Cram

Community

a group of people, often in a defined area, who may share common cultures, values, and norms

community health

reflected in health behaviors, subsequent outcomes of residents, and by the ability of the community as a system to support healthy individuals

community partnerships

involve various members in all phases of assessment, some use models as central activity, coalitions, passive/active participation

passive participation

"for the community"

active participation

"with the community"

nurse's role in community

establish credibility, trust, acceptance, and parter with gatekeepers and community health workers

building trust

beginning of the relationship (assessment)

community as a client

focusing on the health of the community as a whole rather than the health of one individual

primary prevention

preventing disease before it occurs

ex) vaccines, education, health promotion

secondary prevention

detecting and treating diseases

ex) screenings, diagnosing

tertiary prevention

rehab and recovery after disease

ex) meds, PT, support

overall goal of nursing intervention

improved health of the community

physiological needs

must be met first

Maslow's hierarchy of needs

1. physiological needs

2. safety

3. love and belonging

4. esteem

5. self-actualization

community as a partner

divides community structure into subsystems, nurses encourage community members to assist in the creation of health programs

partnerships

increase effectiveness and improve outcomes

can be proactive or reactive

assessment

gather information about the community's condition

diagnosis

identify the community's problems (2030 goals)

planning

set goals for the plan of care, establish clear objective and appropriate actions

implementation

enacting the plan, #1 priority is to implement a problem that is of high concern in the community

evaluation

ensure sustainability, determine if outcomes are achieved

primary data

observation, windshield surveys, photovoice, key informant interviews, focus groups, secondary analysis of existing data, statistical data

secondary data

review organization assessments (hospitals are directed to assess their function), reviews county health ranking, SPARK map, healthy people 2030

key informant interviews

don't provide statistical data, but evaluate the values, beliefs, and needs of an individual or group

review of existing data

saves time and effort while providing new insights

assessment findings

share with any community that will listen

conducting a community assessment

define:

• the geographical boundaries

• the population in the boundaries

• the purpose of the assessment

• identify a data collection plan

needs assessment

conducting detailed assessment to understand the function and weaknesses of a community in order to implement improvements

disparity

a group of people who share common characteristics and are treated differently or require different needs than the majority of the population

equality

each person is given the same opportunities and resources to thrive, regardless of their circumstances

generic, group-focused

equity

individuals have different needs and allocates resources based on those needs to achieve an equal outcome for all

adaptable, individual-focused, fair opportunities, removes obstacles of health

social determinants of health (SDOH)

• health/healthcare (access, literacy)

• education (early, high school, higher ed)

• social/community (discrimination, incarceration)

• economic stability (SES, employment, poverty, housing)

• neighborhood and physical environment (food, housing)

affect the health, mortality, life expectancy of individuals

inequity

intentional discrimination/exclusion of a group

Disparity

unintentional internal differences between groups

primary (upstream)

community impact

focus on improving conditions, laws and policies, and supporting health

secondary (midstream)

individual impact

focus on screenings, questionnaires, data, social/community workers

tertiary (downstream)

clinical care

focus on medical interventions

health in all policies (HiAP)

multi-sectoral consideration of the impact of policies/decisions on health and equity

structural competency

shifts attention to forces that influence health outcomes at levels above individual interactions

changes from 1900-now

1. advertising

2. education and specialization

3. hospital LOS is shorter

challenges we'll face

1. new and old communicable infectious diseases

2. food borne disease outbreaks

3. acts of terrorism

demographic trends

increase in immigrants, hispanics are largest minority, decreased mortality rates, unintentional injuries is among the top 10 COD

social and economic trends

family/living patterns changing, increase in wage gap, increased pay for complimentary therapies, increased appreciation of quality of life enjoyed in the U.S.

healthcare trends

increased focus on preventative care, increased expansion of services, increased turn over and burn out

primary healthcare

essential care to all community members with encouragement of self-care

public healthcare

mandated laws at the national, local, and state level

private healthcare

primary care is first level of system, variety of systems

goals to improve global health

1. tackle SDOH

2. use health outcome driven programs for clinical care

3. offer integrated family-community healthcare

4. collaboration for health at home, school, work, community, and county levels

factors affecting resource allocation

uninsured (immigrants, poverty)

lack of access (rural areas, language barriers)

rationing health care (ability to pay)

rationing healthcare

Restricting access to quality and effective health care based on the ability to pay

healthy people 2030 goal

better healthcare access for all people, use all levels of prevention

blue zones

areas where people live to >100 years old due to lifestyle

lifestyle choices

impact health the most

low SES

most correlated with poor health

aging population

group that has the greatest influence on health care spending

affordable care act goals

1. make affordable health insurance more available

2. expand the medicaid program

3. support innovative medical care to lower the cost of care

feder and state governments

spend the most money on healthcare

highest spending, but not the best

healthcare costs in the U.S.

value

equals high quality plus high service / low (occasionaly high) costs

federal government

provide money through tax relief for private enterprise by:

• businesses paying for health insurance for employees

• employer providing health screenings

• employer offering immunizations to all eligible employees

Medicare

for those >65, with permanent disabilities, ALS, or ESRD covering inpatient hospital care, necessary medical costs, and other expenses

Part A

covers inpatient/hospital bills