Levels of healthcare broken down

What does the healthcare delivery system all include?

patients; healthcare providers; support staff

3 Major Types of Community Health:

Public Health, Community-based, Home Healthcare nursing

What is the main focus of public health nursing?

Care of populations (neighborhoods, cities, counties, states, nations, continents)

Target Populations for Public Health Nursing?

Young, elderly, homeless people, inmates, etc.

What is the first nursing intervention of public health nurses?

Advocating w/ housing authority for accessible and safe housing

What is the second nursing intervention of public health nurses?

Planning multilingual, culturally based immunization clinics to increase participation

What do Public Health Nurses aim to do?

Work with populations rather than just one person or family

Community-Based Nursing:

Provision of skilled nursing care in community or ambulatory care settings

What’s an example of Community-Based Nursing?

Physicians office or outpatient clinic

What are the main focuses of Community-Based Nursing:

Prevent illness, maintain or regain health, or die with dignity while living in a community

Target population for Community-Based Nursing:

Provides personal care to individuals, clients, or families

____ literacy assessment is ESSENTIAL to provide effective education

Health

What is the first RN role in community based nursing?

advocate for clients

What is the second RN role in community based nursing?

routine checkups

What is the third RN role in community based nursing?

caring for sick or dying

What is the fourth RN role in community based nursing?

provide client education

What is the fifth RN role in community based nursing?

managing chronic clients

Health Literacy

What patient understands about health and health related terms

What is health literacy important for?

important for BOTH public health and community-based nurses = EDUCATION

First nursing role in health literacy

Must assess health literacy of both population and individual clients

Second nursing role in health literacy

Provide info + educational materials that are culturally appropriate, in clients language, and @ reading level

Third nursing role in health literacy

Can use readily assessment tool (like Fry readability formula) to determine the reading level of materials (simple + short text = higher readability score)

If a patient can’t understand the health terms you are using what should you do?

Bring literacy down to a level that your patient can understand

Home Health Care Nursing

Alternative to a hospital or a long-term care facility; care provided at patients house

What is home health care nursing used for?

acute, long-term, permanent disabilities, terminal illnesses

What is the first purpose of Home Health Care Nursing?

Promote, maintain, or restore health @ an optimal level of fuctioning

What is the second purpose of home health care nursing?

To reduce effects of disability + illness

Target population for Home Health Care Nursing:

Variety of age groups (everyone)

Nursing roles in Home Health Care Nursing:

RN coordinates majority of care but can collaborate with people (PTs, OTs, social workers, counselors, pharmacists)

What must RN’s be proficient in home health care nursing?

health assessment, technical and clinical skills, critical thinking and reasoning

Case manager role:

coordinates client care, services, supplies; must be well versed as financial resource manager; aware of community resources; strong teaching skills; advocates for pts.

Home Health Care Services Reimbursement

Home health is reimbursed by medicare, medicaid

To be eligible for home health care services patients must be

homebound AND care provided must be medically necessary, short-term, and skilled

Home Health Care Services Reimbursement: Skilled services

Nursing + respiratory care, IV therapy, chemotherapy, ostomy/wound, DM, self-management training

Home Health Care Services Reimbursement: unskilled services

Homemaker, personal care tasks (meal preps, cleaning, laundry, bathing)

Levels of Healthcare: Primary Prevention

To prevent disease/disability

• Ex: flu shot

Levels of Healthcare: Secondary Prevention

Early identification of illness

• Ex: mammograms, colonoscopies

Levels of Healthcare: Tertiary Prevention

For those already diagnosed

• Ex: focus on rehabilitation

Levels of Healthcare: Restorative Healthcare

Intermediate follow up care

• Ex: physical therapy

Levels of Healthcare: Continuing Healthcare

Addresses long-term or chronic healthcare needs

• Ex: management of COPD, DM, HF

Primary Prevention

PREVENTING PROBLEMS = VACCINES

Secondary Prevention

SECondary = SCREEN EARLY to CATCH → SCREENINGS

Tertiary Prevention

THINK TREATMENT → Following diets + being on meds

Social Determinants of Health

Conditions in which people are born, grow, work, live, and age → systems shaping life!

____ _______ can cause populations to be healthy or vulnerable to disease + disability

social determinants

Intrinsic factors

genetics, age, gender, ethnicity

Extrinsic factors

physical environment, workplace conditions, food sources

Next steps in community assessment:

1. Diagnose biggest problems/needs

2. Establish goals

3. Plan interventions (primary, secondary, tertiary)

4. Evaluate effectiveness of interventions

True or False? Community health nurses coordinate as both case managers and home health care nurses

TRUE