Community Health Nursing - Exam 1

aggregate

a mass or grouping of distinct individuals who are considered as a whole and who are loosely associated with one another

community

a group of people who share common characteristics, interests, or experiences, and who live in a specific geographic area

community health

identification of needs and the protection and improvement of collective health within a geographically defined area

community health nursing

• 1970-now

• focused on the good for the most amount of people

• focused on the population as a whole

• found in community based clinics, worksites, and schools

geographic community

a specific population that a nurse or healthcare facility serves. It's defined by a geographic space and a common tie or social interaction

health

holistic state of well-being including soundness of mind, body, and spirit

health continuum

a visual tool that shows a person's health status and how it can change over time

health promotion

All efforts that seek to move people closer to optimal well-being or higher levels of wellness

illness

state of being relatively unhealthy

population

all of the people occupying an area or to all of those who share one or more characteristics

population focused

Has a focus based on entire populations possessing similar health concerns or characteristics

primary prevention

the act of taking steps to prevent disease or injury before it happens

public health

activities that society undertakes to assure the conditions in which people can be healthy

public health nursing

• 1900-1970

• nursing that is community based and population focused

• emphasized curing and preventative measures

• Lillian Wald and Margaret Sanger were influential

• National League of Nursing Education established

• Frontier Nursing Service very prominent

secondary prevention

the practice of detecting and treating diseases or injuries early to prevent them from progressing to more serious stages

tertiary prevention

the management of existing diseases to reduce their impact and improve quality of life

wellness

health plus the capacity to develop a person’s potential leading to a fulfilling and productive life

8 characteristics of community/public health nursing

1. Population Focused

2. The Greatest Good for the Greatest Number of People

3. Clients as Equal Partners

4. Prioritizing Primary Prevention

5. Intervention Selections to Create Healthy Conditions in Which Populations May Thrive

6. Actively Reaching Out

7. Optimal Use of Available Resources

8. Interprofessional Collaboration

10 essential services of public health

1. Monitor Health

2. Diagnose and Investigate

3. Inform, Educate, and Empower

4. Mobilize Community Partnerships

5. Develop Policies

6. Enforce Laws

7. Link to Services

8. Assure Competent Workforce

9. Evaluate

10. Research and System Management

roles in community health nursing

1. Clinician

2. Educator

3. Advocate

4. Manager

5. Researcher

6. Collaborator

7. Leadership

community health nurse practice settings

Homes, Ambulatory Service Settings, Schools, Occupational Health Settings, Residential Institutions, Faith Communities, Community At Large

early home care nursing

• before mid-1800’s during Industrial Revolution

• went into homes to focus on sick poor and disabled

• nurses were self-taught/taught by others

• focuses on curing disease

• Florence Nightingale and Mary Seacole very influential

district nursing

• mid 1800’s to 1900

• focused on sick poor

• emphasized curing diseases

• Clara Barton founded the American Red Cross

• visiting nurse association established in New York, Philadelphia, and Boston

evidence based practice

1. Cultivate a spirit of inquiry

2. Ask the clinical question.

3. Search for and collect the best evidence.

4. Critically appraise evidence for validity, reliability, and applicability and then synthesize it.

5. Integrate the evidence with clinical expertise and patient preferences and values.

6. Evaluate outcomes of the decision or change based on evidence.

7. Disseminate outcomes of the decision or change.

3 types of research reviews

integrative/systemic review, scoping review, meta-analysis

7 ethical principles

1. Respect

2. Autonomy

3. Beneficence

4. Nonmaleficence

5. Justice

6. Veracity

7. Fidelity

DECIDE model

D - define the problem

E - ethical review

C - consider the options

I - investigate outcomes

D - decide on action

E - evaluate results

culture

the beliefs, values, and behaviors that are shared by members of a society and provide a template or “road map” for living

characteristics of culture

learned from others, integrated system of customs and traits, shared, mostly tacit, dynamic

race

a biologically designated group of people whose distinguishing features, such as skin color, are inherited

ethnic group

a collection of people who have common origins and a shared culture and identity; they may share a common geographic origin, race, language, religion, traditions, values, and food preferences

cultural diversity

refers to the coexistence of a variety of cultural patterns within a geographic area

ethnocentrism

bias that a person’s own culture is best, and others are wrong or inferior

biomedical view

a medical model that views health as the absence of disease and is based on physical factors. It's the most common model used in Western healthcare

magicoreligious view

a supernatural belief system that attributes illness and health to supernatural forces, such as God, ancestors, or evil forces

holistic view

a patient-centered approach that considers a person's physical, emotional, social, and spiritual health

federal health agency responsibilities

• Policymaking and implementing legislation

• Financing public health

• Protecting public health, preventing disease

• Collecting and disseminating data

• Assisting states during emergencies

• Developing public health goals

• Building capacity for population health at all levels

• Directly managing health care delivery

examples of federal health agencies

• U.S. Public Health Service

• U.S. Department of Health and Human Services (includes CDC)

• Departments overseeing areas impacting health (i.e.. Labor, Education, Environmental Health, Agriculture, and Transportation)

• Agencies focusing on international health

state health agency responsibilities

• Statewide health planning

• Intergovernmental and other agency relations

• Intrastate agency relations

• Certain statewide policy determinations

• Standards setting

• Health regulatory functions

• State laboratory services

• Surveillance and epidemiology

• Training and technical support

local health agencies responsibilities and services

Responsibilities

• Monitor local health needs and resources

• Develop policy

• Advocate for equitable distribution of resources and services, both public and private

• Evaluate availability, accessibility, and quality of health services for all members of the community

• Keep the community informed about how to access public health services

Services

• Adult and childhood immunizations

• TB screening and services

• Women, Infants, and Children (WIC) services

• Screening for HIV and other STDs

• Blood lead screening

• Home visits

retrospective

a healthcare provider receives payment based on services already provided to patients

ex. After treating a patient for an injury, the provider bills the insurance company for the service rendered.

prospective

a healthcare provider receives a fixed amount of money upfront from an insurance company to cover the estimated cost of care for a patient over and specific period, the provider is responsible for managing the patient’s care within that budget

surprise medical billing

A healthcare facility charges patients for services without informing them about the costs beforehand. Later, the patients receive unexpectedly high bills, especially for out-of-network services, despite having insurance coverage

capitation

A health insurance company reimburses a healthcare provider for a fixed amount per patient for a specified period, regardless of the actual services rendered. The provider’s income depends on the number of patients enrolled, not the services provided to each patient.

claims payment agent

A healthcare organization hires a third-party entity to process and manage its insurance claims, including verifying patient eligibility, processing claims, and handling reimbursement between the healthcare provider and the insurance company

ecosystem

a dynamic community that no organism including humans can exist out of

epigenetics

the study that examines the gene—environment interaction to study the process in which genes are expressed differently as a result of environmental influences

environmental epidemiology

Focuses on environmental exposures and risks that contribute to adverse health effects

toxicology

Study of how body processes toxicants and their ultimate effects in body as well as exposure pathways and biomonitoring

environmental factors to assess

• built environment

• climate change

• land use

• toxic exposes (through air, water, and food)

• toxic waste

• radiation

respect

treating people as unique, equal, and responsible moral agents

autonomy

freedom of choice and the exercise of people’s rights

beneficence

doing good or benefiting others

nonmaleficence

avoiding or preventing harm to others as a consequence of a person’s own choices and actions

justice

treating people fairly

veracity

telling the truth, being truthful and honest with patients

fidelity

remaining true to your word or keeping promises

epidemic

A disease occurrence that clearly exceeds the normal or expected frequency in a community or region

ex. opioid epidemic

pandemic

An epidemic that is worldwide in distribution

Ex. COVID-19, bubonic plague, HIV/AIDS

endemic

The continual presence of a disease or infectious agent in a particular area or population

Ex. Flu, Malaria in certain countries (Africa)

host

Susceptible human or animal who harbors and nourishes a disease-causing agent

agent

A factor that causes or contributes to a health problem or condition

environment

All the external factors surrounding the host that might influence vulnerability or resistance

passive immunity

short term, acquired naturally or artificially

active immunity

long term, sometimes lifelong, acquired naturally or artificially

cross immunity

immunity to one agent providing immunity to another related agent

herd immunity

immunity level present in a population group

risk

• Probability that a disease or unfavorable health condition will develop

• Directly influenced by biology, environment, lifestyle, and system of health care

subclinical disease

infection is in a person’s system but is not showing signs and symptoms yet

clinical disease

signs and symptoms of infection evident in a patient

resolution

recovery period from an illness

incidence rate

refers to all new cases of a disease or health condition appearing during a given time

prevalence rate

all of the people with a particular health condition existing in a given population at a given point in time

direct transmission

occurs by immediate transfer of infectious agents from a reservoir to a new host

indirect transmission

occurs when the infectious agent is transported within contaminated inanimate materials such as air (airborne), water, food, blood, objects (vehicle-borne transmission) or animate intermediaries (vector)

airborne transmission

occurs through droplet nuclei— the small residues that result from evaporation of fluid from droplets emitted by an infected host

vehicle transmission

indirect transmit within agents such as food, water, blood, and inanimate objects (fomites) such as handkerchiefs, bedding, needles

vector transmission

Living organisms that can transmit infectious diseases to humans

ex. mosquitos, rats, ticks, fleas

tuberculosis

a disease that now has strains that are resistant to almost ALL the standard drugs. 1 in 4 people who contract this strain dies rapidly within months of the disease

challenges to immunization of children

1. Oppose government mandates

2. Sheer number of vaccines

3. Veer from the recommended spacing schedule

4. Religious objections

5. Philosophical or medical objections

isolation

separates sick people with a contagious disease from people who are not sick

quarantine

separates and restricts the movement of people who were exposed to a contagious disease to see if they become sick