Week 1 Flashcards
1
Q
Community Health Nursing - Definition
A
- Nursing practice in the community, with primary focus on health care of individuals, families and groups in the community
- The goal is to preserve, prtoect, promote or maintain health
2
Q
Public Health - Definition
A
- What we, as a society, do collectively to assure the conditions in which people can be healthy
- Aim is to generate organized community effort to address public interest in health by applying scientific and technical knowledge to prevent disease and disability
3
Q
Community/Public Health Nursing
A
- synthesis of nursing and public health practice
4
Q
Characteristics of community/public health nursing
A
- population focused
- community oriented
- health and prevention focus
- interventions at the community/population level
- concern for heath of all members of the population
5
Q
Population or Aggregate
A
- a collection of individuals who have one or more personal or environmental characteristics in common
- members of a community defined in terms of geography (ex. a county)
- members of a community defined in terms of a special interest (ex. children attending a particular school)
6
Q
Population-focused practice
A
- problems are defined and solutions are implemented for or with a defined population or subpopulation as ooposed to diagnoses, interventions and treatment carried out at an individual client level
7
Q
Why population-focused practice?
A
- concerns about
- growth of managed care
- access to care
- ability to maintain insurance
- quality of services
- healthcare costs
- new interest in goals of
- protecting health
- promoting health
- preventing disease and disability
8
Q
Historic gains in health of populations
A
- safety and adequacy of food supplies
- provision of safe water
- sewage disposal
- personal behavior changes
9
Q
Core functions of community/public health nursing
A
- assessment
- policy development
- assurance
10
Q
Assurance
A
- Enforce laws and regulations that protect and ensure public health and safety.
- Link people to needed personal health services and assure the provision of health care when otherwise unavailable.
- Assure a competent public and personal health care workforce.
- Evaluate effectiveness, accessibility, and quality of personal and population-based health services.
11
Q
Eight Domains of Public Health Nursing
A
- Analytic and Assessment skills
- Policy Development/Program Planning
- Communications Skills Domain
- Cultural Competencies Skills
- Community Dimensions of Practice Skill
- Public Health Science Skills
- Financial Planning and Management Skills
- Leadership and Systems Thinking Skills
12
Q
Core Function: Assessment
A
- Monitor and evaluate health status to identify community health problems.
- Diagnose and investigate health problems and health hazards in the community.
13
Q
Core Function: Policy Development
A
- Inform, educate, and empower people about health issues.
- Mobilize community partnerships to identify and solve health problems.
- Develop policies and plans that support individual and community health efforts.
14
Q
Florence Nightingale
A
- Crimean War
- First Modern training school for Nurses (London, 1860)
- principles of community health nursing developed
- Five principles of community nursing
- hygeine
- nutrition
- hydration
- exercise
- ventilation
15
Q
William Rathbone
A
- Quaker merchant organized help for poor
- hired Mary Robinson
- first district nurse
16
Q
Lillian Wald
A
- founded Henry Street Settlement (later Visiting Nurses Association)
- originated idea of family focused nursing
- founder of public health nursing
- stressed health teaching in prevention of disease and promotion of health
- initiated public health nursing for MET Life insurance in 1909
- established school nursing (1902)
17
Q
Mary Breckenridge
A
- founded Frontier Nursing Service (1925) for public health nursing in rural KY
- provided visiting nursing
- built hospital
- established medical, dental, surgical clinics
- provided nurse mid-wifery services
18
Q
Lemuel Shattuck, Dorothea Dix, Clara Barton
A
- Shattuck
- report for MA sanitary commission
- Dix
- lobbying for conditions in prisons and mental hospitals
- Barton
- Civil War; founder of Red Cross
19
Q
Community as Client
A
- Concept in community/public health nursing
- makes direct clinical care an aspect of community health practice
- underscores complexity of change process
20
Q
Community as Partner
A
- concept in community/public health nursing
- partnerships with community members and professionals is basic means of improvement
- requires equality in decision-making, shared vision, integrity, agreement on specific goals, plan of action to meet goals
21
Q
Home Care: Factors to Receive
A
- Homebound
- takes extraordinary measures to get that person out of house
- Skilled Need
- Intermittent Care
22
Q
Practice Functions of Home health Nurse
A
- Direct Care
- skilled (to be reimbursed)
- physical assessment, wound care, teaching, IV therapy
- Indirect Care
- does on behalf of client to improve or coordinate care
- consulting, coordinating, supervising health personnel, referring
23
Q
Disciplines in Home Health Care
A
- Each client under care of physician who certifies medical problem
- plan reviewed at least every 62 days
- PT, nurse, speech, MD can lead plan
24
Q
Home health aide and home care
A
- responsiblities can include
- personal hygeine
- light housekeeping/homemaking skills
- directly supervised by nurse or PT
- aide supervision required every 2 weeks
25
Q
Homecare: Medicare and prospective payment
A
- effective Sept 2000
- requires use of Outcomes Assessment Information Set (OASIS)
- 89 questions used to assess client’s health and functional status on admission, recert and discharge
- JCAHO has revised standards of home health care to focus more on performance improvement based on measurable data
26
Q
Major Changes in healthcare in 21st century
A
- development of patient/client-centered care
- increased use of technology
- increased personal responsiblity
27
Q
Healthy People 2020 Overarching goals
A
- Attain high-quality, longer lives free of preventable disease, disability, injury and premature death
- achieve health equity, eliminate disparities and improve public health of all groups
- create social and physical environments that promote good health for all
- promote quality of life, healthy development, and health behaviors across all life stages
28
Q
Social determinants of health
A
- social conditions in which people live and work
- income status
- social status
- education
- literacy level
- home and work environment
- support networks
- gender
- culture
- availability of health services
29
Q
healthcare disparities
A
- gaps in healthcare experienced by one population compared with another
- difference in quality of healthcare delivered or obtainable, often tied to race or ethnicity or socioeconomic status
30
Q
Role of government in healthcare
A
- Three core functions
- assess healthcare problems
- intervenes by developing relevant healthcare policy that provides access to services
- ensures that services are delivered and outcomes are achieved
31
Q
Principles of Public Health Nursing
A
- Client or unit of care is the population
- primary obligation is to achieve greatest good for greatest number of people or people as a whole
- public health nurses collaborate with client as equal partner
- primary prevention is priority in selecting appropriate activities
- focuses on strategies that create healthy environmental, social and economic conditions in which populations may thrive
- PHN obligated to actively identify and reach out to all who might benefit from a specific activity or service
- optimal use of available resources and creation of new EBP strategies are necessary to assure best overall improvement in health of populations
- collaboration with other professions, populations, organizations and stakeholder groups is most effective way to promote and protect health of people.
32
Q
Public Health Intervention Wheel
A
- 17 interventions
- actions taken on behalf of individuals, families, communities and systems to protect or improve health status
- population based model
- focuses upon prevention
- applied to individuals, families, communities or within systems
33
Q
Challenges for Public Health in 21st Century
A
- engaging in EBP
- eliminating health disparities
- demonstrating cultural competence
- planning for community change
- contributing to safe and healthy environment
- responding to emergencies, disasters, terrorism
- responding to global environment
34
Q
Policy-Making Process
A
- setting an agenda
- policy formulation
- policy adoption
- policy implementation
- policy assessment
- policy modification
35
Q
Ten Greatest Public Health Achievements 1900-1999
A
- Vaccination
- Motor Vehicle Safety
- Safer workplaces
- Control of infectious diseases
- Decline in coronary heart disease and stroke deaths
- Safer and healthier foods
- Healthier mothers and babies
- Family planning
- Fluoridation of drinking water
- Recognition of tobacco as a health hazard
36
Q
Principles of Public Health
A
- Focus on aggregate
- promote prevention
- emcourage community organization
- practice ethical theory of the greater good
- model leadership in health
- use epidemiologic knowlege and methods
37
Q
Millenium Development Goals
A
- Eight goals that all 191 UN member states have agreed to achieve by year 2015
- combating
- poverty
- hunger
- disease
- illiteracy
- environmental degredation
- discrimination against women
38
Q
Trends in Public Health in US
A
- federal govt creates report of trends in these areas:
- health status and its determinants
- utilization of healthcare resources
- expenditures and health
- vulnerable populations and healthcare
39
Q
Bilateral and Multilateral agencies
A
- Bilateral agencies conduct services within one specific country
- Multilateral agencies receive funding from both governmental and non-governmental sources
- United Nations
- WHO
- World Bank
40
Q
International Council of nurses
A
- Federation of more than 130 national nurses associations
- first and widest reaching international organization for health professionals
- Active in these areas:
- international classification of nursing
- advanced nursing practice
- entrepreneurship
- HIV/AIDS, tuberculosis and malaria
- women’s health
- primary healthcare
- family health
- safe water
41
Q
World Bank
A
- international organization that uses funds from developed countries to help initiatives of developing countries
42
Q
World Health Organization
A
- international center that collects data, advnaces initiatives and offers support related to public health
43
Q
cultural competency
A
- knowledge, skills, attitudes and behaviors that are learned in order to provicd ghd optimal health service to individuals from a variety of racial, ethnic and cultural backgrounds
44
Q
Economics
A
- study of how individuals, groups, organizations and society allocate and utilize resources
45
Q
GDP
A
- main economic indicator used to evaluate the degree of economic growth in the United States.
- defined as final and total output of goods and services produced in one year by labor input within the US.
46
Q
Policies, Public Health Policy and Health Policies: Definitions
A
- Policies: set of principles that govern an action to chieve a given outcome, or guidelines that direct individuals’ behavior toward a specific goal
- Public health policy: decisions made in regard to the health of the individual and the community
- Health Policies: impact on health of an individual, a familty and a population or community
47
Q
Health: Definition
A
- a state of complete physical, mental and social well-being, not merely the absence of disease or infirmity
48
Q
Global health
A
- encompasses the behavioral and environmental risk factors of a community, which are influenced by politics, economics and culture
49
Q
Determinants of Health
A
- factors that affect outcomes of health status
- physical environment
- social environment
- health behaviors
- individual health
- broader factors such as access to health services and overall health policies and interventions
50
Q
Four Models of Health
A
- Clinical Model
- elimination of disease or symptoms
- Role-performance model
- health that involves a match between people and social roles
- only unhealthy if can’t fulfill your perceived role
- Adaptive Model
- health that involves adaptation to the environment
- adaptation in face of adversity or disease
- Eudaimonistic model
- health that is the actualization or realization of human potential.
- WHO definition strives for this model
51
Q
Demographic and epidemiologic transitions
A
- progressive improvement in health from a global perspective
52
Q
Demographic transitions
A
- high fertility and high mortality, resulting in slow population growth
- improvement in hygiene and nutrition, leading to decreased burden of infectious disease
- mortality declines, and later fertility declines
- relative proportion of elderly population increases
53
Q
Epidemiologic transitions
A
- high and fluctuating mortality, due to poor health, epidemics and famine
- progressive declines in mortality, as epidemics become less frequent
- further decline in mortality, increasing life expectancy, and predominance of noncommunicable diseases
54
Q
risk factors
A
- personal habits and behaviors, environmental conditions or inborn or inhereited charactedristics that are known to affect a health-related condition which could be alleviated or managed
- childhood and maternal malnutrition
- other nutrition-related risk factors and inactivity
- addictive substances
- sexual and reproductive health
- environmental risks
55
Q
noncommunicable diseases
A
- diseases that afflict a population which are chronic in nature and may be due to lifestyle changes, sometimes as a result of modernization of socieities.
- Examples
- cardiovascular diseases
- cancers
- diabetes
- obesity
- chronic respiratory diseases
56
Q
Health Indicators
A
- 4 categories
- morbidity and mortality
- measured by life expectancy at birth
- health adjusted life expectancy (HALE) at birth
- risk factors
- nutrition and health behaviors
- environmental factors (ex clean drinking water, solid fuel burning)
- health service coverage
- health system resources
- capacity and supply of healthcare providers
- morbidity and mortality
57
Q
Principles of Public Health
A
- Focus on AGGREGATE
- Promote PREVENTION
- encourage COMMUNITY ORGANIZATION
- Ethical theory of GREATER GOOD
- LEADERSHIP in health
- Use of EPIDEMIOLOGICAL knowledge and methods
58
Q
5 social factors that are impacting health care delivery and nursing practice locally, nationally and globally
A
- Patient vs. consumer
- litigious society
- technology
- transportation
- insurance - private/payer system
