Note Cards Flashcards
Care Management
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Coordination of a plan or process to bring health services together as a comomon whole in a cost-effective way.
- How to define & evaluate the health intervention & appropriateness of care (predictive modeling & data analaysis to target specific disease management areas more precisely)
Case Management
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“Building block of care management” development & coordination of care for a selected client and family
- emphasizes prevention at the secondary & tertiary level
- Emphasis on the use of telephone coaching, internet resources, & intensive patient & family teaching to advance self-care & adherence to wellness care.
Medicare Criteria
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- Homebound: must require “taxing effort” to leave home & how infrequent
- Plan of Care: Generated written document guided by lengthy assessment - sociodemographic, environmental, functional health, & personal support days with renewals if needed
- Skilled Needs: What professional vs. are needed, skilled nurses vs. non-skilled nursing needs
- Intermittent Care Needs: Skilled care is provided over several hours during the day or week. Medicare requires to be 60
- Necessity: Reasonable care based on acuity
Health Professional Shortage Area (HPSA)
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Geographic area, population group, or medical facility with shortages of healthcare professionals that may not allow a full complement of healthcare services.
Medically Underserved Area (MUA)
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Area that is determined htrough calculation of a ratio of primary medical care physicians (PCPs) per 1,000 population, infant mortality rate, percentage of the population with incomes below the poverty level, & percentage of the population aged 65 or older”.
Medically Underserved Population
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A U.S. federal designation for those populations that face economic barriers (low-income or Medicaid-eligible populations) or cultural and/or linguistic access barriers to primary medical care services.
Advocacy
Always moving the needs of paitents, families, & communities to a point of awareness that will advance change & increase quality of a life & experience
* in case management is significant
Tricare
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U.S. Government Health Insurance plan for all military personnel & dependents
Veteran Administration (VA)
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Federal funds for those who are currently serving or have served in the armed services of the United States.
Home Healthcare Services
Know the 3 types
- Reimbursed by local, state, & federal funds
- Private insurance
- Private individuals
Insurance Companies, HMOs, & Case Management Organizations
From money paid directly to them in monthly or annual increments for the purpose of giving home healthcare when & if they are needed.
What are the 5 phases to home visits?
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1.) Initiating the visit
2.) Preparation
3.) The actual visit
4.) Termination of the visit
5.) Post-visit planning
High Risk Health Disparities
List actual groups that are at higher risk of health disparities
- High-risk mothers
- Chronically ill & disabled individuals
- People living with HIV / AIDS
- Mentally ill individuals
- Substance abusers
- Homeless individuals
- Immigrants & refugees
- Rural / migrant population
- LGBTQIA+
Medically Underserved
- Subgroup of the population
- Higher risk of developing health problems
Greater exposure to health risk because of marginalization:
* sociocultural status
* access to economic resources
* age
* gender
* homelessness
* veterans
Types of disasters
- Natural
- Accidental
- Terrorism
Cycles of Disasters
Know these steps
1.) Pre-impact
2.) Impact
3.) Post-impact
All disaster response begins at a LOCAL level
Disaster Management Cycle
Know & understand each of the steps
1.) Preparedness
* identify all hazards
* proactive planning
* evaluate possible damage
2.) Mitigation
* take measures to limit damage, disability, & loss of life
3.) Response
* implementation of a disaster plan
* provide emergency care
* restore communication & transportation
4.) Recovery
* stabilization & return to normal status
5.) Evaluation
* learn from the past & prepare for the future
Risk Assessment
Helps with prevention through better surveillance
- Improving inspections
- Airport security
- Strengthening public health, etc.
- Immunizations, isolation, & quaritine
- Strengthening levees / barriers to prevent flooding
- Education on prevention of communicable disease transmission
- Assess community’s threats / vulnerabilties & a community’s capabilities & demographics (who is most at risk?)
Category A
KNOW THE EXAMPLES & WHO IS AT RISK
Risk to national security
- easily disseminated
- high mortality
- major impact
- public panic
EX: Small pox, anthrax, botulism, tularemia, ebola, the plague
Category B
KNOW THE EXAMPLES & WHO IS AT RISK
Second highest priority
- moderately easy to disseminate
- high morbidity, low mortality
EX: typhus fever, ricin, west nile virus
Category C
KNOW THE EXAMPLES & WHO IS AT RISK
Third highest priority
- emerging pathogens
- easy to produce
EX: hantavirus, influenza, TB, rabies
Point of Distribution (POD)
a centralized, local area where public can obtain emergency supplies
- staffing, & procedures are followed in set up & deactivation
What do occupational nursing assessments start with?
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Occupational Nursing Assessment begins with an assessment of both the worker & the workplace
Bioavailability
The amount of a contaminant that actually ends up in the systemic circulation.
Risk
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hazard + exposure
- presence of hazard alone does NOT determine the amount of risk
Biological Agent
Know what it is & examples
Living organism that invades a host, causing disease
EX: bleach, aerosols, exhaust, cleaning products
Physical Agent
Know what it is & examples
Factor in the envrionment capable of causing disease in a host
- EX: noise, cold, heat, electric, magnetic, lighting, vibrations, falls, fires, inhalations, machinery
for noise think environment
Psychosocial Agent
Know the examples
- sexual harassment
- emotional abuse
- interpersonal problems
- assaults
School Nursing
Explain what it is guided by
- Michigan School Code (legislates what must be done)
- Michigan Public Health Code (legislates how medical professions may practice in Michigan)
Michigan does not have a separate Nurse Practice Act
Ratio of students for every nurse
Know these ratios!!!!
State task force recommended a ratio of: 1 RN : 750 students
National Association of School Nurses shows MI’s student-to-nurse ratio = 1:4 (nearly six times higher)
* 1 RN : 204 students
OSHA
Occupational Safety and Health Administration
Know the year & what they do
the federal agency that set exposure standards & is responsible for enforcement of safety & health legislation
- 1970
- Employers must “furnish a place of employment free from recognized hazards that are causing or likely to cause death or serious physical harm to employees”
Americans with Disabilities Act (ADA)
Wide-ranging federal legislation enacted in 1990 intended to make American society more accessible to people with disabilities
Veteran Health Risks
- TBI
- Noise
- Radiation
- Cold injuries
- Amputation
- Occupational hazard exposure
- PTSD
- MST (military sexual trauma) - 1/3 women & 1/50 men
- Polytrauma
- Chronic pain
- SUD (substance use disorder)
- Suicide
SANE Nursing
Sexual Assault Nurse Examiner – assist victims of sexual assault
- cultural / developmental differences
- trauma training
- documents detailed physical examination findings
- collects forensic evidence
- testifies as an expert witness
- makes referrals
- pregnancy risk assessment & interception as needed
- Often employed by ER & community clinics
Competency of Occupational Nursing
1.) Competent
2.) Proficient
3.) Expert
Occupational Nursing - Competent
Sufficient experience to recognize issues & funciton as a clinician, coordinator, & case manager
- relies on checklists & protocols
Occupational Nursing - Proficient
Increased ability to perceive situations & recognize when protocols need to be adjusted to meet the needs of the situation
Occupational Nursing - Expert
Extensive experience, broad knowledge, grasps situations quickly & initiates action
- leadership roles
Epidemiologic Triad
KNOW THIS!!!!!!!!!!!
- Host
- Agent
- Environment
Exposure Pathway
- Source of contamination
- Enviornmental media & transport
- Point of exposure
- Route of exposure
- Receptor population
Environmental Protections
Clean Air Act (CAA) 1907 - passed to control the damaging affects of air pollution by regulating source
Clean Water Act 1972 - standards, tools, & financial assistance to address poor water quality
Superfund 1980 - enviornmental program that addresses abandoned hazardous waste sites
Lead
Normal range; location; & S/S
< 5 ug is normal range
- found in paint, dust, soil
- Routine screenings for children
Signs & Symptoms
* Slow growth
* Hyperactivity
* Hearing problems
* Headache
Mercury
Where is it found, who is at risk, & S/S
- found in thermometers, batteries, burning coal, & fish
- Pregnant women are at risk
Signs & Symptoms:
* harm to the brain, heart, & kidneys
* passed through the placenta
* blindness
* seizures
* retardation
Radon
What is it? Where is it found? What does it cause? S/S
- type of radioactive gas
- found in decaying uranium & soils
- # 1 cause of lungn cancer (behind smoking)
- Detectors in basements
Signs & Symptoms:
* Lung damage / cancer
PFAS (Per- and polyfluoroalkyl substances)
Where is it found & S/S
- found in firefighting foams, consumer products like stain resistant & water proof products
Signs & Symptoms:
* Liver, thyroid, pancrease, & hormone effects
Asbestos
Where is it found? S/S
- Found in roofing shingles, ceiling tiles, floor tiles, paper, cement, heat-resistant products, installation, & packaging
Signs & Symptoms:
* causes scar-like tissue to form in the lungs due to inhalation of asbestos
Pesticides
What is it used for? Where is it found?
- Used to kill pests
- Found in soil, water, & foods
- Bed Bugs = increased
Environmental Media
Soil, water, air, biota (plants & animals), or any other parts of the environment that contain contaminants
ANY PART OF THE ENVIRONMENT THAT CONTAINS CONTAMINANTS
Routes of Exposure
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- Inhalation
- Absorption
- Ingestion
- Injection
Biomonitoring
The process of using medical tests such as blood or urine collection to determine if a person has been exposed to a contaminant & how much exposure that person has received
Environmental Epidemiology
Field of public health science that focuses on the incidence & prevalence of disease or illness in a population from exposures in their environment
Children’s Vulnerability
- Body systems are still rapidly developing
- Eat, drink, & breath more in proportion to their body size than adults do
- Breathing zone is closer to the ground compared with adults
- Bodies are less able to break down & excrete contaminants
- Behaviors can expose them to more contaminants
- Spending time outside home where environmental hazards may be present
Environmental Injustice
The belief that no group of people should bear a disporportionate share of negative enviornmental health consequences regardless of their race, culture, or income
