What are communities defined by?
People, place, function
What do communities consist of?
Interest
Concern
Neighborhoods
Practice
What is the systems theory?
Focuses on the who and the how
What theory is this?
The mandala of health: model of the human ecosystem
More personalized
Define the being theory
Represents the actions people undertakes with others as they form a collective unit
Some of the elements of sense of community
What are some of the elements for sense of community for the being theory?
Membership
Influence
Need fulfillment
Shared emotional connection
Define some of the aspects of the community assessment wheel
at the core of the wheel is people
Community is divided
Has line of defense and resistance
Stressors
What are the 7 steps to community assessment
Define community
Establish purpose of assessment
Determine scope of assessment
Gather data
Analyze data
Validate findings
Issues/focus & contributors/factors
Describe the community as partner
Multidisciniplary and interprofessional actions towards SDOH
Community/public engagement in decision-making processes
A socioecological approach which focuses on community systems and environments
2 attributes of community as partner
Community attribute (community assessment wheel)
Nursing process attribute - reflects neuman’s stress adaption model which is based in systems theory
CHN has several roles in community-as-partner model, what are they?
Decrease potential for community to encounter stressors
Limit the impact or effects of stressors on the community through prevention activities
Build the capacity of the community to act on their own behalf
How are neighbour hoods decided?
Based on school catchments
What are the four assessments for a CHN
Windshield: rely on 5 sense
Needs: needs of community
Problem investigation
Environmental scan
Standards of practice #1
Health promotion
Standards of practice #2
Prevention and health protection
Standards of practice #3
Health maintenance
Standards of practice #4
Professional Relationships
Standards of practice #5
Capacity building
Standards of practice #6
Health equity
Standards of practice #7
Evidence informed practice
Standards of practice #8
Professional Responsibilities
Describe standard of practice #1
Health promotion
Process of enabling people to increase control/improve their health
Involves individuals, families, groups, communities, populations and systems
Strategies: build healthy public policy, create supportive environments, strengthen community actions, Develop personal skills, Reorient health services
Describe standard of practice #2
Prevention and health protection
Socio-ecological model
Actions implemented in accordance to government legislation and nursing standards to minimize the occurrence of diseases or injuries and their consequences
Describe standard of practice #3
Health Maintenance
Systematic and planned methods to maximize fx, improve health, support life transitions
Includes full spectrum of care - acute/chronic, terminal illness, end of life
Describe standard of practice #4
Professional Relationships
Work with others to build and nourish professional and therapeutic relationships
Includes optimal participation, self-determination of client
Describe standard of practice #5
Capacity building
Partner with client to promote capacity
Focus is to recognize barriers to health and mobilize and build on existing strengths
Increase in ability to define, assess, analyze and act on health concerns
Describe standard of practice #6
Health equity
Recognizes SDOH and incorporate actions into practice, focuses to advance health equity at individual and societal level
Identify and facilitate universal and equitable access to services
Provide culturally relevant care to diverse individuals and populations
Describe standard of practice #7
Evidence informed practice
Use the best evidence to guide nursing practice and support clients in making informed decisions
Types of nursing: Wise practices
incorporate traditional knowledge, cosmology and lifeways to guide health practices with Indigenous communities.
Types of nursing: Indigenous communities
care informed by traditional knowledge, values and beliefs. Refers to clinical practice, education, research, administration and policy that involve FN, inuit and metis nurses,
Types of nursing: Public health
uses knowledge from public health, nursing, social/environmental sciences and research and integrates it with concepts of primary health care, disease/injury prevention, community participation, community development, SDOH, and health equity. Key functions are health promotion, disease and injury prevention, health protection, health surveillance, population health assessment, emergency preparedness and response.
Types of nursing: Home health nursing
Promote optimal level of well-being and functioning. Job duties include chronic disease management, curative practices, health promotion/education, palliative care, rehab, support/maintenance, social support and family support.
Types of nursing: Primary Care
Provide first contact with the health care system. Focus on health promotion, disease and injury prevention, cure, rehabilitation, support.
Types of nursing: Telehealth
Provide services like triage of health issues, consultations, advice, counseling, support, health education and care coordination for chronic disease management.
Types of nursing: Outreach/street nursing
Often with homeless people and community/government agencies. Provide services such as communicable disease support, STI follow ups.care, birth control, pre and post natal supports, drug and alcohol rehab, harm reduction, primary care, wound care, diabetic care, mental health follow ups.
Types of nursing: rural
Complex roles
Types of nursing: Occupational health
Four components: individual, health, occupational health nursing and environment. Specialty area of nursing practice that focuses on worker/group by promoting health, preventing illness or injury, protecting workers from risks and recommending a safe and healthy work environment.
Types of nursing: Parish
specialized to promote health, healing and wholeness that is hired by a faith community and integrates faith into nursing practice
Types of nursing: forensic nursing
Can be sexual assault nurse examiners (SANE), and engage in community education regarding risk factors for violence, social activism to prevent violance, influence healthy public policy to overcome challenges. Work with crime survivors, ER, ICU, peds, general med and surgery, LTC, schools, prisons, coroner or medical examiner office, and outreach community settings.
Types of nursing: Community mental health
Blend of community, mental health and psychiatric nursing. Services include home care, substance abuse/addiction programs, corrections institutions, community mental health programs, residential homes, and community outreach programs that visit homes/street/shelters.
Types of nursing: Military
Can work in military hospitals and outpatient clinics, also provide disease prevention and outbreak response. Provide preventative, occupational and environmental health care services.
Key principles of public health care
Accessibility
Health promotion
Interdisciplinary collaboration
Use of appropriate skills and technology
Public participation
Strategies of health promotion
Building healthy public polciy
Create supportive environments
Strengthen community action
Develop personal skills
Reorient health services
What is the epidemiological triangle
Three elements: host, agent, environment
Changes can influence the occurence of disease by increasing or decreasing a clients risk for disease
Web of causation
Illustrates complex interrelationships of a number of factors sometimes interacting in subtle ways to increase of decrease the risk of disease
Diagram that links to causes and effects
Hamilton and Bhatti Population Health Promotion Model
Who you work with
What is the issue
How are you going to solve the issue
Evidenced based, embraces systems theory
Primordial prevention
Beginning / before
Dealing with cause of causes
Upstream thinking
Individual choice
Dealing with cause of causes
Quaternary prevention
Dealing with the cause straight on in an individual curative approach
Midstream thinking
Dealing with illness / injury with an individual approach
What are the antecedants of empowerment
Insight, willingess to change, resources to implement change
Downstream thinking
Focusing on the issue at hand
Define health inequities
differences that are unnecessary, avoidable and unfair/unjust
define health equities
fair opportunities for all ppl to achieve full health potential
define health disparities
differences in health status btw groups/populations
define social justic
fair distribution of resources and responsibilities amongst members of population
3 features of social justice approach
ethical use of power
ppl are unique, connected to others, interdependent
everyday ethics
define subjective poverty
perception that there is insufficient income to meet expenses
define relative poverty
deprivation of some individuals in relation to those who have more
define absolute poverty
deprivation of resources that are life threatening
what are LICOs
share of income spent on necessities
thresholds are adjusted/increased each yr according to consumer price index
criticisms
define vulnerable populations
conditions determined by social, physical, economic and environmental factors/processes which increased susceptibility to the impact of hazards
Presences of characteristics which results in higher risk for adverse outcomes
Define marginalization
Marginalization occurs when people are systematically excluded from meaningful participation in economic, social, political, cultural and other forms of human activity in their communities and thus are denied the opportunity to fulfil themselves as human beings.
Define social exclusion
lack of belonging, acceptance and recognition
more economically and socially vulnerable which leads to diminished life experiences
low self esteem and shame
moral compassing diagram
undergoing a visceral reaction → self talk → seeking validation →mobilizing support for action or inaction → moral residue