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what is the blueprint for action of community health nursing in canada?

released by CHNC in 2011 and it provides framework and point of reference for ongoing dialogue on development of CHN in canada.

informs decision making of CHSn and promote and protects health of Canadians


what are the 6 areas of action for the blueprint for action of community health nursing in canada?

1) CHNs need to work at full schope + with greater clarity in all domains of practice, across provinces and territories
2) Support nursing leadership development and positions to advance CHN & provide voice for the profession
3) Build on successful collaboration with other professionals + sectors
4) Transform healthcare system into a system for (community) health
5) Support strong educational preparation in community health nursing
6) Improve access to a range of professional development resources to advance CHN capacity


CHNs or PHN engage in primary, secondary, and teritiary prevention?

community health nurses


who are the community health nurses of Canada and what do they do?

associate members of CNA and represents the voices of CHNs. values are that health is a human right and requires balance between illness care and health promotion, leadership is required for community care and social justice is foundational


CHNC advocate for healthy public policy to address ____ public funded, not-for-profit system for community health



what is home health nursing?

• Specialized area of CHN in which nurse, employed by a home health agency, provides clinical care in the client’s home, school, or workplace


what kind of care does home health nursing provide?

chronic disease management, curative practices, health promotion, health edu, palliative care, rehav, support + maintenance, social support so client can continue to live in the community


what is primary health care?

defined at Alma-Ata as healthcare that is scientifically sound, socially acceptable, universally accessible to individuals and families through their full participation, and at a cost the community and country can afford within the spirit of self-reliance and self-determination ; has broadened to include all social determinants of health


what are the different types of CHN?

forensic, public health, home health, primary care/NP, occupation health, parish nurse, mental health nurse, military nurse, street nurse, telehealth


what is primary care nursing?

provide first contact w healthcare..often within primary care settings such as primary care networks, ambulatory care centres, long-term care facilities, physician offices, fam ily health clinics, community health centres, and community clinics in urban and rural and remote areas


T/F it is part of the practice standards for CHN to be politically competent and to use political and social advocacy to not just accept the conditions that contribute to marginalization and inequities but to change them.



what is health inequity?

implies that everyone, regardless of socially determined circumstances, has an equal opportunity to attain their full health potential without being diadem


what are the 5 areas that the national expert commission (set up by the CNA) in 2011 tackled to meet with Canadians and strategies how to better meet their needs?

1) Recognize health inequiaties and determinants of health within many of our populations groups and working to address access to primary care services
2) Transition to community-based care
3) Manae chronic disease care more effectively within community settings
4) Champion primary and preventative-based care
5) Strenthen the nurse’s role as advocates for vulnerable Canadians


what is ICT

information communication technology (tablets, handheld devices, blue tooth, etc)


what is tertiary prevention

the impairment or disability from the disease process is halted


is this primary, secondary or tertiary prevention?

home visiting by PH for risk assessment



is this primary, secondary or tertiary prevention?

providing treatment, education, self mgmt for ppl with HIV or hepatitis



is this primary, secondary or tertiary prevention?

breastfeeding campaigns where PHN publicly advocate breastfeeding



is this primary, secondary or tertiary prevention?

employees getting blood samples for lead levels, as they are exposed to env't contaminants in workplace

secondary (screening)


is this primary, secondary or tertiary prevention?

designing, planning and implementing social marketing campaigns to de-nromaize tobacco use



what is emancipatory knowing?

knowing that places the practice of nursing within the broader social, political, and economic context

in the capacity of CHN it is to recognize social and political problems of injustice or inequity to realize that things could be different and to piece together complex elements of experience and context to change a situation as it is to a situation that improves peoples lives.


what are the 4 types of knowing typical in nursing?

aesthetic, ethical, empirical, personal


what is sociopolitical knowing?

includes society’s knowledge of knowing, and nursing’s knowledge of society and its politics


what is a metaparadigm?

contains the global concepts essential to the practice of community health nursing


what is the complexity science theory?

• Much of healthcare application of this theory derives from systems theory (understanding human’s as systems that interact w environment)


complexity science theory encompasses many theories, what are these/

interconnectedness or interdependecy, non0linearity, self-organization, emergence, co-evolution


what is o Interconnectedness or interdependency (Complexity Science Theory)

agents in system interact + exchange info to allow info to spread through system. Local interactions give rise to global patterns.


what is non-linearity?(Complexity Science Theory)

disproportionate relationship between cause + effect (small cause → large effect and vice versa)


what is self-organization?(Complexity Science Theory)

people mutually adjust actions to cope + adapt to changing context. This arises through interdependence in the system.


what is emergence?(Complexity Science Theory)

emergence of system-level properties that are distinct from properties of interacting agents. (ex: herd immunity)


what is co-evolution?(Complexity Science Theory)

agents within the system interact with each other and outside of the sytsem so that evolution occurs within and outside of the complex adaptive system


how do you apply complexity science theory into nursing practice?

o Requires us to question whether standardization and “ones size fits all” approach are useful as each system is unique
o Emphasizes we need to see the part in the whole (in its context) and interrelatedness between all people, factors etc in the situation
o Emergence helps to CHN recognize that many small actions may lead to large positive outomce


env't and structures within which CHN practice can be considered complex adaptive systems- what is this?

collection of individual agents with freedom to act in ways that not always totally predictable and whose actions are interconnected


what is the social ecological theory?

• Fundamental theoretical assumption here is that health is influences by the interplay among the individuals or communities and their surroundings (family, community, culture, and physical and social environment

• Draws on both large-scale preventative strategies of public health and individual-level strategies of behavioral sciences


social ecology draws on systems concepts of adaptation- what is this

what people do to adapt to the demands of context


social ecology draws on systems concepts of adaptation, succession- what is that

interventions are influenced by the hx of the setting with its norms, values, policies and social structures


social ecology draws on systems concepts of adaptation, succession, cycling of resources- what is that

interventions must build on existing strengths of individuals, groups, communities and institutions


social ecology draws on systems concepts of adaptation, succession, cycling of resources, and interdependence- what is that,

settings are systems, and changes in one aspect of the setting influences other aspects


social ecological theory is reflected in the field of social epidemiology - what is this

it seeks to explain and uncover social inequalities in health and how these are distributed in a population


what is critical social theory?

• Considers multiple social and economic forces resulting in power differentials within society
• Used by CHNs to inform work with pops that are disadvantaged


does critical social theory challenge status quo?

• This perspective challenges status quo + assumes deliberate engagement w problems of society + processes of social transformation
• Takes historically situated sociopolitical perspective, analyzes it, and then challenges the social inequities and injustices that resulted from it


what does feminist theory focus on? (3 things)

equity, oppression and justice


T/F feminist theory sees inequity based on individual misfortune rather than social oppression

F, • Sees inequity as based in social oppression rather than individual misfortune


what two groups are significantly affected by funding decisions and allocation of health and other resources?

woman and older adults and women are generally the pop caring for the aged


feminism aims to empower both the clients and the ___



what is the intersectionality theory?

provides a way to understand multiple social identities such as genre, race, disability, SE status, and other inequalities intersect at the level of the individual and reflect social constructs of oppression ad privilege


what does intersectionality examine

differnce and influence of power


intersectionality theory offers more inclusive look at the "isms", what are some examples?

sexism, racism, any ism that comes together as oppression


what is the post-colonial theory?

• Challenges us to consider oppressive structures that assume a view reflecting dominant discourse and culture and to give “voice to subjugate and indigenous knowledge, esp non-Western voices
• Recognizing how historical context influences the experience of care today
• Important for CHN as encourages self-reflection and exploration of oppression at play in nurse-client and nurse-community interactions


which theory is this:

• In practice, has a lot to do with tackling issues around social determinants of health and using upstream thinking

social ecological thoeory


what theory is this:

• Takes historically situated sociopolitical perspective, analyzes it, and then challenges the social inequities and injustices that resulted from it

critical social theory


what theory is this:

• Important for global health – helps to explain international health and lead to questions regarding the dominance and authority of Western knowledge in nursing practice throughout the world

post-colonial thoeyr


what theory is this:

• A framework that accounts for the synergistic or amplifying influence of multiple forms of oppression

intersectionality theory


what theory is this:

• Because much of work of CHN has to do w poverty, has potential to address women and children being over-represented in pop of disadvantaged



what theory has recently been a new addition to nursing theory?

complexity science theory


what is the critical caring theory?

this middle range theory uses a broad definition of client to encompass communities and population. the curative health-promoting processes include the process of teaching and learning, the creation of supportive and sustainable environments, social justice building capacity, and honouring local belief systems.


what is the strengths based theory?

this canadian approach incorporates thinking about the positives, the things that work well, and what holds potential it is about finding the balance between focusing on client strengths while at the same time dealing with problems. it is oriented to the individual, family and community levels of intervention


what is the relational inquiry theory?

focuses on the way that persona, interpersonal and contextual elements shape ppl experiences.

considers how capacities and socio-environmental limitations influence peoples health and illness experiences, decision making, and the various ways of managing health and illness. it recognizes that heal, illness and experiences are shaped by social, economic, cultural family, historical, and geographical contexts as well by biology, gender, age, and ability


what is primary care?

narrower concept that refers to a person-centerer comprehensive approach to care deliver at the point of entry into the healthcare system


• WHO describes PHS as the route to better health for all with 5 key elemts:

1. Reducing exclusion and social disparities in health (universal coverage reforms)
2. Organizing health services around peoples needs and expectations (sevice delivery reforms)
3. integrating health into all sectors (public policy reforms)
4. pursuing collaborative models of policy dialogue (leadership reforms)
5. increasing stakeholder participation


what are the 5 principles of primary health care (important)

accessibility, public participation, health promotion, appropriate technology and intersectoral collaboration or co-operation


what is accessibility?

should be accessible to all no matter they live


what is public participation?

encouraged to make decisions about health care and identifying needs in community


what is appropriate technology?

appropriate modes of care are available based on society’s social, economic, and cultural development. Equity is an important part here


what is intersectoral collar or co-operation?

means that bc health and well-being are linked to economic and social policy, intersectoral collab is needed to establish national and local health goals, healthy public polices and planning and evaluation of health services


• The WHO has outlined 8 essential components of PHC:

1. education about health problems and prevention techniques: identify challenges in a pop.
2. Promotion of food supply and proper nutrition
3. Adequate supply of water and basic sanitation
4. Maternal and child healthcare including family planning
5. Immunization against major infectious diseases
6. Prevention and control of locally endemic diseases: endemic diseases are those that are prevalent in people in a particular group but in low numbers. Ie. TB in N of Canada
7. Appropriate treatment of common diseases and injuries using the PHC principle of appropriate technology
8. Provision of essential drugs


what is the population health promotion model?

model explains the relationship between pop health and health promotion. Shows how a pop health approach can be implemented using strategies from Ottawa charter