Multicultural Final Flashcards
What are the components of the Disaster Management protocol?
Preparedness: Assess, Analyze and Document
Response: Damage Assessment, Stabilize & Provide
Recovery: short and long-term
Mitigation: reduce loss by identifying and mitigating potential problems in advance (rolls into preparedness)
What happens during non-disaster (or between disaster) time frames?
Assessing vulnerability Mitigation Modifications of infrastructure Planning/Prep: -communication plan -Education of the public
What happens pre-disaster (as soon as knowledge of impending disaster is relayed)?
Warning
Pre-impact mobilization (getting out pregnant mothers and children before disaster hits)
Evacuation
What happens in the Emergency stage of a disaster?
Community comes to the aid of its members
Outside assistance arrives
What happens in the Reconstruction/Rehabilitation stage of disasters?
Restoration
Reconstruction and mitigation
Clean-up
When looking at the Disaster Management Response Cycle as an ADPIE process, what actions fall under A/D?
Assessing potential disasters
Assessing vulnerabilities
Assessing available agencies and resources
When using ADPIE with the disaster management cycle, what actions fall under P?
Developing:
-a communication plan
-an evacuation plan
=a mobilization plan
When applying ADPIE to the Disaster Management Cycle, what falls under I?
Implementation of emergency reponse, community response, and reconstruction/rehabilitation.
When applying ADPIE to the disaster management cycle, what actions fall under E?
Ongoing evaluation - occurs during EVERY stage of implementation
Debrief (happens interdisaster)
Modify plans for the next disaster
How does getting assistance from state/federal levels work in a disaster?
If the disaster is on a larger scale or a high complexity, the local government petitions the state for support.
If the state can’t handle it without help, the Governor requests help from the president (Federal Stafford Act allows this)
If the response is catastrophic, resources from multiple jurisdictions, agencies and levels of government will be used.
What is the Federal Stafford Act?
Gives the federal gov’t authority to help state/ and local gov’ts in disaster response.
It becomes active once a governor declares a major disaster or a state of emergency
Provides authorities AND funds from the federal gov’t.
Disaster response: who are the responders at the local level?
Police fire public works public utilities public health
Disaster response: who are the responders at the state level?
DOT
National Guard
State Police
Environment/Health officials
Disaster response: who are the responders at the federal level?
DHS FEMA Civilian Agencies: -DOT -DOR -EPA -CDC -HHS
Disaster response: who are the responders from private agencies?
Hospitals
Volunteer agencies (Red Cross)
Health professionals
Suppliers
What is the military’s role in emergency response? What act gives them power to help?
Supplies equipment and personnel able to do the following:
- Remove debris
- Restore power
- Conduct Search and Rescue
- Deploy nuclear, biological and chemical hazard teams
Triage in natural disasters: who gets highest priority?
Life-threatening injuries with a high probability of survival (when stabilized)
Triage and natural disasters: Who gets second highest priority?
Victims with systemic complications that can wait for 45-60m for treatment.
Triage: who receives low priority in a natural disaster?
Local injuries w/o urgent complications - can wait several hours
When doing cot-to-cot management for residents at a shelter, what should the nurse be looking for?
Is there an immediate medical/psychological need?
Are there unusual circumstances (service dog, assistive devices) that need acknowledging?
Are there any things they need to stay healthy while they’re there?
Is there any condition (mental health, disability, health, etc) you’re concerned about?
Who should you pay special attention to in a shelter environment?
Populations most at risk:
- disabilities
- chronic disease needs
- ESL
- kids
What is WISER?
Stands for Wireless Information System for Emergency Responders
Allows you to look up chemicals/agents that are toxic to see effects
Where would you research agents of biological warfare?
CDC’s website, (maybe WISER)
What is a Category A biological agent?
Highest health threat
Easily transmitted from person to person
High mortality rates
Potential for major public health impact
Might cause public panic
What is the nurse’s role in biological attack (all stages)?
Planning/preparation of responses
Identify potential agents that could be used for bioterrorism
Report any suspected activity to health dept.
Contain/control spread of infections (response phase)
Primary prevention interventions in preparedness phase of bioterrorism?
Drills Vaccines Planning/response plan Locate facilities with safety gear ID chain of command Define nursing roles Set up protocols Educate the public
Secondary prevention interventions during the response phase of a bioterrorism attack
Screening: early recognition Activating response plan Decontamination Environmental disinfection Protective equipment Community education/notification Quarantines
Tertiary Prevention (recovery) for bioterrorism
Treatment Antidotes Rehabilitation of survivors Monitoring meds/referrals Evaluating effectiveness of plan Recovery assistance.
Environmental health is…
The influence of environmental conditions on the development of disease or injury.
How can nutritional deficiencies or work settings be considered environmental health issues?
Anything that we’ve constructed/created as humans that contributes to our wellness or lack thereof can be considered env’tl health issues.
So can natural disasters.
Nurse’s roles in environmental health?
Education Prevention Treatment Community involvement Risk assessment Risk communication Epidemiology investigation Policy development
What are the 3 preventative nursing practice types that relate to environmental health?
Restorative: (modify the impact of the disease)
Supportive (modify relationships or the environment to support health)
Promotive (mobilize health patterns to promote/foster self-defined goals of families/individuals/communities)
Using ADPIE with environmental health: What does Assessment look like?
Looking at environmental factors/histories as part of the general assessment.
In applying ADPIE to environmental health, what does Diagnosis look like?
Include the disease and the environmental factors in the diagnosis.
In applying ADPIE to environmental health, what does Goal Setting looks like?
Include outcome measures that prevent and eliminate environmental factors.
In applying ADPIE to environmental health, what does Planning look like?
Look at policy/laws of the community as methods to facilitate care needs of the client
(Include environmental health personnel in planning)
In applying ADPIE to environmental health, what does Intervention look like?
Coordinating medical, nursing and public health actions to meet the clients needs.
In applying ADPIE to environmental health, What does Evaluation look like?
Make sure to include immediate and long-term responses of the client as well as whether the problem has been resolved.
General review card
to revisit the population-based community assessment process
ID all potential partners
Engage as many as possible
Describe all populations that make up the community (strengths, risk, influences)
Elicit the community’s perception of their strengths, problems and health influences
Gather/analyze existing information to ID health indicators
Describe the systems that impact the community
Describe the at-risk population
Identify influences/determinants that contribute to risk
Develop priorities
ID smart goals for each priority
ID measurable health status outcome indicator for each priority.
Examples of primary prevention for diarrhea and dehydration (global health)
Access to safe drinking water
Use of improved sanitation
Hand washing with soap
Exclusive BF 1st 6m of life
Personal/food hygiene
Education about disease spread
Vaccinations (rotavirus)
Secondary prevention for diarrhea and dehydration (global health)
Screenings
Rotavirus stool screenings
Diarrhea and dehydration tertiary prevention (global health)
Oral rehydration salts solutions
Zinc supplements
IV rehydration
Nutrient-rich foods (including BF)
Health consultant - management of persistent diarrhea
Collateral damage from Marshall Islands: what’s happened?
High mortality/morbidity
Diabetes and cancer, Obeseity (d/t SAD diet, imported food, lack of exercise, use of tobacco products).
TB (multidrug resistant)
Primary prevention examples for the collateral damage from the Marshall Islands testing?
Legislation to restrict high-sodium food
Nutrition labeling and regulations to help consumers identify healthy foods
Secondary prevention examples for collateral damage from Marshall Islands
Tobacco control thru graphic health warnings
Tackle tobacco industry interference
Reduce second-hand smoke
Promote quitting smoking
Intensify TB and leprosy screenings
Tertiary prevention examples for collateral damage of Marshall Islands
Strengthen vector control to reduce rates of vector-transmitted disease
What is Social Welfare Policy?
institutional policies that influence the access to goods and services necessary for a decent life
Institutional Social Welfare policy and Residual Social Welfare Policy
Institutional: benefits provided before there’s a problem (like primary prevention). Ex: public education, immunization policies
Residual Social welfare policy (designed to address the identified problem when there is a documented need). Ex: food stamps, TANF, disaster relief.
Are disabled citizens covered by Medicare or Medicaid?
Both
What are the different parts (ABCD) of Medicare?
A: hospital insurance (some home health, hospice)
B: medical insurance (provider visits, home health care costs, nursing, tests, vaccinations, etc)
D: prescription drug coverage
C: Combines parts A and B and often, D.
What are some drivers of change in the health care/insurance industry?
Cost Waste Variability/lack of standardization Quality Aging demographics, increased longevity Chronic illness Healthcare disparities Health care system infrastructure
What are the new provisions of the affordable care act?
Protection for pre-existing conditions
Free preventative care, yearly wellness visit
Seniors get Rx discounts
Young adults can be covered until 26yo
Insurers must justify any 10%+ increase before rate takes effect.
Individual and Employer mandates
Medicaid Coverage expanded to everyone below 138% of FPL (this was struck down by SC - it’s up to the states)
Subsidies (individual and employer)
What is a Pay for Performance principle?
Providers get rewarded for achieving pre-established quality metrics
What is Value-Based Purchasing?
Based on the value of care delivered (must be safe, timely efficient, effective, equitable and patient-centered)
What are shared savings arrangements
Incentives offered to providers to offer quality services and reduce costs (reimburse a % of net savings)
What is a Hospital-Acquired Condition Reduction program?
A reduction in payments by 1% for all hospitals that perform in the lowest quartile for HAIs.
What is a Hospital Readmissions Reduction program?
Hospitals with high readmission rates get a reduction in medicare payments
What are Accountable Care Organizations?
Network of health organizations/providers that take collective accountability for the cost and quality of care for a specific population of patients over time.
What are patient-centered medical homes?
Homes that provide comprehensive, team-based, patient-centered care
Bundled Payment Models
Lump sum payment models for specific medical or surgical care episodes (hip replacements, etc)
What are Coordinated Care Organizations?
Local entities that coordinate medical, physical and dental care based on regions (part of OHP). Designed to reduce cost.
What is the nurse’s role in advocacy and policy development in healthcare?
Change Agents
Lobbyists
Coalition Leadership
Holding Public Office
