Community Health Nursing: A Canadian Perspective PDF

Community Health Nursing: A Canadian Perspective Fifth Edition Chapter 2 Policy, Politics, and Power in Health Care Copyright © 2020 Pearson Canada Inc....

Community Health Nursing: A Canadian Perspective Fifth Edition Chapter 2 Policy, Politics, and Power in Health Care Copyright © 2020 Pearson Canada Inc. 2-1 Historical Milestones in Community Health Nursing in Canada (1 of 2) The Canadian Constitution requires provinces to provide comparable levels of public service for comparable taxation The federal government encourages equalization by contributing money and giving conditions under which that money is received Copyright © 2020 Pearson Canada Inc. 2-2 Historical Milestones in Community Health Nursing in Canada (2 of 2) Provincial government of Saskatchewan establishes publicly funded healthcare in 1947 and federal government follows suit in 1957 ****Canada Health Act passes in 1984 reinforces five central points across provincial healthcare systems: 1) publicly administered – all administration of 2) comprehensive 3) universal 4) portable 5) accessible Copyright © 2020 Pearson Canada Inc. 2-3 Paradigm Shift in Community Health Nursing (1 of 2) The Lalonde Report of 1974 presented a vision for health promotion services as a critical component of Canada’s health care system Lalonde’s framework identified four determinants of health: environment, lifestyle, human biology, and the health care system These determinants of health were the first step in our current conceptualization Copyright © 2020 Pearson Canada Inc. 2-4 Paradigm Shift in Community Health Nursing (2 of 2) Primary health care goal is the attainment of better health services for all Epp Framework formed the basis of the Ottawa Charter for Health Promotion – Jake Epp, (minister of national health and welfare) paper focused on reducing the inequities in the health of low – income groups. The paper offers implementation strategies encouraging public participation, strengthening community services and coordinating healthy public policy. The Ottawa Charter marked a dramatic shift in health promotion Copyright © 2020 Pearson Canada Inc. 2-5 Organizations of Community Health Nursing (1 of 5) Many factors influence how community health nursing is organized and delivered across Canada, including emerging diseases and health emergencies. Copyright © 2020 Pearson Canada Inc. 2-6 Organizations of Community Health Nursing (2 of 5) Public Health Agency of Canada (PHAC) - Delivers federal government’s commitment to: – help protect the health and safety of all Canadians – focus on prevention chronic diseases and injuries – responds to public health emergencies and infectious disease outbreaks, – strengthening the practice of public health in Canada. Copyright © 2020 Pearson Canada Inc. 2-7 Organizations of Community Health Nursing (3 of 5) There are a limited number of Indigenous-specific policies and frameworks. Some provinces have no specific legislative framework for the responsibilities of health care in Indigenous communities. – Ontario was the first province to develop an Indigenous Health and Wellness Strategy in 1990 and to develop the overarching Aboriginal Health Policy in 1994 Copyright © 2020 Pearson Canada Inc. 2-8 Organizations of Community Health Nursing (4 of 5) Community Health Services - Most Canadian provinces and territories have moved to regional health authority structures for all health service delivery and strives to integrate most or all health services (including CHN services) – Primary Health Care – primary care is a core component – Primary Care – first contact in of clinical services – Public Health - enhances health status of communities and promotes health equity Copyright © 2020 Pearson Canada Inc. 2-9 Organizations of Community Health Nursing (5 of 5) Community Health Services - Most Canadian provinces and territories have moved to regional health authority structures for all health service delivery and strives to integrate most or all health services (including CHN services) – Cultural Competence - reduces health inequities and improves health outcomes – Home Care – safe care for individuals in their homes with dignity Copyright © 2020 Pearson Canada Inc. 2 - 10 Policy, Politics, and Power (1 of 2) Community health nursing practice occurs in a sociopolitical environment. Policy guides the work of community health nursing, and policy making is carried out within a political context CHNs must understand how policy and politics impact on the quality, safety, and accessibility of patient care and their working conditions. Power is knowing the team members and their roles, which team members are part of the decision making process, and future leaders Copyright © 2020 Pearson Canada Inc. 2 - 11 Policy, Politics, and Power (2 of 2) Health equity is undermined when these social conditions interact to prevent people from making decisions or taking actions that would promote health. Fairness in the way we treat people or make decisions are core aspects of social justice. A key part of ensuring good health for all is identifying and enhancing systemic disadvantage. CHNs must effectively navigate this complex policy environment by acknowledging the implications of sociopolitical processes on their practice: micro and macro levels Copyright © 2020 Pearson Canada Inc. 2 - 12 Challenges in Community Health Nursing (1 of 3) CHNs influence the health of individuals, families, communities, and society as a whole. Some challenges they encounter include: – Health system challenges - need for advocacy and collective action to shape system change – Lack of role clarity - need for greater role clarity for CHNs across Canada – Need for strong leadership – lack of contributes to invisibility of CHNs – Issues in interprofessional relationships – strong organizational supports needed Copyright © 2020 Pearson Canada Inc. 2 - 13 Challenges in Community Health Nursing (2 of 3) A central strategy for all CHNs is developing leadership and community influence The Registered Nurses Association of Ontario created “Best Practice Guideline: Developing and Sustaining Nursing Leadership” to discuss the positive impact of leadership in the workplace and community Copyright © 2020 Pearson Canada Inc. 2 - 14 Challenges in Community Health Nursing (3 of 3) Nurse leaders must create and articulate a clear purpose and vision with a broad perspective incorporating multiple aspects of communities, the political environment, and the larger health and social systems Attributes that support community and public health nursing practice include: management practice; organizational culture; and government policy Copyright © 2020 Pearson Canada Inc. 2 - 15