Module 12 Flashcards
Public health efforts in the late 1800s focused on what
environmental conditions such as sanitation, control of communicable diseases, education for health, prevention of disease and disability, and care of aged and sick persons in their homes
Public and community health nurses are products of various what
social, economic, and political forces, and incorporate both the sciences of public health and nursing science.
What is the mission of public health nursing
The promotion of health and the prevention of disease
To preserve, protect, and improve the health of populations through activities that improve the environment, encourage lifestyle and behavior change, and assure access to care
All people and cultures have been concerned with events surrounding waht
birth
death
illness
How have various historical events of public health activities reflected the state of knowledge at the time
Spiritual cleanliness and community responsibility of the ancient Hebrews
Systems of personal hygiene practiced by the Greeks
Romans developed public health as a governmental matter beyond individual practice
Clean water, effective sewage removal, swamp drainage systems were the forerunner of politically sanctioned environmental protections of the public’s health
Ancient Babylonians: understood need for hygiene; some medical skills
Egyptians: variety of pharmaceutical preparation; public drainage systems; earth privies
Elizabethan Poor Law of 1601: guaranteed assistance for poor, blind, and “lame” individuals.
Industrial Revolution: previous care structures (family & friends) were not enough so created nursing care institutions & homes
How was the Medieval period important to public health?
Walled towns with crowded together people in very unsanitary conditions led to the development and rapid spread of disease, with little treatment
Most deaths at the time related back to infectious disease
Causative Agent of the Black Death
Yersinia Pestis
Found on rat flees
1/10 died even if treated
How was the Renaissance important to public health
Development of the idea that when a political jurisdiction protected and cared for its citizens, it could reap the economic benefits of production and world trade
Healthy laborers and soldiers became valuable commodities
Health workers seen as a valuable commodity and that healthcare ensured a countries stability
John Bellers
worked with poor in London and argued pop health was too valuable to left to the individual and was the responsibility of the state
Edwin Chadwick
social reformed
Drafted the poor law commission of 1834
Advocated using data to link population characteristics, environmental conditions, and the incidence of disease
Chadwick Report
Poor Law Commission of 1834
Said Government should be involved in protecting the citizens health
improved the sanitation and led to establishing poor houses, workhouses, hospitals, and provisions of service to the poor in England
Elizabethan Poor Law of 1601
Systems to care for the sick, poor, aged, mentally ill, and dependents
What forced early US towns to assume responsibility for the collective health of the people?
Cholera and Yellow Fever
*it started as a family/friend system of care
In 1751 the first what was established in America
hospital
Pennsylvania hospital in Philadelphia
New York Poor Law of 1788
towns were to establish almshouses for the care of the poor; persisted into the 1930s
Early US public health initiatives were motivated by …
economic concerns more so than humanitarian ones
The 1798 Marine Hospital Service would later become …
the Public Health Service
What was founded in 1847 in the US
The American medical association
Lemuel Shattuck
Architect of America Public Health
Provided the report of the sanitary commission of Massachusetts (1850) that documented the differences in morbidity and morality in different locations and linked them to the environment
revolutionized the US census
First Epidemiologist
John Snow
John Snow
first epidemiologist
important roll in 1854 london cholera epidemic by finding the source of cholera at a well
introduced the idea of public health policy that ended the problem
Florence Nightengale
Similar to a public nurse
Crimean War
Used Stat data to prove theories
organized nursing education in hospitals
political reformer for the development of professional and public health nursing in the US
Believed nursing should promote health and prevent illness - emphasis on proper nutrition, rest, sanitation, and hygiene
Avid reader and supported the chadwick report
William Rathbone
Founded the 1st district nursing association in liverpool england
realized there was a lack of trained nursing and training was disorganized and variable in quality
in 1860. F Nightengale advised him to start a nurse training school and home for nurses attached to royal infirmary
Lady Superintendent of each liverpool district underwrote the costs
First US Nursing School
1873
NYC Bellevue Hospital School of Nursing (Following Nightingale principles)
Second and Third Nursing Schools to Open in US
- Mass General Hospital
3. Connecticut Hospital in Hartford
Mary Mahoney
1st AA graduate from nursing school in 1879
She worked with Adah Thoms to found the National Association of Colored Grad NUrses to raise standards for AA nurses
Jessie Sleet (Scales)
1st AA Public Health Nurse when she was hired by NYC Charity Organization Society in 1900
Who was caused the first emergence of home visiting
Saint Vincent de Paul
Saint Vincent De Paul
1612 - worked as a priest and felt convinced he should work with the poor too
1617 - worked among the poor through contact with daughters of charity
Irish Sisters of Charity
1815 Deaconesses
Did what is considered early nursing
Incorporated care of the sick at home and developed a system of district nursing
The idea of Public Health and Public Health nursing did not begin until
1923
What was established in 1869
mass board of health
What was established in 1872
American public health association(APHA) established
What occurred in 1881
Clara Barton established the American Red Cross
The Late 1800s marked the formation of what in the US
local health dept in urban areas
What was established in 1923
Public health nursing section of the APHA made
took till then to make public health nursing a thing
Clara Barton
founded Red Cross in 1881 and its Rural Nursing Service which initiated home nursing care in areas outside larger cities
Henry Street Settlement
non profit healthcare for large immigrant population in NYC and works toward social justice reforms
Who founded the Henry Street Settlement
Lillian Wald and Mary Brewster in 1893
Ada Mayo Steward
worked with families in home visits to help grow industrial nursing into occupational health nursing (related to jobs)
Lina Rogers
Henry Street Settlement resident who became the first school nurse in 1902
She decreased absenteeism by 90% prompting NYC to hire 27 more school nurses
School nursing was also an extension of ..
home visits
___ ___ was the first public health nurse as well as the first to provide home visits for policy holders of insurance
Lillian Wald
Mary Adelaide Nutting
developed 1 post training school course specializing in public health nursing
Sheppard Towner Act
Maternity and Infancy Act
Federal funds for state programs that combatted the high infant and maternal death rates especially in rural areas
The Goldmark Report
recommended that nursing education be based on an educational plan rather than based on hospital service needs
Who was the first president of the National Organization for public health nursing (NOPHN)
Lillian wald
Mary Breckinridge
Started the Frontier Nursing Services which treated mothers and babies in rural areas in America with Midwifery needs
Challenges for AA Nurses in PHN
segregated nursing education in the south until 1960s
Lower salaries in the south than for white nurses
National health circle for colored people (1919)
scholarships for AA nurses
promoted public health work in AA communities in the south
How did the Great Depression influence public health
Agencies and communities unable to meet the huge needs and numbers of the poor
Decreased funding for nursing services
Pearl Mclver
first nurse employed by US public health service during the depression
Social Security Act of 1935
made to prevent recurrence of the effects of the Depression
Federal Emergency Relief Administration
state grants for home medical care
How did WWII influence nursing
increased need for nurses both for the war and at home
Bolton Act
established Cadet Nursing Core
supported increased undergrad and grad enrollment in schools of nursing by providing funding
1946 Hill Burton Act
National hospital survey and construction act
stimulated the growth of the health care industry by providing funds for hospital and health enter construction
What was a significant need post WWII
significant rise in health problems with the military returning requiring more care
The Department of health, education, and welfare (HEW) eventually became …
The US Dept of Health and Human Services (USDHHS)
Important Organizations rising in the 1970s
National league for nursing (NLN)
American nurses association (ANA)
__ __ nursing is required in most baccalaureate nursing programs
public health
in 1969 what was established
American Assoc of Colleges of Nursing (AACN)
What 2 important things passed in 1966
Medicare and Medicaid
Medicare
Title XVIII of the social security act
original hospital care for those over 65
later included disabled and those on dialysis
Medicaid
Title XIX of social security act
support medical and hospital care for people classified as medically indigent
required states to established joint federal state program
states have broad discretion over eligibility, benefits, and reimbursement
What were some social and political influences of the 50-70s that influenced public health nursing
Establishment of Skilled Nursing Facilities
County level nursing services
Increased need for mental health services
Mass vaccination campaigns
Emphasis on child growth and development
Increase in chronic disease
Decrease in communicable diseases
Establishment of school health programs
Contraceptive information and general reproductive health
Around when did chronic disease case management begin
the 1970s to 80s
in the 1980s there was a cont emphasis on what
child health and well being
What was there a focus on in the 1990s and early 2000s
focus on cost
quality
access to services
health care reform debate
nursing shortage
nurse managed centers
Affordable Care Act of 2010
controversial
much of it deals with changes to insurance plans and coverage
What happened in 2018 …
the 125 year anniversary of the henry street settlement
10 great public health achievements of the 1990s
Vaccination
Motor vehicle safety
Safer workplaces
Control of infectious diseases
Decline in deaths from heart disease and stroke
Safer and healthier foods
Healthier mothers and babies
Family planning
Fluoridation of drinking water
Recognition of tobacco use as a health hazard
Government sponsored health insurance
What are important things to seek in the future of nursing
Learn from the past
avoid known pitfalls
seek successful strats to meet todays complex needs of vulnerable populations
data collection and nursing research
Why is understanding government, law, and health policy so important to nursing
these factors influenced current and future roles for nurses and the public health system and is critical for better health policy for the nation
we need to be aware to advocate
Policy
a settled course of action to be followed by a government or institution to obtain a desired end
Health policy
a set course of action to obtain a desired health outcome, for an individual, family, group, community or society
Politics
the art of influencing others to accept a specific course of action
Executive Branch includes…
USDHHS
Enforcement of Health Laws
Legislative Branch includes…
oversight of and creation of regulations and laws through the senate and house of representatives
committees: aging, nutrition, environment, education, etc
Judicial branch includes…
supreme court case decisions
What shapes a governments role
wars
economic instability
political differences between parties
Health Insurance Portability and Accountability Act
HIPPA
protects personal information
State Child Health Improvement Act
way for gov to share funding with states to expand child health coverage
largest expansion of health insurance that’s funded by taxpayers since the establishment of Medicaid
Public Health Threats and Emergencies Act
response to 9/11
Patient Protection and Affordable Care Act
“Obamacare”
Health care Functions of the Government
Direct services like the VA
Financing things like CMS and NINR
Information like the CDC
Policy Setting
Pubic protection - govt has authority to protect publics health
What is the primary health function of government
Policy Setting
Isolation
separates sick people with a contagious disease from people who are not sick.
Quarantine
separates and restricts the movement of people who were exposed to a contagious disease to see if they become sick.
HP2020 has ___ overarching goals
4
What are some important organizations and agencies that are international that influence health?
WHO
UN
Federal health Agencies that influence health
U.S. Dept. of Health and Human Services (USDHHS)
Health Resources and Service Administration (HRSA)
Division of Nursing
Centers for Disease Control and Prevention (CDC: prevention and control of disease, injury and disability)
National Institutes of Health (NIH): biomedical research
National Institute of Nursing Research (NINR)!!!!!
Agency for healthcare research and quality (AHQR)!!!!
Centers for Medicare and Medicaid Services (CMS)
Federal non Health agencies that help public health
Depts of:
Defense - pays VA
Labor - OSHA, etc
Agriculture - collabs with govts for food stamps, etc
Justice - health services for federal prisoners
State and Local health Dept influence on heatlh
Programs vary depending on funding, public commitment and interest, and access to other resources
Coordinating efforts between health departments and other county/city departments is necessary.
PHN is often limited due to ___
funding
PHN Funding is dependent on …
govt commitment to a cause
Constitutional Law
Provides overall guidance for selected practice situations
Legislation
Legislation is law that comes from the legislative branches of federal, state, or local government. Much legislation has an effect on nursing.
Regulation
Regulations are specific statements of law related to defining or implementing individual pieces of legislation; can originate from committees and boards that are appointed
ex:
Board of Nursing (statewide jurisdiction)
Nurse Practice Act
Judicial Law
Judicial law is based on court or jury decisions
Common Law/ Case Law
Case law is the opinions of the court
Each state has a Board of Nursing created by a Nurse Practice Act.. What sort of things does this oversee
Approves schools of nursing; sets educational requirements
Examination and licensure of RNs and LPNs
Defines professional practice and legal titles
Outlines Scope of Practice
What is the purpose of the nurse practice act
to PROTECT THE PUBLIC
Professional Negligence (Malpractice)
an act (or a failure to act) that leads to injury of a client
Scope of Practice
involves defining nursing, setting its credentials, and then distinguishing between the practices of nurses, physicians, and other health care providers
Does having passed the NCLEX mean you are protected?
no, not if you are not thoroughly practiced in some skill or acting outside your scope of practice
Legal Issues Affecting Health care Practices
School and Family Health (immunizations, school physicals, reproductive rights, child protection)
Occupational health (OSHA and DEC)
Home Care and Hospice (insurance coverage)
Correctional Health (basic health services are usually NOT comprehensive nor preventive)
3 Core functions of public health nursing
provide assessment
provide policy development
provide assurance of policies carried out
The number and types of laws influencing health care (legislative action, regulatory action, process of regulation, and nursing advocacy) are increasing which means what…
it is important for nurses to be involved in the policy process (development and assurance!!)
What is a Nurses role in the policy process?
To be informed!!! (policies, advocacy, etc)
To make your voice heard!!!
How did C Winslow (prominent bacteriologist and PH expert) describe public health
the science and art of preventing disease, prolonging life, and promoting health and efficiency through organized community effort
