module 1 Flashcards
Social Determinants of Health: 5
Economic Stability
Neighborhood and built environment
Health and health care
Social and community context
Education
Healthy People 2020 aims
(used to address social determinants of health
Increase the quality of life
Eliminate health disparities
Increase the years of a healthy life
Medical model
Nursing model
Medical model is Diseased focused
Diagnosis, treatment, response
-Nursing model is
Experience focused (focuses on the whole experience)
Diagnosis, treatment, response
The Circle of Caring (Caring attributes): Uses problem solving methodology and has 6 attributes
Knowing
Patience
Authentic presence
Commitment
Courage
Advocacy
Healthy People 2020 highlighted the importance of addressing the social determinants of health by including
“Create social and physical environments that promote good health for al
The model they propose to address symptoms has three dimensions
The symptom experience (subjective)
2.Symptom management strategies
3.Symptom outcomes
In 1948, the World Health Organization (WHO) defined health as a
“state of complete physical, mental, and social well-being.”
this definition provides a more holistic view of health because it incorporates the social and mental aspects of a human being, as well as the physical dimension. In fact, this definition has not been amended since its inception in 1948. However, this definition fails to recognize the spiritual and cultural dimensions of a person.
-Health is, therefore, a state in which the physical, psychological, social, spiritual, and cultural attributes of a person are in balance, creating harmony within the body
The focus in health care during the first half of the 20th century was:
tertiary prevention: Patient sought care when they were sick
2nd half of the 20th century, Switched focus to
secondary prevention, focusing on early screening and detection of disease.
primary prevention
the prevention of disease
secondary prevention
early screening and detection of disease
tertiary prevention
the restoration of health after illness or disease has occurred
Three major government initiatives…..
National Prevention Strategy
Healthy People 2020
U.S. Preventive Services Task Force.
prevalence rate
-measuring existing cases of the disease
-refers to the number of cases of a particular disease at a particular point in time divided by the percentage of the population at a point in time. Prevalence does not distinguish between new and old cases.
incidence rate
-measuring new cases disease
-the number of new cases of a disease diagnosed at a point in time (e.g., 1 year)
Health Promotion
can be defined as activities and preventive measures that contribute to an individual’s state of optimal health.
Questions to Consider Before Ordering Screening Tests
1.Does the condition must have a significant affect on the quality and quantity of life?
2.Are there acceptable treatment options available?
3.Does detection of the condition while it is asymptomatic significantly reduce morbidity and mortality if treated?
4.Does treatment in the asymptomatic phase yield a therapeutic result superior to that obtained by delaying treatment until symptoms appear?
5.Are there tests available that are acceptable to patients and at a reasonable cost that detect the condition in the asymptomatic period?
6.Is evidence of the condition sufficient to justify the cost of the screening?
primary prevention examples
Immunizations
Health education
Skin cancer prevention measures
Weight control
Seatbelt use
Violence prevention
Substance abuse
Education on:
Smoking, alcohol, and drugs
Environmental hazards avoidance
Protective hearing equipment
Protective eye equipment
Safety helmets for motorcycles, skateboards, and bicycles
Nutrition counseling
Exercise
Stress reduction
Eliminating allergen exposure
secondary prevention examples
Screening for:
Skin cancer
Oral cancer
Lung cancer
Breast cancer
Testicular cancer
Prostate cancer
Diabetes
Hypertension
Cardiovascular disease
Ovarian cancer
Cervical cancer
Fecal occult blood
Sexually transmitted infections
Tuberculosis infection
Pediatric developmental screening
Lead screening
Anemia screening
Height, weight, and BMI screening
tertiary prevention
Treatment to prevent further sequelae of:
Cardiovascular disease
Respiratory disease
Gastroenterology disease
Genitourinary disease
Endocrine diseases
Immunodeficiency disease
Infectious disease
Dermatological disease
Oncology disease
Gynecological disease
Musculoskeletal disease
Neurologic disease
Psychiatric disease
Reproductive disease
health literacy
is commonly defined as the degree to which individuals have the capacity to obtain, process, and understand basic information and services needed to make appropriate decisions regarding their health (Affordable Care Act, 2010).
Three major government initiatives that have had great impact on health promotion in the United States
National Prevention Strategy (NPS)
Healthy People 2020
the U.S. Preventive Services Task Force (USPSTF)
4 strategic direction of the national prevention strategy act (NPS)
. Health and safe community environments
*Clinical and community preventive services
*Empowered people
*Elimination of health disparities
Seven priorities are identified to reduce the burden of the leading causes of preventable death and major illness by the NPS
. tobacco-free living
*Preventing drug abuse and excessive alcohol use
*Healthy eating
*Active living
*Injury and violence-free living
*Reproductive and sexual health
*Mental and emotional well-being
The USPSTF
U.S. Preventive Services Task Force
conduct scientific evidence reviews of a broad array of clinical preventive services; develop recommendations for the health-care community; and provide ongoing administrative, research, and technical support to disseminate the findings.
Top 10 Causes of Death (National Vital Statistics Report for 2014)
Heart disease
Cancer
Chronic lower respiratory disease
Accidents (unintentional injuries)
Stroke (cerebrovascular disease)
Alzheimer’s disease: Early diagnosis to slow progression
Diabetes mellitus
Influenza and pneumonia
Nephritis, nephrotic syndrome, and nephrosis
Intentional self-harm (suicide)
Epidemiology
-the evaluation of distribution patterns and determinants of health and disease in populations
-The focus of epidemiology is to study the trends of disease occurrences in groups rather than in individuals.
-The goal of epidemiologic studies is to discover and evaluate the trends of illness or disease in groups of people in order to determine cause and effect and thereby prevent further disease
Morbidity
the number of people who have been diagnosed with a disease divided by the number of total population at risk.
Mortality
The number of people who have died from a particular disease divided by the total population
sporadic
Outbreaks of an illness/disease that occur occasionally and are unrelated in space and time
Epidemic
Presence of an event (illness or disease) at a much higher rate than expected based on past history
Endemic
Presence of an illness/disease constantly present or present at a rate that is expected based on history
Pandemic
Presence of an event in epidemic proportions affecting many communities and countries in a short period of time
Most efficient way to do a family history
Genogram
Level I evidence
systematic review (SR) or meta-analysis of RCTs (randomized controlled trials)
Level II evidence
single well-designed RCTs (Single cohort study, SR of cohort studies)
Level III evidence
well-designed controlled trials without randomizations (Single case-control study, SR of case-control studies)
Level IV evidence
well-designed case–control or cohort studies have (Case reports, case series, cross-sectional and Descriptive studies)
Level V evidence
systematic reviews of descriptive and qualitative studies (Expert opinion, biological plausibilities, laboratory studies, Animal Studies)
The mission of the AHRQ
is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans
the role of AHRQ (Agency for Healthcare Research and Quality )
role includes promoting initiatives focused on developing effective methods for implementing guidelines and analyzing the outcomes of care when clinical guidelines are widely disseminated and used. There are three parts to this initiative: (1) institution of EBP centers (EPCs), (2) development of the online National Guideline Clearinghouse (NGC), and (3) product research and evaluation.
Clinical practice standards
are intended to be used under all circumstances and define correct overall practice. They are generally considered to be inflexible and should not be interpreted as adaptable to fit different contexts
-Practice standards are designed to provide direction to nurses on which to guide and evaluate their practice
practice guidelines
are not cookbooks that take the decision making away from providers; instead, they allow for flexibility when making individual patient-care decisions. Guidelines are intended to provide a reference point and general direction for decision making and are not meant to be interpreted as rigid criteria that must be followed regardless of the context in which they are being used.
-Nonetheless, guidelines should be followed in the majority of cases unless there is a clear rationale for deviating from them to serve the particular needs of individuals.
Level VI evidence
—single descriptive or qualitative studies
-Case studies fall into this category. They are ranked lower because of their likelihood of decreased objectivity. These studies describe the history of one individual or a small group of patients. Case studies are generally told in story form.
Level VII evidence
—opinion of authorities and/or reports of expert committees: This level of evidence is just as it states: it is someone’s opinion. This type of evidence follows the traditional approach for “correct” or “common” practice and may or may not be based on strong evidence
these resources were evaluated for general characteristics, content presentation, and editorial quality. The top resources identified were
UpToDate, Nursing Reference Centre, Mosby’s Nursing Consult, BMJ Best Practice, and JBI COnNECT
