Public Health Final

What challenges do home health nurses face today?

- Ethical issues (e.g., reimbursement criteria, access to care) - role development (e.g. high-technology nursing, hospice nursing) - opportunities for research (e.g. quality of care, cost-effectiveness, client safety)

What is the goal of the Omaha System research?

- To develop a structured and comprehensive system that could be both understood and used by members of various disciplines - to foster collaborative practice

What does care management involve?

- a program or process that established systems and monitors the health status of individuals, families, and/or groups. The program or process develops planning and intervention activities, as well as targeted evaluation outcomes for the client and program. - Includes the following strategies: use management; critical paths; disease management; demand management; and case management.

What does advocacy involve in case management?

- activities for the purpose of protecting the rights of others while supporting the client's responsibility for self-determination -involves informing, supporting, and affirming a client's self-determination in health care decisions.

What are some work place hazards?

- exposure to biological - chemical - environmental & mechanical - physical - psychosocial agents.

The field of bioethics began to emerge and influence nursing in?

1960's

Nurses who do not speak or understand the client's language should use what?

An interpreter

What makes ethical decision making more challenging?

Cultural diversity & moral distress

What is hospice?

Palliative care of the very ill and dying, reducing distress from physical, emotional, and spiritual symptoms

What level of prevention is hearing/vision screening?

Secondary

What are one of the guidelines of the American Academy of Pediatrics (AAP)?

That school health programs teach children the importance of injury prevention because injuries are the leading cause of death in children and most injuries are preventable

Is there scientific evidence of possible health effects for chemical compounds?

There is a lacking.

Why are vulnerable populations more sensitive to risk factors than those who are more resilient?

They are often exposed to cumulative risk factors.

What questions involve a nursing historical approach?

What worked in the past? What did not work? What lessons can be learned about health care, nursing, and the communities in which care is provided?

_______-_____________ __________ ______________ must be investigated and control strategies implemented to reduce exposure.

Work-related health problems

What important skill for nurses allow for an effective and powerful vehicle for initiating and implementing healthful challenges?

Working with groups

Population

a collection of individuals who share one or more personal or environmental characteristics. The term population may be used interchangeably with the term aggregate

Occupational health nursing is an ________________ practice specialty.

autonomous

The Healthy People program

brought a renewed emphasis on prevention to public and community health nursing

What is one of the main issues in faith community nursing?

confidentiality is of utmost importance in parish nursing practice

Important trends that affect the health care (3)

demographic, social, economic, political, and technological trends

By 2002, school nurses provided:

direct care, health education, counseling, case management, and community outreach.

What kinds of conflicts may emerge when performing in the advocacy role?

full disclosure of information, territoriality, accountability to multiple parties, legal challenges to client's decisions, and competition for scarce resources.

Home nursing care has its roots in public health nursing, with an emphasis in what? (3)

health promotion, illness prevention, and caring for people in the contexts of their communities.

What is the main focus of faith community nurse services?

health, healing, and wholeness within the context of the church. Although the emphasis is on health promotion and disease prevention throughout the life span, the spiritual dimension of nursing is central to the practice.

In the early 1900s, school nurses screened children for:

infectious diseases

What is culture?

is a learned set of behaviors that is widely shared among a group of people; the culture of people helps guide individuals in problem solving and decision making

How is parish nursing different from other nursing positions?

it contains an affiliation with a church or congregation and incorporates specific spiritual care into nursing care

Since the advent of medicare, home health, hospice, and palliative care agencies have monitored the quality of care to their clients as a _______________ ____________________ for certification as a home health agency.

mandatory requirement

What knowledge and skill requirements are needed for case management?

o Knowledge of community resources and financing methods o Written and oral communication and documentation skills o Negotiation and conflict-resolution skills o Critical thinking processes to identify and prioritize problems from the view of the provider and client o Application of evidence-based practices and outcome measures

What is the goal of case management?

o to promote respect, understanding, and accuracy of communication of all team members' points of view o to promote quality services provided to clients o reduce institutional care while maintaining quality processes & satisfactory outcomes o to manage resource use through protocols, evidence-based decision making, guideline use, & disease management programs o to control expenses by managing care processes & outcomes

The most sustainable individual and system change comes when?

people who live in the community have actively participated.

Primary Care (3 C's)

personal health care system that provides for first contact and continuous, comprehensive, and coordinatedcare.

The Omaha System offers benefits in three principal areas:

practice, documentation, and information management. o These areas are of concern to community health educators and students, as well as community health practitioners and administrators.

Assessment

systemically collecting data on the population, monitoring of the population's health status, and making information available on the health of the community

What considerations should be made when selecting an interpreter?

the clients' cultural needs and respect their right to privacy (do not use child/parent).

Why is case management complex?

the coordinating activities of multiple providers, payers, and settings throughout a client's continuum of care

Metropolitan Life Insurance Company

the first insurance-based program in 1909 to support community health nursing services

Case management is typically an interdisciplinary process in which the client is:

the focus of the plan.

How does a faith community nurse sustain their role?

the nurse needs to heal and nurture herself or himself while supporting individuals, families, and congregation communities in their healing process.

What is the OMAHA system?

the only ANA-recognized terminology developed initially by and for practicing nurses in the community

Cultural assessments help nurses understand what?

understand clients' perspectives of health and illness and thereby guide them in discussing culturally appropriate interventions.

What is one of the services that health ministries can provide?

visiting & praying with those in need

What is public health?

where members of society do collectively to ensure that conditions exist in which people can be healthy

What are the 4 major health care functions of the federal government?

· direct service, financing, information, and policy setting.

The OSHA of 1970 states that workers must:

· have a safe and healthful work environment.

What are some vulnerable populations?

· poor or homeless persons, pregnant adolescents, migrant workers, severely mentally ill individuals, substance abusers, abused individuals, people with communicable diseases, and people with sexually transmitted diseases.

What should primary care providers need to ask more during their assessment in regards to occupational health?

"where were you previously employed & what did you do there?" (IPREPARE pneumonic)

What is the primary goal of hospice care?

- help maintain the client's dignity and comfort -Alleviating pain -encouraging the client, family, and friends to communicate with each other about essential sensitive issues - coordinating care to ensure a comfortable, peaceful death

The scope of occupational health nursing practice is broad, including:

- worker and workplace assessment and surveillance - case management - health promotion - primary care - management and administration - business and finance skills - research.

Epidemiological methods are used to:

-describe health and disease -to investigate the factors that promote health -or influence the risk for, or distribution of, disease. This knowledge can be useful in planning and evaluating programs, policies, and services and in clinical decision making

What are the processes of public health advocacy? (5)

-identifying problems -collecting data -developing and endorsing regulations and legislation -enforcing policies - assessing the policy process

Nurses are more than able to fill the gap between personal care and public health because they have (5)

-skills in assessment -health promotion -disease and injury prevention; -knowledge of community resources -the ability to develop relationships with community members and leaders.

Basic epidemiological concepts include:

-the interrelationships among the agent, host, and environment (the epidemiologic triangle) -the interactions of factors, exposures, and characteristics in a causal web affecting the risk for disease -and the levels of prevention corresponding to stages in the natural history of disease.

What is the leading chronic illness among children & adolescents in the US and leading cause of absenteeism among children?

Asthma

How can a school nurse be a consultant or be involved in a community outreach?

Consultant = consult nurse on what kind/how a playground could be built at the neighborhood park Community outreach = health fairs

What is the goal of community health nursing practice?

Continuity of care. • It requires making linkages with services to improve the client's health status.

What is an example of primary prevention in Occupational Health?

Donning appropriate PPE

__________ is the establishment and arrangement of events to facilitate learning.

Education

What component of ethics that focuses on the process of how ethical decisions are made?

Ethical decision making

Who are integral part of home health care?

Family members, including any caregiver or significant person who takes the responsibility to assist the client in need of care at home,

What is a required process in home health and hospice care? It is inherent in the definition of home care.

Interprofessional collaboration

___________ is the process of gaining knowledge and expertise and results in behavioral changes.

Learning.

During conflict, what can move conflicting parties towards an outcome?

Negotiations

Who is at most risk for new injuries & should receive the most time regarding education and follow-up evaluation?

New workers employed

The number and types of laws influencing health care are increasing. Because of this, what involvement is necessary to nurses?

Political processes

Which prevention involves interventions to reduce the incidence of disease by promoting health and preventing disease processes from developing?

Primary

What should each nursing assessment include regarding environmental exposures?

Questions and observations about intended and unintended environmental exposure

What level of prevention is screening for lice & debunking myths?

Secondary

Which prevention includes programs (e.g., screening) designed to detect disease in the early stages, before signs and symptoms are clinically evident, to intervene with early diagnosis and treatment?

Secondary

What is the #1 work injury?

Strains/sprains

What level of prevention is treating children with asthma?

Tertiary

Which prevention provides treatments and other interventions directed toward persons with clinically apparent disease, with the aim of lessening the course of the disease, reducing disability, or rehabilitating the client?

Tertiary

What responsibilities do nurses have in regards to environmental health issues? (2)

To be informed consumers and advocates for citizens in their community

There is no safe occupation or profession. True or False?

True.

What are legal issues involving liability from case managers?

When the following conditions are met: o The provider had a duty to provide reasonable care. o A breach occurred through an act or omission to act. o The act or omission caused injury or damage to the client.

When should a nurse perform a cultural assessment?

When they meet a new client

Nurses in community health have ____________ and ________________________within their scope of practice.

advocacy & case management functions

What unique characteristic affects several components of nursing practice in the home-care setting, including establishing trust, developing care partnerships, selecting interventions, collecting outcomes & data, ensuring client safety, and promoting quality?

because health care providers practice in the client's environment in a number of types of settings.

1988 Future of Public Health

documented the reduced political support, financing, and impact of increasingly limited public health services at the national, state, and local levels.

What is the goal of the World Health Organization?

· the attainment by all people of the highest possible level of health.

A clients need can vary with what? (4)

· their age, education, religion, and socioeconomic status.