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Community and Public Health > Week 2 > Flashcards

Week 2 Flashcards

1
Q

Early Periodic Screening, Diagnosis and Treatment (EPSDT)

A
  • federal law
  • 1969
  • children and adolescents younger than 21 have access to periodic screenings
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2
Q

Education for all handicapped Children Act

A
  • 1975
  • federal law
  • free and approporaite public education for people with disabilities
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3
Q

Americans with Disabilities Act

A
  • 1990
  • wide-ranging federal legislation
  • intended to make American society more accessible to people with disabilities
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4
Q

Individuals with Disabilities Education Act (IDEA)

A
  • Federal law
  • 1990; reauthorized 1997
  • free and appropriate public education regardless of ability
  • can provide additional special education services and procedural safeguards
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5
Q

Youth Risk Behavior Surveillance Survey (YRBSS)

A
  • biannual report on common risk behaviors influencing health of nation’s youth
  • school nurse can use as tool for monitoring trends locally and nationally
  • Safety
  • Violence Related Behavior
  • Bullying
  • Suicide
  • Tobacco, Alcohol, Drug, Marijuana use
  • Sex
  • Weight
  • Breakfast
  • Physical Activity
  • Asthma, Sleep, Grades
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6
Q

Role of School Nurse

A
  • Health Assessment
    • individual
    • population based
    • health promotion
    • school health needs
  • Health Educator
  • Emergency Preparedness
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7
Q

Common Health Concerns for School Nursing

A
  • drugs and alcohol
  • smoking
  • sexual behavior and teenage pregnancy
  • sexually transmitted infections
  • nutrition
  • violence
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8
Q

School Nurse as Child Advocate

A
  • Provide education and communication necessary to ensure that the student’s health and educational needs are met
  • Implement strategies to reduce disruptions in the student’s school activities
  • Communicate with families and healthcare providers as authorized
  • Ensure students receive Rx meds and that staff is knowlegeable about those meds
  • provide safe and healthy school environment to promote learning
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9
Q

Advance Directives

A
  • written instructions to a healthcare provider BEFORE the need for medical treatment
  • allows informed consent when no longer able to give consent
  • refusal or agreement to future treatment
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10
Q

Five Wishes

A
  • The person I want to make decisions if I cannot
  • The kind of medical treatment I want/don’t want
  • How comfortable I want to be
  • How I want people to treat me
  • What I want my loved ones to know
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11
Q

POLST

A
  • Physicians’ Orders for Life Sustaining Treatment
  • started in Oregon 1991
  • not a living will - MD order for patient preferences
  • can be applied across care settings
  • having POLST decreases unwanted treatment and enhances symptom management at EOL
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12
Q

Palliative Care

A
  • Palliate: to decrease the severity of symptoms but not cure
  • Optimal quality of life is primary goal
  • focus - treating symptoms not the disease itself
  • Highest priority is comfort
    • physically, mentally, emotionally, spiritually for patient and their support system
  • It is possible to receive curative treatment and aggressive medical mgmt while receiving palliative care (unlike hospice)
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13
Q

Palliative Care (2)

A
  • Affirms Life
  • Regards dying as normal process
  • neither hastens nor postpones death
  • focuses on relief from symptoms
    • pain
    • N/V
    • constipation
    • SOB
    • anxiety, depression
  • integrates psychosocial and spiritual aspects of care
  • offers support system to help patients age in place with highest quality of life
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14
Q

Hospice

A
  • hospice IS a form of palliative care
  • NOT a place - it is “Concept of care”
  • focuses on caring, not curing
  • QUALITY of life is paramount
  • requires MD certification of terminal illness (6 months or less)
  • provides more supportive care than general palliative care
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15
Q

Hospice Benefits

A
  • superior pain and symptom management
  • less hospitalizations
  • fewer invasive procedures
  • increased care through hospice team
  • bereavement support for up to 13 months
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16
Q

Hospice Limitations

A
  • provides additional layer of support - not meant to be sole provider
  • available 24/7 but not present 24/7
  • treatments must be palliative to be part of plan of care
  • hospice does not pay for items outside of Palliative Care Plan
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17
Q

What Medicare covers through hospice

A
  • physician services
  • nursing care
  • med equipment and supplies related to prognosis
  • meds for symptom management and pain relief
  • short term inpatient care (including respite)
  • home health aide and homemaker services
  • ST, PT and OT, when appropriate
  • medical social services
  • spiritual support
  • bereavement counseling
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18
Q

Levels of hospice care

A
  • routine (not in crisis)
  • inpatient (higher level of acuity for specific reasons)
  • respite (for caregiver)
  • continuous (to help pat and family adjust to crisis period in home setting. Used in situations that would otherwise require hospitalization)
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19
Q

Documentation in Hospice

A
  • Attending and hospice medical director must BOTH certify the patient as terminally ill
  • Nursing: Focus is on the decline
  • Care planning
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20
Q

Care Management

A
  • coordination of a plan or process to bring health services together as a common whole in a cost effective way
  • continuity of care: goal of nursing practice in the community; requires making linkages with services to improve client’s health status
21
Q

Case Management

A
  • development and coordination of care for a selected client or family
22
Q

Advocacy

A
  • activities for the purpose of protecting the rights of others while supporting the clients responsibility for self-determination
23
Q

Home Care

A
  • part of a continuum of care where clients have the opportunity to live and move through the experiences of subacute, chronic and end of life care
  • care given in the home setting is interdisciplinary in nature
24
Q

Home Care: Qualifications for Receipt under Medicare

A
  • over 65 or permanently disabled
  • under care of MD
  • confined to home (homebound)
  • in need of skilled nursing service, PT, OT or ST which is medically necessary
  • intermittent basis
25
Q

Reimbursement Home Care

A
  • emphasizes episodic and skilled care
  • does not reimburse for prevention of illness or injury although this can be incorporated into general care plan
  • HCFA (CMS) form is plan of care
    • must be signed by MD and nurse
    • certifies homebound, under medical care, in need of reasonable and necessary home care services
26
Q

Important Dates in Home Care

A
  • 1885 first VNA in Buffalo, Philly and Boston
  • 1940 - hospital interest in HC increased
  • 1966 - Medicare established
  • Balanced Budget Act - cut 16 million from homecare, many closed
  • 2003 - Medicare Modernization and Improvement Act - eliminated inflation
27
Q

OASIS and Omaha

A
  • OASIS
    • type of plan of care
    • tool for initial screening assessment in homecare
  • Omaha
    • 1970 developed by VNA of Omaha
    • screening for homecare
    • assessment and interventions
28
Q

Types of Home Care Agencies

A
  • private/volunatry (not for profit)
    • example VNA
  • hospital based
  • proprietary (for-profit)
    • Bayada, Keystone
  • Official
    • ex. local health department (screenings, immunization clinic)
29
Q

Home Care Models

A
  • Assisted living
  • home visits to the homeless
    • immunizations
    • Code Blue
  • parish/faith community nursing
  • Project Point
    • in Philly; needle exchange
30
Q

Home Visit Initiation and Prep

A
  • Initiating the visit
    • may happen in hospital
  • Preparation
    • Equipment
    • Directions
    • Personal Safety
31
Q

Home Visit: Actual Visit

A
  • assess for risk of medication errors
  • assess for risk of falls
  • assess for risk of abuse and neglect
  • termination of visit
    • go through plan
    • make sure plan understood
    • set up next visit
  • postvisit planning
32
Q

Nurse-Family Interactions in Home Care

A
  • Culture
    • religious, etc
  • Contracts
    • alcoholism, abuse
  • Confidentiality
33
Q

Telehealth

A
  • electronic communication to deliver
    • acute care and specialty consultations
    • home telenursing
    • electronic referrals to specialists in expert health facilities
34
Q

OSHA

A
  • Occupational Safety and Health Administration
  • federal agency
  • sets exposure standards
  • responsible for enforcement of safety and health legislation
35
Q

National Institue of Occupational Safety and Health (NIOSH)

A
  • federal agency
  • ensure safe and healthy working conditions by
    • conducting scientific research
    • gatehring information
    • providing education and training ain occupational safety and health
36
Q

Occupational Health Nursing: Primary Rsponsibility

A
  • injury prevention and health promotion
    • including recognition of conditions that may harm individual worker or community
  • nursing process begins with assessment of both worker and the workplace
37
Q

Worker and Workplace Hazards

A
  • biological
  • chemical
  • physical
  • psychosocial
38
Q

Epidemiologic triad

A
  • host
    • worker, worker family
  • agent
  • environment
    • all external factors
39
Q

Ergonomics

A
  • study of the relationshio between people and their working environment
40
Q

Biological hazards

A
  • hazards resulting from living organisms that cause adverse effects on people
  • poisonous plants
  • snakes
  • insects
41
Q

Chemical Hazards

A
  • generated from liquids, solids, dusts, fumes, vapors and gases
    • drugs
    • toxins
    • aerosols
    • cleaning substances
42
Q

Physical Hazards

A
  • hazards that result from the transfer of physical energy to workers
    • magnetic
    • UV radiation
    • heat/cold stress
43
Q

Psychosocial hazards

A
  • all organizational factors and interpersonal relationships in the workplace that may affect the health of the workers
    • problems in the home (divorce etc. . .)
44
Q

Root Cause Analysis

A
  • a process for understanding and solving a problem with the goal of determining what happened, why it happened and what can be done to prevent its recurrence
45
Q

Workplace Walk-Through

A
  • a complete survey of the workplace, inside and outside, compiling information as to the presence of hazards, the location of entries and exits, the availability of emergency equipment and potential trouble spots
46
Q

OHN: Implementing Health Promotion in Workplace

A
  • developing a team approach
  • choosing interventions
  • implementing a smoking cessation program
47
Q

Epidemiology and occupational Health

A
  • epidemiologic surveillance
    • incidence
    • prevalence
    • ratios
  • epidemiologic studies
    • the knowledge base generated through epidemiologic studies is used to identify and prevent injury and disease
48
Q

OHN and Emergency/Disaster

A
  • OHN nurses participate in concepts of emergency preparedness plan
  • critical functions of plan

Community and Public Health (8 decks)

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