RN 406 – Population & Community Health: Vocabulary Flashcards

Vocabulary flashcards covering key terms from RN 406 Population & Community Health notes.

Community-Based Nursing (CBN)

Setting-specific nursing care focused on illness management for individuals and families where they live, work, and attend school; activities include acute and chronic disease management, care coordination, discharge planning, and home care.

Community-Oriented Nursing (CON)

Population-focused approach emphasizing prevention and health promotion for individuals, families, groups, and communities; activities include community diagnosis, surveillance, screening, program development/evaluation, and health education campaigns.

Public Health Nursing (PHN)

Nursing specialty that protects and promotes population health by emphasizing prevention, determinants of health, advocacy, policy development, and planning; focus is on the community and achieving equitable outcomes.

Benefits of PHN & Population Health

Longer life expectancy, safer food/water/air, reduced infectious and chronic disease mortality, and improved quality of life through prevention and system-level interventions.

Assessment (Core PHN Function)

Systematically collecting, analyzing, and sharing data on population health (e.g., surveillance, health needs assessments, epidemiology, vital statistics).

Policy Development (Core PHN Function)

Using scientific knowledge and stakeholder input to create policies that support population health (e.g., smoke-free laws, immunization mandates, school wellness policies).

Assurance (Core PHN Function)

Ensuring essential services and a competent workforce, linking people to services, enforcing health laws, and evaluating population-based interventions.

Essential Public Health Services

A set of services including monitoring, diagnosing/investigating, informing/educating/empowering, mobilizing partnerships, developing policies/plans, enforcing laws, linking to care, assuring workforce, evaluating, and researching.

Population-Focused Services (Examples)

Immunization programs; communicable disease control; environmental health; maternal–child health; chronic disease prevention; injury prevention; emergency preparedness; health equity initiatives.

Primary Prevention

Preventing initial occurrence of disease or injury; examples include health education, immunizations, healthy-environment policies, fluoridation, and safe routes to school.

Secondary Prevention

Early disease detection and prompt treatment to limit severity; examples include population screening, disease surveillance, and outbreak control.

Tertiary Prevention

Reducing disability and preventing complications once disease is established; examples include rehabilitation, case management, support groups, and disease-specific education.

Elizabethan Poor Law (1601)

Early government responsibility for care of the poor, laying groundwork for publicly funded social/health services.

Industrial Revolution (public health)

Rapid urbanization and poor conditions spurred sanitary reform, district nursing, and occupational health efforts.

Lillian Wald & Henry Street Settlement

Pioneered visiting nursing and school nursing; advanced addressing social determinants and housing through community reform.

Frontier Nursing Service / Mary Breckinridge

Introduced nurse-midwifery in rural Appalachia; reduced maternal mortality via home visits and integrated PHN-midwifery model.

Affordable Care Act (2010)

Expanded insurance coverage, emphasized prevention, strengthened primary care and care coordination, and reduced pre-existing condition exclusions.

Declaration of Alma-Ata (1978)

Health as a human right; primary health care central to Health for All; requires intersectoral collaboration and community participation.

Demographic Trends

Population growth and aging, shifts in racial/ethnic composition, higher chronic disease burden and newer infectious threats.

Social/Economic Trends

Lifestyle changes, rising income inequality, changing family structures, housing instability, and food insecurity.

Health Workforce Trends

Nursing shortages, misdistribution of primary care, growing APRN roles, and need for a diverse workforce.

Technology Trends

Expansion of telehealth, EHRs, data analytics, genomics, AI/automation, and enhanced surveillance.

Social Determinants of Health (SDOH)

Conditions in which people are born, grow, live, work, and age that affect health outcomes (economic stability, education, social context, healthcare access, built environment).

Five SDOH Domains

Economic stability; education access/quality; social/community context; healthcare access/quality; neighborhood/built environment.

Access to Primary Care & Public Health

Available, accessible, and affordable preventive and primary care services that improve population health and longevity.

Barriers to Health Access

Uninsurance/underinsurance, high out-of-pocket costs, structural racism, health literacy limitations, transportation/housing barriers, and fragmented care.

Cultural Awareness

Self-examination of one's biases, stereotypes, and assumptions to improve culturally safe care.

Cultural Knowledge

Understanding beliefs, values, and explanatory models of health in the client’s culture.

Cultural Skill

Ability to elicit cultural data, adapt care plans, and communicate in a culturally appropriate way.

Cultural Encounters

Engaging in cross-cultural care experiences to refine understanding and reduce stereotyping.

Cultural Desire

Intrinsic motivation to engage with and learn from other cultures.

Nursing Interventions for Culture

Use qualified interpreters; involve family; teach-back; respect safe traditional remedies; address health literacy; adapt care plans.

Cultural Assessment Tools

Ethnic and LEARN frameworks, Kleinman questions, FICA, and organizational checklists to assess culture and communication.

Inhibitors to Cultural Competence

Lack of self-awareness, stereotyping, ethnocentrism, time/resource constraints, limited system support, language barriers.

Interpreter Services

Qualified language assistance 24/7 at no cost; use interpreters (in-person/phone/video); do not use minors; document interpreter details.

Ethics & Codes

Autonomy, nonmaleficence, beneficence, justice; ANA Code of Ethics; Public Health Code; advocacy and moral reasoning.

Moral Distress

Knowing the right action but being unable to act due to constraints; can cause burnout; address via triggers, ethics support, and leadership.

Advocacy

Supporting client self-determination; activities include data collection, policy development, enforcement, and public engagement.

Fee-for-Service (FFS)

Payment model based on units of service; incentivizes volume and can raise costs.

Capitation

Fixed per-member-per-month payment; incentivizes prevention and population management; requires risk adjustment.

Retrospective Reimbursement

Payment after services; cost-based or charge-based; limited cost control; now less common in acute care.

Prospective Payment

Pre-set rates (e.g., DRGs); incentivizes efficiency and shorter length of stay.

Rationing

Explicit or implicit limits on services due to scarce resources; emphasizes transparency and equity.

Managed Care Tools

Networks, gatekeeping, utilization management, value-based purchasing, ACOs, and quality metrics.

Safety-Net Financing

Medicaid/CHIP, Disproportionate Share Hospital payments, public health funding, and community health centers.

Federal Agencies

HHS (CDC, HRSA, CMS, NIH, FDA, SAMHSA, IHS), DHS (FEMA), EPA, USDA; roles include financing, regulation, surveillance, research, and emergency preparedness.

State Agencies

State health departments; licensure; disease reporting; Medicaid administration; public health labs; environmental health.

Local Agencies

Local health departments; communicable disease control; maternal–child health; vital records; inspections; community-based services.

Professional/Advocacy Organizations

APHA; ANA; state nurses associations; specialty societies; community coalitions.

Education/Service Innovators

Nurse-managed health centers; FQHCs; school-based clinics; home visiting programs.

Legislative Branch Roles

Enacts statutes (e.g., ACA); sets budgets and appropriations; defines scopes of practice (e.g., Nurse Practice Acts).

Executive Branch Roles

Promulgates regulations; implements/enforces health laws; issues executive orders and declarations.

Judicial Branch Roles

Interprets laws and resolves disputes related to coverage mandates, scope-of-practice, and public health authorities.

Nurse Practice Acts (NPA)

State laws defining scope of practice, licensure, title protection, delegation, and disciplinary processes; Boards regulate practice.

Standards & Guidance

ANA Scope and Standards; PHN standards; institutional policies and procedures.

Policy Cycle

Problem identification → policy analysis → strategy/formation → adoption → implementation → evaluation → maintenance/change.

Public Health Authority

Derived from police powers of the state; balanced with civil liberties and equity considerations.

Environmental Health Domains

Air (indoor/outdoor), water, land/soil, and food; exposures include chemical, biological, and radiologic agents.

Environmental Health Sources

Point vs nonpoint sources; fracking; industrial/agricultural emissions; consumer products.

I PREPARE

Investigate exposures; Present work; Residence; Environmental concerns; Past work; Activities; Referrals/resources; Educate.

Community Assessment Tools

Windshield surveys; environmental databases; risk mapping/GIS; environmental health assessment forms; CCR/MSDS/SDS; Right to Know laws.

Risk Assessment Steps

Hazard identification → dose–response → exposure assessment → risk characterization; consider vulnerable groups.

Environmental Health for Children

Higher susceptibility to lead, pesticides, tobacco smoke, ozone, particulates; unsafe play spaces; contaminants in food.

Environmental Health in Pregnancy

Teratogens; endocrine disruptors; mercury in fish; nitrates; indoor air pollutants; counseling on avoidance.

Nurses’ Roles in Environmental Health

Mitigation and adaptation/response; surveillance, early warning, clinical care in heat waves, wildfires, disasters.

Environmental Health Prevention

Apply primary/secondary/tertiary prevention to exposures; three R’s (reduce, reuse, recycle); risk communication.

Environmental Justice

Ensuring minority/low-income communities are not disproportionately burdened; community-engaged policies.

Healthcare & Immigrants (Barriers)

Barriers include language, insurance status, fear of deportation, unfamiliarity with care; nurses build trust and use interpreters.

Nursing Role for Immigrants

Know community resources; perform focused cultural assessments; protect confidentiality; respect beliefs.

Inhibitors to Cultural Competence (Expanded)

Stereotyping, prejudice, ethnocentrism, language barriers, time/resource constraints, lack of system support.

Types of Environmental Health Sciences

Toxicology, epidemiology, GIS, climate science used to assess and manage environmental health risks.