Community Health Nursing Exam 1 Study Materials

what is primary, secondary, and tertiary care?

primary care = prevention of illness (ex: teaching program for school age children to prevent smoking, education, vaccines)

secondary care = illness/risk is present in community or patient (ex: encouraging smoking cessation before complications occur, screening)

tertiary care = illness is present; aims to prevent/reduce complications (ex: patients with lung cancer are connected to appropriate resources to stop smoking)

public health nurses vs community health nurses:

public health nurses work for state overseeing overall population

community health nurses serve the local population (ex: school nurses)

population-focused vs individual-focused practice:

- population-focused: diagnoses, interventions, and treatments are carried out for population or subpopulation

- individual-focused practice: diagnoses, interventions, and treatments are carried out at individual client level (ex: doctors office)

what are the public health core functions?

assessment, policy development, assurance

what is the purpose of the public health core functions?

used to monitor the community and intervene with policy to improve overall health

what are public health's greatest areas of impact thus far to improve overall population health?

- goal to promote overall health and prevent disease and injury

- improvements in sanitation, immunization, and safety

what are the essential services of public health nursing?

- assessing community needs, health status of populations within the community, and environmental and behavioral risks to identify priority health needs for government support

- policy development: core function and core intervention strategy to support change in public policy (ex: healthy people 2030)

- ensure that activities meet public health goals and plans

community-based vs community-oriented practice:

community oriented: health promotion & prevention of disease in the community; no direct care for individuals (ex: public health nurse)

community based: illness care for individuals and families (ex: home health nurse, school nurse)

what is appealing to some nurses about the public health nurse role?

set own schedule, independence

what was the marine hospital service?

- established in 1798 by the US Public Health Service

- started with the seaports due to it being an entry to the country

- provided care for merchant seamen to prevent disease spread

what was the elizabethan poor law?

- founded in 1601

- guaranteed medical care for the poor and blind

- foundation for colonial America & Medicare

who was lillian wald and how did she contribute to public health nursing?

- helped decreases mother-infant mortality

- first president of the National Organization for PHN (NOPHN)

- helped to standardize PHN education

- persuaded the Red Cross to sponsor home health nurses

what clinic did lillian wald found in new york city?

henry street settlement house

what was the role of the school nurse in the early 20th century?

- focused on investigating causes of absences in their school

- children often missed school due to infection, communicable diseases, lack of clothing, babysitting siblings

typical home health interventions of rural nurses:

- went home-to-home and provided basic nursing care for a fee (much more efficient than taking only one patient)

- mainly concerned with slowing the spread of communicable disease, sanitation, better nutrition, preventative education

- followed physician orders, performed certain procedures at home, obtained temperature and pulse records

US spends most health care dollars on:

in-hospital care setting, lowest amount spent on public health

what caused dramatic increase in uninsured americans?

due to cost (low economic status) and lack of health insurance through their employee health plans

what causes 98,000 deaths per year, according to a report from 1999?

preventable medical errors

why must the nursing force be diversified?

provides for better nursing care due to the nurse understanding the patient's culture

currently, what are major problems in the US healthcare system?

- high costs

- uneven quality & access

- access: dependent on ability to pay

- health care is big business (stocks)

main goals of the WHO:

- main goal: better health for all

- public health nurses and public health services should be accessible to everyone

- reduced exclusion and social disparity

- services organized around needs

- health integrated into all sectors

- collaborative policy dialogue

- increased stakeholder participation

what is the US department of health and human services (USDHHS)? *****

- executive branch of american government dedicated to providing funds and resources to improving health

- agency most heavily involved in health & welfare

- argues for high value to be placed on primary prevention of disease and disability

what are examples of countries having greater need (less developed) in terms of healthcare?

Bangladesh, Haiti, Indonesia, Guatemala, south Africa, Mexico, Uganda, Ecuador

multilateral vs bilateral organizations:

- multilateral organizations: receive funding from multiple sources (ex: WHO, the United Nations Children's Fund (UNICEF))

- bilateral organizations: single government agency provided aid to lesser developed countries (ex: U.S. Agency for International Development)

what are nongovernmental organizations (NGOs) and private voluntary organizations (PVOs)?

- function via nongovernmental or private funding

- ex: international red cross, church-sponsored health care missionaries

where can international disease information be accessed? *****

world health organization

what does medicaid do?

provides financial assistance to states and counties to pay for medical services

what created medicare and medicaid?

Social Security Act Amendments of 1965

what does medicare do?

provides hospital insurance to populations that qualify

who qualifies for medicaid?

the poor, blind, and families with dependent children

who qualifies for medicare?

the elderly, permanently disabled, end-stage renal disease

what do parts a & b of medicare do?

part a: pays for inpatient stays, skilled nursing facilities, home health and hospice care

part b: pays for outpatient needs, doctors visits, home health, medical equipment, mental health, prevention & screening services

why should nurses care about environmental health?

- patients' health is greatly impacted by environmental factors

- nurses need to assess and understand these risks and advocate for policies that support change

what are the main aspects of environmental health that nurses should be concerned about and why?

nurses pay attention to biological, chemical, and radiological because these hazards are often found in our air, water and products

what aspects of the poor's environment puts them at an increased risk for harm?

those in poverty often live closer to exposing environments

limited funds for healthcare, poor nutrition, homes closer to hazardous/waste sites, and unsafe working conditions

what is the greatest source of air pollution in the USA?

motor vehicles

definition of ethics:

branch of philosophy that includes both moral life and process of reflection of determing what a person should do

definition of bioethics:

branch of ethics that applies to the knowledge and process of ethics to the examination of ethical problems in health care

definition of moral distress:

uncontrollable state of self in which one is unable to act ethically

definition of morality:

shared and generational societal norms about what constitutes right or wrong conduct

definition of values:

beliefs about the worth or importance of what is right or esteemed

definition of ethical dilemma:

a puzzling moral problem in which a person, group or community can envision morally justified reasons for both taking and not taking a certain course of action

definition of code of ethics:

moral standards that delineate a profession's values, goals, and obligations

definition of utilitarianism:

maximize the good and minimizing harm for the greatest number of people

definition of deontology:

- actions are good or bad according to a clear set of rules

- deon, meaning duty

- actions that align with these rules are ethical, while actions that don't aren't

definition of principalism:

an approach to problem solving that uses the principles of respect for autonomy, beneficence, nonmalificence, and justice as the basis for organization or ethical issues

definition of advocacy:

act of pleading for a course of action on behalf of a person or community

what is "respect for autonomy"?

based on human dignity and respect for an individual, individuals are permitted to choose those actions to fulfill their life plans unless those choices harm another

what is nonmalificence?

do no harm/ seek the least amount of harm possible

what is beneficence?

complementary to nonmalificence, do good

what is distributive justice?

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

what is an example of showing cultural competency through assurance?

work to get part time translators so you can ensure that you can communicate with immigrants

how can nurses encourage those around them to live healthier lifestyles?

nurses need to be the example of how to live a healthy lifestyle

what is an immigrant?

a person who comes to live permanently in a foreign country; not citizens

legal: 80% of immigrants

what is a non-immigrant?

a person who enters a country for a temporary reason

what is a refugee?

people seeking asylum due to fear of persecution (due to race, religion, political reasons, etc.), war, or a natural disaster

what is culture?

- set of common beliefs, values, and assumptions about life

- race does not = culture

what is race?

- biologic variation within a population

- same race may be of different cultures (NTK)

- ex: African American

what is ethnicity?

- shared feeling of peoplehood

- ex: Jewish

steps to developing cultural competence:

preservation, accommodation, repatterning, brokering

what is preservation?

preserving dignity of the patient and their preferences while acknowledging the cultural differences; maintain traditional practices

what is accommodation?

support cultural practices that are beneficial to health

what is repatterning?

changing cultural practices that are not beneficial to their health

what is brokering?

advocating, mediating, negotiating, and interviewing the patient to compromise on healthcare and their culture

what is stereotyping?

assume certain characteristics go along with every person of a race or culture

what is prejudice?

preconceived opinion that is not based on reason or actual experience

what is racism?

form of prejudice which involves the belief that different races possess distinct characteristics, abilities, or qualities, as to distinguish them as inferior or superior to one another

what is ethnocentrism?

belief that one's own culture should determine the standards of which another culture is judged

what are biologic variations that relate to cultural diversity?

- different lab results and susceptibility to disease is present in different races

- the nursing workforce is mainly white

what does the judicial branch do?

interprets laws and their meaning

Stewart Machine Co. v. Davis

aims to raise funds to spend on unemployment

what does the executive branch do?

- suggests, administers, and regulates policy

- ex: USDHHS

what does the legislative branch do?

identifies problems and proposes, debates, passes, and modifies laws to address those problems. (Senate and House of Reps)

what is police power?

power that allows states to act for the safety/welfare of the citizens (ex: travel ban for COVID)

what is categorical funding?

funding for priority diseases or groups, such as TB or HIV/AIDS

grants issued by Congress which may be spent only for narrowly defined purposes

who regulates how nurses can practice & validate licensure?

boards of nursing

which country was the first to use the term "evidence-based"?

canada

what is the first step to implementing evidence-based practice?

cultivating a spirit of inquiry