Exam 1 Flashcards
0
Q
What is the mission of public health?
A
“to generate organized community effort to address the public interest in health by applying scientific and technical knowledge to prevent disease and promote health”
1
Q
What is public health?
A
“What we, as a society, do collectively to assure the conditions in which people can be healthy”
2
Q
What is the government’s special function in public health?
A
“to see to it that vital elements are in place and that the mission is adequately addressed”
3
Q
What are the public health core functions at all levels of government?
A
- Assessment
- Policy development
- Assurance
4
Q
What is the Community Health Improvement Process (CHIP)?
A
A major outcome of the Institute of Medicine’s committee. A method for improving the health of the population on a community-wide basis. The method brings together key elements of the public health and personal health care systems in one framework.
5
Q
What are the primary features of public health nursing as a specialty?
A
Population focus, community orientation, health promotion and disease prevention emphasis, and population-level concern and interventions, which frequently are at the level of public policy, such as anti-smoking laws, the requirement of immunizations for entry to school, and seat belt legislation.
6
Q
What are the eight principles of public health nursing?
A
- The client or “unit of care” is the population.
- The primary obligation is to achieve the greatest good for the greatest number of people or the population as a whole.
- The processes used by public health nurses include working with the client(s) as an equal partner.
- Primary prevention is the priority in selecting appropriate activities.
- Selecting strategies that create healthy environmental, social and economic conditions in which populations may thrive is the focus.
- There is an obligation to actively reach out to all who might benefit from a specific activity or service.
- Optimal use of available resources to assure the best overall improvement in the health of the population is a key element of the practice.
- Collaboration with a variety of other professions, organizations, and entities is the most effective way to promote and protect the health of the people.
7
Q
Regarding the core public health functions implemented at all levels of government, what does ASSESSMENT refer to?
A
Assessment refers to systematically collecting data on the population, monitoring of the population’s health status, and making available information about the health of the community.
8
Q
Regarding the core public health functions implemented at all levels of government, what does POLICY DEVELOPMENT refer to?
A
Policy development refers to the need to provide leadership in developing policies that support the health of the population; it involves using scientific knowledge in making decisions about policy.
9
Q
Regarding the core public health functions implemented at all levels of government, what does ASSURANCE refer to?
A
Assurance refers to the role of public health in making sure that essential community-wide health services are available, which may include providing essential personal health services for those who would otherwise not receive them.
Assurance also refers to ensuring that a competent public health and personal health care workforce is available.
10
Q
What is frequently viewed as the feature that distinguishes public health nursing from other specialties?
A
Its setting
11
Q
The use of which characteristics of public health are a more useful approach?
A
A focus on populations that are free-living in the community, an emphasis on prevention, a concern for the interface between the health status of the population and the living environment (physical, biological, sociocultural), and the use of political processes to affect public policy as a major intervention strategy for achieving goals.
12
Q
According to the 1985 Consensus Conference sponsored by the Nursing Division of the U.S. Department of Health and Human Services, what are specialists in public health nursing defined as?
A
Specialists in public health nursing are defined as those who are prepared at the graduate level, either master’s or doctoral, “with a focus in the public health sciences”. This is still true today.
13
Q
What is population-focused practice?
A
Population-focused practice is the focus of specialists in public health nursing. This focus on populations and the emphasis on health protection, health promotion, and disease prevention are the fundamental factors that distinguish public health nursing from other nursing specialties.
14
Q
What is a population defined as?
A
A population is defined as a collection of individuals who share one or more personal or environmental characteristics.
The term population may be used interchangeably with the term aggregate.
15
Q
How can a historical approach can be used?
A
A historical approach can be used to increase understanding of public health nursing in the past, as well as its current dilemmas and future challenges.
16
Q
How can the history of public health nursing be characterized?
A
The history of public health nursing can be characterized by change in specific focus of the specialty but continuity in approach and style of the practice.
17
Q
What is public health nursing a product of?
A
Public health nursing, referred to in the text as population-centered nursing, is a product of various social, economic, and political forces; it incorporates public health science in addition to nursing science and practice.
18
Q
Federal responsibility for health care until the 1930s…
A
Federal responsibility for health care was limited until the 1930s when the economic challenges of the Depression permitted reexamination of local responsibility for care.
19
Q
Who designed and implemented the first program of trained nursing?
A
Florence Nightingale
20
Q
Who founded the first district nursing association in England?
A
William Rathbone
21
Q
What increased the need for trained nurses in the US, especially in public health nursing?
A
Urbanization, industrialization, and immigration.
22
Q
What did increasing acceptance of public roles for women permit?
A
Increasing acceptance of public roles for women permitted public health nursing employment for nurses, as well as public leadership roles for their wealthy supporters.
23
Q
Who was the first trained nurse in the US, who was salaried as a visiting nurse?
A
Frances Root. She was hired in 1887 by the Women’s Board of the New York City Mission to provide care to sick persons at home.
24
When were the first visiting nurses' associations founded?
The first visiting nurses' associations were founded in 1885 and 1886 in Buffalo, Philadelphia, and Boston.
25
Who established the Henry Street Settlement?
Lillian Wald established the Henry Street Settlement, which became the Visiting Nurse Service of New York City, in 1893. She played a key role in innovations that shaped public health nursing in its first decades, including school nursing, insurance payment for nursing, national organization for public health nurses, and the United States Children's Bureau.
26
When was school nursing founded and what was its purpose?
Founded in 1902 with the vision and support of Lillian Wald, school nursing sought to keep children in school so that they could learn.
27
Which insurance company established the first insurance-based program?
The Metropolitan Life Insurance Company established the first insurance-based program in 1909 to support community health nursing services.
28
When was the National Organization for Public Health Nursing founded and what did it provide?
The National Organization for Public Health Nursing (founded in 1912) provided essential leadership and coordination of diverse public health nursing efforts; the organization merged into the National League for Nursing in 1952.
29
What happened to official health agencies between 1900 and 1940?
Official health agencies slowly grew in numbers between 1900 and 1940, accompanied by a steady increase in public health nursing positions.
30
What is the Sheppard-Towner Act of 1921?
The innovative Sheppard-Towner Act of 1921 expanded community health nursing roles for maternal and child health during the 1920s.
31
Who established the Frontier Nursing Service?
Mary Breckinridge established the Frontier Nursing Service in 1925, which influenced provision of rural health care.
32
How was it for African-American nurses seeking to work in public health nursing?
African-American nurses seeking to work in public health nursing faced many challenges, but ultimately had significant impact on the communities they served.
33
What have characterized the specialty since at least the 1910s?
Tension between the nursing role of caring for the sick and the role of providing preventive care, and the related tension between intervening for individuals and intervening for groups have characterized the specialty since at least the 1910s.
34
As it attempted to remedy some of the setbacks of the Depression, what established a context in which public health nursing services expanded?
The Social Security Act
35
What were the effects of World War II?
The challenges of World War II sometimes resulted in extension of nursing care and sometimes in retrenchment and decreased public health nursing services.
36
By mid-twentieth century, what led to examination of the goals and organization of public health nursing services?
By mid-twentieth century, the reduced prevalence of communicable diseases and the increased prevalence of chronic illness, accompanied by large increases in the population more than 65 years of age, led to examination of the goals and organization of public health nursing services.
37
Between the 1930s and 1965, what did organized nursing and community health nursing agencies sought to establish?
Organized nursing and community health nursing agencies sought to establish health insurance reimbursement for nursing care at home.
38
What did the implementation of Medicare and Medicaid programs in 1966 establish?
Implementation of Medicare and Medicaid programs in 1966 established new possibilities for supporting community-based nursing care but encouraged agencies to focus on services provided after acute care rather than on prevention.
39
What have the efforts to reform health care organization focused on?
Efforts to reform health care organization, pushed by increased health care costs during the last 40 years, have focused on reforming acute medical care rather than on designing a comprehensive preventive approach.
40
What did the 1988 Institute of Medicine report document?
The 1988 Institute of Medicine report documented the reduced political support, financing, and impact that increasingly limited public health services at national, state, and local levels.
41
What impact did the federal policy changes in the late 1990s have?
In the late 1990s, federal policy changes dangerously reduced financial support for home health care services, threatening the long-term survival of visiting nurse agencies.
42
What have brought renewed emphasis on prevention to nursing?
Healthy People 2000, Healthy People 2010, and recent disasters and acts of terrorism have brought renewed emphasis on prevention to nursing.
43
When conducting a health assessment interview, what should we always ask the client?
When conducting a health assessment interview, always ask if the client has recently traveled out of the US or to one of the border areas along the US-Mexico perimeter. People who travel abroad may bring back diseases that are hard to diagnose. In addition, people often cross the border into Mexico to fill a prescription for medicine because it is often less expensive than in the US. Unfortunately, many times the medications brought back have been relabeled and are out of date.
44
Who's goal is global health?
Global health is a collective goal of nations and is promoted by the world's major health organizations.
45
What is necessary to achieve global health?
Global health cannot be achieved without using the constructs of global health diplomacy: addressing and finding solutions to physical, environmental, fiscal, economic, political, safety, educational, and trade issues.
46
How does the fall of political and economic barriers between countries affect global health?
As the political and economic barriers between countries fall, the movement of people bak and forth across international boundaries increases. This movement increases the spread of various diseases throughout the world.
47
What role do nurses play in the identification of potential health risks at US borders?
Nurses play an active role in the identification of potential health risks at US borders, with immigrant populations throughout the US, and as participants in global health care delivery.
48
What is essential for understanding the health of specific populations?
Understanding a population approach is essential for understanding the health of specific populations.
49
What does universal access to health care for the world's populations rely on?
Universal access to health care for the world's populations relies on strong primary care.
50
The major organizations involved in world health are...?
The major organizations involved in world heath are:
1. Multilateral
2. Bilateral and non-governmental or private voluntary
3. Philanthropic
51
What is the health status of a country related to?
The health status of a country is related to its economic and technical growth. More technologically and economically advanced countries are referred to as developed, whereas those that are striving for greater economic and technological growth are termed lesser developed. Many lesser-developed countries shift financial resources from health and education to other internal needs, such as defense or economic development, and this shift does not help the poor.
52
What is the global burden of disease (GBD)?
The global burden of disease (GBD) is a way to describe the world's health. The GBD combines losses from premature death and losses that result from disability. The GBD represents units of disability-adjusted life-years (DALYs)
53
What do critical global health problems include?
Critical global health problems still exist and include communicable diseases such as tuberculosis, measles, mumps, rubella, and polio; maternal and child health; diarrheal diseases, nutritional deficits; malaria; and AIDS.
54
What have also become global health concerns?
Natural and man-made disasters have become global health concerns.
55
What three dimensions do most definitions of community include?
Most definitions of community include three dimensions:
1. networks of interpersonal relationships that provide friendship and support to members
2. residence in a common locality
3. shared values, interests, or concerns
56
What is the definition of a community?
A community is defined as a locality-based entity, composed of systems of formal organizations reflecting societal institutions, informal groups, and aggregates that are interdependent and whose function or expressed intent is to meet a wide variety of collective needs.
57
Is a community practice setting sufficient reason for stating that practice is oriented toward the community client?
No. A community practice setting is insufficient reason for stating that practice is oriented toward the community client. When the location of the practice is in the community but the focus of the practice is the individual or family, the nursing client remains the individual or family, not the whole community.
58
What is population-centered practice targeted to?
Population-centered practice is targeted to the community-- the population group in which healthful change is sought.
59
What is the definition of community health?
Community health is defined as the meeting of collective needs through identification of problems and management of behaviors within the community itself and between the community and the larger society.
60
What do most changes aimed at improving community health involve?
Most changes aimed at improving community health involve, out of necessity, partnerships among community residents and health workers from a variety of disciplines.
61
What does assessing community health require?
Assessing community health requires gathering existing data, generating missing data, and interpreting the database.
62
What are five useful methods of collecting data?
Five methods of collecting data useful to the nurse are:
1. Informant interviews
2. Participant observation
3. Secondary analysis of existing data
4. Surveys
5. Windshield surveys
63
What is the biggest challenge in assessment?
Gaining entry or acceptance into the community is perhaps the biggest challenge in assessment.
64
What is usually the relationship between the nurse and the community when collecting data?
The nurse is usually an outsider and often represents an established health care system that is neither known nor trusted by community members, who may react with indifference or even active hostility.
65
What does the planning phase include?
The planning phase includes analyzing and establishing priorities among community health problems already identified, establishing goals and objectives, and identifying intervention activities that will accomplish the objectives.
66
What happens after high-priority problems are identified?
Once high-priority problems are identified, broad relevant goals and objectives are developed; the goal is generally a broad statement of the desired outcome while the objectives are precise statements of the desired outcome.
67
What are intervention activities?
Intervention activities, the means by which objectives are met, are the strategies that clarify what must be done to achieve the objectives, the ways change will be effected, and the way the problem will be interpreted.
68
What does implementation mean?
Implementation, the third phase of the nursing process, means transforming a plan for improved community health into achieving goals and objectives.
69
What is evaluation?
Simply defined, evaluation is the appraisal of the effects of some organized activity or program.
70
What is the expected growth of the national health spending in the years between 2010 and 2019?
In the years between 2010 and 2019, national health spending is expected to grow at an average annual rate of 6.1%, reaching $4.5 trillion by 2019.
71
By 2012, what programs are expected to account for over half the health care purchased in the US?
Medicare, Medicaid and the Children's Health Insurance Plan.
72
Which entity reported that the number of uninsured rose to 46.3 million in 2008, from 45.7 million in 2007?
The US Census Bureau
73
What happens with the uninsured in terms of preventive care, diagnosis and treatment?
The uninsured receive less preventive care, are diagnosed at more advanced disease states, and, once diagnosed, tend to receive less therapeutic care in terms of surgery and treatment options.
A recent study found that as many as 27,000 deaths in 2006 were the result of a lack of insurance.
74
What did a study in 2007 found in regards to shortages of primary health care providers?
A study in 2007 found that 56 million people in the US lacked adequate access to primary health care because of shortages of primary health care providers in their communities.
75
Who have the greatest barriers to access?
Those who are poor, minority group members, and non-English speakers have the greatest barriers to access.
76
Among the 18 million who received care in community health centers in 2007...
- one out of every five clients were low-income, uninsured individuals
- one in four were low income and members of minority populations
- one in seven were rural residents.
77
What is globalization?
Globalization is a process of change and development across national boundaries and oceans, involving economics, trade, politics, technology, and social welfare.
78
How is primary health care defined?
Primary health care, the focus of the public health system in the US, is defined as a broad range of services, including, but not limited to, basic health services, family planning, clean water supply, sanitation, immunization, and nutrition education.
79
The US and primary health care
The US, as a WHO member nation, has endorsed primary health care as a strategy for achieving the goal of health for all in the twenty-first century.
80
How does emphasis on the social and physical environment affect Healthy People 2020?
The emphasis on the social and physical environment moves Healthy People 2020 from the traditional disease-specific focus to a more holistic view of health consistent with a public health frame of reference.
81
What agency is the agency most heavily involved with the health and welfare concerns of US citizens?
The US Department of Health and Human Services (HHS)
82
How is public health nursing defined?
Public health nursing is defined as the practice of protecting and promoting the health of populations using knowledge from nursing, social, and public health sciences.
83
What is the only industrialized nation in the world that does not guarantee health care to all of its citizens?
The United States is the only industrialized nation in the world that does not guarantee health care to all of its citizens
84
Passage of the health care reform
The passage of the health care reform by the 111th Congress in March of 2010 was historic, and its full enactment, which will take place through 2018, will usher in an era of expanded access to health care in the United States.
85
What are the four developmental stages the US health care delivery system experienced from 1800 to 2000?
First stage: 1800-1900. Infectious epidemics (cholera, typhoid, smallpox, influenza, malaria, and yellow fever). Inadequate and unsafe hospital care. Minimal technology. Experience-based training.
Second stage: 1900 - 1945. Acute infections, trauma. Specialty hospitals emerge. Therapeutic advances. Shift to science-based training.
Third stage: 1945 - 1985. Chronic diseases (heart disease, cancer, and stroke). Increasing numbers and types of facilities. "Durable" technologies -- therapeutics and diagnostics. Development of medical specialties, new "types" of employees.
Fourth stage: 1984 - Present. Emergence of new and old infectious diseases. Mergers, "integration". "Super" drug therapies, computerization, "service" technologies. Primary care, "turf" issues, multidisciplinary care teams. Managed care.
86
What are the four basic components that provide the framework for the development of delivery of health care services?
1. Service needs and intensity
2. Facilities
3. Technology
4. Labor (workforce)
87
What are the three major factors associated with the growth of the health care delivery system?
1. Price inflation
2. Changes in population demographics
3. Technology and service intensity
88
Does chronic disease have an effect on health care spending?
Yes. Chronic disease is becoming a major health factor affecting health care spending with one in two Americans experiencing at least one chronic disease.
89
How did health care financing evolve in the twentieth and twenty-first centuries?
Health care financing has evolved through the twentieth century from a system financed primarily by the consumer to a system financed primarily by third-party payers. In the twenty-first century, the consumer is being asked to pay more.
90
Is anything being done to solve the problems of rising health care costs?
A number of plans for future payment of health care are being considered; all include some form of rationing.
91
What has been viewed as the major cause of rising health care costs?
Excessive and inefficient use of goods and services in health care delivery has been viewed as the major cause of rising health care costs.
92
What is economics concerned with?
Economics is concerned with use of resources, including money, to fulfill society's needs and wants.
93
What is health economics concerned with?
Health economics is concerned with the problems of producing services and programs and distributing them to clients.
94
What is the goal of public health economics?
The goal of public health economics is maximum benefits from services of public health providers, leading to health and wellness of the population.
95
What is the goal of public health?
The goal of public health is providing the most good for the most people.
96
Why do nurses need to understand basic economic principles?
Nurses need to understand basic economic principles to avoid contributing to rising health care costs.
97
What does the GNP reflect?
The GNP reflects the market value of goods and services produced by the US.
98
What does the GDP reflect?
The GDP reflects the market value of the output of labor and property located in the US.
99
What does microeconomic theory show?
Microeconomic theory shows how supply and demand can be used in health care.
100
How does macroeconomic theory help?
Macroeconomic theory helps one look at national and community issues that affect health care.
101
What are the problems of the twenty-first century?
Social issues, economic issues, and communicable disease epidemics mark the problems of the twenty-first century.
102
Which are two government-funded programs that help meet the needs of high-risk populations in the US?
Medicare and Medicaid.
103
What the health insurance status within the US population?
A majority of the US population has health insurance. The remaining uninsured segment represents millions of people, mostly the working poor, older adults, and children, and those who lost jobs in the economic downturn of 2008.
104
How does poverty affect health?
Poverty has a detrimental effect on health.
105
Is health care rationing new to the US health care system?
No. Health care rationing has always been a part of the US health care system and will continue to be with the proposed new health care reform.
106
Are nurses cost-effective providers?
Yes. Nurses are cost-effective providers and must be an integral part of health care delivery.
107
What is Healthy People 2020?
Healthy People 2020 is a document that has established US health objectives.
108
Is human life valued in health economics?
Yes. Human life is valued in health economics, as is money. An emphasis on changing lifestyles and preventative care will reduce the unnecessary years of life lost to early and preventable death.
109
Where can the legal basis for most congressional action in health care be found?
The legal basis for most congressional action in health care can be found in Article I, Section 8, of the US Constitution
110
What are the five major health care functions of the federal goverment?
The five major health care functions of the federal government are:
1. Direct service
2. Financing
3. Information
4. Policy setting
5. Public protection
111
What is the goal of the World Health Organization?
The goal of the World Health Organization is the attainment by all people of the highest possible level of health.
112
What is the agency most directly involved with the health and welfare of Americans?
Many federal agencies are involved in government health care functions. The agency most directly involved with the health and welfare of Americans is the US Department of Health and Human Services (USDHHS).
113
Do state and local government affect nursing practice?
Most state and local governments have activities that affect nursing practice.
114
Do functions of governmental agencies have an impact on nursing?
The variety and range of functions of governmental agencies have had a major impact on nursing. Funding, in particular, has shaped the role and tasks of nurses.
115
Can the private sector influence legislation?
The private sector (of which nurses are a part) can influence legislation in many ways, especially through the process of writing regulations.
116
Why is involvement in the political process important to nurses?
Because the number and types of laws influencing health care are increasing.
117
What are two legal aspects particularly relevant to the practice of nursing?
Professional negligence and the scope of practice.
118
What must nurses consider in each clinical encounter?
Nurses must consider the legal implications of their own practice in each clinical encounter.
119
What are the three branches the federal and most state governments are composed of?
The federal and most state governments are composed of three branches: the executive, the legislative, and the judicial.
120
Which branch of government plays a significant role in health policy?
Each branch of government plays a significant role in health policy.
121
When was the US Public Health Service created?
The US Public Health Service was created in 1798.
122
When was the first national heath insurance legislation challenged?
The first national health insurance legislation was challenged in the Supreme Court in 1937.
123
What is an important source of data about the nation's health care problems?
Health: United States (NCHS, 2010)
124
When was the Sheppard-Towner Act passed and why is it important?
In 1921 the Sheppard-Towner Act was passed, and it had an important influence on child health programs and population-centered nursing practice.
125
What are three governmental agencies important to nursing?
1. The Division of Nursing
2. The National Institute of Nursing Research
3. The Agency for Healthcare Policy and Research
126
What are the functions of nurses through state and local health departments?
Nurses, through state and local health departments, function as consultants, policy advocates, population level and direct care providers, researchers, teachers, supervisors, and program managers.
127
Who is responsible for regulating nursing practice within the state?
The state governments are responsible for regulating nursing practice within the state.
128
What were federal and state social welfare programs developed for?
Federal and state social welfare programs have been developed to provide monetary benefits to the poor, older adults, the disabled, and the unemployed.
129
Do social welfare programs affect nursing practice?
Yes. Social welfare programs affect nursing practice. These programs improve the quality of life for special populations, thus making the nurse's job easier in assisting the client with health needs.
130
What is the nurse's scope of practice defined by?
The nurse's scope of practice is defined by legislation and by standards of practice within a specialty.
131
How does the home setting affect practice?
Home health, hospice, and palliative nursing practice provided in the client's home differ from care in institutional settings. The home setting affects practice in unique ways including establishing trust, developing care partnerships, selecting interventions, collecting outcomes and data, ensuring client safety, and promoting quality.
132
Who are the members of the health care team in home health?
Family members, including caregivers and significant persons who provide assistance and/or care, are essential members of the health care team.
133
What are the roots of home health?
Home health has its roots in public health nursing, with an emphasis on health promotion, illness prevention, and caring for people in their communities.
134
When did home health and hospice practice and reimbursement change?
Home health and hospice practice and reimbursement changed when they become major Medicare benefits.
135
What are the five models of care in home health and hospice?
1. Population-focused home care
2. Transitional care
3. Home-based primary care
4. Home health
5. Hospice
Home health, hospice, and all other nurses should become familiar with the models to inform clients and their families about options and educate providers who are potential referral sources.
136
Is medicare-certified home health and hospice different?
Medicare-certified home health and hospice agencies are divided into various types of the administrative and organizational structures. However, many aspects of nursing practice are the same in the various types.
137
Where do the standards of home nursing practice originate?
Standards of home nursing practice originate from the ANA and specialty organizations, and encourage adoption of evidence-based practice.
138
What is essential for home health, hospice, and palliative care nurses?
Consistently demonstrating professional competency is essential for home health, hospice, and palliative care nurses.
139
What do home health nurses practice in accordance with?
Home health nurses practice in accordance with the ANA (2007) Home Health Nursing Scope and Standards of Practice.
140
What do hospice and palliative care nurses use?
Hospice and palliative nurses use the Hospice and Palliative Nursing Scope and Standards of Practice published by the Hospice and Palliative Nurses Association and the ANA (2007)
141
What is inherent in home health and hospice?
Interprofessional collaboration is inherent in home health and hospice.
142
How was the Omaha System developed and refined?
The Omaha System was developed and refined through a process of research. Reliability and validity were established for the entire system.
143
What make the Omaha System unique?
The Omaha System is unique in that it is the only comprehensive vocabulary developed initially by and for nurses practicing in the community.
144
What does the Omaha System consist of?
The Omaha System consists of the
1. Problem Classification Scheme (assessment)
2. Intervention Scheme (care plans and services), and
3. Problem Rating Scale for Outcomes (client change/evaluation)
145
What is the Omaha System designed for?
The Omaha System is designed to enhance practice, documentation, and information management. These areas are of concern to community health educations and students as well as practitioners and administrators.
146
What do interprofessional practitioners employed in Medicare-certified home health agencies use?
Interprofessional practitioners employed in Medicare-certified home health agencies use OASIS-C at designated intervals, it is the outcome measurement tool mandated by the Centers for Medicare and Medicaid Services' conditions of participation.
147
What are Outcome-Based Quality Improvement programs used for?
Evidence-based quality/performance improvement is important in all home health and hospice agencies. Currently, Medicare's Outcome-Based Quality Improvement program is used for outcome measurement and cost control.
148
How are the trends and opportunities in home health and hospice nursing?
Exciting trends and opportunities are pervasive in home health and hospice. Many nurses are developing skills using technology, informatics, and telehealth; a commitment to life-long learning is necessary.
149
What is epidemiology?
Epidemiology is the study of the distribution and determinants of health-related events in human populations and the application of this knowledge to improving the heath of communities.
150
Is epidemiology an independent enterprise?
No. Epidemiology is a multidisciplinary enterprise that recognizes the complex interrelationships of factors that influence disease and health at both the individual level and the community level; it provides the basic tools for the study of health and disease in communities.
151
What are epidemiologic methods used for?
Epidemiologic methods are used to describe health and disease phenomena and to investigate the factors that promote health or influence the risk or distribution of disease.
This knowledge can be useful in planning and evaluating programs, policies, and services as well as in clinical decision making.
152
What do epidemiologic models explain?
Epidemiologic models explain the interrelationships between agent, host, and environment (the epidemiologic triangle) and the interactions of multilevel factors, exposures, and characteristics (casual web) affecting risk of disease.
153
What is a key concept in epidemiology?
A key concept in epidemiology is that of the levels of prevention, based on the stages in the natural history of disease.
154
What does primary prevention involve?
Primary prevention involves interventions to reduce the incidence of disease by promoting health and preventing disease processes from developing.
155
What does secondary prevention include?
Secondary prevention includes programs (such as screening) designed to detect disease in the early stages, before signs and symptoms are clinical evident, to intervene with early diagnosis and treatment.
156
What does tertiary prevention provide?
Tertiary prevention provides treatments and other interventions directed toward persons with clinically apparent disease, with the aim of lessening the course of disease, reducing disability, or rehabilitating.
157
Are epidemiologic methods also used in terms of the levels of prevention?
Epidemiologic methods are also used in the planning and design of community health promotion (primary prevention) strategies and screening (secondary prevention) activities, and in the evaluation of the effectiveness of these interventions.
158
What do basic epidemiologic methods include?
Basic epidemiologic methods include the use of existing data sources to study health outcomes and related factors and the use of comparison groups to assess the association between exposures or characteristics and health outcomes.
159
What do epidemiologist rely on?
Epidemiologists rely on rates and proportions to quantify levels of morbidity and mortality. Prevalence proportions provide a picture of the level of existing cases in a population at a given time. Incidence rates and proportions measure the rate of new case development in a population and provide an estimate of the risk of disease.
160
What do descriptive epidemiologic studies provide?
Descriptive epidemiologic studies provide information on the distribution of disease and health states according to personal characteristics, geographic region, and time. This knowledge enables practitioners to target programs and allocate resources more effectively and provides basis for further study.
161
What do analytic epidemiologic studies investigate?
Analytic epidemiologic studies investigate associations between exposures or characteristics and health or disease outcomes, with a goal of understanding the etiology of disease. Analytic studies provide the foundation for understanding disease causality and for developing effective intervention strategies aimed at primary, secondary, and tertiary prevention.
162
Why is health education a vital component of nursing?
Health education is a vital component of nursing because the promotion, maintenance, and restoration of health rely on clients' understanding of health care topics.
163
What do nurse educators do?
1. Identify learning needs
2. Consider how people learn
3. Examine educational issues
4. Design and implement educational programs
5. Evaluate the effects of the educational program on learning and behavior.
164
What is often used as a guide to identifying community-based learning needs?
Nurses often use the Healthy People 2020 educational objectives as a guide to identifying community-based learning needs.
165
What is the difference between education and learning?
Education and learning are different. Education is the establishment and arrangement of events to facilitate learning. Learning is the process of gaining knowledge and expertise and results in behavioral changes.
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What are the three domains of learning?
Three domains of learning are cognitive, affective, and psychomotor. Depending on the needs of the learner, one or more of these domains may be important for the nurse educator to consider as learning programs are developed.
167
What are the nine principles associated with community health education?
1. Gaining attention
2. Informing the learner of the objectives of instruction
3. Stimulating recall of prior learning
4. Presenting the stimulus
5. Providing learning guidance
6. Eliciting performance
7. Providing feedback
8. Assessing performance
9. Enhancing retention and transfer of knowledge
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What are the two useful theories that can guide the development of health education programs?
Often theory can guide the development of health education programs. Two useful ones are
1. the Health Belief model
2. the Transtheoretical Model (TTM), which is discussed in connection with the Precaution Adoption Process Model (PAPM)
169
What are the principles that guide the effective educator?
Principles that guide the effective educator include
1. Message
2. Format
3. Environment
4. Experience
5. Participation
6. Evaluation
170
What are some educational issues?
Educational issues include population considerations, barriers to learning, and technological issues.
171
What are two important learner-related barriers?
Two important learner-related barriers are low literacy, especially health literacy, and lack of motivation to learn information and make the needed changes.
172
What are the five phases of the educational process?
The five phases of the educational process are
1. Identifying educational needs
2. Establishing educational goals and objectives
3. Selecting appropriate educational methods
4. Implementing the educational plan
5. Evaluating the educational process and product
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What does the evaluation of the product include?
Evaluation of the product includes the measurement of short- and long-term goals and objectives related to improving health and promoting behavioral changes.
174
Is working with groups an important skill and why?
Working with groups is an important skill for nurses. Groups are an effective and powerful vehicle for initiating and implementing healthful changes.
175
What is a group?
A group is a collection of interacting individuals with a common purpose. Each member influences and is influenced by other group members to varying degrees.
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How is group cohesion enhanced or diminished?
Group cohesion is enhanced by commonly shared characteristics among members and diminished by differences among members.
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What is cohesion?
Cohesion is the measure of attraction between members and the group. Cohesion or the lack of it affects the group's function.
178
What are norms?
Norms are standards that guide and regulate individuals and communities. These norms are unwritten and often unspoken and serve to ensure group movement to a goal, to maintain the group, and to influence group members' perceptions and interpretations of reality.
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Is diversity of member backgrounds a positive or negative influence on a group?
Some diversity of member backgrounds is usually a positive influence on a group.
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How do groups operate?
Groups also go through a set of stages in order to form, operate, and adjourn.
181
How does leadership and group connect?
Leadership is an important and complex group concept. Leadership is described as patriarchal, paternal, or democratic.
182
How does group structure emerge?
Group structure emerges from various member influences, including members' understanding and support of the group purpose.
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How do conflicts in groups develop?
Conflicts in groups may develop from competition for roles or member disagreement about the roles ascribed to them.
184
How is health behavior influenced?
Health behavior is influenced by the groups to which people belong and for which they value membership.
185
Why is understanding of group concepts important?
An understanding of group concepts provides a basis for identifying community groups and their goals, characteristics, and norms. Nurses use their understanding of group principles to work with community groups toward needed health changes.
186
What priority should be given to infectious diseases?
The burden of infectious diseases is high in both human and economic terms. Preventing these diseases must be given high priority in our present health care system.
187
What are the three factors of infectious disease and why is it important to know the characteristics of them?
The successful interaction of the infectious agent, host and environment is necessary for disease transmission. Knowledge of the characteristics of each of these three factors is important in understanding the transmission, prevention, and control of these diseases.
188
What must interventions be aimed at?
Effective intervention measures at the individual and community levels must be aimed at breaking the chain linking the agent, host and environment. An integrated approach focused on all three factors simultaneously is an ideal goal to strive for but may not be feasible for all diseases.
189
What must health care professionals be constantly aware of when it comes to emerging infectious diseases?
Health care professionals must constantly be aware of vulnerability to threats posed by emerging infectious diseases. Most of the factors causing the emergence of these diseases are influenced by human activities and behavior.
190
Are communicable disease preventable?
Communicable diseases are preventable. Avoiding infection through primary prevention activities is the most cost-effective public health strategy.
191
What must health care professionals always do to prevent infectious disease from spreading?
Health care professionals must always apply infection control principles and procedures in the work environment. They should strictly adhere to universal blood and body fluid precautions to prevent transmission of HIV and other bloodborne pathogens.
192
What does effective control of communicable diseases require?
Effective control of communicable diseases requires the use of a multisystem approach focusing on enhancing host resistance, improving safety of the environment, improving public health systems, and facilitating social and political changes to ensure health for all people.
193
What must be emphasized as part of communicable disease prevention and control programs?
Communicable disease prevention and control programs must move beyond providing drug treatment and vaccines. Health promotion and education aimed at changing individual and community behavior must be emphasized.
194
What is the role of the nurses in prevention and control of communicable diseases?
Nurses play a key role in all aspects of prevention and control of communicable diseases. Close cooperation with other members of the interprofessional health care team must be maintained. Mobilizing community participation is essential to successful implementation of programs.
195
Smallpox and global eradication campaigns...
The successful global eradication of smallpox proved the feasibility of eradication of selected communicable diseases. As professionals and concerned citizens of the global village, health care workers must support the current global eradication campaigns against poliomyelitis and dracunculiasis.
196
(PPT) What can the roots of home care nursing be traced back to?
Religious and charitable groups
197
(PPT) Who was the first visiting nurse?
Phoebe, a friend of St. Paul
198
(PPT) What happened during the Dark Ages of Nursing in the 16th Century?
- Charitable organizations such as hospitals were no longer permitted to function.
- Henry VIII closed monasteries greatly affecting the aged and poor.
- Nursing lost the support of the church, no longer considered respectable work, nurses were recruited from lower classes.
199
(PPT) What was founded in 1813 in Charleston, South Carolina in response to the aftermath of war of 1812 and what did they provide?
The Ladies Benevolent Society. It provided social services and care in home.
200
(PPT) What was established in Philadelphia in 1832?
Lying in Charity for Attending Indigent Women. Later combined with Nursing Society.
201
(PPT) When and where were the roots of professional public health nursing firmly established?
During the industrial revolution throughout the late 1800s and early 1900s. First in England and quickly after in the US.
202
(PPT) Who are organizational designs of visiting nurse services attributed to?
William Rathbone and Florence Nightingale.
