PT Exam Study Material: Health Barriers & Screening Challenges

beneficence

do good

nonmaleficence

do no harm (or minimize harm)

False

T/F beneficence and nonmaleficence are antonyms

-beneficence

-nonmaleficence

what are the consequence oriented principles in healthcare ethics

-autonomy

-justice

-veracity

-fidelity

-avoid killing

what are the duty based principles in healthcare ethics

autonomy

self determined

justice

burdens and benefits distributed equally

veracity

truth telling

fidelity

agreement to keep promises

avoid killing

NOT the same as letting one die

-must be ultimate

- must be universal

- must treat the good of everyone

what 3 characteristics to incorporate in ethical decision making

True

T/F you should avoid ad hominem arguments that are directed at the person rather than the position they are maintaining

false

T/F two actions cannot be right depending on the situation

-2 principles must be in conflict

-normative evaluations

how do we know when we are in a moral crisis

normative evaluations

-indicate that an ethical dilemma is present

-just because we can do something doesn't mean we should do it

prevention

according to merriam webster's dictionary what is the act of preventing or hindering and the act or practice of keeping something from happening

-death

-disease

-disability

-discomfort

-dissatisfaction

what are the 5 Ds the provider tries to prevent

screening

is the identification of an ASYMPTOMATIC DISEASE, unhealthy condition or risk factor

types of clinical prevention

-immunization

-screening

-behavioral counseling

-chemoprevention

primary prevention

intervening before health effects occur, through measures such as vaccinations, altering risky behaviors and banning substances known to be associated with a disease or health condition

true

T/F a single intervention may prevent multiple diseases

secondary prevention

screening to identify diseases in the earliest stages before the onset of signs and symptoms

-mammography

-BP testing

what are examples of secondary preventions

screening

is the identification of an unrecognized disease or risk factor by hx taking, physical exam, lab test or other procedure that can be applied reasonably rapidly to asymptomatic people

no

is screening intended to be diagnostic

tertiary prevention

managing disease post diagnosis to slow or stop disease progression through measures such as chemo, rehab, and screening for complications

primary

what preventions goal is for a disease to not occur

secondary

what preventions goal is for detection and treatment of asymptomatic disease before symptoms occur

tertiary

what preventions goal is for consequences of existing disease or recurrent disease does not occur

-the burden of suffering caused by the condition

- the effectiveness, safety, and cost of the preventive intervention or treatment

- the performance of the screening test

what should PAs consider when judging whether a condition should be included in preventative care

-how much suffering it causes

-its frequency

the burden of suffering of a medical condition is determined by

performance screening tests

what kind of tests are

-high sensitivity and specificity

-low positive predictive value

-simplicity and low cost

-safety

-acceptable to pts and clinicians

unintended consequences of screening

-risk of positive results

-risk of negative labeling effect

-risk of overdiagnosis

-incidentalomas

provider barrier

-knowledge

-uncertainty about conflicting recommendations

-uncertainty about the value of tests or interventions

-disorganized medical records

-delayed and indirect gratification from screening

-lack of time

-attitudes and personal characteristics

pt barrier

-ignorance of benefits

-doubts about the physicians ability to detect a hidden disease

-cost of procedures

-discomfort

-a conscious or unconscious desire not to change unhealthy habits

-social and cultural norms

health system barriers

-inadequate amount and system reimbursement

-lack of health insurance

-population mobility

-pts w/ multiple physicians

-categorical, sporadic screening programs such as health fairs

-inadequate information systems

-lack of specific preventive service systems

-tobacco

-nutrition, obesity

-food safety

-HAI

-motor vehicle accidents

-teen prgnancy

-HIV

opioids

gunviolence

what are the winnable battles according to CDC

strategies to curb tobacco use

-track tobacco use & prevention policies

-use media to highlight dangers

-reduce exposure to secondhand smoke

-provide effective cessation services

-restrict tobacco advertising, promotion and sponsorship

challenges to curbing tobacco use

-range of emerging tobacco products

-states have billions in dollars from tobacco taxes and tobacco industry settlements to prevent use

strategies for nutrition, physical activity, obesity and food safety

-increase the number of people who meet the physical activity guidlines in america

-reduce sodium levels in processed and restraunt foods

-Research and evaluate the effect of front‐of‐package labeling

-Improve state and federal epidemiologic, laboratory and environmental health capacity to quickly

detect and respond to foodborne outbreaks

-Decrease the rate of foodborne illness and the number of foodborne outbreaks each year

challenges for nutrition, physical activity, obesity and foos safety

-childhoos obesity (complex issue)

-food marketing and promotion

150 minutes

how many minutes a week do adults need of moderate intensity aerobic activity

2 days

how many days a week do adults need muscle strengthening activity

food safety streategies

Improve knowledge of incidence, trends, burden and causes of foodborne illness

-Improve state and federal epidemiologic, laboratory and environmental health capacity to quickly

detect and respond to foodborne outbreaks

-Decrease the rate of foodborne illness and the number of foodborne outbreaks each year

food safety challenges

Declining state and local resources have impaired the ability to reduce food-related illness outbreaks

-Changes in food production and supply, including more imported foods

-New and emerging bacteria, toxins, and antibiotic resistance --Unexpected sources of foodborne illness (ie ice cream, raw sprouted nut butter)

hospital acquired infections strategies

-improve adherence to infection prevention guidelines

-improve national surveillance

-improve capacity at state and local health departments

hospital acquired infection challenges

Commitment from traditional and new public health and healthcare stakeholders at all levels; also need assistance from public and private sectors

-Embrace transparency and accountability from all stakeholders

-Develop a NEW NORMAL‐ an environment where HAIs are considered unacceptable

-central line associated bloodstream infection (CLABSI)

-catheter associated urinary tract infections (CAUTI)

-surgical site infection (SSI)

-ventilator associated pneumonia (VAP)

what are the different types of HAIs

HIV strategies

Implement and support the National HIV/AIDS strategy

-Reduce the number of new HIV infections in the US

-Implement comprehensive prevention with positives and ensure linkage to continuity of care

-Implement prevention with high-risk negatives

-Improve data monitoring and dissemination

-Reduce HIV related disparities

HIV challenges

-Gay, bisexual and other men who have sex with men of all races and ethnicities remain the

population most profoundly affected by HIV in the US

-Burden of HIV is not evenly distributed, rates of HIV and AIDS diagnoses are higher in the south

-Too many people living with HIV are not receiving ongoing care and achieving viral suppression

-Lack of education by providers on effective new prevention tools and preventative medication (make friends with your fellow ID practitioners!)

teen pregnancy strategies

-Decrease pregnancies among adolescent females

-Delay initiation of sexual activity among teens

-Increase the use of contraception (especially long-acting reversible methods, among sexually active teens)

teen pregnancy challenges

-Disparities in rates of teen pregnancy

-Access to contraception

-Quality of family planning services

motor vehicle accident strategies

-Prevent crash related deaths by increasing restraint use and decreasing impaired driving

-Improve motor vehicle safety in occupational settings

-Improve motor vehicle safety, decrease crashes and reduce motor vehicle related fatalities among tribal populations

-Deepen understanding of MVAs through improved data linkages to improve prevention efforts

motor vehicle accident challenges

-linking MVA data from various sources can be complex

-oral health

-sleep health

what are additional top health priorities that clinicians typically encounter

barriers to oral health

Lack of access to dental care as oral health is not universally integrated into primary or behavioral health care services

-Lack of integration between medical and dental records

-Separate insurance coverage and payment systems

-COST

-Lack of oral health literacy

strategies to help with oral health

Integrate Oral Health and Primary Health Care

-Prevent disease and promote oral health

(expand school based programs, expand

community water fluoridation)

-Increase access to oral health care (expand

number of federally funded health centers

that provide dental care)

-Improve the knowledge, skills and abilities of

providers to serve diverse populations

-Increase the dissemination of oral health

information and improve health literacy

-Advance oral health in public research

strategies to combat sleep health issues

-Increase the proportion of persons with symptoms of obstructive sleep apnea who seek medical

evaluation

-Improve public education on the need for sleep and the consequences of insufficient sleep

-Improve training for public health professionals and healthcare providers on screening and

counseling

-Improved evidence of the burden of insufficient sleep acquired through surveillance and monitoring tools

-Reduce the rate of vehicular crashes per 100 million miles traveled that are due to drowsy driving

-Increase the proportion of students in grades 9 through 12 who get sufficient sleep

-Increase the proportion of adults who get sufficient sleep