Crisis Management and Characteristics

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Questions and Answers

What is the primary goal of case management?

To conduct research on health outcomes

To ensure all patients receive identical treatment

To improve coordination of services and patient outcomes (correct)

To provide emergency care in healthcare settings

How does care management differ from case management?

Care management is only applicable to chronic illnesses.

Care management focuses on individual patients, while case management focuses on populations.

Both case and care management serve individual patients identically.

Case management focuses on populations, while care management focuses on individual patients. (correct)

What is the role of the Occupational Safety and Health Administration (OSHA)?

Managing worker compensation claims

Creating workplace health promotion initiatives

Enforcing occupational health standards (correct)

Providing healthcare to injured workers

What is a key element of transitional care management?

Face-to-face visits with high-risk patients post-hospitalization Signup and view all the answers

What is an essential activity in case management?

Applying systems and evidence-based science to improve practices Signup and view all the answers

Which of the following is NOT a responsibility of occupational health nurses?

Managing compensation claims for patients Signup and view all the answers

Which statement best describes home health services eligibility?

Patients must be receiving care from a physician and be homebound. Signup and view all the answers

What is a major focus of research in occupational health nursing?

Evaluating the effectiveness of primary care delivery at work sites Signup and view all the answers

What is a primary focus of health promotion in families?

Preventing chronic illnesses through lifestyle changes Signup and view all the answers

Why is care coordination essential in healthcare?

It integrates fragmented care and improves patient transitions between services. Signup and view all the answers

What is a common characteristic of a healthy family?

Facilitative processes of interaction among members Signup and view all the answers

Which framework emphasizes communication and decision-making processes within a family?

Interactional framework Signup and view all the answers

In the family nursing process, which phase involves helping families implement a plan and evaluate outcomes?

Implementation and Evaluation Signup and view all the answers

What defining characteristic separates the epidemiological triangle from other models?

Three components: host, agent, and environment Signup and view all the answers

What is the purpose of conducting a family health assessment?

To gather insights into health behaviors and dynamics Signup and view all the answers

What aspect of family dynamics can significantly influence an individual's health?

Shared dietary practices Signup and view all the answers

Which of the following best describes the term 'endemic' in relation to disease occurrence?

Disease consistently present within a geographic area Signup and view all the answers

In case management, what is a primary objective of a case manager?

To ensure appropriate service delivery across settings Signup and view all the answers

Which framework of family assessment considers a family's life cycle and the evolving roles of its members?

Developmental framework Signup and view all the answers

Which principal aspect influences the ability of families to adhere to health promotion practices?

Exposure to similar dietary behaviors Signup and view all the answers

In the context of epidemiology, what does the term 'relative risk' mean?

Comparison of disease occurrence rates between two groups Signup and view all the answers

Which scenario illustrates a family life event that may influence health outcomes?

Experiencing a major illness or loss in the family Signup and view all the answers

What role do case managers play in community health settings?

They help coordinate care and resources for patients Signup and view all the answers

What is a primary reason families find it difficult to engage in care management?

Limited access to resources and support Signup and view all the answers

Which type of crisis occurs during periods of transition in normal growth and development?

Developmental Crisis Signup and view all the answers

What is the primary focus of secondary prevention in crisis management?

Early diagnosis and prompt treatment Signup and view all the answers

Which factor is NOT associated with the perpetration of partner or spousal abuse?

High academic achievement Signup and view all the answers

What is a characteristic sign of Shaken Baby Syndrome?

Bilateral retinal hemorrhages Signup and view all the answers

The cycle of violence includes all of the following stages EXCEPT:

Complete recovery Signup and view all the answers

Which of the following is a common misconception about the factors that contribute to elder abuse?

Elder abuse predominantly occurs in affluent families Signup and view all the answers

The acronym IS PATH WARM identifies warning signs for which issue?

Suicidal ideation Signup and view all the answers

Which of the following is a key role of community health nursing in family crisis situations?

Assessment of crisis responses and coping abilities Signup and view all the answers

Which statement about the characteristics of victims of intimate partner violence (IPV) is true?

Young females, especially those who are pregnant, are often at higher risk Signup and view all the answers

What underlying elements are essential for identifying potential cases of human trafficking?

Fraud, force, coercion Signup and view all the answers

Which of the following strategies is NOT effective in preventing elder abuse?

Isolation of at-risk elders from their families Signup and view all the answers

What is a potential lifelong impact on children who witness domestic violence?

Increased likelihood of engaging in criminal activity Signup and view all the answers

Which of the following statements about multiple crises is true?

They can compound stress felt by individuals. Signup and view all the answers

In crisis management, which approach emphasizes promoting health and reducing vulnerability?

Primary prevention Signup and view all the answers

Study Notes

Crisis/Abuse - Characteristics of a Crisis

Internal or external forces disrupt a system's balance
Attempts to restore balance through coping mechanisms
A specific identifiable event triggers the crisis, becoming too overwhelming for usual problem-solving skills
People experience occasional overwhelm, but this isn't necessarily a crisis
Crisis resolution can be positive (adaptive, growth, improved health) or negative (maladaptive, illness, death)

Types of Crises

Developmental: Periods of disruption at transition points during normal growth and development
Situational: Stressful disruptive events arising from external circumstances, often sudden and without warning (affecting individuals, groups, aggregates, or communities)
Multiple: Multiple overlapping crises can worsen experiences for individuals involved

Primary Prevention

Health promotion and education:
- Anticipatory guidance
- Parenting skills
- Positive coping strategies
- Social problem-solving skills and assertiveness
- Social support and resources
Health protection:
- Reduce vulnerability factors
- Reduce hazards in events

Secondary Prevention

Early diagnosis of crisis/abuse signs/symptoms
Prompt treatment

Reporting of abuse

Provide necessary assistance
Refer to resources
Set goals with clients
Ensure client safety

Tertiary Prevention

Promote adaptation to changed levels of wellness
Promote independence
Reinforce newly learned behaviors and lifestyle changes
Explore learned behaviors in new situations
Identify and use additional resources
Continue primary prevention to avert future crises

Specific Abusive Situations

Shaken Baby Syndrome:
- Bilateral retinal hemorrhages
- Subdural or subarachnoid hematomas
- No other external abuse signs
- Breathing difficulties, seizures, dilated pupils, lethargy, and unconsciousness
Munchausen Syndrome by Proxy:
- Parent or caretaker attempts to bring medical attention to self by injuring or inducing illness in the child
Internet crimes against children, Child abduction, Crimes against children by babysitters, School violence, Physical abuse
Bruising, lacerations, abrasions, and fractures associated with physical abuse
Partner/Spousal Abuse/Dating violence
- Includes physical, sexual, emotional, economic, or psychological abuse
- Violence during pregnancy
Cycle of Violence
- Tension building
- Acute battering
- Loving reconciliation
Batterer Characteristics
- Low income, low self-esteem
- Low academic achievement
- Involvement in aggressive or delinquent behavior as youth
- Heavy alcohol and drug use
- Depression
- Anger and hostility
- Personality disorders
- Prior history of being physically abusive
- Few friends and isolation from others
- Unemployment
- Emotional dependence and insecurity
- Belief in strict gender roles
- Desire for power and control
- Victim of physical or psychological abuse
Victim Characteristics
- Prior history of physical violence
- Young age (especially pregnant)
- Low income
- Witnessing/experiencing abuse as a child
- Low education level
- Unemployment
- Single parent with children
- Different ethnicity than partner (males)
- Greater education level than partner (women)
- Being AA/Indian (women)
- Disabled (women)
- Verbally abusive or jealous or possessive partner (women)
- Veterans and active military (women)
Effects of Violence on Children -Increased risk of abuse victim or perpetrator -Increased risk of substance abuse -Increased risk of depression and anxiety -Hindered health and development -Increased risk of poor school performance

Other Forms of Family Violence

Suicide (warning signs - IS PATH WARM)
Homicide
Rape
Elder abuse
IS PATH WARM: Ideation, Substance abuse, Purposelessness, Anxiety, Trapped, Hopelessness, Withdrawal, Anger, Recklessness, Mood change
Neglect, Physical, Sexual, Emotional, or Fiduciary abuse
Perpetrator characteristics, Victim characteristics, Risk factors (invisibility, vulnerability)
Factors contributing to Elder abuse

Human Trafficking

Elements of trafficking: fraud, force, coercion
Estimated 14,500 to 17,500 people trafficked into the US yearly
Risk factors: Primarily female (20% male), transient living, youth, unaccompanied minors, foster system involvement, history of sexual/physical abuse, substance use, LGBTQ+, gang involvement, disability, ESL
Risk factors & comorbid conditions

Exposure to violence/sexual violence, Psychological violence, Children removed, Abortion, Injury, Mental health issue, STI, Addiction, Suicidal.

Signs/symptoms: Scripted/inconsistent story, History of physical/sexual abuse, Unable to provide address, unable to provide emergency contact, No social network, Cash pay, Anxious, Refusal to be without phone, No ID, Not allowed to speak for themselves, Avoids eye contact, Hostile behavior
Physical Exam, Constitutional, Well groomed, Sex Trafficking Language, Dermatological, GU, Obstetrics, HEENT, Pharyngeal trauma, Broken teeth, Hearing loss, Vision issues, Substance abuse

Pathological caregivers

Learned hopelessness, living in violent neighborhoods

Preventing Elder Abuse

Awareness/education through media campaigns
Increase care attention directed at unique needs of elders
Training for caregivers
Statutory requirements for reporting abuse
Crisis hotline, World elder abuse awareness day

Epidemiology/Outbreak Surveillance

Science of PH- distribution and determinants in specified populations
Epidemiology- focus on patterns, causes, and effects of health & disease in populations. Provides foundation for understanding spread, risk factors, and prevention strategies
Role of epidemiology: Data collection to identify trends, identify risk factors of specific populations, assess and implement interventions targeted at high-risk groups

Wheel Model of Human-Environment

Host- genetic, personality, environmental- social, biological, physical
Frequency rates- measuring birth, death, and morbidity for health and disease
Incidence- occurrence of new cases
Prevalence- total with the disease

Communicating Disease- Principles

Principles of infection: Multicausation (host, agent, environment), Spectrum of infection (stages of infection), Latency, Communicable, Incubation period, Spectrum of disease occurrence (incidence)
Endemic, Outbreak, Epidemic, Pandemic, Chain of transmission (pathologic agent, reservoir, portal of exit, transmission, portal of entry, host susceptibility)
Breaking Chain of Transmission
- Inactivating the agent
- Eliminating the non-human reservoir
- Controlling human reservoir (and ports of entry/exit)

Immunity

Natural: protecting body develops after fighting off an infection -Active: body actively produces own antibodies -Passive: person receives antibodies from an outside source, like breastfeeding
Artificial -Active: vaccination with weakened or inactive pathogen (e.g., flu, MMR) -Passive: direct antibody receiving (e.g., immune globulin)

Infection (new or latent)

Treatment: Isoniazid for 6-9 months for all new/latent infections, Treat HIV patients with Isoniazid in conjunction with antiretrovirals

Care of Family

Defining family, Many ways to define, Examples, a Gang is a Family

Kinship, Relations & Residence

Important individuals, Conceptual frameworks (interactional, Structural-functional, developmental)

Purpose of the Family

Meets needs of individuals (economic, protective, emotional support)
Meets needs of society (socializing children)

Characteristics of a Healthy Family

Facilitative interactions, healthy development, effective relationships, strong home environment, links with the community
Characteristics of a changing family -Marriage: Increased later marriage, rising rates of cohabitation -Children: Later having children, fewer children, more childless couples -Household: Increased multigenerational households

Nursing Process

Assessment (Family interview), Methods (Genogram, Eco-map), Diagnosis (Health promotion, Role relationships, Coping/stress tolerance), Planning, Implementation (Nurses help families), Evaluation

Barriers to Healthcare

Family apathy/indecision, nurse imposed ideas, labeling, overlooking strengths, cultural/gender implications, perceptions of hopelessness, fear of failure, limited access to resources, limited finances, fear/distrust of healthcare systems

Case Management

Variety of pt care programs (acute hospitals, community settings)
Case managers work in various settings (medical homes, occupational health, geriatrics, ambulatory care clinics)
Case management is a service approach (cost-effective, access to care, alternatives to institutionalization, coordination of services)

Case Management essential activities

looks at individuals, populations
Improve coordination of services for elderly, low income families with chronic illness

Transitional care management

Face-to-face visits with high-risk patients post-hospitalization to prevent readmission and improve pt outcomes

Occupational Health

Work environment is not risk free
Preventative and restorative care
OSHA (Occupational Safety and Health Administration) is the regulatory agency for occupational health
Code of Federal Regulations (29CFR1910) for health standards
Focus on illness and injury, and physical/chemical/biological/ergonomic/psychosocial factors affecting workers
Supervising care, counseling for health risks, following up on workers' compensation claims.

Home Health

Service is aimed at helping patients regain independence and increase health outcomes
Physician authorization is required, Patients must be eligible, and regularly reviewed, as well as needing skilled nursing, therapy (in home care) and homebound.
Home visits, initial phone call, improving communication, relationship building, specific interventions, assessments, diagnosis, care plan development, evaluation.

Performing periodic health assessments,Evaluating health status of employees returning to work, Disaster planning, Safety in work place

Focus on effectiveness of primary care delivery, health promotion, workplace stress, and effects of stressors

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Description

Explore the various characteristics and types of crises through this quiz. Understand the impact of internal and external disruptions, and examine primary prevention techniques including health promotion and education. Challenge your knowledge on developmental, situational, and multiple crises.