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Module 14 Flashcards

1
Q

Healthy environments are …

A

essential for optimal health and health care

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2
Q

ANA Scope and Standards for Environmental Health

A

Environmental health is essential knowledge for nurses

Nurses should avoid products or practices that harm health or the environment

Nurses have a right to work in a safe and healthy place and have the right to timely information regarding any hazardous exposures

Multidisciplinary collaboration sustain healthy environments

Best practice should govern choice of materials, products, technology and practices in the environment that affect nurses

Nurses should respect the diversity of the people whom they serve

Nurses should focus on the quality of the environment in which they and their clients work and live

Nurses, other health care workers, families, patients and communities have the right to know timely information about potentially harmful products

Nurses should participate in research related to promoting a safe and healthy environment

Nurses should participate in advocacy related to promoting a safe and healthy environment

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3
Q

HP2020 Objectives involve what topicsq

A

Outdoor air quality

Water quality

toxics and waste

Healthy homes and healthy communities

infrastructure and surveillance

global environmental health

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4
Q

T and F: ANA considers environmental health an essential part of a nurse’s practice

A

True

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5
Q

Important Nurses in regard to Environmental Health

A

Florence N

Lillian Wald and Mary Brewster (Henry Street Settlement)

focus on environmental contamination and poverty and exposure to environmental hazards

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6
Q

Institute of Medicine recommendations for nurses

A

to have basic understanding of environmental health principles and integrate them into all aspects of practice, education, advocacy, policies, and research

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7
Q

Toxicology

A

study of negative effects of chemical exposure

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8
Q

Epidemiology

A

science of association between exposures and human health effects

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9
Q

Epidemiology Triangle

A

Agent, host, and environment

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10
Q

Geographic Information Systems (GIS)

A

code data related spatially to place

a way to take data and map it to a place on earth - can look at a specific pop there and housing, diseases, family things etc

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11
Q

When approaching environmental health, you must use a ___ approach

A

multidisciplinary (geologies meteorologists, politicians, chemists, nurses, etc)

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12
Q

Point Source

A

a fixed identifiable site and source for where a contaminant is coming from

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13
Q

What are examples of point source?

A

Air - like with smoke stacks

Water - discharges into water from industry

Land - chemicals added to soil, animal waste

Food - bacteria pesticides, etc

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14
Q

Non Point Source

A

Diffuse sources without a very determined sources

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15
Q

What are examples of point source?

A

Air - smog

Land - acidity of soil, run off

Water - run off, contamination

Food - fishing, low o2 in water, mercury - large quantities

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16
Q

What sort of source is motor vehicle traffic emission on Vestal Parkway

A

non point source (cannot be traced to a certain vehicle)

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17
Q

What sort of source is lourdes hospital pipe draining into the susquehanna river?

A

point source - particular spot of pollution

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18
Q

What sort of source is run off from city streets after a rain storm into the sewers?

A

non - point source - general in origin

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19
Q

What does IPREPARE mean for a windshield survey for an environmental health assessment ?

A

Windshield Survery first then …

Investigate potential exposures

Present work

Residential exposures

Environmental concerns

Past work exposures

Activites

Referrals and resources

Educate (follow up)

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20
Q

Right to Know Laws

A

the public hawse a right to know about hazardous chemicals in the environment

EPA provides envirofacts, CCR is a consumer confidence report on what pollutants are found in drinking water, and MSDS sheets are OSHA initiated stickers for dangers

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21
Q

MSDS

A

Material Safety Data Sheet

Blue - health hazard rating; red - fire hazard rating; white - specific hazard; yellow - reactivity rating

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22
Q

Environmental laws are contentious for what reasons

A

not only because of public or ecological health concerns, but also because of economic interests

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23
Q

Risk Assessment

A

process to determine the probability of a health threat associated with an exposure

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24
Q

What sort of things are done/needed for a risk assessment?

A

Access toxicological or epidemiological data, and determine if chemical associated with negative health effects.

Has a chemical been released into the environment (water, air, food)? How?
Multiple sources?

Estimate how much chemical might enter the body.

Is the chemical toxic? What is the source and amount of exposure? What is the route and duration?

The goal of assessment is to try to predict the potential for harm on the basis of the estimated exposure.

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25
What are high risk vulnerable populations for environmental health?
Pregnant women children
26
Why are children and pregnant women more at risk with environmental populations?
Size and immaturity of systems. Greater respiration rate = great exposure to air pollutants Short stature so closer to biological and chemical agents on floors and carpeting. Higher risk during disasters Bodies work differently than adults: blood-brain barrier, kidneys, growing bodies
27
How can nurses reduce environmental health risks?
Apply basic principles of disease prevention (since its less costly) reduce reuse recycle risk communication (provide right info, to the right people, and at the right time) ethics governmental environmental protection
28
Ethics and environmental health
essential for making ethical decisions regarding environmental health. asking people to sacrifice some of their self interests to benefit the greater good of more people (fracking)
29
Environmental Justice
equal protection from environmental hazards for individuals, groups, or communities regardless of race, ethnicity, or economic status (ex: env justice act, executive order 12898, 2012 environmental justice strategy and implementation plan )
30
Nursing Skills: Advocacy
Nurses have responsibilities to be informed consumers and to be advocates for citizens in their community regarding environmental health issues
31
Nursing Roles in environmental health
Individual and Population Risk Assessment Referral Community involvement and public participation Risk communication Epidemiologic investigations Policy development
32
Examples of Environmental Hazards
lead pain quality of your water and air has your home been checked for radon do you have CO2 and smoke in the home do you or your neighbors use pesticides
33
No workplace is ...
completely risk free (and people spend half their time at work!!)
34
Occupational health Nursing
specialty practice that focuses on the preventive healthcare, health promotion, and health restoration within the context of a safe and healthy environment (at work) it includes prevention of adverse health effects from occupational and environmental hazards, and health promotion in general
35
Scope of practice is determined by __ ___
state law
36
What are some things in the scope of practice for occupational health nurses?
``` Worker/workplace assessment and surveillance Primary care Case management Consulting Counseling Health promotion/protection Administration and management Research Legal-ethical monitoring Community orientation ```
37
Ada Mayo Stewart
First "industrial nurse" (occupational health nurse) worked in vermont marble company visited sick employees homes and provided emergency care, taught mothers to care for kids, and taught health living habits
38
Betty Moulder
hired coal miners in 1888 to take care of ailing workers and their families
39
Evolution of Occupational health nursing
workers comp (1911) American association of occupational health nurses (1942) occupational safety and health act (1970) --> OHSA and NIOSH
40
Roles of occupational health nurses
Clinician; case manager; coordinator; manager; nurse practitioner; corporate director; health promotion specialist; educator; consultant; researcher
41
What is academic education for occupational health nursing usually?
graduate level (but assoc and bach work in here too)
42
Workers act as a ___ ___
population aggregate
43
jobs are shifting from __ to ___ to ___
agrarian to manufacturing to service
44
3 Levels of Responsibility for Accidents and Accountability
1. Individual 2. Management 3. Organization and Policies
45
Individual level of responsibiity
individual responsibility to make decisions with safety in mind
46
Management level of responsibility
responsibility of management to assure safe environment and equipment
47
Organization and Policy levels of responsibility
responsibility of organization to create policies for safety standards and compliance
48
Host
any susceptible human being; assume that all employed individuals are at risk of being exposed to occupational hazards
49
Agent
factors associated with illness and injury; classified as biological, chemical, environmental and mechanical, physical, or psychosocial
50
Environment
includes all external conditions that influence the interaction of the host and agents
51
How is the epidemiologic model use in occupational health nursing?
Used to plan interventions to restore and promote the health of workers.
52
Susan, a new nurse on the unit has a coworker that is caustic in her attitude towards Susan. this is an example of what type of agent causing Susan's distress
psychosocial (not biological, physical, or environmental)
53
What is a prominent and important chemical agent in hospitals
Latex
54
most chemical agents have some sort of...
cancer risk
55
Organizational and public efforts to promote worker health and safety can be ...
limited or comprehensive
56
Milk With Dignity
migrant justice with ben and jerry's they do a program to recruit farmers and improve conditions for migrant workers
57
Worker Assessment aspects
Traditional history and physical assessment, emphasizing exposure to occupational hazards Occupational health history Teach about workplace hazards and preventive measures
58
Workplace Assessment aspects
Worksite walk-through
59
HP2020 in relation to occupational health
Identifies the national health objectives aimed at reducing the risk of occupational illnesses and promoting safety. Health education and health protection strategies are proposed to address the needs of large population groups such as the American workforce.
60
Important legislation related to occupational health
Occupational safety and health administration (OHSA) hazard communication standards material safety data sheets (MSDS) national institute for occupational safety and health (NIOSH)
61
OSHA
Occupational Safety and Health Administration (OSHA): federal agency charged with improving worker health and safety by establishing standards and regulations, educating workers, and enforcing standards.
62
Hazard Communication Standard
the “right-to-know” standard that requires all manufacturing firms to inventory toxic agents, label them, develop information sheets, and educate employees about these agents
63
NIOSH
National Institute for Occupational Safety and Health (NIOSH): the branch of the U.S. Public Health Service that is responsible for tracking workplace illnesses, accidents, and hazards
64
MSDS
inventory toxic agents, make info sheets, label, and educate employees on them EVEN WINDEX - every company in US must have a way for employees to have chemical sheets for anything
65
Occupational Safety and Health Administration (OSHA) is a federal agency in charge of tracking workplace illnesses, accidents, and hazards
False (THIS IS NIOSH)
66
Superfund Amendment and Reauthorization Act (SARA)
effective disaster plans designed by those with knowledge of the work processors and materials, the workers and workplace, and the resources of the community shared with key community agencies specific steps must be detailed for actions to be put in place by specific individuals in the event of a disaster nurse is a key person in disaster planning!
67
What is a disaster?
A natural or man made incident causing human suffering and creates human needs that victims cannot alleviate without assistance
68
When a disaster occurs, what happens to needs a resources
Needs (outnumber) > Resources
69
What is the DISASTER paradigm
``` Detect Incident command Scene security and safety Assess hazards Support Triage and treatment Evacuation Recovery ```
70
Why do nurses need to be prepared for disasters
most do not get disaster education and have to learn from the experience, so we need to prepare
71
Nurses now have a list of what for disasters
core competencies | core disaster life support, basic disaster life support, advanced disaster life support
72
Types of Natural Disasters
flooding earthquake hurricane tornado blizzard communicable disease epidemic
73
Types of Man Made Disasters
Train derailment dam breakage plane crash nuclear reactor meltdown bombing and warfare hazardous material incident water supply containment civil unrest
74
Heavy rains caused flooding of Smithville forcing 50% of the town to evacuate. After seven days, a dam near the town broke, and compounded the flooding of the village causing the rest of the residents to evacuate, and the businesses to close. This disaster could be classified as a:
both man made (the dam condition) and natural (heavy rain storm)
75
It is ideal to think in what way for disasters?
Both preventative role as well as reactive role we tend to enter a preventative and single patient care vacuum, but prevention of problems is rare and nursing and medicine are more responsive than preventative in disasters
76
Mitigation
reducing risks to people and property from disasters before they occur
77
Examples of Primary Disaster Prevention
community wide disaster preparedness education
78
Examples of secondary disaster prevention
screening for community level risks monitoring safety initiatives developed for disaster prevention efforts to restore community to "normal"
79
Examples of tertiary disaster prevention
disaster response life after the disaster
80
Mission of the US Dept of Homeland Security (via Homeland Security Act)
develop and coordinate comprehensive national strategies to secure the US from terrorist threats and attacks - 2002 in 2011 it was updated to include disasters
81
National Incident Management System (NIMS)
2004 an all disciplines, all hazards approach for a organized response to any disaster in the U.S. including the Incident Command System (ICS), a multi-agency coordination of systems
82
What things does NIMS discuss and detail
Discusses the need for preparedness Discusses resource management, communications, and information management. Details command structure to assist you in understanding the response plan and implementation of resources.
83
National Response Frameworks
Outlines how the federal government will use all of its agencies to respond to the needs of a community in a disaster. In the past, response time lagged behind what people needed. It is problematic to think that disaster response is a federal job.
84
How does disaster response start locally?
Start in your home with you and your family. Moves to the local community response. Proceeds to the regional response . Next to the State Office of Emergency Management. Finally to the state Governor’s office (state of emergency), initiating a request to the U.S. President for assistance. Stafford Act mandates the President to respond with a Declaration of Disasters for States. President assigns a Federal Coordinating Officer (FCO) to each disaster.
85
Phases of a Disaster
``` Pre impact phase Impact phase Honeymoon phase Disillusionment and Recovery Phase Reconstruction Phase ```
86
Pre Impact Phase
this is usually evident in disasters where we have some warnings issued (example: NOAA weather patterns indicate a storm or hurricane are coming). Predictions provide guidance for preparation (example: snow storm is coming with predicted 3 feet of snow. We prepare the community for the storm).
87
Impact Phase
when the disaster has occurred and we are in the mist of emergency response to the disaster. Initial assessments are needed: how many injured, how many may need rescue, and how many need medical attention. Also referred to the “heroic phase” Common to see citizens working to rescue and help each other. Fire and emergency personnel performing daring rescues .
88
Honeymoon Phase
many expressions of joy at being alive and have survived the incident Outside organizations have brought in help. People from outside of the community feel they can and want to help!!
89
Disillusionment and Recovery Phase
people who have survived the ordeal now become frustrated Realization of how long it may take to rebuild, claim insurance, and redevelop the community Often many are outspoken and resentful that the government did not do enough
90
Reconstruction Phase
occurs anytime between between 3 months to years after the disaster Rebuilding a community may not happen quickly and rebuilding businesses and other infrastructure may take longer then expected
91
After Puerto Rico was devastated by the recent hurricane, the Mayor severely criticized the Trump administration for its poor response. This is an example of what disaster phase?
This is the recovery phase (or disillusionment phase) when people realize how long recovery may take and become vocal about the government’s response
92
Disaster Response includes thinking ..
outside the box do the greatest good for the greatest number involves more than assigned priorities for treatment and transport it means using available medical resources as efficiently as possible
93
Triage
large part of caring for large numbers the assignment of degrees of urgency to wounds or illnesses to decide the order of treatment of a large number of patients or casualties.
94
ID-ME
Triage Basics degrees of triage CARE: Immediate (red), Delayed (yellow), Minor (green), Expectant near decreased (black)
95
Immediate Care (red)
life threatening with a change for survival in triage
96
Delayed Care (Yellow)
they can wait a few hours or days for surgical intervention, given pain medications and splinted fractures in triage
97
Minor Care (green)
walking wounded, need minor care, first aid in triage
98
Expectant Near Decreased (Black)
impending death, no chance for survival or recovery with the resources on hand
99
T/F: People tagged green in a triage situation will receive immediate care
False green tag can have any care delayed, they only need basic first aid and are ambulatory

NURS322 (13 decks)

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