Ch. 3 and Ch. 4 Flashcards
what is community based health care?
focuses on health promotion
- care that is occurred outside the hospital
- provide acute and chronic conditions
- health foundation is the foundation of primary, secondary, and tertiary care
1st: we want to encourage health promotion, 2nd: we want to prevent the disease, 3rd: if necessary, go to a primary/secondary/tertiary care
what is Health People 2020?
the purpose is to establish goals for the United States population
- ex: decreases the % of people in the population who smoke
what is the purpose of the Health People 2020 goals?
for people to live longer, improve the quality of life, and eliminate health disparities
- ex: decrease the amount of people smoking will lead to less likely getting lung cancer and will have a longer lifespan
how are Health People 2020 goals made up?
Components of improved health care
Assessment of health care needs
- ex: look at infections or diseases within that certain population, crashes caused by teen drivers, teen pregnancies, looking at policies (Flint Michigan: lead in the water)
Access to care
- ex: prenatal care programs
what is social determinants of health
1st: look at Biology and Genetics
- certain sex and certain age groups are risked for medical problems
- ex: older males are more at risk for clots in their lungs
what is individual behaviors?
smoking, drugs, alcohol, unprotected sex are related to adverse medical problems
what are social environments?
Income
- ex: if you don’t have health insurance you will have a lower life span
what is a physical environment?
if a person lives in a crowded condition, they would be at risk for tuberculosis
what is health services?
having access to healthcare
Many older homes in a neighborhood are undergoing a lot of restoration. Lead paint was used to paint the homes when they were built. The community clinic in the neighborhood is initiating a lead screening program. This activity is based on which social determinant of health?
A: Individual behaviors
B: Social environment
C: Physical environment
D: Health service
C: Physical environment
what is health care disparities?
A preventable health promotion that you will find in a group of people
- ex: In OB, there is a higher infant mortality rate for A.A babies
- poverty and inadequate access to prenatal care and healthcare
- behavioral problems: when women smoke while pregnant, the baby can die in its sleep (SIDS)
It is important to allow all populations to have:
Access care
- ex: prenatal care
Quality care
Equity care
what is community oriented nursing?
Community health nursing
Public health nursing
- Focuses on a certain population
- ex: High risk babies, ethnic groups (Native Americans) elderly
Want a bachelor’s degree, if wanting to specialize you need a master’s degree
what is an example of how you use Public Health Nursing?
Looking at a population of school kids
- The nurse will gather data based on statistics on playground injuries, lobby the community to encourage them to use shock absorbency material instead of concrete
Focus on the specific population, collect data, change the situation)
A community health nurse is working in a clinic with a focus on asthma and allergies. What is the primary focus of the community health nurse in this clinic setting? (Select all that apply.)
A. Decrease the incidence of asthma attacks in the community
B. Increase patients’ ability to self-manage their asthma
C. Treat acute asthma in the hospital
D. Provide asthma education programs for the teachers in the local schools
E. Provide scheduled immunizations to people who come to the clinic
A. Decrease the incidence of asthma attacks in the community
B. Increase patients’ ability to self-manage their asthma
D. Provide asthma education programs for the teachers in the local schools
what is the nursing practice in community health?
Expert community health nurses
- has an advanced degree: masters degree or higher
Understand the needs of a population or community
Use critical thinking skills to apply knowledge
Understand resources
- ex: when dealing with kids: schools are the best resource
Build relationships within the community
Are responsive to changes in the community
what is community based nursing?
Purpose: to reduce healthcare costs
- ex: homes and clinics
Need minimum 2 years of experience
Involves acute and chronic care
Provides services to enhance individuals capacity for self care
- provide services to where people live, work, and where you socialize
Promotes autonomy in decision making
The nurse caring for a refugee community identifies that the children are under vaccinated, and the community is unaware of resources. The nurse assesses the community and determines that there is a health clinic within a 5-mile radius. The nurse meets with the community leaders and explains the need for immunizations, the location of the clinic, and the process of accessing health care resources. Which of the following practices is the nurse providing? (Select all that apply.)
A. Raising awareness about community resources for the children
B. Teaching the community about health promotion and illness prevention
C. Promoting autonomy in decision making about health practices
D. Improving the health care of the community’s children
E. Participating in professional development activities to maintain nursing competency
A. Raising awareness about community resources for the children
B. Teaching the community about health promotion and illness prevention
C. Promoting autonomy in decision making about health practices
D. Improving the health care of the community’s children
what are vulnerable populations?
A group of patients with excessive risk factors
Limited access to health care
Depend on others for care
what are examples of vulnerable populations?
Immigrant populations
Poverty and homelessness
Patients who are abused
People living with substance abuse and mental illness
Older adults
what makes immigrant populations vulnerable?
A language barrier
May not have insurance
May or may not have transportation to a clinic
May use nontraditional healing practices (herbs)
what makes poverty/homelessness populations vulnerable?
Don’t have access for food or don’t have ways to store it if they do
When there is a healthcare problem, they go straight to the ER
what makes patients who are abused vulnerable?
You are a mandated reporter to report if you see:
- elderly abuse (65+)
- child abuse (younger than 18)
- disability abuse
what makes people living with substance abuse and mental illness vulnerable?
Homeless and people living in poverty
Risk for abuse and assault
what makes older adults vulnerable?
they have chronic diseases (heart problems, hypertension, diabetes) have a higher demand for health services
Vulnerable populations of patients are those who are more likely to develop health problems as a result of:
A. living at home.
B. abusive habits. (drugs/alcohol)
C. citizenship.
D. middle age.
B. abusive habits (drugs/alcohol)
What factor results in vulnerable populations being more likely to develop health problems?
A. The ability to use available resources to find housing
B. Adequate transportation to the grocery store and community clinics
C. Availability of others to help provide care
D. Limited access to health care services
D. Limited access to health care services
A nursing student is giving a presentation to a group of other nursing students about the needs of patients with mental illnesses in the community. Which statement by the student indicates that the need to provide further teaching? (false statement)
A. “Many patients with mental illness do not have a permanent home.”
B. “Unemployment is a common problem experienced by people with a mental illness.”
C. “The majority of patients with mental illnesses live in long-term care settings.”
D. “Patients with mental illnesses are often at a higher risk for abuse and assault.”
C. “The majority of patient’s with mental illnesses live in long term care settings.”
what is a caregiver?
Any kind of skills you do in the hospital you can do at home
- administer IV fluids, administer medications, changing dressings
what is a case manager?
Coordinate resources and services
- ex: office of aging, meals on wheels (service), a nurse to see her
what is a change agent?
- A patient is not going to their visits after they have been discharged from the hospital
- It is important to follow up with the patient to see why they aren’t going: if the clinic is too far, or they don’t have transportation
- Find a doctor office close to the patient or help coordinate transportation
what is a patient advocate?
Advocate: we are the patients voice when the patient can’t speak, we speak for them
- ex: a patient is dying of cancer: present both healthcare options: hospice or being at home
Let the patient make the decision
Whatever the patient wants, we support their decision
what is collaborator?
Working with other disciplines
- ex: working with a pastor, a social worker, physical therapist
what is a counselor?
Help patients identify the problem
Help develop different actions the patient would take
- ex: if someone is a victim of domestic violence; we would help develop different actions the patient could take (stay in a shelter)
what is an educator?
Teaching
- ex: prenatal classes, childbirth classes, infant care and child safety, and cancer screening
what is epidemiologist?
Look at the incidence, the distribution, and control of diseases
- ex: working at a school, someone contracted active tuberculosis, we need to see how they contracted it (if it was at home, school, or in the community)
A community health nurse conducts a community assessment focused on adolescent health behaviors. The nurse determines that a large number of adolescent’s smoke. Designing a smoking cessation program at the youth community center is an example of which nursing role?
A. Educator
B. Counselor
C. Collaborator
D. Case manager
B. Counselor
A nurse in a community health clinic reviews screening results from students in a local high school during the most recent academic year. The nurse discovers a 10% increase in the number of positive tuberculosis (TB) skin tests when comparing these numbers to the previous year. The nurse contacts the school nurse and the director of the health department. Together they begin to expand their assessment to all students and employees of the school district. The community nurse was acting in which nursing role(s)? (Select all that apply.)
A. Epidemiologist
B. Counselor
C. Collaborator
D. Case manager
E. Caregiver
A. Epidemiologist
C. Collaborator
what is community assessment?
Data collection on the population
Monitor health problems
Make information available to the community
- Structure of locale
- Name of community or neighborhood
- Geographical boundaries
- Emergency services (police, fire)
- Water and sanitation (Michigan had lead in the water)
- Housing
- Economic status: (the average household income and # of residence on public assistance)
- Transportation: (need transportation to get to resources- trains, taxis, busses)
- Safety: crime rates
- People
- Age and sex distribution- how many males/females
- Growth trends: (is there an increase in Geriatrics population- need to make sure resources/services are available)
- Density: a rural or urban area
- Education level: teach at an 8th-grade level
- Predominant ethnic and religious groups
- Social systems: what supports the people
- Education, Communication, and welfare system: (schools, universities, how do these communities communicate, how many people on welfare)
- Government
- Volunteer programs
- Health system: (do they have free health clinics, is there enough clinics in that area)
In identifying needs for health policy and health program development and services, a community assessment focuses on which of the following elements?
A. Structure
B. People
C. Social systems
D. All of the above
D. All of the above
