Community Nursing Exam #1 Questions & Answers correct

Community Nursing Exam #1 Questions & Answers correct 3 major changes in health care in the 20th century 1. Patient/Client centered care 2. Technology 3. Personal responsibility for health What is "Public Health" -What society collectively does to ensure that conditions exist in which people can be healthy Community Health nursing -Use of systematic processes to deliver care to individuals, families, and community groups with a focus on promotion, preserving, protecting, & maintaining health Community-Based nursing practice -Minor acute & chronic care that is comprehensive and coordinated where people work, live, or attend school -(i.e., school nurses, stat care nurses, doctor's offices) Public Health nursing -A synthesis or nursing and public health within the context of preventing disease and disability, promoting & protecting the health of the entire community -Population as a whole -(i.e., health department, community boards, & epidemiology) Public Health Responsibilities -Communicable Disease Prevention -Occupational Health -Environmental Health Programs -Reproductive Health -Chronic Disease Prevention (#1 cause of death in U.S., #2 is communicable) -Injury Prevention Activities (Children across lifespan) The 8 Domains of Public Health Nursing 1. Analytic assessment skills (never group by race or religion!) 2. Policy development & program planning 3. Communication skills 4. Cultural competency skills 5. Community dimensions of practice skills 6. Basic public health science skills 7. Financial planning & management skills 8. Leadership & systems thinking skills Aggregate -Live or work in/out of community & may travel in/out of community for resources Geopolitical Communities -Share geographical boundaries & resources (i.e., Canton) Phenomenological Communities -Share interests or beliefs within the community Communities of Solution -People that form groups to address health concerns or issues in community What's a community assessment? -A critical process for the future because the process may identify a method to improve the health of at-risk clients -Includes examination of biological, psychological, & sociocultural influences Gordon's Functional Health Pattern -An organized approach to assessment in the form of an evaluation -11 patterns -Can be used as a framework for community assessments How are public health departments organized? NationalStateLocalCounty -The Ohio Department of Health (ODH) is the public agency for the state of Ohio Government Agencies -Provide services that benefit the social welfare & health of citizens at a local, state, & national level -E.g., CDC, USDHHS, WIC, Medicaid, Medicare, Non-government Agencies (NGO) -Agency that acquires resources to help others from private vs. public sources -Often bigger than Gov't Agencies -E.g., Red Cross, Project Hope, Oxfam International, J&J Philanthropic Organization -Organizations that use endowed funds or private fundraising to address the needs of individuals, families, & population Role and Regulation of USDHHS -The agency most heavily involved with the health & welfare concerns of US citizens -Charged with regulating health care & overseeing the health status of U.S. citizens or Refugees/Asylees -Directed by Secretary of Health -Collaborate with the State & Local Health Departments -All other Gov't agencies fall under USDHHS (e.g., CDC, State Health Departments, etc.) What are Public Health Entities and how are they related to the Federal Gov't? -The Federal Gov't plays and important role in the regulation of Public Health Entities: 1) Food 2) Medications (FDA) 3) Devices 4) Occupational Health 5) Environment -Federal Gov't creates policy and allocates funds -Federal Gov't provides services that benefit the social welfare of citizens (safeguards the public) What must every state report yearly? 1) Health status and it's determinants (i.e., Morbidity & Mortality) 2) Utilization of health care resources (i.e., track public usage of facilities and resources) 3) Health expenditures (i.e., where is the Federal Gov't's money going?) 4) Vulnerable populations and health care (i.e., What individuals are at high risk of morbidity and mortality?-Low socioeconomic status) Multilateral Agencies -Funding from multiple Gov'ts & funds going anywhere based on need -E.g., WHO (goal? Make the world healthy), World Bank (offers loans based health Bilateral Agencies -Single country giving to another (rich to poor) -Often based on good/cooperative relations E.g., USAID (The U.S. Agency for International Development) WHO Definition of Health -A state of complete physical, mental, & social well-being, not merely the absence of disease or infirmity #1 Risk Factor that affects disease burden in high income countries? -Smoking #1 -HTN #2 -Hyperlipidemia #3 -Obesity #4 WHO Health Indicators in order... 1) Morbidity & Mortality (What's trending?) 2) Risk Factors (What is causing it?) 3) Health Service Coverage (# of services available in area) 4) Health System Resources (What do we have available) Ten Highlights of the WHO World Health Statistics Report for 2008 1) Maternal mortality is declining too slowly 2) The gap in coverage in the four key intervention areas of family planning, maternal and neonatal care, immunization, & Tx of sick children remains wide 3) The number of ppl living with HIV continues to rise but is lower than previously expected 4) Use of insecticide-treated nets to prevent malaria has increased, but the poor do not benefit as much from malaria interventions 5) Tobacco use is a risk factor for six of the eight leading causes of death 6) Less than a quarter of women aged 50-69 years had a breast cancer screening 7) Excess mortality in Europe is due to noncommunicable diseases and injuries 8) Meningococcal meningitis epidemics in Africa call for a system of early detection & Tx 9) Noncommunicable conditions will cause over three quarters of all deaths in 2030 10) 150 million people suffer catastrophic healthcare costs each year UN Millennium Development Goals (8 goals) -Believe that all people have a right to health -Developed by the United Nations Goal 1: Eradicate extreme poverty & hunger Goal 2: Achieve universal primary education Goal 3: Promote gender equality & empower women Goal 4: Reduce child mortality Goal 5: Improve maternal health Goal 6: Combat HIV/AIDS, malaria & other diseases Goal 7: Ensure environmental sustainability Goal 8: Develop a global partnership for development Culture -The shared symbols & meanings that people create in the process of social interaction & orients people in their ways of thinking, feeling, & being in the world. Includes: -Language, religion, occupation, economics, art, politics, & philosophy -Affects practices of individuals, families, & institutions -Dynamic, shared, & learned Cultural Competency -The ability to consider cultural aspects of health, illness, and treatment for each client or community, as well as doing so at each stage of the nursing process -An ongoing process that involves accepting and respecting differences and not letting one's personal beliefs have an undue influence on those whose worldview is different from one's own Cultural Humility -The ability to continually self-evaluate and critique your own cultural assumptions and advocate for the client in a nonpaternalistic way -Ask open-ended questions about beliefs or practices, & ask about traditions (what does the client believe caused the illness and how have they already tried to address it?) Cross Cultural Nursing -Any nursing work in which the nurse and patient have different values Epidemiology -Study of the distribution and determinants of the states of health and illness in human populations -Primary focus is on the group and/or community -Concentrates on improving public health practices -The goal of epidemiology is to prevent or limit illness, spread of disease and disability (primary prevention!) -Basic science of public health that provides insight into the nature, causes, and/or the extent of health & diseases -"That which befalls man" Epidemiologic Triad -The belief that health status is determined by the interplay of these three factors: Host, Agent, Environment Wheel of Causation -2nd epidemiological model -De-emphasizing the agent as the sole cause of disease while -Emphasizing the interplay of environment (physical, biological, & social environments) & host Non-modifiable host factors -Age, sex, physical and emotional health, immune status Modifiable host factors -Nutrition, lifestyle Lillian Ward -Considered the founder or "mother" of community health -Established the Henry Street Settlement House in NYC Hippocrates of C0s -Considered the first epidemiologist & father of modern medicine -First to propose that nature and environment had an effect on health & not demons/spirits John Graunt -"Bill of Mortality" creator -Analyzed weekly reports of births and deaths in London & developed a better understanding of diseases & their causes William Farr -Considered the founder of modern statistics & gathered data for future considerations John Snow -Investigated the epidemic of cholera using natural experiments, mapping, and rates in London -Identified a public water source as the cause Florence Nightingale -Considered the founder (mother) of the nursing profession -Began sanitary reforms -Used statistical data to prove efficacy of reforms Primary Prevention -Aimed reducing the incidence (new cases) of disease or injury -Preventative trials Secondary Prevention -Aims at early diagnosis, minimizing damage & limiting resulting disabilities -Limit the spread of -Therapeutic trials Tertiary Prevention -Rehab measures that enable the individual to function at his or her maximum capacity despite the existence of a chronic illness Nursing Process Vs Epidemiologic Process Nursing Process: -Individual client -ADPIE Epidemiologic Process: -Population based -Gathers and interprets data -Focus is on health promotion and controlling outbreaks Behavioral Risk Factor Surveillance System (BRFSS) -Collect and analyze specific modifiable risk factors -Collected per state & is unique to each area -Data used to implement programs/health promotion activities -Nurses!!! in their care of individual and community clients have the potential to link environmental exposure to illness and disease Rate -Used to describe the quantity or existence of states of health in a specific group of people in a given time period -(Occurrence in a given time period/Everyone in a given time period) x 100 -Rates always have time periods! Incidence Rate -New cases of a disease -E.g., new cases of asthma in 2012? Prevalence Rate -Existing cases/conditions -E.g., number of people with asthma in 2012? Attributable Risk -The difference between the incidence rates in an exposed group and an unexposed group of people -People with Vs. without Crude Mortality Rate -Probability of death from any cause among a population within a particular geographical area Descriptive Epidemiology -Information is collected to characterize and summarize problem -Who, where, when? -Lead to hypotheses for future research Types: 1) Case Study 2) Cross-sectional Study 1) Case Study (Descriptive Epidemiology) -In-depth analysis of an individual, group, or social institution 2) Cross-sectional Study (Descriptive Epidemiology) -Provide a snapshot of a population or group Analytic Epidemiology -Study that uses comparisons b/t groups to determine the role of various risk factors in causing the problem -Looks at why (cause)? Types: 1) Cohort Study 2) Case-Control Study 1) Cohort Study (Analytic Epidemiology) -Monitor subjects over time to find associations between risk factors and health outcomes 2) Case-Control Study (Analytic Epidemiology) -Studies one group with the health problem (case-subjects) and another group without the health problem (controls) Infectious Disease -Caused by the growth of pathogenic microorganisms in the body Surveillance Reporting -Mandated by law -List of reportable diseases varies by state -We report to the state, state reports to the CDC on a voluntary basis Norovirus - Foodborne -Contaminated shellfish -Self-limiting Camplyobacter enteritis - Foodborne -Most common bacterial foodborne illness in U.S. -Contaminated poultry -Lasts about a week Listeria - Fordborne -Contaminated deli meats, soft cheeses, & smoked seafood Tx: -Penicillin E. Coli - Fordborne -Undercooked ground beef, fresh produce, and contact with animals in public places -Educate on cleanliness Waterborne diseases -Usually enter water supply through animal or human fecal contamination -Associated with sewage/septic contamination STDs/STIs -U.S. has the highest rates in industrialized world Any person is in a high-risk group for STDs/STIs if they: -Have multiple sex partners -Do not use condoms -Have other STDs -Have a partner who has had an STD Bacterial STDs -Chlamydia, Gonorrhea, Syphilis Viral STDs -HIV, Herpes, HPV, Hep B SARS (Recent Emerging and Reemerging Infectious Diseases) -Severe Acute Respiratory Syndrome -Viral -Mostly transmitted by respiratory secretions To prevent: -Enhance infection control measures -Hand hygiene -Cover cough Influenza (Recent Emerging and Reemerging Infectious Diseases) -Avian flu (bird flu), H1N1 (swine flu) TB (Recent Emerging and Reemerging Infectious Diseases) -Airborne droplet transmission -TB bacilli can remain dormant and viable for many years in the human lung -Testing for TB is required in healthcare centers TB & HIV -If you have a patient that TB symptoms and they test negative, you must test them for HIV! -Have an increased chance of HIV with TB or vice versa Key Values in Community Health 1) Social Justice #1 Value!!! (Everyone should have the right to healthcare) 2) Health Equity