizes the broader SDOH and provides more population based, preventative, and health promotion services
implements all care provides, not just those provided only by doctors
population health promotion model
illustrates the need for intersectoral activities in developing and implements programs to improve the populations health
literacy
the ability to understand, evaluate, use, and engage with written texts
there is a strong link between literacy and income/pay
health literacy
60% of Canadians are not health literate
the degree to which an individual had the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions
there are many contributors to health literacy
people adapt and compensate for limitation, literacy will not be a reliable indicator for health literacy
low health literacy
people with low health literacy have poorer health
- lower life expectancy
- increased # of accidents
- increased incidence of diabetes
- misuse of meds
- more hospitalization
- misunderstanding of health information and directions
universal precautions
using a universal precautions approach for health literacy minimizes risk for everyone
it means taking specific actions to minimize risk for everyone when it is unclear who is health literate
plain language
clear, effective, and efficient written communication
organizes info for readers perspective
helps readers find key information
no one is excluded, it is fair, open, and inclusion
does not reduce the message or dumb it down
plan for plain language
what is the purpose
who is the audience
what do you need to communicate
how to present the information
writing tips for plain language
use short, simple words -> 1 or 2 syllables
use short sentences
use chunking-> short paragraphs, bullet points, logical organization
use active voice
address the reader whenever possible
use a question and answer format
use large font 12-point or larger
leave white space
diagrams and visuals
epidemiology
study of what befalls a population
epidemiologic triad
environment, agent, and host
public health epidemiologists
study disease and predict trends:
- infectious diseases
- non-infectious diseases
- injuries and other health events
- health equity and social determinants of health
- behaviours
public health nursing and epidemiology
- complete follow up of cases, contacts and outbreaks
- screening, investigation, prevention, surveillance, education, counselling
- immunization
- emergency preparedness
communicable disease
an infectious disease transmissible by direct contact with an affected individual of the individuals discharges by indirect means
TB, vaccine preventable disease, rabies, STIs
PHN role in communicable disease
- TB screening and treatment
- provide routine immunization programs
- provide immunizations for special populations
- report respiratory and gastrointestinal illness outbreaks in local schools
achieving active immunity
natural infection -> acquiring the disease
vaccination
components of active immunity
humoral immunity
- mediated by B cells
- produce antibodies
cellular immunity
- mediated by T cells
- eliminate the foreign substance by phagocytosis
live vaccines
employ humeral and cellular immunity
similar to getting the natural infection
usually provide life-long immunity with 2 doses
ex. MMR, chickenpox
inactivated vaccines
- mostly humeral immune response
- antibody levels fall over time
- require booster
ex. tetanus
informed consent 7 steps
- determine authority
- assess capability
- provide standard info
- confirm understanding of info
- provide opportunity for questions
6, confirm consent - document consent or refusal
vaccine preventable diseases
- tetanus/diptheria
- pertussis -> whooping cough
-varicella -> chicken pox - measles
- mumps
- HepB
- influenza
- small pox
- polio
tetanus/diptheria
most severe in young and elderly
vaccine needs to be boosted every 10 years
diptheria is found at the back of throats of people
chicken pox
itchy red rash
highly contagious
spread through the air
vaccination is best defense against it
the 4 Ms
what matter
mobility
mentation
medication
life expectancy in Canada
82
potential harms of substance use
- injuries and accidents
- addiction/ dependence
- overdose
- blood borne infection
- chronic illness
- costs/financial implications
- stigma
homelessness and substance use
addiction or substance use was most common reported reason for housing loss
housing loss related to substance use most prevalent among youth
harm reduction
reduce the adverse health effects of drug use
reduce the negative social consequences of drug use
reduce economic consequences of drug use
doxy PEP
involves taking doxycycline within 72 hrs of possible exposure to prevent STI
PEP for HIV
involves taking ant-HIV drugs within 72hrs of a possible exposure to prevent HIV
