Primary Health Care Study Guide PDF

Class #1 Study Guide: Primary Health Care & Health Care Systems 1. What is Primary Health Care? ​ Definition: A comprehensive, multisectoral approach focusing on empowered communities, primary care, and essential public health functions 2. Roles and Benefits of Primary Health Care ​...

Class #1 Study Guide: Primary Health Care & Health Care Systems 1. What is Primary Health Care? ​ Definition: A comprehensive, multisectoral approach focusing on empowered communities, primary care, and essential public health functions 2. Roles and Benefits of Primary Health Care ​ Roles: ○​ Continuous and comprehensive care. ○​ Connection to social welfare and public health services. ○​ Quality services for vulnerable populations. ​ Benefits: ○​ First point of professional care. ○​ Preventative measures (screenings, immunizations). ○​ Increased accessibility to healthcare services. 5. Primary Care vs. Primary Health Care ​ Primary Care: ○​ First point of contact (doctors, nurses, NPs). ○​ Focuses on medical care for individuals. ○​ Preventive Care: Focuses on preventing illnesses through vaccinations, screenings, health education, and lifestyle counseling. ○​ Diagnosis and Treatment: Physicians diagnose and treat common health issues, from minor ailments to chronic conditions, and provide specialist referrals. ○​ Continuity of Care: Emphasizes long-term patient-provider relationships for better health history understanding. ○​ Coordination: Manages referrals, hospital admissions, and follow-ups. ​ Primary Health Care: ○​ Broader concept including SDoH ○​ Integrates health promotion, disease prevention, and public health initiatives. ○​ Equity and Access: Ensures access to essential healthcare services without financial hardship or discrimination. ○​ Community-Centered: Engages communities in health decision-making and service planning. ○​ Interdisciplinary Approach: Collaborates with healthcare professionals, social workers, nutritionists, and specialists to address health determinants.  ○​ Health Promotion: Focuses on education, sanitation, nutrition, and lifestyle changes. ○​ Sustainability and Empowerment: Builds self-reliance and empowers individuals and communities to manage their health. 7. Levels of Health Care ​ Primordial: Prevent risk factors (helmets, seatbelts). ​ Primary: First contact, health promotion, counselling. ​ Secondary: Screening, referrals, early disease detection. ​ Tertiary: Chronic disease management, rehabilitation. ​ Quaternary: Advanced specialized care (dialysis, chemo). 8. Five Principles of Primary Health Care (AAHIP) 1.​ Accessibility: Health services for all. 2.​ Appropriate Skills & Technology: Effective tools for healthcare delivery. 3.​ Health Promotion: Education and prevention. 4.​ Intersectoral Collaboration: Cooperation across sectors. 5.​ Public Participation: Community involvement in health decisions. 9. Five Elements of Primary Health Care 1.​ Primary care 2.​ Health 3.​ Care 4.​ Health Promotion 5.​ Population Health 10. Health Care Delivery in Canada & BC ​ Shift from hospitals to community-based primary care. ​ Health Authorities (3): ○​ WHO (Global) ○​ PHAC (Canada) ○​ BC Ministry of Health, regional health authorities. ​ First Nations Health Authority (FNHA): Unique model providing culturally appropriate care. ​ Primary Care Networks (PCNs): ○​ Integrated community-based care. ○​ Focus on marginalized populations. 11. Team-Based Primary Health Care  ​ Interdisciplinary Teams: Nurses, NPs, physicians, social workers, counsellors, dietitians, OTs, PTs. ​ Tuckman’s Team Phases: ○​ Forming: Establish roles. ○​ Storming: Resolve conflicts. ○​ Norming: Create collective identity. ○​ Performing: Encourage innovation. ​ Benefits of Team-Based Care: ○​ Seamless transitions, reduced duplication, better patient outcomes, improved communication, cost reduction. 1. BC’s Population and Public Health Framework ​ Part of the Strengthening Public Health Initiative. ​ Guides community health by outlining a vision for population and public health systems. 2. Ottawa Charter for Health Promotion ​ Signed at the First International Conference on Health Promotion (WHO, Ottawa, 1986). ​ It discusses the prerequisites for health (SDoH) ​ Identifies fundamental conditions necessary for health: ○​ Peace, Shelter, Education, Food, Income, A stable ecosystem, Sustainable resources, Social justice, and Equity 3. Social Determinants of Health (SDoH) ​ Key determinants from The Canadian Facts: ○​ Income & Distribution, Education, Employment, Food Security, Housing. ○​ Indigenous Ancestry, Race & Social Exclusion, Social Safety Net. ​ Canadian Nurses Association: Nurses should integrate SDoH in assessments and interventions. ​ Improved in health requires a secure foundation in these basic prerequisites 4. Community/Public Health Nursing ​ Combines primary healthcare and nursing practice in a community setting. ​ Settings: Homes, schools, community centers, care homes, and police custody. ​ Objective: Reduce hospital treatments by promoting preventative care. 5. Standards of Practice for Community Health Nursing ​ Defined by Community Health Nurses of Canada. ​ Provides a framework for RNs in community/public health nursing. 6. Primary Focus of Community Health Nursing ​ Holistic Approaches to Health & Wellness ​ Addressing Health Disparities. ​ Promoting Active Lifestyles. ​ Mental Health Support & Awareness. 7. Population Health Promotion Model ​ Guiding questions for nursing action: 1.​ With whom? (Individuals, families, communities, systems). 2.​ How? (Strategies from the Ottawa Charter). 3.​ What? (Addressing health determinants). ​ Focuses on primary and secondary prevention. 8. Client-Centered Care Approach ​ Principles: ○​ Improves health outcomes along the continuum of care ○​ Utilizes evidence-based practices and outcomes ○​ Maintains or enhances access and capacity ○​ Streamlines patient flow ○​ Supports individual self care and self responsibility ​ Upstream Health Care Focus: ○​ Strengths and assets of individuals, families, communities ○​ Where the client is at – “recognize and provide care from where the client is at” ○​ Collaborative relationships ○​ Capacity building ○​ Empowering ○​ Health education – to promote behavior change 9. Community Assessments ​ Definition: A community assessment is the ongoing systematic quantitative and qualitative appraisal of a community ​ Purpose: ○​ Identify community needs, gaps, and strengths. ○​ Assess for resources and develop health improvement strategies. ​ Methods: ○​ Windshield Survey: Observational data collection (primary data). ​ Most common tool used to conduct a community assessment ​ An informal survey where health professionals observe and document community strengths and gaps ○​ Epidemiological data, census reports, interviews with key informants. ​ Assessing for: ○​ Community fitness centers ○​ Childcare ○​ Trending health issues ○​ Health services ○​ Cooling, warming spaces ○​ walkability/accessibility ○​ Transit ○​ housing 10. Public Health Nursing Process (ADPIE) ​ Community Assessment: Gather data on community health. ​ Diagnosis: Identify health needs. ​ Planning & Interventions: Develop strategies to address issues. ​ Evaluation: Assess effectiveness of interventions. 11. Nursing Diagnosis Example ​ Format: "Problem", "due to", "as evidenced by". ​ Example: Decreased senior physical fitness due to lack of walkability as evidenced by absence of safe sidewalks. 12. The 7 A’s for Community Health Services Assessment 1.​ Acceptability – Cultural congruence 2.​ Access – Availability when needed 3.​ Adequacy – Sufficient quantity of services 4.​ Affordability – Financial feasibility 5.​ Appropriateness – Relevance to population needs 6.​ Availability – Convenience in time and location  7.​ Awareness – Community knowledge of services. 1. Health Equity and Equality, Disparities, and Discrimination ​ Health Equity vs. Equality: ○​ Equality: Treats everyone the same, assuming equal starting points. ○​ Equity: Provides resources based on individual needs to ensure fair outcomes. ​ Health Disparities: Differences in health outcomes between populations. ​ Discrimination: Unequal treatment based on group membership. 2. Social Determinants of Health (SDoH) ​ Key Factors: Income, Education, Employment, Food Security, Housing. ​ Vulnerable Populations: ○​ 2SLGBTQIA+ ○​ Those with disabilities ○​ Immigrants ○​ Indigenous populations ○​ Racialized groups ○​ Canadians in remote areas 3. Health Inequality vs. Health Inequity ​ 4 main concepts that affect the health of individuals, groups, populations ○​ 1. Health equality ○​ 2. Health inequality ○​ 3. Health equity ○​ 4. Health inequity ​ Health Inequality: Differences in health status due to varying life conditions. ​ Health Inequity: Unfair differences in health outcomes due to systemic barriers. ​ Causes of Health Inequities: ○​ Unequal distribution of income, power, and wealth. ○​ Structural barriers (e.g., access to healthcare, nutritious food, clean water). ○​ Differences peoples’ health status and differences in the care that people receive and the opportunities they have to lead healthy lives ​ Differences in: ​ Health status (e.g. life expectancy) ​ Access to care (e.g. availability of given services) ​ Quality and experience of care (e.g. levels of patient satisfaction) ​ Behavioural risks to health (e.g. smoking rates) ​ Wider determinants of health (e.g. quality of housing) 4. Addressing Health Inequities ​ Solutions to Health Inequity: ○​ Remove systemic barriers. ○​ Address discrimination and biases in healthcare. ○​ Provide universal and targeted health services. ​ Proportionate Universality: ○​ Universal programs with additional support for those in greater need. ​ Examples: ○​ Mobile screening clinics for underserved populations. ○​ Health education targeted at specific cultural or racial groups. 5. The Social Gradient in Health ​ Definition: Higher income levels correlate with better health outcomes. ​ Effects of the Social Gradient: ○​ Lower socioeconomic status = Higher health risks. ○​ Affects life expectancy and chronic disease prevalence. 6. Systemic Racism and Indigenous Health ​ Key Reports and Initiatives: ○​ Joyce’s Principle (Ensuring equitable access for Indigenous peoples). ○​ In Plain Sight Report (Addresses racism in BC’s healthcare system). ​ Impacts: ○​ Discrimination leads to lower healthcare access and poorer health outcomes. ○​ Indigenous communities face disproportionately high chronic disease rates. 7. Nurses' Roles in Health Equity ​ Equity-Oriented Care Strategies: ○​ Recognizing social determinants of health. ○​ Implementing trauma and violence-informed care. ○​ Advocating for policy changes to reduce systemic barriers 1. Marc Lalonde Report ​ Key Ideas: ○​ Shifted focus from just doctors and hospitals to biology, environment, lifestyle, and health care as determinants of health (Social Determinants of Health - SDoH).  ○​ Politicians took years to recognize the importance of SDoH and redirect funds to community-based health care. ○​ Impact: ​ One of the most influential documents in health promotion. 2. Alma-Ata Declaration ​ Key Ideas: goal is commitment to primary health care ○​ Advocated for community and individual self-reliance in health. ○​ Emphasized equitable and sustainable improvements in health. ○​ Impact: ​ Strengthened the global movement toward universal healthcare and primary care models. ○​ Everyone deserves 3. Framework for Health Promotion – Jake Epp Report ​ Key Ideas: ○​ Goal: To help Canadians meet emerging health challenges. ○​ Introduced the term “Health Promotion”. ○​ Impact: ​ Laid the foundation for policies supporting preventative care and health education. 4. Ottawa Charter for Health Promotion ​ Key Ideas: ○​ Built on the Lalonde Report (1974), the Alma-Ata Declaration (1978), and the Jake Epp Report (1986). ○​ Ottawa Charter’s Key Strategies for Health Promotion: ​ Building healthy public policies ​ Creating supportive environments ​ Strengthening community action ​ Developing personal skills ​ Reorienting health services toward prevention ○​ Impact: ​ Defined health promotion as a process that enables people to take control of their health. 5. Astana Declaration of the Alma-Ata Declaration ​ Key Ideas: reaffirming alma-atma  ○​ Reaffirmed global commitment to primary health care and universal health coverage. ○​ Impact: ​ A renewed push for stronger public health systems worldwide. Study Guide: Palliative Care in the Community 1. Introduction to Palliative Care ​ Definition: An approach to care focusing on quality of life, prevention, and relief of suffering. ​ Provided from the time of diagnosis of a life-limiting illness through to death and bereavement. ​ Uses an interdisciplinary team, with the client/family as central decision-makers. ​ Available 24/7. Key Objectives of Palliative Care: ​ Provides symptom relief (physical, psychosocial, spiritual). ​ Affirms life and sees death as a natural process. ​ Helps clients live fully according to their goals. ​ Supports families during illness and bereavement. 2. The Palliative Approach ​ Early Integration: Ideally incorporated early in an illness but was not widely adopted initially. ​ Modern Approach: Focuses on goals, wishes, and serious illness conversations. ​ More Flexible Criteria: Access to services is no longer rigidly restricted. 3. How Clients Access Palliative Care Referral Pathways: ​ Internal referral (within healthcare system). ​ External referral (e.g., from BC Cancer Agency). Examples of Clients:  ​ Frank (67, ALS): Wanted to stay home, but his wife couldn't provide care. ​ Alice (81, Heart Failure): Family didn’t want her to know she was dying. ​ Charlie (46, Liver Cancer): No permanent home, declined hospice, agreed to clinic follow-up. 4. Support Systems in Palliative Care ​ Healthcare Team Members: ○​ Home Health Nurse ○​ Palliative Access Line (RNs) ○​ Palliative Resource Nurse ○​ Nurse Practitioner ○​ Palliative Physicians ○​ Spiritual Care Practitioner ○​ Social Worker ​ Care Facilities: ○​ Freestanding Hospices (e.g., Cottage Hospice, May’s Place) ○​ Palliative Care Units (Hospitals) ○​ Long-term Care Facilities 5. Considerations for Dying at Home ​ Factors influencing if a client can remain at home: ○​ Family & caregiver availability ○​ Client & family values ○​ Access to home care services ​ Quote: “People with terminal illness spend most of their dying time at home.” (Ward-Griffin & McKeever, 2000) Home Health Nursing Role: ​ Assess needs (physical, emotional, psychosocial). ​ Support caregivers and prepare them for changes. ​ Plan medication and symptom management. 6. Palliative Performance Scale (PPS)  ​ Measures functional decline in patients. ​ Scoring (0-100% in 10% increments): ○​ Stable (100-70%): Early education, symptom management, psychosocial support. ○​ Transitional (60-40%): Increased nursing care and family support. ○​ End-of-Life (