community exam 1

community health nursing

• a population-focused approach to nursing + public health theory

community health nursing foundations

• evident through history

• advances in knowledge led to education of providers + regulation of water

• formation of public health service

public health service

• formed in 1798, with nursing care in homes implemented in early 1800s

• local health boards were established in late 1800s to monitor disease, promote health, + collect community statistics

systems thinking

• how an individual or unit interacts with others

• examines cause/effect relationships + the singular vs the whole

upstream thinking

• interventions to promote health or prevent illness

• what can we do to stop this from happening

nightingale’s environmental theory

• relationship between individual's environment + health

• health is a continuum, with an emphasis on preventive care

health belief model

• predicts or explains health behaviors with an emphasis on the individual

• assumes preventive actions are taken to avoid disease

• includes perceived threat of disease, modifiable factors (demographics + education level), cues to action (media campaigns or effected family/friends), + perceived benefits minus perceived barriers

milio’s framework for prevention

• focuses on change at the community level (complements the health belief model)

• identifies relationship between health deficits + availability of health resources

• theorizes that behavior changes in a group of people can lead to larger social change

pender’s health promotion model

• similar to health belief model

• health risk is not a factor for provoking change

• factors that affect individual actions to promote health are personal factors (biological, psychological, sociocultural), behaviors, abilities, self-efficacy, feelings, benefits, barriers, characteristics, attitudes of others, + competing demands

transtheoretical model (TTM) + stages of change model (SOC)

• six distinct stages that occur over time

• precontemplation (individual is unaware that change needs to occur)

• contemplation (individual considers change + weighs pros/cons)

• preparation (individual plans to take action)

• action (individual takes action)

• maintenance (individual implements action to continue behavior)

• termination (individual is consistent + no longer needs to make a conscious effort, but most do not get this far)

precaution adoption process model

• similar to the TTM/SOC model

• includes a stage of being engaged (between stages of precontemplation + contemplation)

• no termination stage

determinants of health

• client or environmental factors that influence health

• nutrition, social support + stress, education, fiances, transportation, housing, biology/genetics, + personal health practices

health indicators

• describes the health status of a community + serve as targets for improvement

• includes mortality rates, disease prevalence, levels of physical activity, obesity, tobacco, or other substance use

nurse’s role in community nursing

• determine community health by examining degree to which community’s health needs are identified + met

community

• a group of people/institutions that share geographic, civic, + social parameters

location

• community health clinic, county health department, or client’s environment (home, school, + workplace)

client in community nursing

• the community or a population (an aggregate that shares one or more characteristics) within said community

public health nursing

• population-focused with a combination of nursing knowledge + social/public health sciences

• goal of public health nursing = promote health + prevent disease

• provides ten essential services, like conducting research to on solutions to public health problems

public health assessment

• core function of public health nursing 

• systematic methods to monitor population health, identify problems, + diagnose/investigate hazards in the community

public health policy development

• core function of public health nursing 

• laws/practices to promote health that are formed by informing people about health issues

• mobilizing community partnerships to identify/solve problems

• developing plans to support both individual/community health efforts

public health assurance

• core function of public health nursing 

• make sure adequate health care personnel/services are accessible + enforce laws/regulations

• link people to needed health services + ensure competent health care workforce

• evaluate effectiveness accessibility of services

key concepts of public health nursing

• emphasize primary prevention

• recognize that client is a partner in health

• work to achieve greatest good for largest number of individuals + use resources wisely to promote best outcomes

broad community-oriented nursing

• focus of care includes aggregates, communities, populations (public health), + other at-risk/unserved people

• goal is health promotion + disease prevention

• community-oriented activities are indirect (program management), but may include direct care of at-risk people

specific community-based nursing

• focus of care is individuals + families

• goal is management of acute + chronic conditions

• community-based activities are direct (one-on-one) management of conditions in settings where people live, work, + attend

population-focused nursing

• determine needs, intervene to protect/promote health, + prevent disease within a specific population

• examples include people at risk for hypertension, without health insurance, or with a specific knowledge deficit

• public health intervention wheel (model for public health interventions by the Minnesota Department of Health)

• community partnerships among community members, agencies, + businesses who participate in health promotion + disease prevention

principles guiding community health nursing

• ethics, advocacy, evidence-based practice, quality, + professional collaboration + communication

ethics principle

• preventing/doing no harm, promoting good, respecting individual/community rights, + respecting autonomy + diversity

• provide confidentiality, competency, trustworthiness, + advocacy

• protecting/promoting/preserving/maintaining health + preventing disease (promote good + prevent harm)

client rights

• right to information disclosure, privacy, informed consent, information confidentiality, + treatment participation

core functions of ethics principle

• apply during assessment, policy development, + assurance

• autonomy (individuals select actions that fulfill their goals, as in self-determination)

• nonmaleficence (no harm is done when applying care standards)

• beneficence (maximize benefits + minimize harms)

• distributive justice (distribute benefits/burden fairly based on needs/contributions of society)

advocacy (principle)

• nurse is the client’s informer, supporter, + mediator

• clients are autonomous + responsible for their own health

• nurse-client relationship requires trust, collaboration, + shared respect (be considerate of feelings)

• nurse must advocate for resources/services to meet client’s needs, which requires assertiveness, prioritizing, + willingness to progress through chain of command

public health advocacy

• nurses changing healthcare systems to improve quality of life

• for example, promoting access to clinics in rural areas

evidence-based practice (principle)

• use best practices, expert opinion, + client preferences to change delivery/outcome of care

• includes data analysis, evidence-based practice, + community-based participatory research (CBPR)

data analysis

• choose highest level of evidence (validated by peer-review) for application to practice

• quality (minimal bias)

• quantity (number of studies, participants, + strength of effect)

• consistency (if results are repeatable)

evidence-based practice in the community

• improves public health of certain groups (assessment, policy development, + assurance)

• an example is using evidence to support media campaigns related immunizations

• task force on community preventive services reviews health promotion + disease prevention guidelines compared to current evidence, then determines if there is need to implement an intervention

• factors are cost, benefit to client, client satisfaction, safety, + culture/demographics

• interventions on the family level may not work on the community level

community-based participatory research (CBPR)

• includes partners, professionals, + community residents in identifying health issues

• fosters supports from community members, develops leadership, + promotes positive collaboration with health professionals

quality principle

• quality assurance, quality improvement, + quality management

• promotion of quality care includes professional licensing, adhering to facility policies, professional development, + compliance with the law

• quality/community report cards provide data for effectiveness of care (health profiles, needs assessments, information about quality of life, + health status) + then used to develop strategies to improve care

• total quality management (TQM) is an approach seeking to improve performance + meet/exceed expectations

continuous quality improvement (CQI)

• emphasizes organization/systems + uses objective data to analyze/improve processes

• effectiveness (providing services to those who will benefit)

• timeliness (reduce waits + harmful delays in care)

• client-centered care (ensure the client’s values guide decision making)

• equity (provide equal care with discrimination against gender, race, sexual orientation, or socioeconomic status)

• safety (avoid injuries to clients from care that is intended to help them)

• efficiency (avoid wasting in supplies, ideas, + energy)

professional collaboration + communication (principle)

• communication skills are needed to care for clients, collaborate with others, + inform the public

• used for mentoring, coaching employees, managing conflict, + supervising programs

• use clear language with a respectful tone (verbal + nonverbal communication, literacy needs, + client preferences)

• bound by laws (privacy + confidentiality)

benefits of professional communication

• increases client adherence to their treatment plan

• reduces admissions to acute care, cost of care, + medication errors

• shared decision-making with client + family

health promotion + disease prevention

• health promotion + disease prevention are used interchangeably

• refers to individual’s overall health, promotion of good health to reduce the overall risk for disease, + reduction of risk for specific conditions like vehicle injuries or influenza

healthy people (health promotion)

• national health goals based on data + trends collected from the prior decade

• began in 1979, with new objectives published every ten years (Healthy People 2020 began in january 2010)

• coordinated by US Department of Health + Human Services + other federal agencies

• measures quality of health + guides nurse in health promotion strategies

• implementation decreases healthcare expenses + increases lifespan

healthy people objectives

• access to health services, adolescent health, chronic kidney disease, disability, genomics, global health, health-related quality of life + well-being, hearing/sensory communication disorders, nutrition/weight status, older adult, oral health, preparedness, family planning, food safety, mental health/disorders, medical product safety, LGBT health, substance abuse, + sleep health

healthy people preventative services

• health education, counseling, immunizations, preventive medication, lifestyle changes, + other actions to prevent disease/disability

• screenings provide accurate, reliable, inexpensive, + quick results to large, at-risk groups

• nurse should evaluate screenings for consistency (reliability), accuracy (validity), + efficacy (predictive value)

primary disease prevention

• prevention of the initial occurrence of disease/injury

• nutrition education, family planning/education, smoking cessation, prevention of communicable diseases, health/hygiene issues specific to groups (day-care workers or restaurant workers), safety education (seat-belt + helmet use), prenatal classes, providing immunizations, + advocating for health care access/healthy environments

secondary disease prevention

• early detection + treatment of disease (goal is to limit severity + adverse effects)

• community assessments, home safety checks, disease surveillance (notifying those exposed), screenings, cancer (breast, cervical, testicular, prostate, or colorectal), diabetes, hypertensions, hypercholesterolaemia, sensory impairments, tuberculosis, lead exposure, genetics disorders/metabolic deficiencies in newborns, + control of disease outbreaks

tertiary disease prevention

• reduce limitations of disability + promote rehab

• maximization of recovery after injury/illness, nutrition counseling for Crohn’s disease, exercise rehab, case management for chronic or mental illnesses, physical/occupational therapies, support groups, + exercise for a client with hypertension

five social determinants of health

• neighborhood/built environment, social/community context, economic stability, health/healthcare, + education

family unit

• their beliefs, cultural values, environment, + genetics can positively or negatively impact one’s health

culture

• the beliefs, values, attitudes, + behaviors shared by a group that can be transmitted by generations

• consider cultural variations, uniqueness of client, + specific cultures in the local community when making a plan of care

culturally + linguistically appropriate services (CLAS)

• made by the office of minority health

• promotes development of healthcare workforce to be able to work with diverse populations

• standards are to provide language assistance in client’s preferred language + promote ongoing improvement/accountability for culturally appropriate care

cultural competence

• a skill nurses develop by learning to respect client’s dignity, preferences, + cultural differences (guided by four dimensions)

• used by nurse leaders to create + work with a diverse workforce to meet needs of a diverse population

cultural preservation

• helping client to maintain their traditions/practices

cultural accommodation

• supporting the client’s use of cultural practices that are beneficial to their health

cultural repatterning

• assisting the client to change cultural practices that are bad for their health

cultural brokering

• advocating + intervening between the client’s culture + health care culture on behalf of the client

cultural assessment

• tells provider about the effect of culture on communication, space + physical contact, time, social organization, + environmental control factors

• prevent personal bias = do a self-assessment + ask self about your own culture, views, how to be culturally sensitive, if you have the knowledge to develop culturally appropriate nursing interventions, + what your goal is in learning about diverse populations

environmental control as cultural assessment

• environment affects the person

• those who believe the environment can be mastered to affect health status will actively engage in health promotion, disease prevention, + treatment

• those who believe their outcome is predetermined are not likely to engage in health-related behaviors

• those who believe in harmony with the environment are more likely to look for natural solutions to correct a supposed imbalance between mind, body, + spirit

time orientation as cultural assessment

• whether a person focus more on the past, present, or future

• those who focus on the past/present may have little interest in health promoting behaviors that would benefit their future

social organization as cultural assessment

• the significance of individuals of a family or the family as a whole

• often affects how decisions are made within the family

• client may makes decisions based on the greater good of their family rather than their self (nurse should respect this choice)

health beliefs + practices as cultural assessment

• whatever a person believes is the cause of their disease will affect the actions they take to prevent/treat it

• biomedical beliefs (body acts like a machine + operates based on cause + effect, this is how most medical facilities function)

• naturalistic beliefs (individual is part of nature or creation, with an imbalance causing disease, this is part of eastern/chinese medicine + mexican belief of the hot-cold theory)

• magico-religious beliefs (health is linked to supernatural forces like good/evil, christian belief of healing by faith + voodoo/witchcraft in the Caribbean)

biological variations in health

• genetic influences from biological relatives

cultural assessment parameters

• ethnic background, religious preferences, + family structure

• education, language, communication, + literacy needs

• cultural values + food patterns

• health promotion/mainatience + types of practitioners, medicines, remedies, treatments, + therapies used

steps of (cultural) data collection

• first step is collect self-identifying data about client’s ethnic background, religious preference, family structure, food patterns, + health practices

• second step is ask questions that address the client’s perception of their health needs

• final step is identify how cultural factors can affect the effectiveness of nursing interventions

conveying cultural sensitivity

• address clients by their last name

• introduce yourself by name + explain your job

• be honest if you do not know something about the client’s culture (do not assume)

• find out what the client knows about their health/treatments + determine if they will adhere to the prescribed plan

• incorporate client’s preferences/practices when possible

• encourage client to ask questions if they do not understand

• provide teaching materials in client’s primary language at the recommended readability level

using an interpreter

• should have knowledge of medical terminology

• do not use family members they may lack objectivity when relaying information, may not understand medical terminology, + client may prefer privacy

• consider client when selecting age/gender of interpreter

• interpreter should not be from same community as client

• barriers are differences in socioeconomic status, subcultures, religion, education level, + spoken dialect

• government mandates that agencies have plans to improve access to federal health care programs for people with limited english proficiency

environmental health

• the quality of the air, land, water, + other surroundings that people come into contact with

• nurse’s role is to identify risks, participate in research, + advocate for improved environmental quality (use environmentally friendly practices/materials + educate public)

• toxicology (how exposure to chemicals can harm health)

environmental risks

• toxins like lead, pesticides, mercury, solvents, asbestos, + radon

• air pollution like carbon monoxide, particulate matter, ozone, lead, aerosols, nitrogen dioxide, sulfur dioxide, + tobacco smoke

• water pollution like wastes, erosion from mining/timbering, + run-off from chemicals added to the soil

• contamination like food/food products with bacteria, pesticides, radiation, + medication (growth hormones or antibiotics)

environmental nursing role

• encourage public participation in measures to improve the environment

• perform individual/population risk assessments + conduct epidemiological investigations

• implement risk communication + participate in policy development

environmental assessment (“I PREPARE”)

• determines current + past environmental exposures

• investigate (I) = potential exposures

• present work (P) = exposure, use of PPE, location of safety data sheets (SDSs), hazardous materials brought home from work via clothing, + trends

• residence (R) = age of home, heating, recent remodeling, chemical storage, + water

• environmental concerns (E) = air, water, soil, industries in the neighborhood, + nearby waste sites or landfills

• past work (P) = exposures, farm work, military, volunteer, seasonal, + length of work

• activities (A) = hobbies, activities, gardening, fishing, hunting, soldering, melting, burning, eating, pesticides, + alternative healing/medicines

• referrals + resources (R) = environmental protection agency (EPA), agency for toxic substances + disease registry, association of occupational + environmental clinics, SDS, OSHA, local health department, environmental agency, + poison control

• educate (E) = risk reduction, prevention, + follow-up

national environmental health care goals to decrease

• indoor allergen levels

• toxic air emissions + exposure to chemicals, pollutants, or pesticides 

• waterborne disease + per capita water use

• blood lead levels in children + homes with lead-based paint

• hazardous sites + new schools near highways

• global burden of disease related to environmental concerns

national environmental health care goals to increase

• recycling of solid waste

• alternative transportation modes for work

• days that beaches are open/safe for swimming

• testing for lead in homes built prior to 1978

• monitoring for diseases/conditions caused by environmental hazards

• homes with radon mitigation + radon-reducing features

• schools with policies to promote health/safety

• presence of information systems related to environmental health

primary environmental prevention

• individual primary prevention is to educate individuals on how to reduce environmental hazards

• community primary preventions are to educate groups to reduce environmental hazards + advocate for safe air, water, waste reduction, + effective waste management

secondary environmental prevention

• individual secondary preventions are to survey for health conditions that can be related to environmental + occupational exposures, obtain health histories of individuals, monitor workers for chemical exposure levels at job sites + screen children (6 months to 5 years) for blood lead levels

• community secondary preventions are to survey for health conditions that can be related to environmental + occupational exposures, + assess neighborhoods, schools, work sites, + community for hazards

tertiary environmental prevention

• individual tertiary preventions are to refer homeowners to lead abatement (reduction) resources + educate clients with asthma about triggers

• community tertiary preventions are to become active in consumer/health organizations + legislation related to environmental issues + support cleanup of toxic waste sites + removal of other hazards

global health

• healthcare delivery + health problems around the world affect the health of all countries

• global health initiatives improve the worldwide health status + promote equity in treatment

• health for all in the 21st century (HFA21) = outlines goals to promote adequate healthcare services worldwide

• by examining years of life lost from early death/disabilities, we gain information about the global burden of disease

influences on global health

• wars, political unrest, + limited resources/structure in lesser-developed nations

• climate change + natural/man-made disasters 

• international travel + poor sanitation practices

• nutrition + maternal health

goals for global health

• millennium development goals (MDGs) were created by UN to call for developed nations to contribute resources to improve lesser-developed countries

• sustainable development goals made in 2015

• eradicate hunger + poverty

• make primary education available worldwide

• promote women empowerment + gender equality

• promote sustainable use of ecosystems (forests + oceans)

• develop global partnerships + promote equality

• promote individual well-being + healthy lives

• ensure sustainable water, energy, + sanitation

• promote economic growth, industrialization, + innovation

• make safe human settlements + cities

• combat the effects of climate change

• promote peaceful + just societies

global health nursing interventions

• support development of health care roles in lacking countries

• promote benefits of nursing as a distinct profession in health promotion, disease prevention, + cost reduction

• work with government + other developers of policy to promote nurse’s rights

• foster programs that promote environmental sustainability (go green, preserving natural resources, + recycling facilities)

• act as mentors/consultants to address health of those in other countries

access to health care

• impacted by availability of services to the individual, family, + community

• goal of primary care system = make care available close to people who need it + ensure it is comprehensive with flexible costs

• shift focus of healthcare system from acute care to primary prevention in order to decrease costs + promote equity

• community assessment = evaluating adequacy of health services in community + accessibility

• identify barriers that community members (especially vulnerable populations) encounter

barriers to healthcare

• inadequate health insurance + inability to pay for care

• eligibility requirements for state/federal assistance programs

• language + cultural barriers

• lack of providers in a community, geographic isolation, + social isolation

• lack of communication (phones) + lack of transportation to healthcare facilities

• inconvenient hours

• poor attitudes of providers towards low socioeconomic or culturally different clients

organizations + financing

• health care delivery is a human service, but also a business that is affected by the economy

• good health status = positively affects the economy by increasing productivity + wage-earning

• microeconomic theory = individual preference/finances + how those actions affect care costs + resource distribution

• macroeconomic theory = focuses on aggregate behaviors, economic growth, + employment

• some providers ration care by only offering services to those with certain coverage

• US government is involved in providing direct health care services, providing information/protection to the public, setting policies, + assisting providers/public with finances

world health organization (WHO)

• provides daily information about occurrence of internationally important diseases

• establishes world standard for antibiotics + vaccines

• focus on health care workforce, education, environment, sanitation, infectious diseases, maternal/child health, + primary care

US department of veterans affairs

veterans health administration (VA) finances services for active + retired military persons/dependents

US department of health + human services

• Administration for Children + Families (ACF)

• Administration for Community Living (ACL)

• Centers for Medicare + Medicaid Services (CMS) controls HIPAA, disability insurance, aid to families with dependent children (AFDC), + supplemental security income (SSI)

• Agency for Healthcare Research + Quality (AHRQ) conducts research to improve quality, affordability, + safety of healthcare services (published guidelines/recommendations for various conditions)

• Centers for Disease Control + Prevention (CDC) works to prevent/control disease, injury, + disabilities both at home + abroad

• Agency for Toxic Substances + Disease Registry (ATSDR) strives to decrease harmful exposure + diseases linked to toxic substances 

• Food + Drug Administration (FDA) works to ensure food + medication safety

• Indian Health Service (IHS) promotes tribal health for american indians + alaskan natives

• National Institutes of Health (NIH) supports biomedical research + includes the national institute of nursing research

• Substance Abuse + Mental Health Services Administration (SAMHSA) promotes behavioral health + aims to reduce negative effects of substance abuse/mental illness

state health agencies

• obtain funding from state legislature + federal public health agencies

• establishes public health policies, provides assistance to local health departments, + is responsible for administration of the medicaid program

• reports notifiable communicable diseases in the state to the CDC

• Women, Infants, + Children (WIC) promotes nutrition for groups (children up to age 5) who are of low socioeconomic status

• Children’s Health Insurance Program (CHIP) offers expanded health coverage to uninsured children whose families do not qualify for medicaid

• State Boards of Nursing = oversees state’s nurse practice act + nursing schools

local health department

• receives funds from state level to then use for community programs

• primary focus is health of their citizens

• responsible for identifying + intervening to meet health needs of community

• they work closely with local officials, business, + stakeholders

• report notable diseases to state department of health

• nurses act as caregivers, advocates, case managers, referral sources, counselors, educators, outreach workers, disease surveillance experts, community mobilizers, + disaster responders

• funded by local taxes + federal/state funds

financing

• individual payment, payment through organized insurance or health maintenance organizations, + public funding

Patient Protection + Affordable Care Act

• made to help make health insurance affordable for all people + to decrease federal spending on health care

• affects how medicare is implemented + how private insurance companies supply coverage

• full law is on the US department of health + human services website

important elements of Affordable Care Act

• dependents can remain on their parent’s insurance until age 26

• health plans cannot deny benefits for pre-existing coverage to children under age 19

• banned lifetime limits on benefit coverage

• covers preventive care services

medicare

• must be older than 65 + receiving social security, have been receiving disability benefits for two years, have amyotrophic lateral sclerosis + receiving disability benefits, have kidney failure with dialysis, or have had a kidney transplant

• part A = hospital care, home care, hospice, + limited skilled nursing care

• part B = health care provider services, outpatient care, home health, diagnostic services, physiotherapy, durable medical equipment, ambulance service, mental health, + preventive services

• part C (medicare advantage plan) = combination of part A + part B, but is provided through a private insurance company

• part D = prescription medication coverage

medicaid

• provides coverage for people of low socioeconomic status + children

• eligibility is based on household size + income, but priority is given to children, pregnant women, + disabled people

• provides inpatient + outpatient hospital care, laboratory + radiology services, home health care, vaccines for children, family planning, pregnancy‑related care, + early + periodic screening, diagnosis, + treatment (EPSDT) services for those under age 21

private funding

• health insurance or employer benefits

• managed care is when a case management approach with a specific group of providers in an attempt to contain the cost of care

• health maintenance organizations (HMOs) are when care is provided to members by a set of designated providers

• preferred provider organizations (PPOs) are when predetermined rates are set for the services provided to members (financial incentives are in place to promote us of PPO providers)

• medical savings account is untaxed money put into an account for medical expenses

self-pay

• individuals must pay for charges that are not covered by a third party

• some clinics offer sliding scale payment (rate is based off of a person’s income)

nursing interventions

• use data about genetics, family illnesses, the environment, + lifestyles to identify disease patterns to then prevent/treat disease

• use community assessment to identify barriers to health care

• be aware of healthcare standards + organization that influence delivery of care

• promote distributive justice for healthcare resources

• understand communication between local, state, + federal health entities

• assist individuals/groups in getting access to care + work to promote equity in health care delivery

• maintain knowledge + skills related to economic principles (budgeting + funding of care)

air quality index (AQI)

• how the EPA reports air quality

• green is good (0 to 50)

• yellow is moderate (51 to 100)

• orange is unhealthy for sensitive groups (101 to 150)

• red is unhealthy (151 to 200)

• purple is very unhealthy, with health risks for everyone (201 to 300)

• maroon is hazardous (301+)

• five major pollutants are ground level-ozone, particle pollution (particulate matter), carbon monoxide, sulfur dioxide, + nitrogen dioxide

epidemiology

• the study of health-related trends in populations for the purposes of disease prevention, health maintenance, + health protection

• examines numeric indicator of the occurrence of diseases, how long they last, + compares that to historical trends

• epidemiological principles = allow nurses to provide intervention to targeted groups

• epidemiological calculations = provide numerical information about the impact of disease + death on populations

epidemiological triangle

• agent = physical (noise/temperature), infectious (virus/bacteria), or chemical (drugs/toxins) factors that causes disease

• host = the living being that an agent or the environment influences (age, sex, genetics, ethnicity, immunological status, physiological state, + occupation)

• environment = the setting or surrounding that sustains the host (physical, like geography, water/food supplies, + presence of reservoirs/vectors, or social, like access to healthcare, poverty, + high-risk working conditions)

epidemiological calculations

• epidemiology relies on statistical evidence to determine the rate of spread of disease + the proportion of people affected

• used to evaluate the effectiveness of disease prevention + health promotion activities + to determine the extent to which goals are met

incidence + prevalence rates

• used to measure the existence of a particular disease + allow the nurse to compare the rate of disease in one population to another

• incidence calculation = (new cases / population total) x 1,000 = answer per 1,000

• prevalence calculation = (existing cases / population total) x 1,000 = answer per 1,000

mortality rates

• crude mortality rate = overall death rate

• cause-specific or case fatality rate = deaths from specific causes

• infant mortality ratio or age-specific rate = deaths at specific times across the lifespan

• crude mortality rate calculation = (deaths / population total x 1,000) = answer per 1,000

• infant mortality rate calculation = (infant death before age 1 in a given year / live births in same year) x 1,000 = answer per 1,000