Community final expanded

Lillian Wald

Founded the Henry Street Settlement in New York and is considered a pioneer in public health nursing, focusing on providing healthcare to immigrant populations.

Florence Nightingale

Revolutionized nursing with a focus on sanitation, hygiene, and environmental factors that contribute to health.

Mary Breckinridge

Founded the Frontier Nursing Service in rural Kentucky, pioneering the role of nurse-midwives in underserved areas and contributing to the development of community-based healthcare.

Community-Oriented Nursing

Focuses on improving the health of populations through health promotion and disease prevention (e.g., immunization programs, public health education).

Public health nurse

goal is to prevent disease, preserve, promote, and protect health for the community and the populations within it (NO INDIVIDUAL CARE)

Community health nurse

community benefit, school nursing, occupational health, FQHC, CHC, free clinic, tertiary clinics

Community-Based Nursing

Provides direct care to individuals and families within a community (e.g., home visits, managing chronic conditions).

Assessment

Collecting and analyzing data to understand health needs and issues in the community (e.g., conducting a community health needs assessment).

Policy Development

Creating policies that address public health needs (e.g., smoking bans, nutrition programs).

Assurance

Ensuring that essential health services are available and accessible (e.g., WIC, FCM, public health screenings, vaccination clinics).

Medicare Part A

Covers inpatient hospital stays, skilled nursing facilities, hospice care, and some home health care.

Medicare Part B

Covers outpatient services like doctor's visits, outpatient hospital services, and some preventive services.

Medicare Part D

Provides prescription drug coverage.

Medicare Advantage (Part C)

Combines Part A, B, and sometimes D, through private insurance plans.

Medicare Supplemental

Offers additional coverage to help with costs not covered by Original Medicare.

COBRA

Allows individuals to continue their health insurance coverage after leaving employment or other qualifying events.

HMO (Health Maintenance Organization)

Cheaper, limited doctors.

PPO (Preferred Provider Organization)

More expensive, more choices.

Federal Poverty Levels

The percentage of the poverty level determines eligibility for various assistance programs based on income relative to the federal poverty guidelines and varies by household size.

% of FPL determines eligibility for programs (e.g., Medicaid).

Calculated by income vs. family size.

Affordable Care Act

Expanded Medicaid.

Requires insurance for most people.

No denial for pre-existing conditions.

For individuals without access to affordable healthcare coverage- Enrollment is annual- Covers:· Ambulatory patient services· Emergency services· Hospitalization· Maternity & newborn care· Mental health and substance use disorder services· Prescription drugs· Rehabilitative services· Laboratory services· Preventive and wellness services· Pediatric services

Community

A group of individuals who share common characteristics or interests, often defined geographically (e.g., a neighborhood).

Aggregate

A collection of individuals who share a common characteristic, such as people with a specific disease or age group.

Facilitating Change

How we promote lasting change within our community. Working with community members to identify the most relevant problems and create change

Root Cause

Identifying the underlying factors contributing to health disparities.

Symptoms of the problem- "the weed"- above the surface (obvious), the underlying cause- "the root"- below the surface (not obvious)

Sustainable Change

Creating interventions that result in lasting improvements in health.

Example: addressing food insecurity, solution, food pantry

Health Disparity

Differences in health outcomes due to factors such as socioeconomic status, geography, or ethnicity.

Gaps in health between groups (e.g., rich vs. poor).

Social Determinants of Health

Factors like housing and education that affect health.

Conditions in the environments in which people are born, live, learn, work, play, worship, and age

Epidemiology

Study of how diseases spread and affect populations.

Risk

The probability of developing a disease or health condition.

Incidence

The number of new cases of a disease in a population over a specific period.

Prevalence

The total number of cases (both new and existing) in a population at a specific point in time.

Morbidity

The condition of being diseased or the incidence of disease within a population.

Mortality

The rate of death in a population.

Epidemic

§ Spreading rapidly and extensively by infection (sometimes other things as well) and affecting many individuals in an area or a population (localized) at the same time- an epidemic outbreak of influenza

Pandemic

§ Worldwide outbreak of an epidemic disease. Spread over several countries or continents

§ Example: covid-19

Descriptive Epidemiology

Focuses on who, what, where, when, and how diseases occur (e.g., describing patterns of disease in a population).

Analytic Epidemiology

Looks at the etiology (origins or causes) of the disease and deals with determinants of health and disease

example: how does it occur? Why ae some people more affected more than others?

Epidemiologic Triangle

A model used to understand the factors involved in disease spread: Host, Agent, Environment.

Host

What causes the disease (e.g., flu)

Agent

The person who gets the disease

Environment.

Where it spreads (e.g., hospital).

resistance

the ability of the host to withstand infection

natural immunity

Body fights on its own.

innate ability to resist an infection (skin, mucous membranes, immune system)

AKA innate immunity

acquired immunity

After vaccine or illness.

resistance as a result of previous exposure

passive immunity

protection by transfer of antibodies to host EX: mother to newborn

active immunity

· protection by administration of an antigen EX: vaccination

herd immunity

refers to the immunity of a group

infectiousness

a measure of the potential ability of an infected host to transmit an infection

- incubation period

time interval between invasion and onset of symptoms

communicable period

period of time that you are capable of spreading the disease

· Vertical

parent to offspring

· Horizontal

person to person spread

· Common vehicle

shared surfaces

· Define direct observed therapy (DOT)

· Used when patient non-compliance is suspected

· Ensures ongoing medication regimen

· Helps prevent drug-resistant disease

food-borne disease

- bacterial (salmonella, E. coli)

- viral (hepatitis A)

- parasitic (trichinosis)

Food intoxication toxins: toxins from bacterial growth (botulism), chemical contaminants (heavy metals- mercury), disease producing substances found naturally (mushrooms and some seafoods)

vector-borne disease

- lyme diease (ticks)

- rocky mountain spotted fever (ticks)

- west nile (mosquito)

nosocomial infections

· Acquired during hospitalization or developed within a hospital setting

· EX: CAUTI, CLABSI, VAP, MRSA

· Best prophylaxis: good handwashing

Primary Prevention

Aims to prevent disease before it occurs through health promotion (e.g., vaccination, health education).

Prevent before it happens (e.g., vaccines).

Secondary Prevention

Focuses on early detection and prompt intervention to reduce the severity of the disease (e.g., screening for cancer).

Catch it early (e.g., cancer screenings).

Tertiary Prevention

Focuses on managing existing health conditions to prevent further complications (e.g., rehabilitation, chronic disease management).

Manage after diagnosis (e.g., rehab).

Goal of Primary Prevention

To reduce the risk of developing a disease by promoting health and preventing the onset of disease through interventions like immunization and lifestyle changes.

Culture

Shared beliefs, values, and behaviors within a group.

Acculturation

The process of cultural exchange or adaptation between groups.

Ethnocentrism

The belief that one's own culture is superior to others.

Stereotyping

Making generalized assumptions about a group based on limited information.

Cultural Competency

Understanding and effectively responding to cultural differences in healthcare.

Perceived Susceptibility

Belief about the likelihood of getting a disease.

Perceived Severity

Belief about the seriousness of the consequences of a disease.

Perceived Benefits

Belief that taking a specific action would reduce the threat.

Perceived Barriers

Belief about the costs or obstacles to taking an action.

Cues to Action

Triggers that motivate an individual to take health-promoting actions.

Educator Barriers

Time constraints, lack of resources, and insufficient knowledge about the learner's cultural or educational background.

Learner Barriers

Limited literacy, language differences, lack of motivation, or perceived irrelevance of the content.

Possible Solutions

Tailoring education to the learner's needs, using simple language, providing written materials, and using visual aids.

Local Vaccine Reactions

Site reactions- redness, soreness

Systemic Vaccine Reactions

Fever and rash, cold/flu like symptoms

Severe Vaccine Reactions

Anaphylaxis

Goal of Secondary Prevention

Secondary prevention focuses on early identification of diseases to reduce their severity and impact, improving the quality of life through early treatment (e.g., cancer screening, blood pressure monitoring).

Modifiable Risk Factors

Behaviors or conditions that can be changed to reduce disease risk (e.g., smoking, diet, physical activity).

Non-Modifiable Risk Factors

Factors that cannot be changed (e.g., age, gender, genetics).

Goal of Tertiary Prevention

Tertiary prevention aims to manage and reduce the impact of long-term disease or injury, improving the quality of life, and preventing further complications (e.g., stroke rehabilitation, diabetes management).

Behavioral Lifestyles Contributing to Chronic Disease

o Tobacco use and exposure to secondhand smoke

o Poor nutrition, include diets low in fruits and vegies and high in sodium and saturated fats

o Lack of physical activity

o Excessive alcohol/tobacco use

Definition of Vulnerable Populations

Vulnerable populations are groups who have a higher risk of developing health problems due to social, economic, environmental, or health-related factors (e.g., the elderly, homeless, low-income families, racial/ethnic minorities).

Vulnerable Populations of Special Concern to Nurses

§ Poor and homeless

§ Veterans

§ Pregnant adolescents

§ Migrant workers

§ Immigrants

§ Severely mentally ill

§ Substance abusers

§ Viictimsof abuse/ IPV

Nursing Interventions for Vulnerable Populations

Providing culturally competent care, advocating for better healthcare access, educating about disease prevention, and addressing social determinants of health are key interventions.

Nursing Roles for Effective Care

Nurses can serve as case managers, health educators, advocates, and counselors to help vulnerable populations navigate healthcare systems and receive necessary services.

How the Environment Influences Human Health

Environmental factors, such as air quality, water quality, housing, and exposure to toxins, can significantly affect human health, contributing to diseases like asthma, cancer, and infectious diseases.

Lead Poisoning, Risk Assessment, and Community Health

Lead poisoning, often from old paint or contaminated water, affects children's development and can lead to neurological impairments

A risk assessment involves evaluating potential sources of lead exposure in homes and schools.

Skills Needed in Environmental Health

o Assessment

o Including Risk Assessment

o Referral

o Community involvement and public participation

o Risk communication

o Epidemiologic investigations

o Policy development

IPREPARE Environmental Assessment

IPREPARE is an acronym for a comprehensive environmental health assessment approach:

I (Investigate potential exposures),

P (Present work-related exposures),

R (Residence history),

E (Environmental concerns),

P (Past work-related exposures),

A (Activities and hobbies),

R (Referrals and resources),

E (Educate).

Natural Disasters

§ Earthquakes

§ Extreme Heat

§ Floods

§ Hurricanes

§ Landslides & Mudslides

§ Lightening & Tornadoes

§ Tsunamis

§ Volcanoes

§ Wildfires

§ Winter Weather

Human-Made Disasters

Chemical spills, nuclear accidents, mass shootings, terrorism (e.g., 9/11 attacks)

Disaster Management Phases and Nurse's Role

Nurses provide triage, emergency care, coordination, and psychological support during all phases of disaster management.

Prevention

Stop it before it starts.

Preparedness

Make plans (e.g., emergency kits).

§ Help initiate or update the agency’s disaster plan

§ Provide educational programs and materials regarding disasters specific to the area.

§ Organize disaster drills.

§ Provide an updated record of vulnerable populations within the community.

§ Review individual strategies.

Response

Help during the disaster (e.g., triage).

Recovery

Rebuild after the disaster.

Purpose of Triage in Disaster Response and Triage Categories

Triage categorizes victims based on the severity of their condition and the likelihood of survival

Red (Immediate)

Life-threatening injuries requiring immediate attention.

Yellow (Delayed)

Serious but not life-threatening injuries that can wait.