Midterm Flashcards
What is health planning?
an organied process in which problems are identified, priorities selected and objectives set for the development of community health programs on the basis of the findings of community health assessments
What are examples of health planning at the global level?
WHO, Ottawa Charter, Sustainability development goals, and shanghai declaration
What are examples of health planning at the national level?
Healthy People (2030)
National Prevention Strategy
What is an example of health planning at the state level?
state departments of public health
What is the goal of the national prevention strategy?
to increase the number of americans who are healthy at every stage of life
Who is involved in community assessment?
a systematic process that uses several approaches - including key informant interviews, analysis of data on health status and health behavior indicators, observation and community surverys
What is the goal of a community assessment?
to identify the community health program that are the priorities for intervention, as well as community resources to address any health problem or need
What is the systems theory?
“the whole is greater than the sum of its parts”
What are coalitions?
a group formed of different organizations or people who agree to act together, usually temporarily, to achieve something
Who are stakeholders?
someone who has a direct interest
i.e: doctors or nurses
What is the social ecological model?
multiple determinants of health interact at different levels to affect the health stauts of individual people, population aggregates or communities
What are multi-level interventions?
needed to achieve change in complex community health conditions that have multiple determinants
- upstream: at the societal, environmental or policy level
- mainstream: at the population or community level
- downstream: at the individual point
What is Lewin’s Model of Change?
it is a comprehensive change model aiming to understand why change occurs and what must be done to deliver change in the most seamless way possible
- unfreeze
- changing
- refreezing
What is force feild analysis?
it is identifying factors within a community or organization that are driving or reinforcing change in the desired direction including those that are resisting change
What is the purpose of using levers of change?
is to increase driving forces and or to decrease restraining forces
What are smart objectives?
- specific (what behavior, knowledge, skill, change in health status indicators or outcome will result from the program?)
- measurable (how will the outcome be measured and how will one know if the objective is achieved? Are the data available?)
- Achievable (is it realistic to achieve the desired outcome with the resources and time available to the program?)
- Relevant (is the objective related to the programs goals and activities?)
- Time-Bound (when will the objective be achieved?)
What is the logic model?
it is how a program is expected to hit a desired outcome
What is the goal of community preventative services?
it is to make recommendations for translation of research into practice
What is social marketing?
use of marketing principles and practices to change health behaviors or beliefs, social, or cultural, norms or community standars to improve health or benefit society
What is culture?
a set of practices and behaviors defined by customs, habits, language and geography that groups of individuals share
What are properties of culture?
dynamic (not static; changes over time),
shared (not private; shared among people),
learned (not inherited; learned from parents, siblings, peers)
What is cross-cultural nursing?
it is any nursing work in which the nurse and the patient have different cultures
What is cultural safety?
it is culturally appropriate health services to disadvantaged groups whole stressing dignity and avoiding institutional racism, assimilationism and repressive practices
(ex: Vodou not Voodoo)
What is cultural humility?
it is the acknoledgement that everyones views are culturally influenced that our own are no better than anyone elses and that our clients can teach us
- ask open ended questions and ask about traditions
What is ethnocentrism?
assumption that others believe and behave as the dominant culture does or the belief that the dominant culture is superior to others
What is a subculture?
members share some cultural facets such as experiences or beliefs, language, practices and values
(I.e: nyc (little italy or chinatown)
What are aspects of culture directly affecting health or healthcare?
- attribution of illness
- diet
- communication
- non-verbal communication
- style of communication
How do western vs eastern culture view time orientation?
western: tend to plan ahead, keep stricter time, plan and behave in the present with an eye toward the future
eastern: focus more on the past, consulting history to helpe make decisions
What is care management?
coordination of a plan or process to bring health services together as a common whoel in a cost-effective way
- acts as a key component in the care of patinets because of continued rising medical costs
- uses outside resources to get a patient care at the LOWEST cost
What is case managment?
an integrated collaborative process of assessment, planning, facilitation and advocacy for options and servies to meet an individuals health needs through communiccation and available resources to promote quality cost-effective outcomes
- uses outside resources to get the patient the HIGHEST QUALITY care
What is a case managers role?
- advocacy and education: ensuring the pt has a representative who can speak up and represent their needs for needed services and education
- Clinical care coordination/facilitation: coordination multiple aspects of care toensure that pt progresses
- Continuity/Transition mangement: transitioning of the client to the appropriate level of care needed
- Utilization/Financial Management: managing resource utilization and reimbursement for services
- Performance and outcome managment: monitoring and interveining to achieve desired goals and outcomes for both the client and the hospital
- psychosocial: assessing and addressing psychosocial needs, including individual, familial and environmental
- research and practice development: identifying practice improvements and using evidence-based data to influence needed practice changes
What is home healthcare?
caring for patients and their families wherever they may call “home” regardless of economic and class divisions
- examples: private/voluntary, hospital based, proprietary agencies, official agencies
What is interprofessional care?
sharing of evidence based practice and skills by severla disciplines as an integration strategy with patient and families in homes and other healthcare settings
What are the five phases of a home visit?
- initiating the visit
- preparation (gathering equipment, directions, personal safety)
- The in-home visit
- Termination of the visit
- Post visit planning
What is the US Census Bureau’s definintion of family?
people living together and are related by birth, adoption or marriage
What is family structure?
the characteristics and demographics of individual members who make up family units
What is family health?
a dynamic changing relative state of well-being that includes the biological, psychological, sociological, cultural and spiritual factors of the family system
- an individuals health affects the entire familys functioning and teh familys functioning affects the health of the individuals
What is the family structural-functional theory?
- it views the family as a social system
- emphasizes the orginzation/structure (whos who in the family)
What is the family development theory?
Life cycle theory
- 8 stages: from leaving home to get married, start a career, childbearing, childrearing, launching young adult kid towards married life and career, aging families with a focus on empty nest, establishes intergeneraltional relationships, coping with loss of spouse, living alone
What is the family nursing theory?
emphasizes the reciporcal relationship between individual members and family as a whole
What is the Calgary family assessment model?
3 basic categories:
structual (genogram and ecomaps),
functional (interactions, routines, behaviors and patterns among family members),
developmental (how the family is going through developmental stages in life)
What is the calgary family interventional model?
addresses 3 domains: cognitive, affective, behavioral
- focusing on enhancing, improving and sustaining family functionaling through the establishment of a collaborative partnership between the nurse and family
What is the cognitive domain of the calgary family intervention model? Whats their goal?
related to thinking and need to gain new information and knowledge of health problem affecting family
- goal is to change the perception of the health problem
What is the affective domain of the calgary family intervention model?
related to feelings interfering with familys ability to solve, cope, heal, and increase emotions to support family functioning
What is the behvaioral domain of the calgary family intervention?
related to action of helping families change behaviors that may be detrimental to family functioning
What is an ecomap?
- an essential tool used in family nursing
- shows the relationship between family and their enviornment and everything that effects them
What is an endemic?
outbreak within a population
What is an epidemic?
A sudden increase in an infectious disease in a certain geographical area
What is a pandemic?
outbreak of a disease across several countries or continents
What is public health surveillance at the state level?
healthcare providers/facilities
What is public health surveillance at the federal level?
maintains surveillance systems to analyze data for disease trends and outbreaks
How do you prevent food borne illnesses?
- only pasturized milk or cider
- proper handeling, storage, prep, thawing, cooking, serving, handling of leftovers and refreezing food
- wash hands and utensils after handleing raw eggs, meat, poultry pets, farm animals
How do you prevent waterborne diseases?
- do not swallow pool water
- wash hands after restroom and changing diapers
- do not swim if you have diarrhea
- Change diapers in bathroom not poolside
How do you prevent STIs?
screening
education
community prevention and wellness activities
What are (5) factors that influence emerging infectious diseases?
- microbial adaptation
- human suseptibility
- climate/ecosystem change & human behavior
- travel, tech and industry
- lack of political will and breakdown of public health infrastructure
What are the 3 stages of microbial adaptation?
- an epidemic occurs - microbes enter virgin population with no prior exposure to organisms and they have little defenses
- infection become endemic
- symbiosis is possible, further adaptation occurs, results in mutual tolerance
What is herd immunity?
a large portion of people in a population are not susceptible to a communicable disease and the few people that are will not liekly be exposed
What is the defintion of family?
- 2 or more people that consider themselves family
- they help support and rely on eachother for basic needs
What is a genogram?
- ancestry DNA
- shows intergeneration relationships that exists and shows health quality
What is a vector?
- something that carries a pathogen
What are modes of transmission?
- airborne
- contact
- droplet
- food
- environment (water)
- Indrect contact
What is airborne transmission?
when microorganisms are carreid in the air at distances that exceed a few feet
(ex: coughing, sneezing, talking or singing)
TUBERCULOSIS
What is droplet transmission?
droplets are generated during coughing, sneezing, talking and are propelled a short distance through air
MEASLES FLU
Examples of current health care reform (case management and home health care)
Medicare
Healthcare home model (PCMH)
What are the three family theories?
Family systems theory
Family structural functional theory
Family developmental theory
How do community health nurses support families?
Family focused home visits
Family caregivers in need of education and support (caregiver burden)
What are three ways immunity can be impaired?
Poor nutrition
Medication
Environmental stressors
What is the causative agent for SARS?
coronavirus
Lyme Disease
Most common vector borne disease
Characteristic bulls eye rash (erythema migrants) but not always present
How is Lyme disease diagnosed?
Based on symptoms (hallmark rash), possibility of exposure and or blood work
What is the best clinical marker for Lyme disease?
Initial skin lesion
What are symptoms of Lyme disease?
Rash, joint pain, mental changes, inflammation of heart and or nerves
How do you prevent Lyme disease?
- insect repellant
- proper ID and removal of tick
- applying pesticides and reducing tick habitat
- avoid contact with soil, leaf litter and vegetation
- keep hair tied back
- do a full body tick check
What is the treatment of Lyme disease?
- doxycycline
-amoxicillin or cefuroxime axetil
Worse conditions may require IV to
TB usually effects…but also effects
Lungs… and kidneys, spine or brain
What are S/S of TB?
chronic productive cough
Low grade fever
Night sweats
Weight loss
Positive mantoux test
Who are high risk populations for getting TB?
Jails
Homeless shelters
Inner cities
Methadone clinics
Syringe/needle exchange program
What kind of precaution is TB?
Droplet
How is TB diagnosed?
Mantoux test and or quantiFERON-Gold followed by chest X-ray
What are the first line drugs used to treat TB?
Isoniazid (INH)
Rifampin (RIF)
ethambutol (EMB)
pyrazinaminde (PZA)
How is Ebola spread?
Close contact with blood, secretions or other bodily fluids and organs of infected chimps, gorilla, fruit bat, monkey, forest antelope or porcupine
Travelers in Ebola outbreak areas should
- practice careful hygiene
- avoid contact with blood and body fluids (urine, feces, saliva, sweat, vomit, breast milk, semen and vaginal secretions)
- avoid funeral or burials of infected individuals
- avoid contact with bats
- avoid contact with semen from men who have Ebola
- avoid facilities that tx Ebola pts
What a fun fact about Ebola?
Ebola can live in semen for 61 days
How is Zika virus transmitted
Through bite from an infected vector (mosquito), sexual contact and blood transfusions
How do you prevent Zika virus?
- pregnant women should not travel to Zika infected areas
- Wear long sleeves and or pants outdoors
- sleep under mosquito net if ac not available
- use condoms or abstain
- use insect repellant
