1
Q
Community Based Nursing
A
- SETTING SPECIFIC PRACTICE whereby care is for the “sick”
- “Community Health Nurse”
- need an associates degree or diploma prepared
2
Q
Is community based nursing a specialty?
A
no
3
Q
What is the focus of community based nursing?
A
- Individual and family health
- acute/chronic care and the provision of continuous and comprehensive services
ex: a school nurse / primary care nurse
4
Q
4 Things Leading to Individual and Family Health in Community Based Nursing?
A
- Illness Care
- Occurs in a community setting
- One on One
- The focus is mostly secondary and tertiary prevention
5
Q
Primary Prevention
A
- way to prevent disease from occurring
- more education focused/vaccines
- more community oriented
6
Q
Secondary Prevention
A
- screening for a problem (ex: a blood pressure screening) or may be treating an acute problem with a high probability of solving it
- community based and oriented
7
Q
Tertiary Prevention
A
- Watching a more chronic disease
- Not about getting rid of, but rather giving comfort and stability
- More community based
8
Q
Is community oriented nursing a specialty?
A
yes
9
Q
Community Oriented Nursing
A
- “Public Health Nursing” or “Community Health Nurse”
- Emphasis is health of the community and population to prevent disease/disability and promote/maintain “health” and conditions for people to be healthy
- Individual is part of a larger social system ehre
- Bachelor’s / Master’s Degree needed
- Found in government and official agencies like a health department
10
Q
4 Things Leading to community and population health in community oriented nursing?
A
- health care
- occurs in community agencies
- one-to-one, groups, AND organizations
- the focus is on primary and secondary prevention
11
Q
Community/Public Health Nurse
A
takes care of populations, and wants prevention and detection to promote a health community lifestyle
12
Q
Community Assessment Wheel
A
- Helps Identify what key health needs are required in a community
- The core is demographic information, values, belief systems, and ethnicity - and then there are 8 subcategories around it
13
Q
8 Community Assessment Wheel Subsystems
A
“P-PERCHES”
- Physical Environment
- Politics and Government
- Economics
- Recreation
- Communication
- Health and Social Services
- Education
- Safety and Transportation
14
Q
Community as Partner Model
A
- model focusing on health promotion of individuals and families in a community context
- open system in continuous interaction with the whole environment
- Evaluation/assessment can give a diagnosis of primary/secondary/tertiary prevention needed on the assessment wheel
15
Q
Process of the community as a partner model
A
Analysis of Assessment Wheel Core –> Stressors and Lines of Resistance that protect against stressors in the community –> community nursing diagnosis –> plan –> interventions –> community assessment wheel analysis
16
Q
How is the community as partner model different from the nursing process?
A
There is an analysis step in the middle of it
17
Q
Who does the community/public health nurse care for?
A
- Individuals, Families, Communities, Populations
- The nurse considers individuals and families in a community and population context, and intervention on that level strengthens the individual and family health (trickle down)
ex: COVID-19 preventions
18
Q
Population or Aggregate
A
- collections of people sharing 1 or more environmental characteristics and are loosely associated with each other
ex: diabetics in Broome county
19
Q
Community
A
- Collection of people who interact with one another and whose common interests form a basis for sense of unity or belonging
ex: Diabetics in a support group
20
Q
Public Health
A
- Scientific discipline including epidemiology, statistics, assessment - including attention to behavioral/cultural/economic factors - as well as program planning and policy development
- Aids food, waste, personal behavior changes, GMOs, immigration, etc
21
Q
What does public health aim to do?
A
- prevent epidemics/disease spreading
- protect against environmental hazards
- prevent injury
- promote and encourage healthy behaviors
- respond to disasters
- ensure accessibility to health services
22
Q
What is public health nursing as a specialty?
A
- Synthesis of nursing theory and public health theory applied to promoting and preserving the health of a population
ex: population based prevention programs in the 70s changed things nowadays like smoking
23
Q
What is the focus of public health nursing?
A
- Protecting the community!
- the community as a whole and the effect of the community’s health status (including resources) on the health of individual, families, and groups
24
Q
In what context is public health nursing care given?
A
In the context of preventative disease and disability, and protecting and promoting the health of the community as a whole
25
3 Core Functions of Public Health
1. Assessment
2. Policy Development
3. Assurance
26
Public Health Core Function: Assessment
- Systematic data collection of the population
- monitoring the population health status to find existing/potential health problems
- Requires infrastructure to use data, and many places do not have it
27
Public Health Core Function: Policy Development
- Inform, educate, and empower people on health issues
- Make legislation on all levels to promote the health of the population (using scientific data to decide things)
- Mobilize partnerships between many disciplines, not just nursing
- Its about INFORMING PEOPLE ON HEALTH ISSUES
28
Public Health Core Function: Assurance
- Insuring essential community oriented health services are available
- Enforce health and safety laws
- Link health services with those who need it
29
Subsections of Assessment on Public Health Research Wheel?
1. Monitor Health
2. Diagnose and Investigate
3. Evaluate
30
Subsections of Policy Development on Public health Research Wheel?
1. Inform, educate, empower
2. Mobilize community partnerships
3. Develop policies
31
Subsections of Assurance on public health research wheel?
1. Enforce Laws
2. Link to/provide care
3. assure competent workforce
32
All subsections of the Public Health Research wheel should ...
guide research
33
8 Tenets of Public Health Nursing
1. 3 Core Functions
2. partner with community representatives
3. Primary prevention gets priority
4. Intervention strategies chosen to get people to thrive
5. Actively reach out to ALL who may benefit
6. Obligation is for the greater good of ALL people
7. Allocate resources for max population health benefit gain
8. Collaborate with other professions/organizations to make the most protected and promoted health for the people
34
10 Essential Services of Public Health
1. Assess and Monitor
2. Diagnose and Investigate
3. Inform and Educate
4. Mobilize community Partnerships
5. Provide Leadership
6. Promote and Enforce public health laws
7. Link individuals to services
8. Assure the capacity of the public health workforce
9. Evaluate effectiveness/accessibility/ and quality of personal health and population based service
10. Support Research
35
APHA
- American Public Health Association
| - Came out with NYS disease reporting requirements
36
Global Organization of Public Health
- WHO
- Health arm of the UN
- No legal standing and no enforcing power
- advises, directs, suggests the member nations on health matters
- Overall goal is to improve world health
37
17 Sustainable Development Goals of WHO
```
No Poverty
No Hunger
Good Health and Well Being
Quality Education
Gender Equality
Availability of clean water and sewage removal
Affordable Clean Energy
Decent Work and Economic Growth
Industry, Innovation, Infrastructure
Reduced Inequalities
Sustainable Cities/Communities
Responsible Consumption and Production
Climate Action
Life Below Water
Life on Land
Peace, Justice, Strong Institutions
Partnerships for Goals
```
38
Federal Organizations of Public Health
1. U.S. Department of Health and Human Services (USDHHS)
| 2. Centers for Disease Control and Prevention (CDC)
39
USDHHS Mission and Job
- Executive branch
- enforces and protects health and wellbeing of americans
- provides services and fosters advances in medicine, public health and social services
- Directs health policy
- creates federal laws (Acts)
40
CDC Mission and Vision
- Mission to promote health and quality of life by preventing and controlling disease, injury, and disability
- VISION: "Healthy people in a health world through prevention"
41
State Health Departments
- State organizations of public health
- Every state has one
- public health laws are enforced here (not made)
- may be granted authority to pass public health rules/regulations
42
NYS Health Departments
- Oversees COUNTY health departments
| - Local health officials (MD, APN, RN, Engineer, Sanitarian, Nutritionist, Dentists, etc) --> They MUST HAVE an MPH
43
One City in NYS with its own health department
NYC
44
Local health departments
- Local organization of Public Health
- can be city or county
- not every state has both, and some have neither
- enforces state health laws and local ordinances
- the backbone of the Public health system
45
Future Public health challenges
- Reducing needed hospital days
- decreasing hospital financial burden
- new and emerging infectious disease
- need for emergency preparedness
- Increase in chronic illnessess (from lifestyle)
- Global Healthcare issues
46
3 Levels of QCC Guided Practice
1. Tier 1 - Generalist
(work directly with population, data collection)
2. Tier 2 - Management or Supervisory
(manage, supervise, budget development, home visit)
3. Tier 3 - Senior Management or Leadership
(administer programs, set vision and strategies)
47
Systems Theory
- Proposes systems are open when there is an interaction between systems and their environment
- Whole > Sum of its parts (community > individuals)
48
3 Community Types in Community/Public Health
1. geographic
2. common interest
3. Health problem or solution
49
Geographic Community
defined by geographic boundaries
50
Common Interest community
Interest/Goal bind members together
| ex: church over a large area
51
Community of Solution (or Health Problem)
people coming together to solve a problem that affects them all
52
Wellness
- Health PLUS it incorporates capacity to develop a person's potential to lead a fulfilling and productive life
- Measured in terms of quality of life
53
Illness
- State of being RELATIVELY unhealthy
| >wellness and illness are RELATIVE concepts
54
Health (and Wellness-Illness) Continuum
- Health has a range of degrees
- Applies to individual, families, and communities
- Obesity, smoking, gaining more control, proper v. improper grief, etc., all can move you toward or away from wellness or illness
55
Health is a ...
-STATE OF BEING
| > all dimensions of people/community determine health state of being
NURS322
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Decks in class (13)
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