Pop & Public Health Nursing

Population Health

the health outcomes of populations

pop → the distribution of health outcomes across a defined group

improving this requires that health care providers and organizers look beyond their own systems and partner with other organizations, entities, and professionals

SDOH

the economic and social conditions that influence the health of individuals, communities, and jurisdictions as a whole

ex: safe affordable housing, education, job security, living wage, food, and transportation

Considerations

health is more than health care

health is tied to the distribution of resources

choices we make are shaped by choices we have

high demand + low control = chronic stress

chronic stress can be deadly (cortisol response)

Chronic Stress HPA Axis

factors determine the magnitude of the HPA axis response

novelty of the individual

unpredictable nature

perceived threat to the person

sense of loss of control

Health Equity

when all people have the opportunity to attain their full health potential and no one is disadvantaged from achieving this potential because of their social position or other socially determined circumstance

to improve this we must go beyond asking who is at a greater risk for disease and ask why some pops are at a greater risk

Social Justice

involved in health equity

the fair and compassionate distribution of the fruits of economic growth

Health Disparity

a particular type of health difference that is closely linked with social or economic disadvantage

Public Health Nursing

the practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences

focuses on entire populations and grounded in assessment of pop health status

considers the broad determinants of health

focuses on all levels of prevention with an emphasis on primary prevention

intervenes at community level, the systems that impact health of communities, and individual + family levels

collaborates with a variety of other professions and stakeholder groups

Public Health Nursing Principles

the client unit of care is the populations

achieve the greatest good for the greatest number

health promotion and protection are priorities

select strategies that create healthy environmental, social, and economic conditions

actively reach out to all who might benefit

use available resources

collaborate with other professions and organizations

Nursing Practice Components

health promotion → individual to pop level to attain optimal health

risk reduction → reduces persons risk for disease

health protection → persons ability to protect against disease

Legal Guidelines

state nurse practice acts

education, license, and certification

standards of practice

code of ethics

public health laws (mandatory reporting)

civil laws (surveillance, investigations, confidentiality)

criminal laws (prisons)

Minnesota Interventions Wheel

3 levels of practice → individual/family, community, and systems

17 public health interventions

17 Interventions

screening → surveillance, disease investigation, outreach, and case finding

case management → delegated function, referral/follow-up, and case management

health teaching → health teaching, counseling, and consultation

community collab → collab, coalition building, and community organization

policy development → advocacy, social marketing, and policy development and enforcement

Public Health Nurse

generalists (covers all areas of public health) or specialists (communicable disease speciality or health screening)

Core Public Health Function

assessment → systematic data collection on population, monitoring the populations health status, and making info available about health of community

policy development → efforts to develop policies that support the health of the population including specific scientific knowledge to make decisions

assurance → ensuring essential community oriented health services are available and that a competent public health workforce is available

Florence Nightingale

devoted life to prevention of needless illness and death through prevention of infection and focus on environmental health

reformed hospital care and founder of professional nursing

pioneer in use of statistics and policy → pop based approach (crimean war) and demonstrated need for reform

Lillian Wald

believed nurse should not only care for the sick in their home but teach prevention and address social conditions

coined term public health nursing and introduced school nursing

convinced red cross to work with rural communities

started NYC henry street settlement

Mass and Lemuel Shattuck Report

monumental 1850 report that established permanent boards of health in mass

began collecting and recording vital stats and promoted sanitary measured to prevent disease

movement spread to other localities → SC state board of health

Mary Breckenridge

established the frontier nursing service to provide nursing for underserved pops in remote mountains of kentucky

Community Assessment

a process to get to know the community

logical, systematic approach to identifying community needs, clarifying problems, and identifying community strengths and resources

gather primary and secondary data

analyze data collected and draw conclusions to determine actual/potential needs and identify strengths, resources, and barriers to meeting needs

Primary Data

key informant interviews

windshield survey

focus groups

Secondary Data

vital statistics

sociodemographic

health indicator surveys

Anderson McFarlane Community Assessment Wheel

recreation

communication

economics

health and social services

physical environment

education

safety and transportation

politics and government

Assessment Wheel Core

residents of the community are affected by and influenced by eight subsystems of the community

Community Assessment Indicators

compare benchmark rates from sources like HP 2030 targets, to local/state/national rates

consider demographic and socioeconomic comparability of the pops from which the comparison rates are derived examine both recent data and trend data

guides program planning, implementing intervention, and evaluation