Week 1-5 Flashcards
Standards of Practice for CHN were developed by?
geographically representative committee of CHNs under Community Health Nurses of Canada (CHNC)
Practice standards took how many ppl?
1000
Practice standards took how many years?
3
When were the CHN practice standards published
October 2003, Revised in March 2011
What are the CCHN Standards of practice important?
- define SCOPE of practice
- Establish criteria and expectations for acceptable CHN practice and SAFE, ETHICAL CARE
- provide criteria for MEASURING PERFORMANCE
- support ongoing DEVELOPMENT of community health nursing
- PROMOTE as a SPECIALTY
- Foundation for CERTIFICATION
- Inspire EXCELLENCE and COMMITMENT
- SET BENCHMARK
Why are the Standards of Nursing Practice at the bottom of the pyramid in the illustration of standards?
because they are foundational
Originally how many standards were there?
5
What are the 7 standards of CHN?
- Health Promotion
- Prevention and Health Protection
- Health Maintenance, Restoration, and Palliation
- Professional Relationships
- Capacity Building
- Access and Equity
- Professional Responsibility and Accountability
- Health Promotion
- Prevention & Health Protection
- Health Maintenance & Restoration
are supported by what Standards?
- Professional Relationships
- Capacity building
- Access and Equity
- Professional Responsibility & Accountability
Which practice standard relates to the following situation; and what is the CHN role in the situation?
PHN works with a community to advocate for a smoke-free town or municipality
Health Promotion through healthy public policy
Which practice standard relates to the following situation; and what is the CHN role in the situation?
CHN assists in the creation physical activity and healthy eating programs with the school in a local community
Healthy Promotion through reorienting health services
Which practice standard relates to the following situation; and what is the CHN role in the situation?
HHNs encourage families dealing with a chronic illness to participate in regular physical and social activities
Health promotion through developing skills and access to information
Which practice standard relates to the following situation; and what is the CHN role in the situation?
PHN track immunization schedules for each child so that when a child is overdue for vaccine they can be contacted. (CHNAC)
Prevention and Health Protection through use of
a. surveillance activities, analyze and utilize data to identify and address health issues or in this case vaccinations prevent disease, etc.
Which practice standard relates to the following situation; and what is the CHN role in the situation?
A CHN observes high rates of smoking within a particular client group. The concern is raised with the practice team and a plan is developed to find ways to address the issue.
Prevention and Healthy Protection through
A. participates in surveillance to identify and address health concerns in the community; facilitates informed decision making perhaps in regard to smoking prevention
Which practice standard relates to the following situation; and what is the CHN role in the situation?
PHN work with a parent’s organization and the police to promote proper installation of car seats through the media and conduct several clinics to provide one-on-one assessment and teaching
Prevention and Health Protection through
H, applied epidemiology principles for planning strategies like education regarding car seats
Which practice standard relates to the following situation; and what is the CHN role in the situation?
HHNs care for disabled students in the classroom: Communication is required with the child’s guardian, teacher and/classroom assistant to provide health teaching re child’s status and response to treatment
Demonstrates health maintenance, restoration and palliation through adapting community health nursing strategies (providing teaching to guardian, teacher, and classroom assistant) to health challenges (child’s status and response to treatment) and challenges r/t equity in health in the community setting needed (the classroom)
Which practice standard relates to the following situation; and what is the CHN role in the situation?
CHNs provides ongoing nursing care to families with seniors who are experiencing difficulties. The care may be provided directly or through unregulated workers. This may include telephone follow-up, home visits or community referrals.
Restoration, maintenance and palliation
d. The CHN maximizes the ability of the seniors by providing care, follow-up, home visits and referrals to the community. Makes connection with community resources
Which practice standard relates to the following situation; and what is the CHN role in the situation?
A HHN working in palliative care listens to the concerns of stressed and exhausted caregivers and supports them in making decisions about respite and hospice care
Professional Relationships
c. Assess beliefs around health and inequities.
f. Respect trust and support the ability of this individual to know her limits.
j. Promote and support linkage with appropriate community resources, in this case hospice and respite care, when this individual was ready to receive it.
Which practice standard relates to the following situation; and what is the CHN role in the situation?
A group of PHN working with families experiencing child care difficulties identify that post natal visits based on issues or tasks moves them around too much to be able to develop a continuing relationship with families. They bring their concern to the attention of management.
Professional relationships
g. The PHN involved this group of women (experiencing child care difficulties) in applying community development principles (the concern of being moved around too much, effecting development of relationships with families brought to the attention of management)
Which practice standard relates to the following situation; and what is the CHN role in the situation?
A HHN encourages a mother and teens to work out a schedule for ROM exercises for the grandmother. The family is happy that they were able to work out the problem together.
Capacity Building
k. Encourage life style choices that support health ( the ROM exercises will support the health of their grandmother)
l. Advocating for the grandmother’s need for ROM exercises, since she is unable to take action on her own.
Which practice standard relates to the following situation; and what is the CHN role in the situation?
A PHN encourages a school to mobilize a school health committee that includes students, parents, teachers, administration, and community partners. Committee members identify the school community’s strengths and needs, and prioritize, plan, implement, evaluate and celebrate action for a healthier school. The school community’s capacity to take its own action for health is enhanced via a sustainable structure (the committee). The PHN is a partner in the process.
Capacity Building
a. The PHN works with the school to form a collaborative health committee that works to identify strengths, needs, and prioritize a plan, implement and evaluate. PHN partners in the process.
Which practice standard relates to the following situation; and what is the CHN role in the situation?
A PHN identifies that one ethnic group does not use health care services (including prenatal classes) outside their area. The PHN works with a champion from this group to organize local prenatal classes delivered by a PHN and translated by a woman from the community.
Access and equity
h. Advocates for equitable access to health and other services (prenatal classes, etc.) and equitable resources allocation (it was not in their error or first language). PHN collaborates with women of the community to translate and organize local delivery of prenatal classes.
f. culturally sensitive care
Which practice standard relates to the following situation; and what is the CHN role in the situation?
A HHN and Case Manager advocate for families caring for medically fragile children by:
• Seeking respite care for an exhausted families
• Contacting the local MPP
Access and Equity
g. the HHN supports families in caring for fragile children by seeking respite care for exhausted families and contacting local MPP to advocate for them
Which practice standard relates to the following situation; and what is the CHN role in the situation?
• A PHN is assigned to work in a needle exchange program based on harm reduction. He has difficulty accepting the tenets of harm reduction and uses reflective practice personally and with his supervisor to understand and change his assumptions.
Professional Responsibility and Accountability
a. Assess and identify risk management issues and take preventative (needle exchange to prevent spread of disease) or corrective action individually or in partnership to protect individuals, families, groups, communities, populations, and organizations from unsafe (needle sharing/dirty needles), unethical, illegal or socially unacceptable circumstances.
p. use reflective practice to assess and improve personal community health nursing practice.
Which practice standard relates to the following situation; and what is the CHN role in the situation?
Both teamwork and communication are reduced after the hiring of a new manager. You have been with the program for awhile and can see that people are not receiving the same level of services and newly hired staff are not being supported. You decide to meet with the new manager to discuss the situation. Depending on the response from the manager, you will either go to a higher level or offer to collaborate to improve the work and service environment.
Professional Responsibility and Accountability
b. Identify ethical issues and address with appropriate person
k. identify and work proactively to address nursing issues that effect clients (individuals, families, groups, communities, populations, or systems)
What is community health nursing?
Community health nursing is an UMBRELLA TERM which describes the work of nurses who WORK in the COMMUNITY
- CHN PARTNER with ppl where they live, work, meet, play, pray, etc. to promote health (ex. streets, shelters, churches, community health centres, outpost stations, workplaces, home)
- Combines theory/knowledge, social science, and public health sciences
What are the key characteristics of CHN?
- Independence
- Autonomy
- Resourcefulness
- Ability to collaborate
- Ability to understand needs of pop
- Strong skills in health assessment and community assessment
- Critical thinking skills
- Understanding of community and community resources
- Understanding of health care system
- Knowledge of legislation (federal, provincial, municipal and professional)
What is the goal of CHN?
Promote health of the client(s)
Define health promotion.
“process of enabling people to increase control over their health and improve their health”
What does health promotion involve?
- health enhancement
- health protection
- disease prevention/treatment
- health restoration/recovery, palliation
What is Primary Health Care?
Health care that is scientifically sound, socially acceptable, universal, clients participate, cost effective, and includes self determination
What are the conceptual foundations of CHN practice?
Health Promotion and Primary Health Care
What is the national CHN organization called?
Community Health Nurses of Canada
What is the CHN provincial organization?
An interest group of RNAO
Community Health Nurses Initiatives Group
CHNIG
What does CHNIG stand for?
community health nurses initiatives group
What are the broad skills of CHN?
- Communication
- Facilitation
- Leadership
- Advocacy
- Consultation
- Collaboration, team building, coalition building
- Community development
- Coordination, resource management
- Case Management
- Direct care/counselling
- Referral and follow up
- Outreach
- Screening
- Surveillance and health threat response
- Educator
- Policy formulator
- Research and evaluation
What are the different types of CHN?
Public Health Nurse Home Health Nurse Mental Health Nurse Military Nurse Occupational Health Nurse Parish Nurse Community Health Nurse Primary Care Nurse/Nurse Practitioner Outpost Nurse Forensic Nurse Other
Define Community (WHO 1988)
A specific group of people, often living in a defined geographical area, who share a common culture, values, and norms and are arranged in a social structure according to relationships which the community has developed over time (WHO 1988
What are the 3 dimensions of community?
People
Place
Function
What is the function of community?
- space and infrastructure for housing, schools, exercise, etc.
- employment and income, distribution of goods, economic growth
- security, protection, law enforcement
- participation, socialization, networking with others
- linkage with other communities and systems with opportunities for growth and capacity building
In the 19th-20th century what were the 3 sectors of nursing?
Hospital
Private duty
PHN and VN/DN (district nurse)
What are some characteristics of the PHN and VN/DN of the 19th and 20th century?
- more educated
- enjoyed more financial reward
- traveled and found new and challenging communities to work in
- usually rural and poor
- sense of adventure, courage, independence
- in practice blurring of boundaries and practice between 2 groups
in the 17th and 18th century who took care of the sick?
women and religious orders (priests and nuns)
In the 19th century what changed?
Industrial Revolution occurred with social changes that include, migration, urbanization, increased pop (due to technological advancements)
What was this issue with urbanization in the 19th century?
- inadequate or non existant sanitation structures
- overcrowding, inadequate housing created urban poverty
- ^ diseases (small pox, cholera, influenza, TB, typhoid)
- resulted in ^ mortality
How did the PH movement begin?
no one wanted to take responsibility for the sick, though the number had increased due to the industrial revolution (poor sanitation, overcrowding, increased disease)
Immigrants arriving in Canada carried ____ causing ___
diseases
spread to aboriginal populations
What factors influenced the change in beliefs around health?
social, economic, political influences
What are the 2 streams of CHN origins?
- DN/VN
2. Public Health Nursing
1900’s PHN was _____. Formed in response to ___, ____ and ___
voluntary
social, economic and political conditions
When was the Public Health Movement?
1890’s to early 1900’s
Public health departments during the public health movement started to ___ nurses.
hire
What were some of the first PH programs to be established?
REGULATION and INSPECTION of…
- water
- milk (milk depots)
- meat
- bread
EDUCATION
- combat disease and death (communicable disease prevention, TB, STIs, hygiene)
SCREENING
PH was not ___ ___ before WW1.
CENTRALLY RUN
PH centrally organized after the Spanish flu in ____ year.
1920’s
What changed over the course of the 20’s through 90’s?
role of the PHN
PHN went from generalist to became more _____
specialized-generalists
PHN role shifted from health promotion to _____ ___.
medical model
When were antibiotics introduced?
after WWII
Today’s PHN has moved toward ___ ______
health promotion (DoH focus)
slide 14
slide 14 HISTORY
