Exam 1 Readings (PDF)

Chapter 1:Community & Prevention-Oriented Practice to Improve Population Health What is public health nursing? ○ What we as a society do collectively to ensure the conditions in which people can be healthy. ○ Healthcare of communities and populations is the p...

Chapter 1:Community & Prevention-Oriented Practice to Improve Population Health What is public health nursing? ○ What we as a society do collectively to ensure the conditions in which people can be healthy. ○ Healthcare of communities and populations is the primary focus of public health (test bank) ○ Monitor disease, promote health, and collect statistics about the community (ATI) What is the mission of public health? ○ To generate organized community efforts to address the public interest in health by applying scientific and technical knowledge to prevent disease and promote health. ○ Promote physical and mental healht and prevent disease, injury, and disability (page 5, Stanhope book) What is the vision of public health? ○ Healthy people in healthy communities The vision and focus of public health and benefits of public health ○ The vision and focus are the healthcare of communities and populations What are the benefits of PH nursing? ○ Safer and cleaner environments and food/water ○ Dramatic increase in life expectancy ○ Decreased number of deaths from heart disease and stroke ○ Declines in death rates of adults and children ○ Motor vehicle safety ○ CDC’s (1999) Ten Great Public Health Achievements in the 20th Century Healthier mother and babies Immunizations Motor vehicle safety Workplace safety Control of infectious diseases Family planning Drinking water flouridation Tobacco as a health hazard What are the 3 core functions of PH? ○ Assessment: systematically collecting data on the population monitoring the population's health status making information about the health of the community available Monitor healht status to identify community health problems (page 5) Diagnose and investigate health problems and health hazards in the community ○ Policy Development: Provide leadership in developing policies that support the health of the population  Using scientific knowledge when making decisions about policies Inform, educate, and empower people about the health issue (page 5) Mobilize community partnerships to identify and solve health problems (page 5) Develop policies and plans that support individual and commity health efforts (page 5) ○ Assurance: The role of PH is to ensure that community-oriented health services are available Includes providing essential personal health services for those who would otherwise not receive them Making sure that a competent public health and personal health care workforce is available Assurance means public health officials should be involved in developing & monitoring the quality of services provided Page 5 Enforce laws and regulations that protect health and ensure safety Link people to needed personal health services and assure the provision of health care when otherwise unavailable Assure a competent public health and personal health care workforce Evaluate effectiveness, accessibility and quality of personal and population-based health services What is the health services pyramid? ○ Tertiary Health Care: Designed to limit the progression of the disease or disability ○ Secondary Health Care: Designed to detect & treat disease in the early acute stage ○ Primary Health Care: Both primary care & public health services are designed to meet the basic needs of people in communities at an affordable cost ○ Clinical Preventative Services: ○ Population-Based Healthcare Services: What is aggregate (population)? ○ Collection of individuals who share one or more personal or environmental characteristics ○ defined in terms of geography (e.g., a county, a group of counties, or a state) or in terms of a special interest or circumstance (e.g., children attending a particular school) can be seen as constituting a population. What is community-based nursing? ○ Goal: manage acute & chronic conditions ○ Focuses on “illness care” across the lifespan by providing comprehensive, coordinated, & continued care Setting specific practice is where people live, work, & attend school What is community-oriented nursing? ○ Goal: prevent disease/ disability , promote/protect/ maintain health  ○ Focuses on “health care” of person, family, or groups in the community Provide health care to promote quality of life Community diagnosis, health surveillance monitoring, & evaluation of community & population What are some challenges for the future in community health nursing? ○ Barriers to nurses specializing in leadership roles in population health initiatives ○ Developing population health nurse leaders ○ Shifting public health practice to address social determinants of health & vigorous policy efforts to create conditions for a health population Chapter 2: The History of Public Health & Public & Community Health Nursing What is the Shattuck Report & what is its impact? Health and living conditions ○ (1850)- Modern approach to public health organization Establishment of state health department & local health boards Sanitary survey & collection of vital statistics Environmental sanitation Food/drug, & communicable disease control well-child care health education tobacco & alcohol control town planning teaching of preventive medicine in medical schools What is the Elizabethan Poor Law? ○ Guaranteed medical care for poor, blind, & “lame” individuals: minimal care provided by almshouses; this care tried to regulate the poor as well as provide refuge during illness What is Frontier Nursing Service? ○ Introduced first midwives in the US ○ Reduced pregnancy complications & maternal mortality & fewer stillbirths What is the Maternal & Infancy Acts (Sheppard-Towner Act of 1921)? ○ Emphasized promoting the health of the mom/ child & encouraged mothers to seek prompt medical care during pregnancy ○ Federal matching funds to establish maternal & child health divisions in state health departments ○ Nurses influenced public policy by advocating for the Children’s Bureau and the Sheppard-Towner Program What is the Industrial Revolution? ○ Previous care structures (family & friends) were not enough so created nursing care institutions & homes ○ During this period small # of catholic & protestant women provided care at institutions & homes ○ Previous care structures became inadequate  ○ Because Great Britain was poorly educated & untrained, community advocates wanted to improve the quality of nursing What is Metropolitan Life Company? ○ Program using visiting nurse organizations to provide care for sick policyholders; nurses assessed illness, taught health practices, & collected data from policyholders What is Instructive District Nursing? ○ (1886) two women wanted to improve their chances of gaining financial support for their cause; the term highlights the relationship of nursing to health education Explain nursing education in the 1950s. ○ (1952): nursing programs started at jr./ community colleges; Louise McManus wanted to see if bedside nurses could be prepared in a 2-year program to prevail nursing shortage ○ Public health nursing became required for baccalaureate nursing education programs (1950) Explain school nursing in the early 20th century. ○ Jane Delano in 1909, supported the the need for PH nurses to stay in the U.S. for people who were not serving in the army ○ 1918- influenza pandemic hit & turned houses, churches, & social halls into hospitals for sick & dying patients ○ Limited funding was an issue & relied on contributions from the wealthy & middle class; it required a small fee from poor families for services ○ 1909- Metropolitan Life Insurance Company was made ○ 1912- Metropolitan Life Insurance & maternal/infant welfare ○ 1925- Frontier Nursing Service Founder : Mary Breckinridge ○ Nurse-managed centers now provide a range of nursing services, including health promotion & disease & injury prevention, in areas where existing organizations have been unable to meet community & neighborhood needs. ○ These centers provide valuable services but typically face many challenges in securing adequate funding. What is the Affordable Care Act of 2010? ○ Changes in insurance plans and coverage and it continues to be controversial with continued debate among congressional members ○ Ensures affordable, accessible, & high-quality health care for the uninsured & those who had inadequate health insurance ○ emphasizes preventive care & management of chronic disease Historical Figures: ○ Mary Breckinridge: Frontier Nursing Services (FNS) founded by M.B. introduced the first nurse-midwives into the United States when she deployed FNS nurses trained in nursing, public health, & midwifery Reduced pregnancy complications/ maternal mortality and to one-third fewer stillbirths and infant deaths in an area of 700 square miles in Appalachia (Kalisch and Kalisch, 1995  ○ Florence Nightingale: Organized hospital nursing practice and nursing education in hospitals to replace lay nurses with trained nurses Nursing should promote health & prevent illness,& emphasized proper nutrition, rest, sanitation, & hygiene ○ Lillian Wald: 1st president of the National Organization for Public Health Nursing Firstpublie Established the Henry Street Settlement * Developed approaches & programs to solve health care and social problems Chapter 13: Community Assessment & Evaluation Community - It is a system and NOT just a sum of the characteristics ○ People - The members of the community ○ Place - The geographical location or shared space ○ Function - the goals, aims, and activities of the community Community as client - This is when the nurse focuses on the collective/common good of the population instead of only on individual health ○ Directive primary, secondary and tertiary preventative measures can be used ○ Changes at several levels can ultimately affect the health of the community ○ To improve the health of the community is the overall goal Community partnerships - divides the community structure into subsystems ○ Coalitions (active partnership): formal partnerships where individuals and organizations serve in committees, workgroups, or advisory groups Passive participation: negative approach Active participation: community members are recognized as community leaders Community-focused nursing process [ADPIE] ○ Assessing Define - we must first define the community and the geological boundaries along with the population within that boundary Data Collection - through different types of data collection Analyze the data ○ Diagnosis Establish a community diagnosis ○ Planning Plan programs ○ Implementation Implement programs ○ Evaluation Evaluate program interventions  Healthy People 2030 - identifies public health priorities to help individuals, organizations, and communities across the US to improve their health and well-being. ○ Offers a vision of the future of “healthy” communities & the objectives needed to help fill that vision ○ States that we need to work collectively in community partnerships in order to bring change to fill the vision Data collection methods ○ Primary Source of Data - Health Indicators: collected through interaction of members within the community, which includes community leaders or interested stakeholders Participants observations Windshield Surveys - assess several community components by driving through a community; can give a descriptive overview of the community but requires a driver and transportation and can be time-consuming. Key informative interviews Focus groups Photovoice Secondary analysis of existing data Surveys ○ Secondary Sources of data - Health indicators: Gathered through existing reports on the community (ex: census, statistics & numerical reports) Healthy People 2030 County health ranking ○ Diverse community stakeholders ○ Spatial data