Community Quiz #3

b.) Plague c.) Botulism e.) Tularemia f.) Anthrax

A community health nurse is educating the public on the agents of bioterrorism. Which of the following are Category A? a.) Escherichia coli b.) Plague c.) Botulism d.) Brucellosis e.) Tularemia f.) Anthrax

b.) displaced persons. Displaced persons are those who have to evacuate their home, school, or business as a result of a disaster. An indirect victim may be a family member or friend of the victim or a first responder. A mass casualty event is one in which 100 or more individuals are involved. Poverty is not considered a disaster classification.

A family of five people presented to a hospital after the flooding of their urban home. These family members are classified as a.) poverty victims. b.) displaced persons. c.) indirect victims. d.) mass casualties.

c.) youths and young adults. e.) international markets. The tobacco industry has now started targeting youths and dramatically increased international exports. Tobacco sales among American adults is down.

After the implementation of various policies to reduce tobacco use, the tobacco industry has begun targeting (Select all that apply.) a.) elderly people. b.) Hispanics. c.) youths and young adults. d.) African Americans. e.) international markets.

b.) International travel increases the likelihood infectious disease can spread

An ER nurse researches current infectious diseases in Africa. What is the most likely reason for the nurse's research? a.) Patient care improves when nurses know about international diseases b.) International travel increases the likelihood infectious disease can spread c.) The nurse wants to present a poster at an international convention d.) Nurses have a requirement to participate in professional development yearly

• Frequency • Predictability • Preventability • Imminence • Scope and number of casualties • Intensity

BOX 29.3 Characteristics of Disasters?

• Three-day supply of nonperishable food • Three-day supply of water—one gallon of water per person, per day • Portable, battery-powered radio or television and extra batteries • Flashlight and extra batteries • First aid kit and manual • Sanitation and hygiene items (moist towelettes and toilet paper) • Matches and waterproof container • Whistle • Extra clothing • Kitchen accessories and cooking utensils, including a can opener • Photocopies of credit and identification cards • Cash and coins • Special needs item, such as prescription medications, eye glasses, contact lens solution, and hearing aid batteries • Items for infants, such as formula, diapers, bottles, and pacifiers • Other items to meet your unique family needs • If you live in a cold climate, you must think about warmth. Be sure to include one complete change of clothing and shoes per person, including: -• Jacket or coat -• Long pants -• Long-sleeve shirt -• Sturdy shoes -• Hat, mittens, and scarf -• Sleeping bag or warm blanket (per person)

BOX 29.7 Federal Emergency Management Agency Recommendations for Basic Disaster Supplies Kit?

a.) reach almost 10 billion. The world's population soared to 4 billion between 1960 and 1974 and then to 5 billion between 1974 and 1987. In 1999, the world population was 6 billion; in 2016, it was 7.4 billion. The population is projected to reach 8 billion by 2025 and 9.8 billion by midcentury.

By the middle of the 21st century, the world population is expected to a.) reach almost 10 billion. b.) reach 8 billion. c.) be largely unchanged from the 20th century. d.) show a slight decline.

a.) weapons of mass destruction. Weapons of mass destruction refer to any weapon that is designed or intended to cause death or serious bodily injury through release, dissemination, or impact of toxic or poisonous chemicals or their precursors. Chemical warfare agents are classified as nerve agents, vesicants, pulmonary agents, and cyanides.

Chemical warfare agents such as pulmonary agents and cyanides are classified as a.) weapons of mass destruction. b.) computer-based attack weapons. c.) recovery agents. d.) prevention medications.

Four phases: Heroic phase—helping others -Sacrificing for each other if they need to; banding together Honeymoon phase—relive event and tell stories; express gratitude -Gather and talk about disaster Disillusionment phase—feelings of despair and exhaustion -Having trouble processing Reconstruction phase—rebuilding, return to normalcy Common reactions to a disaster: Box 29.1 Posttraumatic stress disorder: With positive coping skills can get through these issues with no problem but sometimes not possible

Community Responses to a Disaster?

Environmental stressors: categorized in five types​ 1.) Lead poisoning and air pollution; direct assault human health​ 2.) Effects of air pollution on products and structures damage society's goods and services​ -​Can effect good and services you attain 3.) Noise and litter affect QOL​ 4.) Global warming interferes with the ecological balance​ 5.) Natural disasters, terrorism, and war affect all aspects of life -Worried about safety more than your health

Environmental Factors?

U.S. Department of Homeland Security (DHS) -Prevent terrorism and ensures resilience to disasters -Created after 9/11

Government Agencies during disasters: Federal Government?

Prepare citizens for emergencies and disasters First responders Office of Emergency Management- mock drills

Government Agencies during disasters: Local Government?

Assist local officials with emergency plans Workshops and training courses -First responders Advise and support local government -Provide direction to local governments on what to do in emergencies National Response Framework is the core operational plan for domestic incident management.

Government Agencies during disasters: State Government?

Essential role in preparing, responding, and recovering from disaster Educate on preparedness Work within disaster teams -Lend help to other teams Perform triage duties -START -Green, yellow, red, black Stabilize and transport patients Provide first aid and essential healthcare -If a nurse has to ride up to ohio state with patient if not enough EMTs or not in the scope of practice for them Participate in evaluation of response

Nurses role relating to disasters?

d.) lack of interest in health issues and health care. In developing countries, people are more likely to be exposed to communicable diseases as a result of a number of factors, including high population density, lack of accessible health care and treatment, and poor or limited sanitation. In addition, although tobacco use is decreasing in most developed countries, it is increasing in many underdeveloped ones. Although people in developed countries often lack resources and information, they are nonetheless interested in health promotion, disease prevention, and many aspects of health care delivery.

People who live in developing countries are at risk for a variety of health threats as a result of all factors except a.) limited sanitation facilities. b.) increased chance of exposure to communicable diseases, including AIDS, tuberculosis, and hepatitis B. c.) higher rates of tobacco use compared with most developed countries. d.) lack of interest in health issues and health care.

1.) Mitigation 2.) Preparation 3.) Response 4.) Recovery

Place the phases of the disaster management cycle in order. Recovery Response Mitigation Preparation

c.) increased incidence of disease. Overcrowding leads to pollution, stress, disease, and violence. Mortality rates are increased, and quality of life decreases.

Population overcrowding can result in a.) increased productivity. b.) improved education. c.) increased incidence of disease. d.) decreased mortality.

All governmental and nongovernmental organizations and agencies that contribute to improvement of the health of populations Public Health Agencies: Primary agency for medical response -Detect outbreaks -Identify risk factors -Teach the public American Red Cross: Nongovernmental agency Chartered by Congress to provide disaster relief Education, preparedness, and response -Meets needs of affected people and supports workers

Public Health System?

d.) Quickly identify the severity of mass casualty victims

START triage is used to: a.) Categorize patients that walk into the ER b.) Conduct a 5 minute head-to-toe assessment c.) Determine how to decontaminate trauma victims d.) Quickly identify the severity of mass casualty victims

Location: Home Instructions: Bring children and pets indoors immediately; close and lock all outside doors and windows; close the window shades, blinds, or curtains; turn off fans, heating, ventilation, or air conditioning system, and close the fireplace or woodstove damper; get the disaster supplies and make sure the radio is working; take everyone, including pets, into an interior room with no or few windows and shut the door; if instructed to seal the room, use duct tape and plastic sheeting (e.g., heavy-duty plastic garbage bags) to seal all cracks around the door into the room; keep the phone handy in case it is needed to report a life-threatening condition; keep listening to the radio or television until told all is safe or told to evacuate (do not evacuate unless instructed to do so). Location: Day care centers and schools Instructions: Close the school; activate the school's emergency plan and follow reverse evacuation procedures to bring students, faculty, visitors, and staff indoors; have all children, staff, and visitors take shelter in preselected rooms that have phone access, stored disaster supply kits, and, preferably, access to a bathroom; shut the doors and lock all windows and doors; if it is not possible for a person to monitor the telephone and the school has voice mail or an automated attendant, change the recording to indicate that the school is closed and that students and staff are remaining in the building until authorities say it is safe to leave; turn off heating, ventilating, and air conditioning systems; if children have cell phones, allow them to use them to call a parent or guardian to let them know that they have been asked to remain in school until further notice and that they are safe; one teacher or staff member in each room should write down the names of everyone in the room and call the designated contact to report who is in that room; everyone should stay in the room until school officials announce that all is safe or say everyone must evacuate. Location: Work Instructions: Close the office or business, making any customers, clients, or visitors in the building aware that they need to stay until the emergency is over; close and lock all windows, exterior doors, and any other openings to the outside; a knowledgeable person should use the building's mechanical systems to turn off all heating, ventilating, and air conditioning systems (systems that automatically provide for exchange of inside air with outside air, in particular, need to be turned off, sealed, or disabled); turn on call-forwarding or alternative telephone answering systems or services; if there is danger of explosion, close any window shades, blinds, or curtains; go to a predetermined sheltering room(s), and when everyone is in, shut and lock the doors; monitor radios or TVs for updates until you are told all is safe or you are told to evacuate. Location: Vehicle Instructions: If close to home, workplace, or a public building, go there immediately and go inside. If unable to get indoors quickly and safely, stop the vehicle in the safest place possible (e.g., stop under a bridge or in a shady spot to avoid being overheated); turn off the engine and close windows and vents; if possible, seal the heating, ventilating, and air conditioning vents with duct tape or anything else you may have available; listen to the radio periodically for updated advice and instructions; stay in place until you are told it is safe to get back on the road, and follow the directions of law enforcement officials.

TABLE 29.2 Shelter-in-Place Instructions?

c.) United Nations International Children Emergency Fund (UNICEF). UNICEF works for children's survival, development, and protection by developing and implementing community-based programs. UNICEF achievements are well documented in child health, nutrition, education, water, sanitation, and progress for women. PAHO is an international public health agency that works to improve the health and living standards of the Americas. The WHO introduced the goal of "health for all." The CDC strives to prevent and control infectious and chronic diseases, injuries, workplace hazards, disabilities, and environmental health threats.

The global health organization that works for children's survival, development, and protection is the a.) World Health Organization (WHO). b.) Centers for Disease Control (CDC). c.) United Nations International Children Emergency Fund (UNICEF). d.) Pan American Health Organization (PAHO).

True

True or False: In developing countries where basic needs are unmet, healthcare needs of community outweigh the needs an individual

False

True or False: Disease patterns are the same throughout the world

Natural disasters: Weather events, earthquakes, volcanoes, diseases Manmade disasters: Wars, structural collapses, accidents, riots, pollution Terrorism: May include use of weapons of mass destruction, includes bioterrorism (Review Box 29.2 and Table 29.1, page 592) -HOMELAND SECURITY -National level prevents terrorism Combination disasters Natech or NA-TECH (natural/technological) disaster—a natural disaster that creates or results in a widespread technological problem

Types of Disasters?

Such as the Carter Center and the Bill & Melinda Gates Foundation. International council of nurses -Founded in 1982, the Carter Center is a nonprofit NGO founded by former President Jimmy Carter and First Lady Rosalynn Carter and based in Atlanta, Georgia. The Carter Center's objectives include (1) to prevent and resolve conflicts, (2) to enhance freedom and democracy, and (3) to improve health and quality of life. -Founded in 2000, the Bill & Melinda Gates Foundation has local, national, and global objectives. Globally, the foundation focuses on reducing hunger and poverty, improving health through harnessing advances in science and technology to save lives in developing countries, and to improve U.S. high school and postsecondary education and support vulnerable children and families. Within Africa, the foundation has had a profound effect on improving access to antiretroviral medications and prevention and treatment for HIV, TB, and malaria.

What are Non-governmental agencies?

d.) Communication Communication is one of the biggest problems during a disaster. The reliance on telephone systems or cell phones should not be the only plan for communication during a disaster. Authority focuses on the people in charge, logistical includes focuses on storage of equipment and location of key responders, and search and rescue focuses on the search and rescue of victims.

What element of a community disaster plan investigates the citizen's reliance on telephone systems or cell phones during disasters? a.) Authority b.) Logistical c.) Rescue d.) Communication

Mitigation (Prevention): Increase surveillance -Ex: outbreak, weather Improve inspections and airport security -To check for terrorism Strengthen public health processes -Teach people handwashing/ ways to prevent disease spread Teach to prevent disease spread Identify populations at risk -Knowing who might be at risk for certain things, -Ex: mass school shooting so school children are at risk

What is the Disaster Management Cycle: Mitigation (Prevention)?

Goal: improve the health and living standards of the Americas

What is the Pan American Health Organization (PAHO)​?

b.) Air pollution Air pollution and lead poisoning directly assault human health. Noise and litter affect quality of life. Global warming affects the ecologic balance.

Which environmental stressor directly assaults human health? a.) Global warming b.) Air pollution c.) Noise d.) Litter

b.) Work Health Organization

Which global health organization disseminates global health standards? a.) United Nations b.) Work Health Organization c.) Pan American Health Organization d.) United Nations International Children's Fund

Vaccines/Immunizations Because getting a Herd immunity helps prevent disease

_____ is the most powerful and cost-effective strategy to combat many infectious diseases

Globalization

________ is the process of increasing social and economic dependence and integration across state boundaries.

100

What is the minimum number of victims involved in a mass casualty?

a.) Provide and coordinate care in shelters

Which of the following actions occur during the recovery phase of the disaster management cycle? a.) Provide and coordinate care in shelters b.) Use START triage to determine injury severity c.) Gather supplies to create a disaster kit d.) Identify disasters likely to impact a community

a.) Primary Primary prevention occurs in the nondisaster and predisaster stages. Actions during these stages includes developing local, state, and federal disaster plans; conducting drill tests; training volunteers and health care providers; and providing educational programs. Secondary measures are those taken after the disaster has occurred and tertiary measures are aimed at rehabilitation. Disaster prevention is a broad term covering all types.

You teach a community disaster preparedness class on how to find shelter during and after a disaster situation. This is an example of what kind of prevention? a.) Primary b.) Secondary c.) Tertiary d.) Disaster

Positive Coping Strategies: • Relaxation methods (muscular relaxation, deep breathing, meditation) • Exercise in moderation. • Talking to another person for support • Getting adequate rest • Positive distracting activities • Trying to maintain a normal schedule (if appropriate) • Scheduling pleasant activities • Eating healthy meals • Taking breaks • Spending time with others • Keeping a journal • Participating in a support group • Seeking counseling Maladaptive Coping Strategies: • Use of alcohol or drugs to cope • Social isolation and withdrawal • Extreme avoidance of thinking or talking about the event • "Workaholism" • Anger or violence

BOX 29.10 Positive and Maladaptive Coping Strategies?

Category A: High-priority agents include organisms that pose a risk to national security because they: • Can be easily disseminated or transmitted from person to person • Result in high mortality rates and have the potential for major public health impact • Might cause public panic and social disruption • Require special action for public health preparedness Agents/Diseases: • Anthrax (Bacillus anthracis) • Botulism (Clostridium botulinum toxin) • Plague (Yersinia pestis) • Smallpox (Variola major) • Tularemia (Francisella tularensis) • Viral hemorrhagic fevers (filoviruses [e.g., Ebola, Marburg]) and arenaviruses [e.g., Lassam, Nacgyoi]) Category B: Second-highest-priority agents include those that: • Are moderately easy to disseminate • Result in moderate morbidity rates and low mortality rates • Require specific enhancements of CDC's diagnostic capacity and enhanced disease surveillance Agents/Diseases: • Brucellosis (Brucella species) • Epsilon toxin of Clostridium perfringens • Food safety threats (e.g., Salmonella species, Escherichia coli 0157:H7, Shigella) Category C: Third-highest-priority agents include emerging pathogens that could be engineered for mass dissemination in the future because of: • Availability • Ease of production and dissemination • Potential for high morbidity and mortality rates and major health impact Agents: • Emerging infectious diseases such as Nipah virus and hantavirus

BOX 29.2 Bioterrorism Agents/Diseases?

1. Measures usually taken are not sufficient for major disasters. 2. Plans should be adjusted to people's needs. 3. Planning does not stop with development of a written plan. 4. Lack of information causes inappropriate responses by community members. 5. People should be able to respond with or without direction. 6. Plans should coordinate efforts of the entire community, so large segments of the citizenry should be involved in the planning. 7. Plans should be linked to surrounding areas. 8. Plans should be general enough to cover all potential disaster events. 9. As much as possible, plans should be based on everyday work methods and procedures. 10. Plans should specify a person's responsibility for implementing segments by position or title rather than by name. 11. Plans should develop a record-keeping system before a disaster occurs regarding: • Supplies and equipment • Records of all present at any given time (to account for everyone and to identify the missing) • Identification of victims and deceased, conditions and treatment documented, and to which facility victims are sent 12. Backup plans need to be in place for the following: • Disruption of telephone and cell phone lines • Disruption of computer data (should be downloaded weekly and stored off-site) • Protecting essential public health functions (e.g., vital records and communicable disease data)

BOX 29.9 Disaster Planning Principles?

Frequency—how often a disaster occurs Predictability—ability to determine when and whether a disaster will occur -Can now sometimes predict hurricanes and tornadoes -Cannot predict shootings, man made disasters Mitigation—actions taken to reduce loss of life and property -Take action before disaster happens -Chillicothe has a flood wall Imminence—speed of onset and anticipated duration of incident Scope—the range of the effects of the disaster -Hurricane ian affected both coast of florida= huge scope Number of casualties—number of individuals affected, injured, or killed -Direct and indirect Intensity—level of destruction and devastation -Earthquake score scale and with a higher number = worse the destruction

Characteristics of Disasters?

A disaster is any event that causes a level of destruction, death, or injury that affects the abilities of the community to respond to the incident using available resources. Mass casualty: involves 100+ individuals. Multiple casualty: involves 2 to 99 individuals. Casualties classified as: Direct victim: lose house, victim of shooting Indirect victim: Family members of a first responder that has to respond Displaced person: Has to leave their home -People who have to leave their home during a hurricane -"Evacuating" Can gather belongings before Refugee: May flee their country (famine or drought; civil unrest; war) -Sometimes nothing to return to

Disaster Definitions?

Requires interdisciplinary, collaborative team effort Network of agencies and individuals -Red cross Planning creates a quicker and more efficient response. -Ensures resources are available -Roles and responsibilities of all personnel and agencies, both official and unofficial, are delineated. -Priority resources- water, housing, food, psychological help, medication

Disaster Management?

Primary prevention—preventing occurrence of disaster or limiting consequences Secondary prevention—strategies are implanted once the disaster occurs Tertiary prevention—recovery

Disaster Prevention Levels?

Can affect access to health -Food; water; safety access?

Disasters related to Community Health?

Countries can learn much from one another.​ -Can learn about healthcare reform (what did and didn't work) and about technology from US -Can learn from developing countries the use of primary health care providers Research and development must be relevant to infectious diseases that affect the poor. Market- and population-based approaches need to learn from each other. -Market: base it on capital gain --Where everyone pays all this money in to try and treat diseases but ends up making these businesses a ton of money but it should be a more health promotion instead Nursing role is less traditional because of the rapidly changing health care environment. -Doctors without borders All nurses in the world must understand and learn from one another. Nurses are the largest cadre of health care professionals.​ -Have the potential to make a change Community public health nurses improve access to care for the most vulnerable and hard-to-reach groups in any country. -The degree for NP helps get access to more people because it takes less time to become one than an actual doctor so there can be more of an access

International Health Care Delivery Systems?

Population growth presents a threat to health and the economy in many nations.​ -Too many people, not enough resources -Overwhelms the system by not being able to keep up with resources for the amount of the population The population is projected to reach 9.8 billion by 2050 and 11.2 billion by 2100. Large populations create pressure and contribute the overall health of a community Life expectancy varies significantly in different countries.​ Example: Girls born in Japan 86.8 years, Zambia 64.7 years; Population density not evenly distributed -Living conditions differ, might place holistic health at a higher standard in Japan leading to a longer lifespan -Zambia infrastructure: do they have access to immunizations? Clean drinking water? Malnutrition? 56% of the deaths in Africa are d/t communicable disease, maternal/fetal health and nutrition Goal is to improve Quality of Life (QOL) -You do not care to exercise everyday if you do not have clean drinking water -It is important to have the basic necessities first (clean drinking water) before trying to get them to do other health improving behaviors -If you get basic necessities under control then it is important to do health promotion and education: exercise, vaccines, doctor appointments -China, India, United States, and Indonesia are where 50% of the world's population live

Population characteristics?

c.) Local

Select the level of government that conducts mock disaster drills? a.) National b.) State c.) Local

a.) National

Select the level of government that prevents terrorism a.) National b.) State c.) Local

Chemical Agent: Sarin (nerve agent) Lethality: High Treatment: Move to fresh air; wash skin; drugs have limited effectiveness Impact: Likely nerve agent; chemicals needed to produce are banned by International Chemical Weapons Convention Chemical Agent: VX (nerve agent) Lethality: Very high Treatment: Move to fresh air; wash skin; drugs have limited effectiveness Impact: Not likely weapon; difficult to manufacture Chemical Agent: Tabun (nerve agent) Lethality: High Treatment: Move to fresh air; wash skin; drugs have limited effectiveness Impact: Easy-to-manufacture nerve agent; likely agent to be used Chemical Agent: Chlorine (pulmonary agent) Lethality: Low Treatment: Move to fresh air; wash skin; no antidote Impact: Readily available; likely agent because of availability; breaks down with water Chemical Agent: Hydrogen cyanide (blood agent) Lethality: Low to moderate Treatment: Move to fresh air; wash skin; some drugs mitigate effects Impact: Industrial product; some chemicals used to produce it are banned; likely agent because of availability

TABLE 29.1 Chemical Agents of Mass Destruction?

a.) An 18-year-old client with a previous gunshot wound b.) A 50-year-old client who saw people die in the disaster c.) A 23-year-old client experiencing extreme fear e.) A 35-year-old client with a history of schizophrenia Risks for PTSD include living through dangerous events or traumas; having a history of mental illness; getting hurt; seeing people hurt or killed; feeling horror, helplessness, or extreme fear; having little or no social support after the event; and dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home.

The community health nurse is working in an emergency shelter with displaced families. Which clients have risk factors for posttraumatic stress disorder (PTSD)? (Select all that apply.) a.) An 18-year-old client with a previous gunshot wound b.) A 50-year-old client who saw people die in the disaster c.) A 23-year-old client experiencing extreme fear d.) A 60-year-old client who had little social support before the event e.) A 35-year-old client with a history of schizophrenia

a.) World Health Organization (WHO) The WHO introduced the goal of "health for all." The CDC strives to prevent and control infectious and chronic diseases, injuries, workplace hazards, disabilities, and environmental health threats. UNICEF focuses on child and women's health.

The concept of "health for all by the year 2000" was initially introduced by which international organization? a.) World Health Organization (WHO) b.) Centers for Disease Control (CDC) Incorrect c.) United Nations International Children Emergency Fund (UNICEF) d.) National Institutes of Health (NIH) Healthy People 2000

d.) Florence Nightingale. Florence Nightingale's legacy serves as the foundation for community health nursing in the global health care arena. She channeled her energy into all aspects of health from the care of wounded soldiers at Scutari to the broad public policies that affected health in her time. The other three women were instrumental primarily for their contributions in the United States.

The first nurse to establish international links and networks was a.) Clara Barton. b.) Mary Breckenridge. c.) Dorothea Dix. d.) Florence Nightingale.

b.) malaria. Malaria is a life-threatening parasitic disease transmitted by mosquitoes. Malaria causes more than 212 million acute illnesses and 429,000 deaths annually. AIDS is a disease caused by the HIV virus. Tuberculosis is an infectious disease caused by the tubercle bacillus. Hepatitis is inflammation of the liver.

The life-threatening parasitic disease that causes nearly 500,000 deaths annually is a.) AIDS. b.) malaria. c.) tuberculosis. d.) hepatitis.

d.) Green Green is for the wounded or individuals with minor injuries who are able to walk and to wait several hours before receiving medical treatment. Red is for those with life-threatening injuries but have a high probability of survival, yellow is for those with systemic but non-life-threatening complications, and black is for the deceased or those with nonsurvivable injuries.

The nurse at the disaster site is using the SMART triage system. What color triage tag would be provided to an ambulatory individual with a superficial cut on the left elbow and bruise to the right hand? a.) Red b.) Yellow c.) Black d.) Green

Surveillance to ensure clean drinking water, food, shelter, and medical care -Provide guidance if there is an outbreak

What is Centers for Disease Control and Prevention (CDC)?

Supports citizens and first responders to build, sustain, and improve the capacity to prepare for, protect against, respond to, recover from, and mitigate all hazards -Published in-depth guide for citizen preparedness, Are you ready? -Funding! -Will stage in areas to be ready to respond -Give people the stuff they need to make it through a disaster

What is The Federal Emergency Management Agency (FEMA)?

Goal: direct/coordinate international health efforts, disseminate global health standards/guidelines, help countries address public health concerns -"Health for all"; Declaration of Alma-Ata Goal: everyone will be healthy by the year 2000 and they keep pushing it back by 10 years -Focuses on upstream idea of preventing these diseases before they are bad diseases Primary Healthcare seven elements: -Health education regarding disease prevention and cure, proper food supply and nutrition, adequate supply of safe drinking water and sanitation, maternal and child health care, immunizations, control of endemic diseases, and the provision of essential drugs. According to the declaration, a primary health care system should provide the entire population with universal coverage; relevant, acceptable, affordable, and effective services; a spectrum of comprehensive services that provide for primary, secondary, and tertiary care and prevention; active community involvement in the planning and delivery of services; and integration of health services with development activities to ensure that complete nutritional, educational, occupational, environmental, and safe housing needs are met. Book Definition: The concept of primary health care stresses health as a fundamental human right for individuals, families, and communities; the unacceptability of the gross inequalities and disparities in health status; the importance of community involvement; and the active role of all sectors.

What is World Health Organization (WHO)​?

Triage- identify and separate individuals quickly based on injury severity or treatment needs Decontamination, if needed, occurs at the scene START triage/JumpSTART triage- "Simple triage and rapid treatment" -Put them in a group for the needs they have -"Can hear me and you can walk stand up and follow me" -Don't have a significant injury that needs immediate treatment -Then assess other individuals regarding ABCs System of colored tags designates both seriousness of injury and likelihood of survival: Green—minor injury Yellow—urgent but non-life-threatening Red—life-threatening injury; immediate intervention needed Black—dead or expectant

What is disaster triage?

Globalization - the process of increasing social and economic dependence and integration as capital, goods, persons, concepts, images, ideas, and values cross state boundaries is inextricably liked to the benefits and challenges of our times. -Because goods and services are so easy to go across state borders (even across the globe) -Also easy to trade diseases now Nurses must study models of health promotion, community, assessment, community empowerment, service learning, and sustainability to improve health care access and efficient and effective delivery. Lifestyles, health and cultural beliefs, infrastructure, economics, and politics affect existing illnesses and society's commitment to prevention. ​ -Infrastructure- what a country is built on: how do we distribute good services and foods? What are our policies? Disease patterns vary throughout the world. ​ -Different resources (infrastructures) -If we are not putting emphasis on getting rid of human waste, it could seep into drinking water system and cause issues (sanitation) -Health needs of community outweigh individual Racial, ethnic, and access disparities exist within and between countries. -Impoverished and minorities -#1 cause of children death is accidental injuries and #2 is suicide -Stroke/MI is most prevalent throughout whole world Now more filled with chronic diseases rather than infectious -People have better understanding on infectious prevention What contribute to chronic disease: -Obesity (foods, sedentary lifestyle) -Less physical jobs [Contribute to: Heart disease, high BP, diabetes To prevent: Educate on how to avoid it, what causes it, what choices you could make To limit chronic disease changes: In early 80s// 90s there was a lot of tobacco advertising and now there is rarely any commercials or advertisements promoting them; so now there are commercials that talk about the bad effects of these What changes have we made to have less infectious disease: More Vaccines- prevents the spread of disease and most cost effective -No smoking in public buildings -Don't sell tobacco in pharmacies -Discovering the etiology of these diseases -Developed treatments -50% of the world's population lives in cities

What is globalization?

Principal agency in the US government for protecting for health and safety of all -Provide surveillance for diseases (where and why they occur) -Provide guidelines for decreasing transmission -The agency has remained at the forefront of public health efforts to prevent and control infectious and chronic diseases, injuries, workplace hazards, disabilities, and environmental health threats and to protect the health of international travelers through advisories and immunization and vaccine recommendations.

What is the Centers for Disease Control and Prevention (CDC)?

Recovery: Restoration of public services Provide and coordinate care in shelters -If lost or can't access their homes Reassess health needs of the population Provide stress counseling Assess for post traumatic stress disorder (PTSD) Make referrals for psychological treatment Cleanup and repairs begin Financial impact evaluated -For fema? To give us money there needs to be a larger population effect

What is the Disaster Management Cycle:

Response: National Incident Management System (NIMS) -Structured process to manage disaster -Clear chain of command -Effective communication is goal -Use triage and communication is important for all the systems responding What do we do? -Shelter in place (Table 29.2, page 602) -Evacuate: Like pre hurricane -Search and rescue

What is the Disaster Management Cycle:

Preparedness: Personal/family preparedness -Action plan: Meeting place for everyone to go? -Creating a disaster kit (Box 29.7, page 597) Professional preparedness -Nurses: Have a bag of clean scrubs in the car during winter to have just in case you have to stay at the hospital over night Plans created from threats identified in mitigation phase -Local, State and National levels Communication is key Practice, practice, practice- disaster drills Planning Principles, Box 29.9, page 601

What is the Disaster Management Cycle: Preparedness?

Sustainable: -Good communications -Community support -Grants, fundraising, loans for funding (many resources so if one fails you have back up) Unsustainable: -Inaccessible healthcare -Does a community want it? -Do we have healthcare professionals/people who want it? -Lack of respect -One source of funding and it does work then it collapses

What is the Integrated Model of Sustainability and Innovation (IMSI)?

193 member nations who are committed to world peace and security through international cooperation

What is the United Nations (UN)​?

Founded to assist millions of sick/hungry children in war-ravaged Europe & China

What is the United Nations International Children's Fund (UNICEF)​?

Improvement of health for individuals living in areas that lack economic development by providing low interest loans/grants -Promote health and decrease infectious disease rates -The US holds a lot of these loans/grants

What is the World Bank​?

c.) Honeymoon phase

What is the community response to disaster called when survivors gather and talk about the disaster? a.) Heroic phase b.) Disillusionment phase c.) Honeymoon phase d.) Reconstruction phase

c.) National Incident Management System

What is the name of the standardized system used by first responders and healthcare providers during disaster response? a.) United Response to Tragedy Plan b.) American Disaster Response System c.) National Incident Management System d.) National Disaster Prevention Plan

a.) Flashlight and extra batteries b.) Cash and coins c.) Whistle e.) Three day supply of water f.) Extra clothing

What items would you include in a disaster supply kit for one person? (select all that apply) a.) Flashlight and extra batteries b.) Cash and coins c.) Whistle d.) Favorite board game e.) Three day supply of water f.) Extra clothing

c.) Federal Emergency Management Agency (FEMA) FEMA's mission is to support citizens and first responders to ensure that as a nation everyone works together to build, sustain, and improve the capacity to prepare for, protect against, respond to, recover from, and mitigate all. The other agencies may be peripherally involved in national disasters, but it is not their primary focus.

Which agency has a mission to support citizens and first responders to ensure that as a nation everyone works together to build, sustain, and improve the capacity to prepare for, protect against, respond to, recover from, and mitigate all? a.) American Red Cross (ARC) b.) National Institute for Health (NIH) c.) Federal Emergency Management Agency (FEMA) d.) Centers for Disease Control and Prevention (CDC)

c.) A tornado resulting in flood and destruction of electrical systems for a community A natech disaster is a natural disaster that creates or results in a widespread technological problem. A flood covering crops and recreational areas of a geographic area does not mention a technological problem, and a terrorism attack and a nuclear accident are not natural disasters.

Which describes a NA-TECH (natural technological) type of disaster? a.) A flood covering crops and recreational areas of a geographic area b.) A terrorism attack causing major interruption of communication technologies c.) A tornado resulting in flood and destruction of electrical systems for a community d.) A nuclear accident at a power plant causing evacuation of people in an urban community

a.) AIDS d.) Parasitic infection e.) Dengue fever Among the infectious diseases that contribute to higher mortality rates in developing countries are AIDS, tuberculosis (TB), malaria, hepatitis B, rheumatic heart disease, parasitic infection, and dengue fever. Although these diseases claim the lives of millions, it is estimated they could be reduced by up to 50% through effective public health interventions.

Which diseases contribute to higher mortality rates in developing countries? (Select all that apply.) a.) AIDS b.) Hepatitis C c.) Cancer d.) Parasitic infection e.) Dengue fever

d.) To act as command station for disaster responders to report to and get assignments The staging area is the onsite command station. Dispatch responders should report to this area and check-in. This allows everyone to be accounted for and to gather assignments. The other options are not appropriate uses for the staging area in a disaster.

Which is the purpose of the staging area in a disaster plan? a.) A triage area outside the hospital, supplying first aid and transport to medical facilities b.) A stage for entertainment to cheer up disaster victims c.) To provide sheltered area for displaced victims to sleep, eat, and bathe d.) To act as command station for disaster responders to report to and get assignments

b.) Heroic phase The heroic phase of a community's reaction to a disaster involves people feeling the need to rush to help people survive the disaster. Medical personnel may volunteer to work long hours without sleep and in dangerous conditions to care for patients. During the honeymoon phase, people who have survived the disaster get together to talk about their experiences. People begin to look to the future during the reconstruction phase and during the disillusionment phase people recognize that many things are different, and much needs to be done to adjust to the current situation.

Which phase of the community response to disaster includes medical personnel contributing long hours of volunteer work helping unfamiliar people after a disaster? a.) Honeymoon phase b.) Heroic phase c.) Reconstruction phase d.) Disillusionment phase