Community Health - module 1 Flashcards
1
Q
Affordable Care Act purpose (two fold)
A
Enacted by Congress March 23, 2010
1) increase the number of number of Americans covered by health insurance
2) decrease the cost of health care
2
Q
Community Health Nursing
def.
A
systematic process of delivering nursing care to improve the health of an entire community.
3
Q
Commuity Based Nursing
definition
A
Nursing care primarily at the individual / family level
generally outside the acute care setting
(in a hospital)
4
Q
Population focused care
def.
A
refers to interventions aimed @ health promotion / disease prevention that shape a communities overall health
5
Q
Public Health Nursing
def.
A
protecting the health of populations by
by focusing on the health & prevention of disease / disability of all people w/in a popluation.
focuses on the entire population
6
Q
-World Health Organization (WHO)
Def. of Health
What happened in 1986
A
1958
For Everyone to obtain a state of complete physical, mental and social well being
not mearly the absence of disease or infirmity.
1986
added Community - extent to which an individual or grp is able to realize aspirations of safety and are able to change & cope w/i the environment.
7
Q
Florence Nightingale
A
founder of modern nursing, developed the 1st school of nursing at London’s St. Thomas 1860
directive was to manipulate the pts. envorinment to allow nature to take it’s course in the healing process.
8
Q
Community definition
A
a community is a group of people who share something in common and exhibit a commitment to one another.
A community interacts with one anohter
ex. Retirement community / Corvette club
9
Q
Population definition
A
group of people who have at least one thing in common
they may or may not Ineract with one another.
ex. Cross country truck drivers / street musicians / soccer players
10
Q
Acute Care Nursing
A
takes place in a controlled environment (hospital) where the patient is subordinate and treatment / care is scheduled around the hospital timeframe.
the healthcare team is in control of outcomes
11
Q
What the benefits of Comunity Health nursing for patients
A
Pts have more control over their environment (nurses are dependent upon the patient willingness to share information).
less resources for the nurse / lack of collegues to collaberate w/
Pts. are on their own turf.
12
Q
Healthy People 2020
A
1980 Federal Government set up national guidelines for National Health / goals to measure progress
Updated every 10 years
movement from illness / cure to that of health prevention & education.
13
Q
Three P’s of Global Health
A
Pollution
Population
Poverty
14
Q
Levels of Prevention
A
Primary - Health measure that focus on prevention / education
Secondary - begin when patholgy is involved and is directed at early detection through diagnosises / treatment
Tertiary - focuses on rehabilitation after illness / disability has occured - goal is to restore to optimal level of health
15
Q
Epidemiology definition
A
is the study of the distrubution and determinents of states of health and illness in human populations
16
Q
Distribution def.
A
refers to the frequency of occurences r/t to states of health / illness w/i a population
17
Q
Determinents def.
A
refers to agents or factors that contribulte to the causes of various states of health / illness w/i a population
Things that cause it.
18
Q
Who was responsible for medial statistics
A
William Farr 1839
19
Q
List two 19th Century infectious diseases
A
cholera and the “plague”
20
Q
Who ralated cholera to the water supply
A
John Snow
21
Q
Who initiated sanitary reforms, recorded illness / deaths (one of the 1st to use statistics)
A
Florence Nightingale
22
Q
List 3 types of Models for community / population nursing
A
1) Triad
2) Web of Causation
3) Ecological
23
Q
Triad Model
A
includes / refers to
host
agent
environment
24
Q
Web of Causation model
A
refers to health status as a multifactorial event, not caused by any single factor
25
Eccological model
refers to causes of illness that stem from the molecular level to that of broader categories
includes: biological, emotional, behavioral, socioeconomic, cultural, political & envionmental.
26
What are some of the factors r/t Global Health statistics
**- 99%** of global growth will occur in poor countries
**- Countries** where **HIV** is prevelent
**1)** life expectancy is only 30-40 yrs
**2)** Working age people are few (mostly child & the elderly)
**3)** Immigration laws have been tighted to protect the economy
27
**The United Nations**
- when were thy founded and who are they
Founded in 1945 w/192 member nations
created for world peace & security
Provides help / means to assist in resolving conflict and formulate global policies
28
**UNICEF**
- when were thy founded and who are they
**United Nations International Children's Emergency Relief Fund**
Founded in 1946 to protect children in worn-torn countries
Expanded in 1950 to address developing nations
today provides economic and humanitarian relief
29
**WHO**
- when were thy founded and who are they
**World Health Organization**
founded in 1948
Partner w/the UN
Directs / coordinates issues dealing w/international health
**Mission is to assist all people in attaining the highest possible level of health**
30
**World Bank**
- when were thy founded and who are they
founded in 1944
stated to aid reconstruction of Europe after World war II
now works to alleviate poverty in developing countries
31
**Carter Center**
- when were thy founded and who are they
What are their 3 main objectives
founded in 1982 by Jimmy & Rosalynn Carter
- promote peace and fight diseases
1) prevent / resolve conflicts
2) enhance democracy
3) improve health
32
Gates foundation
- when were thy founded and who are they
founded in 2000 by Bill & Melinda Gates
- finances projects to reduce poverty, improve health & increase access to libraries
33
What are the **top 3** leading infectious Disease's worldwide
Infectious diseases are the leading cause of death worldwide
top 3 in low/middle income nations include:
- **HIV**
- **TB**
- **Lower respriatory infections**
34
What are some of the Non-communicable diseases
top 4 Chronic
- Obesity
- CV disease
- Cancer
- Chronic respiratory
35
What is "Declaration of Alma Ata"
Mtg in 1978 to recognize concept of primary care
- document was created
- Definition of primary care developed
- Declared healt to be a fundamental human right
- Gov's have a moral responsability to provide health & services to it's people.
36
What are two consequences of the current nursing shortage
1) developed countries are recruting from less-developed nations
2) Countries with the greatest need are ending up with the greatest shortage.
37
Political power is defined as
defined by Hewison (1994) as the ability to influence or persuade an individual holding a govenmental office to exert the power of that office to effect change.
38
Coercive power is defined as
use of force to gain compliance, often born our of real or preceived fear or theat to self.
ex. police often use this
39
Reward power is defined as
involves giving something of value for compliance
ex. politician helps constituents in exchange for support
40
Expert poweris defined as
results from expert knowledge or skills.
ex. Bill Gates has considerable expert power
41
Legitimate power is defined as
results from a title or postition
ex. judge or police officer
42
Referent power is defined as
results from being closly associated with someone of real power.
ex. spouse of a senator
43
Information power is defined as
results from the desire for information held by one person from one who does not have access to that information
44
Connection power is defined as
results from the belief that a certain person has a special connection to another or an organization that is powerful.
45
The **Preamble** of the US Constitution states:
one of the purposes of the federal government is to
- promote the general welfare of the people
Article 1 Section 8
46
What are some of the organizaiton the federal government set up to assist it's population
list 4
1) 1852 Hospital for federal employees
2) 1965 Medicare
3) 1965 Medicaid
4) 1976 Marine hospital - assist verterans of war
47
US Public Health Agencies
list the top 7
- National Institutes of Health
- Food and Drug Administration
- Center for Disease Control and Prevention
- Health Resources and Services Administration
- Substance Abuse and Mental Health Svc Admin
- Agency for Healthcare Research / Qual
- US Public Health Services Commissin Corp.
48
National Institutes of Health
NIH
worlds primer health research organization - Bethesda MD
49
´Food and Drug Administration
FDA
- responsible for ensuring safety of food and cosmetics
- safety and efficacy of pharmaceutical / medical products.
50
´Centers for Disease Control and Prevention
CDC
founded in 1946 Atlanta GA
provides a system of health surveilance to monitor and prevent outbreak of disease (including bioterrorism)
51
´Health Resources and Services Administration
HRSA
provides access to essential healthcare services for people who are low income, are uninsured, or live in rural / urban area's where healtcare is scarce.
52
´Substance Abuse and Mental Health Services Administration
SAMHSA
founded in 1992
monitors the prevalence and incidence of substance abuse and ID's and disseminates info r/t the best practises for prevention / txmt
53
´Agency for Healthcare Research and Quality
AHRQ
founded in 1989
to generate and distribute evidence-based info that improves healthcare delivery and outcomes.
54
´US Public Health Service Commissioned Corps
PHS
director is the Surgeon General
uniformed service of more than 6000 helath professionals who serve in federal capacity
55
Human Services Agencies
list the top 5
´Centers for Medicare and Medicaid Services
´Administration for Children and Family
´Administration on Aging
´Department of Education
´Department of Labor
56
´Centers for Medicare and Medicaid Services
CMS
founded 1977
administers the Medicare & Medicaid programs which provide heatlh care for 1 in 4 americans.
Also administer CHIP (Childrens Health Insurance Program)
57
´Administration for Children and Family
founded in 1991
responsible for 60 programs that promote the economic / social wellbeing of Children, families and communitites.
58
´Administration on Aging
AoA
provides svc's to older Americans living at home
e.g. meals, rides, information / assistance, protection rights
**Goal is to enable elderly to remain healthy, secure and independent**
59
´Department of Education
DOE
provides billions of dollar each year to educate the US popluation
60
´Department of Labor
DOL
responsible for enforcing the Fair Labor Standards Act (minimum wage & overtime)
Retirement plans
Occupational issues
61
What is negligence
failure to act as any prudent or reasonable persoun would
62
What is Malpractise
it is more specific - the person must be a professional acting in a prefessional capacity
63
What is a correctional nursing
goal is for inmates to remain healthy while incarcerated and to return to the community properly educated about remain free of comminicalbe diseases.
64
What is Forensic Nursing
fastest growing specialties that are a link between healthcare and law enforcement
can be found in rape crises centers, emergency departments and nursing homes.
65
Community-based transcultural nursing refers to...
the creative use of transcultural nursing concepts, principles, research, knowledge and practices that focus on large overall designated communities or geographic contexts to provide culturally competent nursing care
66
What are (4) of the fundamentals that describe the power of **Cultures**
´Tend to be stable
´Have powerful influences on human care & practices
´Have values and beliefs that vary between and within cultures
´Have rituals, taboos and practices that are important to identify and understand for transcultural nursing
67
What are the four aspects about Community-based transcultural nursing that we all must be aware of?
´**Nurses** must study the total lifeways of people – including spirituality, economics, technologies, kinship ties, environment and specific values and practices
´**Nurses** must identify modes of communication – including space, land, property, use of home remedies
´**Nurses** must identify caregivers, healers in a culture
´**Nurses** must identify subcultures within the dominant culture
68
Culture def
learned, shared and transmitted values & beliefs of a particular group
This guides their thinking, decision and actions in patterned ways
69
Cultural values def.
powerful directive forces that give order and meaning to people's thinking, decisions, and actions.
70
Cultural variations def.
subtle or obvious variables btwn cultures that make them unique with respect to traditional / nontraditional ways of living
71
Cultural lifeways def.
patterned ways of living of a paricular group or individual
72
Cultural impostion def.
tendency to impose one's values / beliefs on another due in largely to ignorance about the culture.
73
Ethnocentrism def.
belief that one's own values or way of living are superior to others
74
Stereotyping def.
tendency to pre-judge and fix cultures on a rigid and biased ways due in large to racism and ethnocentrism.
75
Cultural blindness def.
inability to recognize one's own values and lifeways or those of another culture, making culture invisible.
76
Cultural clashes def.
major conflict in valuing and understanding differences btwn cultures and vaiability among cultures.
77
Caring def.
Actions and activities directed toward assisting, supporting or enabling another individual / group to help improve their condition or even face death.
78
Nursing def.
a learned humanistic and scientific profession focused on human caring.
79
Emic View def.
insiders or local perspective about cultures, families, lifeways, and heatlh care.
80
Etic view def.
outsiders or external perspective about cultures, families, lifeways, and heatlh care.
81
Culturally competent care def.
deliberate and creative use of transcultural nursing knowledge and skills to assist individuals or groups to maintain their wellbeing, recover from illness, or even face disablity or death.
82
Cultural ignorance def
refers to insufficient knowledge about a specific culture to provide safe and meaningful care.
leads to nontherapeutic outcomes
83
Cultural bias def.
refers to a strong position that all decisions must be based upon ones own values / beliefs.
ex. nurse who firmly values "nursing homes' for all those at the end of life.
84
Cultural pain def.
refers to the considerable discomfort, suffering, or unfavorable response experience by an individual or group when insults are made by an outsider.
ex. An asian nurse tells a African american family it is not good to eat chitlins.
85
Cultural barriers def.
refer to obstacles that interfer with cultures accessing or achieving their desired goal or opportunities.
ex. Anglo american nurse made an appointment with a muslim family during the noon hour (prayer time)
86
Cultural bound def
refers to specific care, health, and illness conditions that are unique to a culture and often exist w/i a specific geographical area.
87
Cultural backlash def.
phenomenon that ouccurs when a culture has been "bought" or encouraged to use another's cultural values, material goods, beliefs or lifeways.
Western medicin often imposes their method of healtcare on other cultures
88
Immigrant def
an immigrant is a person who comes to another country willingly (voluntarily)
for many reasons
89
refugees def.
individuals who are suddenly forced to come to another country due to civil unrest / war or oppession in their own country.
90
What is the goal of Leininger’s Theory of Culture Care and Universality
´to discover ways to provide culturally congruent and responsible transcultural nursing care
91
What are ´3 major modes (Leininger's Theory) to guide cultural care decisions
1. Culture care preservation or maintenance
2. Culture care accommodation or negotiation
3. Culture care structuring or repatterning
92
What are some of the assumptions of Leininger’s Theory of Culture Care and Universality
´Care is focus of nursing
´Humanistic and scientific care are essential
´Caring is essential to curing/healing
´Cultural care guides nurses to discover, explain and account for health
´Cultural care expressions are diverse yet with commonalities
´Cultural care values, beliefs and practices are influenced by world views, social/structural factors
93
What is the Sunrise Model – visual guide
´Shows areas that need to be examined to provide care of patents of different cultures
´Technology
´Religious/philosophy
´Social/kinship
´Cultural values/lifeways
´Political/legal
´Economic
´Educational
94
Upstream Thinking def.
Connection btwn past exposures & the current health problems.
River is an illness, it is the responsibility of the RN to save individuals / groups from that illness.
Typically, pts. do not get help until downstream...it is important for healthcare provides to be proactive & **LOOK UPSTREAM**
**Prevention**
95
How did Florence Nightingale use "Upstream thininking"
she placed an emphasis on the pts. environment:
pure air
pure water
efficient drainage
cleanliness
light
96
What are Community Health & Occupational Health?
nursing specialties tied with the health hazards w/in the physical environment.
97
What are some of the "risk assessments" we can use in Community Health
**1) Hazard Identification:** does the agent cause an adverse effect?
**2) Exposure assessments:** which exposures are currently experienced / anticipated
**3) Dose-response assessments:** What is the relationship bwtn dose & incidence?
**4) Risk Characteristic's:** What is the estimated incidence of the adverse effect w/in the Population
98
What are some of the "home assessment" Q's that need to be asked?
- **hobbies / crafts** - potential for lead exposure?
- **Home heating** - exposure to gas or electric hazards?
- **Insecticides in the Home**?
- **Cleaning agents**?
- **Pets** - litterboxes
- **What is your source of water** - municiple or well?
99
What does "Social justice" refer to
equality in the distribution of benefits vs. the burdens of society.
100
What does "environmental justice" refer to
that all persons/ groups of people should be able to live in a healthy environment.
101
What can nurses doe about social / environmental justice
They can:
Provide education
Reduce exposure to toxins
Advocate for change
Organize communities at risk.
