1. Community Nursing- Community Health Overview

systems thinking

Studies how an individual or unit interacts with other organizations or systems

Useful in examining cause and effect relationships

upstream thinking

Used to focus on interventions that promote health or prevent illness, as opposed to medical treatment models that focus on care after an individual becomes ill

(metaphor with river)

nightingale's environmental theory

Infection prevention

Highlights the relationship between an individual's environment and health

Depicts health as a continuum

Emphasizes preventative care

health belief model- individual level

Purpose is to predict or explain health behaviors

Assumes that preventative health actions are taken primarily for the purpose of avoiding disease

how does the health belief model describe the likelihood of taking an action to avoid disease?

Perceived susceptibility, seriousness, and threat of a disease

Modifying factors (demographics, knowledge levels)

Cues to actions

Perceived benefits minus perceived barriers to taking action

milo's framework for prevention- community level

Complements the health belief model

Identifies relationship between health deficits and availability of health- promoting resources

Theorizes that behavior changes within a large number of people can ultimately lead to social change

pender's health promotion

Similar to health belief model

Does not consider health risk as a factor that provokes change

what factors does the pender's health promotion affects individual actions to promote and protect health?

Personal factors

Feelings, benefits, barriers, and characteristics associated with the action

Attitudes of others, and competing demands and preferences

transtheoretical stages of change

1. Precontemplation

2. Contemplation

3. Preparation

4. Action

5. Maintenance

6. Terminate

precontemplation

unaware of change

contemplation

considers change and weighs benefits with costs

preparation

plans to take action

action

doing the change

maintenance

implements actions to continue the behavior

terminate

conscious efforts to continue the health behavior are no longer needed because individual is consistent

Most never reach this point

precaution adoption process

Similar to TTM and SOC

Includes a stage of being unengaged regarding an issue between the stages of being unaware and contemplating action

Does not include a termination stage

determinants of health

Client or environmental factors that influence the client's health

example of determinant of health

Nutrition, social support and stress, education, finances, transportation and housing, biology and genetics, and personal health practices

health indicators

Can make them an outcome target or a goal

Describe the health status of a community and serve as targets for the improvement of a community's health

example of health indicator

Mortality rates, disease prevalence, levels of physical activity, obesity, tobacco or other substance use

community

group of people and institutions that share geographic, civic, and/or social parameters

vary in their characteristics and health needs

community health nursing

synthesis of nursing and public health theory

goals of community health nursing

promote, preserve, and maintain the health of populations by the delivery of health services

client in community health

community or population is the "client"

assessment

using systematic methods to monitor the health of a population

Monitor health status to identify community health problems

Diagnose and investigate health problems and health hazards in the community

Laws practices to promote health based on scientific evidence

Inform, educate, and empower people about health issues

Mobilize community partnerships to identify and solve health problems

Develop policies and plans that support individual and community health efforts

assurance

making sure adequate health care personnel and services are accessible, especially to those who might not normally have them

more on assurance

Enforce laws and regulations that protect health and ensure safety

Link people to needed personal health services and ensure the provision of health care when otherwise unavailable

Ensure a competent public health and personal health care workforce

Evaluate effectiveness, accessibility, and quality of personal and population-based health services

key principles

Prevent disease

Primary prevention

Utilitarianism

Partners in health

Resource utilization

Promote health

focus of care

Aggregates, communities, populations (public health)

Can include at-risk or unserved individuals and families

Individuals and families

primary goal

Health promotion and disease prevention

Management of acute and chronic conditions

indirect nurse activity

program management

direct nurse activity

one-on-one

illness care

management of acute and chronic conditions in settings where individuals, families, and group live, work, and "attend" (schools, camps, prisons)

respect for autonomy

individuals select those actions that fulfill their goals

Respecting a client's right to self-determination

nonmaleficence

Developing plans of care that include a system for monitoring and evaluating outcomes

No harm according to a standard or policy

beneficience

maximize possible benefits and minimize possible harms

Assessing costs, risks and benefits when planning interventions

distributive justice

fair distribution of the benefits and burdens in society is based on the needs and contributions of its members

Determining eligibility for health care services based on income and fiscal resources

community health nurses address...

challenges of autonomy and providing ethical care

advocacy

Autonomy

Trust

Collaboration

Shared respect

Personal responsibility

Client autonomy

Assertiveness

Prioritize client values

Chain of command

Improve quality of life

Resources that meet client needs

Change of health care systems

evidenced-based practice

Quality

Quantity

Consistency

Aligns with core functions

Community Preventive Services Task Force (CPSTF)

Community-based participatory researc (CBPR)

Highlest level of available evidence

Validate by systematic peer review

total quality management (TQM)

An approach that seeks to improve quality and performance which meets or exceeds expectations

Continuous quality improvement (CQI)

approach to quality of management that emphasizes the organization and its processes and systems and uses objective data to analyze and improve processes

aspects of care

effectiveness, timeliness, client-centered, equity, safety, efficiency

effectiveness

providing services to those who will benefit

timeliness

reducing waits and harmful delays in providing and receiving care

client-centered

Ensuring client values guide decision making

equity

providing equal care without discriminating against gender, race, sexual orientation, socioeconomic status

safety

avoiding injuries to clients from the care intended to help them

efficiency

avoiding waste in supplies, ideas, energy

professional collaboration and communication

Clear

Respectful

Verbal, nonverbal

Continuum of care

Confidentiality

Privacy

Benefits

changes/challenges in 21st century

patient/client-centered care

Technology

Personal accountability

Evidence-based practice

Health disparities

Community change

Healthy, safe environment

healthy people

national health goals are derived from scientific data and trends collected during the prior decade

healthy people goals are based on...

issues that are considered major risks to the health and wellness of the US's population

healthy people goals

National health objectives

Guide to health promotion/disease prevention

Measures quality

Decreased healthcare cost

Overarching goals

Health equity

Health literacy

Social determinants of health, key focus

primary prevention

prevention of initial occurrence of disease or injury

(Education, immunizations, advocacy)

secondary prevention

early detection and treatment of disease with the goal of limiting severity and adverse effects

(Screening, surveillance, early detection, quarantine, containment)

tertiary prevention

reducing the limitations of disability and promoting rehabilitation following health alterations

(Rehabilitation, support groups, monitor treatment compliance, decrease complications, link to resources)