Population Community Nursing- Exam #1 Questions & Answers correct

Population Community Nursing- Exam #1 Questions & Answers correct Public Health care what society does collectively to ensure that conditions exist in which people can be healthy community based nursing minor acute and chronic care that is comprehensive and coordinated where people work live and attend school (disease care outside of the acute setting/primary care in the community) Community oriented care use of systematic processes to deliver care to individuals families and community groups with a foucs on protmoting preseving and protecting health Population aggregate a population group with common characteristics Intervention Wheel Nurse Services Direct: care giver, case manger, advocate, educator, counselor, collaborator, information broker, coalition builder, change agent, policy advocate, culture broker, resercher for epidemiology Coalition builder catalyst to try and promote a community based organization that is already working A group of consumers, health professionals, policy makers, and others working together to improve community health status or to solve a specific community health problem. 8 domains of public health nursing A-analytically assessment B-basic public health science skills C- communication skills C- cultural competency C- community dimensions of practice skills L- leadership and system thinking Mmoney management/financial planning skills P- policy development and planning 10 assumptions- core fucntions of public health nursing practice Nnurse versed in both RN and public health Ddisparities- determinatnts of health and inequalitys (race, gender, socioeconomics) Llevels- of practice (community, system, individual) Iintervention- Pprevention level-of prevention (primary seconday tertiary) Ppriorities- idenitifed thorugh an assessment of the community PProcess- nursing process Levels of Nursing Practice community system individual 1. Community Level: Goal to Increase knowledge and attitude of entire community about the importance of health behavior in (community norms, attitudes, awareness, practices and behaviors) Ex: education about importance of immunization and consequence of note being immunized to increase the percent of people that get them. 2. Systems: Goal to change laws, policies and practices that influce public-- Ex: promoting population based immunization registries and improving clinic and provider practices changes organizations, policies, laws and power sturctures within communities 3. Individuals: Goal is to increase indiviudual knowledge attitdes, beliefs and behaviors Ex: idenifity individuals who are not immunized and idenity the barrier to immunizaiton to ensure that the individuals immuizaiton are brought up to date Public Health prioires and Achievements of 19th 20th 21st cent 19th: John Snow=tracking disease, Florence Nightengale identified betwn sick and healthy, Lillian Wald is founderfounder of public nursing 20th Medicare, hospice, healthy people intiatives 21stHealthy people 2020, FEMA, oral care, ID health disparities, Breast feed, chrinc disease, afford care act, techonolgy 3 public health core functions 1. assessment 2. Policy develop 3. assurance 1. assessment: systematic data collection on population 2. Policy develop: provide leadership in policity to support health based on evidence (flourination of water) 3. Assurance: role of public health in ensuring that essential community orient health services are available to provide essential person helath services like regualting nursing licensure Healthy people 2020 Bbreast feeding benefits Cchronic illness Hhealthy foods Ooral care Ppreventative- well child and well woman Eequalities/disparetes Social Justice refers to an equitable Shari of both common burdens and the common benefits or advantage policy level: lobbying community level: volunteer at clinic Health Equity based on principles of fairness and social justice as well as the belief that all people have an equal value Sustainabiliy Establishing the condition for the health improvement achieved by an intervention to continue beyond the period of a forma comm health program --address sustainabiliyt right away.. how will it continue when the grant is gone SMART objectives Objectives- planning identifies specific problems and how to solve SSpecific Mmeasurable Aacheivable Rrelevant Ttime bound Top down vs bottom top down starts at global level/national- dictated to community bottom up state/local level problem start (less funded and support= hard) Models for Health Planning: Logic Model Visual rep of how a prog is organized including activites resources, short term and intermediate outcomes and program goals Models for Health Planning: Social Ecological Model based on general system theory and health promtion theory-- multiple determinants of health act at different level upstreamat societal, environmental or policy level--think high UP mainstream at popualtion or community level downstream the individual (think LOW/smallest level) Models for Health Planning: Force Field Analysis factors in a community that driving and rinforcing change in a desired direction or restaining change Ex: fast food, decreased parks--- lobby for more parks and grocery stores Models for Health Planning: Lewis Change Model 1. Unfreezing - necessary precursor to change 2. Changing - once a community has become sufficiently aware of the need for change of sufficiently dissatisfied with the current conditions through increasing awareness of an issue or as the result of a crisis, the process of changing or transition may begin 3. Refreezing - process of stabilizing once a change has occurred with the goal of SUSTAINING the change in the community's state of health or health behavior Making the new behaviors norms help ensure that change toward a more positive health status will remain in place once the intervention or program is completed - refreezing establishes a new status quo from which change may be possible in the future Care managment coordination of a plan or process to bring health services together as a common whole in a cost effective way Case Managment development and coordination of care for a selected client and family -- primary level prevention main jobs: advocate, collaboration, case manage Population management managing the health of populations by integrated systems (wellness and health promotion, illness prevention, acute care, rehab, end of life care) Disease managment system of coordinated health care intervention for groups of individuals for whom self care efforts are significant, emphasize disease Data collection methods: Communitiy assessment 1. Windshield survey: observations while driving 2. Epidemiolgical approach: assess statiscial realtionships to eval the level of health and wellbeing (relationships between health and illness) 3. Functional Health status approach: systmeatic approach eval of patterns of disease, health conditions etc to idenityf prioroy health issues and how groups respond to problems//take action 4. Geographic Information Systems (GIS): drawing relatiohsop and associations -- map outlining drought area/lcoations and environments 5. Developmental appraoches retrospecive and historical anaylsis of system eniron, edu, safety etc (ex: look at cultural changes over time) 6. Asset based approach look at community strengths and resources as a primary approach along with community needs 7. collaborative approach public health experts collaborate through community assessment model that emphasizes interdisciplinary taks Key information person knowledgeable about specific aspects of problem and the communitys current and past attempts to address it; community members with specialized knowledge that we as nurses can learn from (like firemen or store owners) --interview them for data collection on community Stakeholder Any individual organization or group that has interest (stake) in a specific community health issue or the outcome of a community level intervention --an individual, organization, or group that has an interest (stake) in a specific community health issue or the outcome of a community-level intervention. Can be both a stakeholder & a key informant Community assessment model: function health pattern evaluates healht pattersn in the community as patterns will help us address the priority health issues Community assessment model : mulilevel interventions MOST SUCCESSFUL when combined with other interventiosn at more than one system levels. so if we want to change individuals to stop smoking dont just take action at the indivdual level but also societal like cultural norms --upstream --mainstream --downstream (individual) Community assessment model: web of causation identify the causes of chronic disease and identifying points for intervention is complicated... a web of causation can help in understanding the multiple pathways and factors that contribute to a chronic disease like obesity--contributing factors that result in obestity Models of Family Assessment The process community health nurses make to appraise famliy health care needs it is holistic and includes examination of cultural, spiritual and developmental needs. 1. life span development approach 2. family health routines and rituals 3. functional health patterns Models of Family Assessment 1. life span development approach 2. family health routines and rituals 3. functional health patterns 1. life span development approach : identify family health practices within a social and historical context/provides background in which to frame particular health behaviors 2. family health routines and rituals: idneifies family routiens and rituatls that could influence family health- patterns that involve 2 or more family members like self imagemental helath behaviors illness care and member caregiving. COMPLEX not simple envion and interperson interactiosn 3. functional health patterns structured approach to indentify group behaviors that occur over time and sequence fo evnets as oppsed to isolated incidents--opn ended questions with 11 areas of fmaily health (nutrition, sleep, cognitive, relationship, sexuatlity, stress coping, values, managment) Family Interview component -15 mintues 1. manners- introduce self, show interest- minimize writing , face the person, relaxed body language 2. acknowldedge fam strengths: share any genograms and ecomaps that illustrate realtionship with family memebers and ask family for theri impressions and interpretiatons 3. AVOID offering advice 4. everyone gets a voice 5. plan goals/outcomes-- full fmaily paricipation, coolaboration to set prioirites together Genogram diagram of family relationships between blood relatives that can span two or more generation. Life events such as marriages, divorces, births and deathes are included in diagratm to identify relationships as will as posisilbe patterns of disease Ecomap diagram used to identify the direction and intensity of afmily relationships between meembers or or community institutions of importance to failmy (ex: schools, workplaces, places of worship) Components of family risk reduction GOAL IS PREVENTION work together to promote behaviors that are directed to reduce health risks in family members ; family works as a gropu toward the gaol PRIMARY, SECONDARY TERTIARY ex: genetics, age, biolocial background, personal health habits/liefstyle, environ Primary Secondary Tertiary prevention 1. primary: prevention before problem 2. secondary: early screening and managment 3. tertiary: have the disease and managing chronic problems