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
Homecare: Medicare and prospective payment
* 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
Major Changes in healthcare in 21st century
* development of patient/client-centered care
* increased use of technology
* increased personal responsiblity
27
Healthy People 2020 Overarching goals
1. Attain high-quality, longer lives free of preventable disease, disability, injury and premature death
2. achieve health equity, eliminate disparities and improve public health of all groups
3. create social and physical environments that promote good health for all
4. promote quality of life, healthy development, and health behaviors across all life stages
28
Social determinants of health
* 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
healthcare disparities
* 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
Role of government in healthcare
* 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
Principles of Public Health Nursing
* 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
Public Health Intervention Wheel
* 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
Challenges for Public Health in 21st Century
* 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
Policy-Making Process
* setting an agenda
* policy formulation
* policy adoption
* policy implementation
* policy assessment
* policy modification
35
Ten Greatest Public Health Achievements 1900-1999
1. Vaccination
2. Motor Vehicle Safety
3. Safer workplaces
4. Control of infectious diseases
5. Decline in coronary heart disease and stroke deaths
6. Safer and healthier foods
7. Healthier mothers and babies
8. Family planning
9. Fluoridation of drinking water
10. Recognition of tobacco as a health hazard
36
Principles of Public Health
* 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
Millenium Development Goals
* 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
Trends in Public Health in US
* 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
Bilateral and Multilateral agencies
* 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
International Council of nurses
* 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
World Bank
* international organization that uses funds from developed countries to help initiatives of developing countries
42
World Health Organization
* international center that collects data, advnaces initiatives and offers support related to public health
43
cultural competency
* 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
Economics
* study of how individuals, groups, organizations and society allocate and utilize resources
45
GDP
* 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
Policies, Public Health Policy and Health Policies: Definitions
* **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
Health: Definition
* a state of complete physical, mental and social well-being, not merely the absence of disease or infirmity
48
Global health
* encompasses the behavioral and environmental risk factors of a community, which are influenced by politics, economics and culture
49
Determinants of Health
* 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
Four Models of Health
* 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
Demographic and epidemiologic transitions
* progressive improvement in health from a global perspective
52
Demographic transitions
* 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
Epidemiologic transitions
* 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
risk factors
* 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
noncommunicable diseases
* 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
Health Indicators
* 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
57
Principles of Public Health
* Focus on AGGREGATE
* Promote PREVENTION
* encourage COMMUNITY ORGANIZATION
* Ethical theory of GREATER GOOD
* LEADERSHIP in health
* Use of EPIDEMIOLOGICAL knowledge and methods
58
5 social factors that are impacting health care delivery and nursing practice locally, nationally and globally
* Patient vs. consumer
* litigious society
* technology
* transportation
* insurance - private/payer system
