Vulnerable Pops Test 3
Vaccine and Infectious Disease Prevention
-CDC lists the recommended vaccine schedule -Vaccine information statements (VIS)Must be given to anyone getting a vaccineGives them info about adverse outcomes, what to expect -Precaution needed when giving immunizations, What vaccine, Who should be given the vaccine, How they should be given, How they are to be transported, stored, and administered -Vaccine adverse event reporting system Healthcare providers are required to report certain adverse effects to vaccines to the VAERS
Medicaid
o - federal and state § Poverty (indigent/poor), people with disabilities, children, and pregnant women § For some states it is all adults below the poverty line § Eligibility depends on size of the family and income § Title XIX of the social security act
Primary Vaccine Failure
When the vaccine does not stimulate any immune response -could be because it was improperly stored, not handled properly.
Proceed-Precede Framework
§ An approach to planning that examines factors contributing to behavior change: · Predisposing- knowledge, attitudes, behavior, beliefs, and values before intervention that affect willingness to change · Enabling- environment or community of an individual that facilitates or presents obstacles to change · Reinforcing factors- the positive or negative effects of adopting new behavior (social support)
Individual Relations
§ Autonomy, independence (do not consult anyone) § Group goal become secondary § Take things into their own hands, do not look to family or group for approval
Clock Drawing Test
-Alzheimer's screening Tell person the time, ask them to draw a clock Assess for dementia -Screenings are not diagnostic
Mini-Mental State Exam
-Alzheimer's screening Used to assess cognitive impairment Asks questions in a series
Preferred Provider Organization (PPO)
§ Blank negotiate with healthcare providers for services at a reduced rate in exchange for a guaranteed increase in consumers § Negotiated reimbursement rate allows the cost of the plan to be somewhat controlled § Offered cost incentives for choosing healthcare within plans network HCPs § Can see pretty much anyone, more flexible than blank
Functional Aging
(ability to perform ADLs) That you are "only as old as you feel" How well are you able to do your ADLs? Do you still feel you are intelligent? It is what you are capable of How well are they able to FUNCTION
Chronological Aging
(number of years a person has lived) Young-old 65-76 Middle-old 75-84 Old-old 85+ Advanced technology and medical care is increasing our lifespan
Purpose of Youth Risk Behavior Survey
-Conducted by the CDC, done every 2 years -Reports prevalence of health risk behaviors (CDC found these six things needed to be focused on according to the YRBSS) -Alcohol, drugs, sex, anything. -Injury and violence -Tobacco use -Poor nutrition -Lack of physical activity -Sexual behavior resulting in STDs or unwanted pregnancy Purposes -Determine prevalence of health risk behaviors -Assess where they increase, decrease, or stay the same over time -Examine co-occurrence (like STDs and pregnancy, smoking and drinking) -Provide comparable data among subpopulations of youth -Provide comparable national, state, territorial, tribal, and local data -Monitor progress towards achieving health people 2030 goals
Factors That Impede Men's Health
-Risk taking -Infrequent use -Less preventative health -Difference in orientation -Less reporting -May be the primary worker -Curative rather than preventative -Reluctance to take time off work
Health Risk Behaviors in Rural Areas
-Rural residents in southern states have higher rates of obesity, smoke use, smokeless tobacco, sedentary lifestyles -Rural west has higher rates of alcohol and smokeless tobacco use -Lower risks for smoking, seat belt use, and obesity -intentional injuries most often due to firearm use -working with agriculture means they have to work with a lot of heavy equipment, high risk for accidents -unintentional injuries leading cause of death in the united states -the rate of unintentional injuries in rural areas is 2X higher than urban -suicide is the second leading cause of death in rural America
Mini-Cognitive Test
-Screening for Alzheimer's -Instruct patient to listen carefully and remember three unrelated words then to repeat. -Have them do the clock test -Ask them to repeat the words -Patient gets three tries -Assesses them for item recall ability
Vital Statistics
-Strategy for assessing the community o official registration records of births, deaths, marriages, divorces, and adoptions § Reported every year
Census Data
-Strategy for assessing the community § Metropolitan statistical areas: large metropolitan areas that extend beyond formal city boundaries
Men's Health
-Use of medical care -Men are less likely to seek care -Men have shorter lives -Death rates of almost all causes are higher for men -Males lead females in mortality rates in each leading cause of death -Women more likely to be chronically ill, whereas men are at grater risk for death -No specific specialty for men's health -Men tend to see themselves as being in better health than they may actually be in -Men have fewer routine checkups and screenings, seek ambulatory care less often than women, delay medical treatment (so they are sicker when they do seek help) -Males are less likely than females to participate in the data collection process - they report less about what issues they may be having
Multi-Causation
There are multiple factors for the cause of disease Interaction among the host (human), the infectious agent, and the environment
Secondary Vaccine Failure
Waning of immunity after the initial immune response
Seasonal
in one place and work when labor is needed (typically summer)
Migrant
move from place to place, migrate to where the work is
Education (determinant of health)
o People with higher levels of education are more likely to be healthier and live longer o Focus on providing high-quality educational opportunities for children and adolescents - and on helping them do well in school o Children from low-income families, children with disabilities, and children who routinely experience forms of social discrimination - likely bullying - and more likely to struggle with math and reading o oAlso, less likely to graduate from high school or go to college o oLess likely to get safe, high-paying jobs and more likely to have health problems like heart disease, diabetes, and depression o Some children live in places with poorly performing schools, and many families can't afford to send their children to college o The stress of living in poverty can also affect children's brain development, making it harder for them to do well in school o Interventions to help children and adolescents do well in school and help families pay for college can have long-term health benefits
Social and Community Context (determinant of health)
o People's relationships and interactions with family, friends, co-workers, and community members can have a major impact on their health and well-being. o Focuses on helping people get the social support they need in the places where they live, work, learn, and play. o Positive relationships at home, at work, and in the community can reduce the negative impact on healthy and safety throughout life. Those with complex backgrounds like children with parents in prison often don't get the support they need.
Proceed Framework
o guides the implementation and evaluation of the programs § Policy, regulation, resourcing, organizing -Policy -Regulatory -Organizational -Constructs in -Educational and -Environmental -Development
Active Acquired Immunity
- exposure to a specific infectious agent, either - you produce your own antibodies either by...Being infected by a pathogen (may be called "naturally active acquired") Vaccine (may be called "artificially active acquired")
Natural Immunity
- nothing has to happen -Innate -Given to you
Cultural Barriers to Migrant and Seasonal Farm Workers
-Barriers cause little to no preventative care -Provider shortages, it costs a lot of money to start a health care facility in a rural area, it's a risk for the company. -Healthcare sometimes is not a priority for them because they might have to go through a lot of work to get care Poorest health, least access -Can be a really tight nit group, they might not trust a healthcare provider -They really need to trust their healthcare provider -Cultural, linguistic, economic, mobility barriers
Herd Immunity
-State in which those are not immune to a disease are protected by the rest of the population being immune -80% vaccinated or otherwise immune
Community Based
A nurse is working at the health department in French town, providing a flu shot for a resident. Is this community health or community based?
Direct Transmission
Direct from and infected host or reservoir to another uninfected host Physical contact or direct projections of mucous secretions by droplet spray to conjunctiva or mucous membranes of the uninfected host
Factors that Contribute to Homelessness
Being male - tend to be risk takers (idk she said this in a lecture) Shortage of affordable housing - Housing is considered affordable if it costs a renter or owner no more than 30% of his or her income Income insufficient to meet basic needs Inadequate and scarce support servicesRemember, these are contributors, not cause
Factors Affecting Child and Adolescent Health
Health habits children and adolescents pick up commonly come from parental habits Issues start all the way back during pregnancy Make sure mom gets the prenatal care she needs Breast feeding has a positive impact on child's health Parents' or caregivers' income, education, and stability Poverty is the greatest threat to a child's health Less access to food, shelter, health care More likely to have health problems Security and safety of the home Nutritional and environmental issues Health care access and use
Glaucoma
Increase of pressure Acute and chronic forms Can be extremely dangerous if acute Leading cause of blindness in America No cure! There are treatments for the symptoms though
Rural and Migrant Health
Lack of access to primary care, general health services, health insurance decreased access to healthcare because they do not have as many offices out in rural areas people who live in rural areas tend to be uninsured
Cataracts
Leading cause of visual impairment in the elderly Clouding of the lens Can be surgically removed and cured!
DNR
Patient does not want any kind of resuscitation if their heart stops beating, if they stop breathing, etc. Must be put in as an order by the physician
Resistance
Person's ability to ward off infection (keeping infection away) overall good health, good nutrition, making good choices in terms of health behaviors.
Durable Power of Attorney
Power you give to someone to take care of your medical decisions once you are incoherent/incapacitated Allows a competent individual to designate health care proxy or surrogate to make decisions Person can also make decisions regarding property and financial matters
Living Will
Something you create while you are still alive to designate what you want to be done once you become incoherent/die Must be competent in order to create and sign this document
Environmental Health History
Take an IPREPARE questionnaire I - investigate potential exposuresP - Present work (what work the person is currently doing)R - residence (where they live)E - Environmental concerns P - Past work (what did they do for work previously)A - ActivitiesR - referrals and resources E - Educate (tell them how to decrease their exposure to bad stuff)
Indirect Transmission
Vectors - animals who can transmit infectious agents through biochemical and mechanical routes Fomites - inanimate objects Ex - doorknobs, tables, hard surface objects
Women's Health
Women are more likely than men to be hospitalized Women are more likely than men to be disabled from chronic conditions Women have fewer disabilities overall, though Women are more likely than men to have surgery; many surgeries relate to reproductive health Women tend to be sicker even though they are living longer livesFor rates:Women are higher for disability, hospitalization, and morbidity But when men do go to the hospital, they stay for longerMen are higher for mortality Morbidity - illness Mortality - death
Passive Immunity
antibodies given to a personEx: mother to fetustemporary
Medicare
o - only federal 65+, end stage renal disease, (ALS was also included in the book
Patient Protection and Affordable Care Act
o Also called the healthcare reform act o One of the primary intents is to reduce the number of uninsured Americans, increase coverage o All U.S citizens and legal residents mandated to have qualifying health coverage · Either individually purchased, acquired through employers, or provided with federal plans o Changed eligibility requirements for Medicaid and expanded CHIPS · Allowing coverage of childless adults with incomes up to 133% of the federal poverty line o Subsidized premiums for lower- and middle-income families
Assessment (Health Planning Model)
o Based on Hogue's group intervention model in need of population focus o Aims to Improve aggregate (a community or group) health o Applies nursing process to larger aggregate within systems framework (literally just the nursing process but no diagnosis) · Specify the aggregate (group) to be studied · Describe the group's specific characteristics: sociodemographic, health status, suprasystem influences · Do a literature review and provide relevant info · Identify the group's specific health problems and their needs
Microscopic Conceptualizations of Community Health Problems
o the individual/patient is the blank § Focuses health problems of interest in a specific person/small group § Often emphasizes behavioral responses to an individual's illness or lifestyle patterns
Thinking Upstream
o Blank is thinking of how to prevent things from happening, rather than doing damage control once something bad has already happened o Focuses on true prevention, not just treating symptoms o Preventative intervention before any problem happens o If an outbreak has already happened, there is no blank o It is primary prevention! Being proactive! o "modifying economic, political, and environmental factors that are precursors of poor health" § I like to think of it like from a policy perspective. Blank would be saying "maybe our youth will have health problems because of looking at their phones. Let's start an initiative (law, policy, idk) now to promote decreased time on the phone so that problem doesn't happen"
To Err is Human
o Defines safety as "freedom from accidental injury" and defines error as "the failure of a planned action to be completed an intended or the use of a wrong plan to achieve and aim" o Four messages § The magnitude of harm that results from medical errors is great § Errors result largely from systems' failures not individual failures § Voluntary and mandatory reporting programs are needed now to improve patient safety § The IOM committee and others call on health care systems to focus on error and reduction as an important part of their operations and to embrace organizational change and needed to reorient error reddened systems and process o Report by IOM (national academy of medicine) § Talks about how errors occur it is usually a systematic problem, not necessarily an individual problem. o Goal is to correct the SYSTEM
Example of Macro and Micro
o EX: Child with lead poisoning § Micro: focusing on child and family for treatment and getting it removed from home § Macro: examining trends the prevalence of lead poisoning over time, estimating the percentage of older homes in the neighborhood that may contain lead pipes o Ex: 59 YO female obese, HTN, DM § Community nurse focusing on health issues - microscopic (its individualized) § Community health nurse provides community-based teaching sessions - macroscopic (addressing with a large audience) o Nursing interventions § Micro - focus on an individual § Macro - focus on modifying social or environmental variables
Purpose of Case Management
o Has emerged as an interventions strategy for quality improvement initiatives. Improve the coordination of services provided to clients who're enrolled in a care management program. o Term that describes a wide variety of patient care coordination programs in acute hospital and community settings o Client centered: helps the client proceed through a complex, fragmented, and often confusing health care delivery system and achieves specific client centered goals o System centered: recognizes that health care resources are finite o Used to promote and integrate patient coordination of clinical service linking to community services and agencies o Aim to provide a service delivery approach to ensure: § Cost effective care § Alternatives to institutionalization § Access to care § Coordinated services § Patient's improved functional capacity o Know WHY we have case management, when does it begin § Cause management begins the minute you are introduced to the patient § We use it to connect all of the services a patient needs and just make everything work well together. o May also be called "care management" or "care coordination"
Lineal Relationships
o Heredity and kinship o Follow in order of succession o The most important person (sometimes the eldest) makes the decisions
Neighborhood and Built Environment (determinants of health)
o Neighborhoods people live in have a major impact on their health and well-being o Focus on improving health and safety in the places where people live, work, learn, and play o Neighborhoods with high rates of violence, unsafe air or water, and other health and safety risks o Racial/ethnic minorities and people with low incomes are more likely to live in places with these risks o Some people are exposed to things at work that can harm their health, like secondhand smoke or loud noises o Interventions and policy changes at the local, state, and federal level can help reduce these health and safety risks and promote health o oEx: providing opportunities for people to walk and bike in their communities - like by adding sidewalks and bike lanes - can increase safety and help improve health and quality of life
Cross-Cultural Communication (Gender)
o Only female-female contact for middle eastern people o some men will not look women in the eye (middle eastern?) o look in the book o some cultures men cannot be in the same room as a woman (Arab/middle eastern) -Violating norms related to appropriate male-female relationships among various cultures may jeopardize the therapeutic nurse-client relationship
Economic Stability (determinant of health)
o People live in poverty, many people can't afford things like healthy foods, health care, ad housing. People with steady employment are less likely to live in poverty and more likely to be healthy. But people with steady work don't earn enough to afford the things they need to stay healthy.
Precede Framework
o assess the diagnostic and planning process to assist in the development of focused public health programs § Planning phase -Predisposing -Reinforcing -Enabling -Constructs in -Educational (ecosystem) -Diagnosis and -Evaluation
Public Health Care System
o focuses on populations § Federal program, State programs, Local programs · Federal example: CDC, NIH · State example: Florida department of Health · Local example: police, fire, EMS, community development · Constitution requires by law that the public health system promote the general welfare of the population § Major focus is prevention of disease and illness
Private Health Care System
o focuses on the individual § Nonprofit and profit · Personal care services from various sources § Health promotion, prevention and early detection of disease, diagnosis and treatment of disease with focus on cure, rehabilitative-restorative care, custodial care § Capitated payments for care, solo practice fading
Patient-Centered Medical Home
o is a recent model of care developed to provide collaborative, quality driven, safe primary care § A new primary care model § Comprehensive, patient centered, coordinated, accessible, and safe · Goal is to move away from the model of "symptoms and illness care" and transition to a system of comprehensive, coordinated primary care for all ages. · Proactive, preventative, and chronic care management
Determinants of Health
o leading health indicators in each topic area help track progress toward meeting the goals
Macroscopic Conceptualizations of Community Health Problems
o society or social economics factors influencing health status § Emphasizes social, economic, and environmental precursors of illness § Bigger picture
Retrospective Studies
§ Compares individuals with a particular condition or disease and those who do not have the disease § Addresses the questions of causality better than cross-sectional studies · Tries to determine if the group WITH the disease differ in their exposure to a specific factor or characteristic compared to the nondiseased group · Looking for previous exposure or risk factors ("In blank ...") § Require fewer resources and less data collection time than prospective studies § Example: · Compare people with lung cancer and people without lunch cancer. The researcher wants to know what the people with lung cancer were exposed to that the people without lung cancer avoided. (could be smoking, environmental hazard like bad air, etc).
Windshield Survey
§ Define the community § Use demographic and epidemiological methods to assess the community's health and diagnose its health needs § Performed by driving or walking through an area and making organized observations · Allows the nurse to observe people and their role in the community
Incidence Rate
§ Describes the occurrence of NEW cases of a disease or condition in a population at a given point in time relative to the size of the population at risk for that disease or condition § Blank = (# of new cases / population) x 1k § May be the most sensitive indicator of the changing health of a community because it captures fluctuations § Can take a teen-pregnancy incidence rate, but the only population you can look at is teenage girls because they are the only ones capable of having a teen pregnancy!
Health Maintenance Organization (HMO)
§ Designed to provide more comprehensive care, but this type of program lacks enrollee freedom of choice § Preventive care is covered and encouraged, but specialty care is somewhat restricted § Try to reduce costs by providing only the most necessary services § Only can see certain people § Cannot see anyone you want, inflexible
Web of Causation
§ Epidemiologic model § Illustrates the complexity of relationships among causal variables § No memorizing, know the purpose (to show multi cause lol) § Shows that there's always multiple causes to things, not one · Purpose - shows multiple causation for problems · How many times do we have to say multiple cause lmfao
Cross-Sectional Studies
§ Examines relationships between potential causal factors and disease at specific time · CORRELATIONS rather than causation § Can identify associations among disease and specific factors, it is impossible to make causal inferences because the study cannot establish temporal sequence of events · Example: Salt intake versus hypertension? Which came first? Unable to discern. § Help identify preliminary relationships § Hypothesis-generating studies
Descriptive Epidemiology
§ Focuses on the amount and distribution of health and health problems within a population · Purpose: describes the characteristics of both people who are protected from the disease and those who have the disease o Just trying to figure out why certain people are sick, and others are not! · Person, place, and time factors can form a framework for disease analysis and may suggest variables associated with high versus low disease rates (remember the person-place-time model!) · Cannot establish cause § Factors of particular interest are age, sex, ethnicity, or race, socioeconomic status, occupation, and family status.
Non-Modifiable Risk Factors
§ Genetics, age § Unable to change
Collateral Relationships
§ Group goals and decisions § The group gets together and decides what happens
Wheel Model of Human-Environment Interaction
§ Host in middle with their genetics and factors around it · Biological environment · Physical environment · Social environment § Shows that diseases have multiple causes
Naturalistic Perspective
§ Human life being one aspect of nature and a part of a general order of the cosmos § Viewpoint found frequently in Native Americans, Asians, and others who believe that human life is only one aspect of nature and a part of the general order of the cosmos · Believe forces of nature must be kept in natural balances or harmony to maintain health and wellbeing § Yin & Yang theory: health believe to exist when all aspects of the person are in perfect balance (BALANCE AND HARMONY) · Yin= female, negative forces, emptiness, darkness, cold o I remember Yin being female because Yin is shorter than Yang and females are shorter than men · Yang= male, positive forces, full, light, warmth · Cold foods=hot illness, hot foods=cold illness
Secondary Prevention
§ Implemented after the problem and but before symptoms arise § Early detection is key § Screening for diseases § Ex: Screening for STDs, pap tests, blood pressure screening Aimed at early diagnosis, early treatment interventions and attempts to limit disability Health screenings held at the worksite at minimal cost Assessment of commonly occurring health issues at that specific job. Preplacement, periodic, and job transfer evaluations should be made to ensure that a worker is being placed or is continuing to work in a job that is safe for him/her
Analytic Epidemiology
§ Investigates the causes of disease by determining why a disease rate is lower in one population group than in another § This method tests hypotheses generated from descriptive data and either accepts or rejects them on the basis of analytic research § Based on cause of disease - establish causation
Prospective Studies
§ Monitor a group of disease-free individuals to determine whether and when disease occurs § Assess the cohort with respect to an exposure factors associated with the disease and this classifies it at the beginning of the study · Example: a neighborhood was found to be within a plant that exposed them all to radiation. They are all currently not diseased. Follow these people are see IF/WHEN they become sick. Who does? Who doesn't? § Summarizes data collected over time by incidence rates § Obtain more reliable information - however, costly in terms of resources and staff to monitor cohort over time § Follow people over time to see if they develop the problem § This is before there is any disease at all.
Medicare Part A
· Hospital insurance · Includes patient care in hospitals, nursing skilled facilities, hospice, and some home health care · A deductible must be paid for health services (covers up to 60 days, additional copayment for days 60-91, then additional fees per day there on)
Interventions (health planning model)
· Implementation happens here · Implement at least one level of planned intervention · If blank was not implemented, provide reasons
Prevalence Rate
§ Number of ALL cases of a specific disease or condition in a population at a given point in time relative to the population at the same point in time · Cases already in existence § Blank = (number of existing people in population / population) x 1k § Blank can be influenced by: · # of people who experience a specific condition · Duration of the condition § Increase in the incidence rate or increase in the duration increases the prevalence rate · Due to life prolonging therapies, blank may increase without an increase in the incidence rate (because people are getting older/living longer but still have the disease - ex: COPD) § People getting better and recovering decreases the blank
Person Place and Time Model
§ Person: who factors · Demographics, health and disease status § Place: where factors · Geographic location, environmental conditions, political/social environment § Time: When factors · Time of day, week, month, and secular trends over the months and years § Form of descriptive epidemiology - no causation can be determined. Just looking at data.
Community Health Nursing
§ Primary client is the blank (focusing on the health of the blank) § Blank nursing - the synthesis of nursing practice and public health practice applied to promoting and preserving the health populations § Emphasize preservation and protection of health § Care of GROUPS which impacts the population as a whole
Tertiary Prevention
§ Problem has already started, aims to keep It from getting worse and causing extensive damaged § Health maintenance § Teaching insulin administration in the home Avoid problems/diseases getting worseAvoiding disability syndrome Rehab programs Programs for workers who are disabled - the occupational health nurse can negotiate and facilitate accommodations needed for the worker's health limitations Goal to return the employee as soon as possible to employment with caution to not reinjure Ex - if someone hurt their back on the job, make accommodations for them to not have to life but still be able to work
Epidemiological Triangle
§ Requires analysis of 3 elements - agent, host, and the environment § The development of disease depends on the extent of the host's exposure to the agent, the strength of virulence of the agent, and the host's genetic or immunological susceptibility § HOST, AGENT, ENVIRONMENT · Given a scenario know what aspect/factor the problem is coming from · Agent - etiological factors (infectious agents, chemical agents, physical agents) · Host - intrinsic factors (genetics, age, sex) · Environment - physical, biological, SES § This model implies that the rate of disease will change when the balance among host, agent, and environment is changed · How strong/contagious is the agent? Does the host have bad genetics? Is the environment dangerous which exposes the host to the agent?
Experimental Studies
§ Scientific method, randomized clinical trial § Have an experimental group and a control group · Only the experimental group receives an intervention · Control groups often receive placebos or nothing at all
Modifiable Risk Factors
§ Smoking, eating poorly (which causes sometimes diabetes, high cholesterol) § All health-risk activities § Anything you are able to control/change
Magicoreligious Perspective
§ Supernatural aspects dominate § the world is seen as an arena in which supernatural forces dominate. The fate of the world and those in it depends on the action of supernatural forces for good or evil · ex: voodoo in Caribbean, witchcraft · faith healing is based on religious beliefs like Christian scientists · healing rituals found in roman Catholicism
Community Based Nursing
§ Takes place where the person resides, in their own community § Setting specific and includes such practice areas such as home health and nursing in outpatient or ambulatory settings. § Blank nursing is the application of the nursing process in caring for individuals, families, and groups where they live, work, or go to school or as they move through the healthcare system · Primary client is individual people/families (focusing on the health of the people based in the community) § Emphasize managing acute and chronic illness § BASED IN THE COMMUNITY - setting specific
Culture Care Repatterning and Restructuring (model of nursing decisions and actions)
§ The persons cultural practices are strictly forbidden in a certain situation and you are unable to accommodate, and the person will have to change. § Cannot do it at all
Primary Prevention
§ True prevention. § Stopping something before it can occur § Ex: education about diseases that keeps people safe § Can be anything that prevents disease, even tings such as environmental sanitation or adequate housing § Ex: immunization, good nutrition, providing adequate shelter Health promotion Facilitates lifestyle changes Enhances awareness Increases motivation Builds skills Creates environments that support positive health practices Disease prevention Recognize health risks, diseases, environmental hazards Then implement strategies to prevent them Nursing walk throughs of workplaces Non-occupational programs CPR, first aid, ergonomics One on one training Concerns specific to certain groups (women, racial/ethnic minorities. Etc) Work-home balance, safe environment for pregnancy, translators
Culture Care Preservation and Maintenance (model of nursing decisions and actions)
§ Trying to maintain their culture and incorporate their culture into the care you are providing § Fully let them do it
Culture Care Accommodation and Negotiation (model of nursing decisions and actions)
§ You are accommodating § Ex: part of culture to burn sage, but hospital policy will not allow. · We respect your values but cannot burn it. Could we place the sage around the room without burning it? Or some variation of that? § Let them do it in a different way that is agreed upon
Observational Studies
§ used for descriptive purposes to help discover etiology of disease § just looking at numbers, no manipulation § still establishes cause though because its analytic???? Idk. · Book says it can help to discover the etiology of the disease by observing disease rates in different groups of people with differing experiences.
Medicare Part C
· Also called the "Medicare Advantage Plan" · It is optional "gap" coverage provided by private insurance companies · Covered services vary by plan o More specific and specialty care that is not otherwise covered by A&B such as dental, vision, hearing, etc. o Can include HMO and PPO
Medicare Part D
· Enacted to help defray the cost of prescription drugs · Pay a monthly premium, yearly deductible, and copayments
Health Care Access and Quality (a determinant of health)
· Many people in the US don't get the health care services they need o People without insurance are less likely to have a PCP, may not be able to afford the health care services and medications they need. o Strategies to increase coverage rates are critical for making sure people get important health care services, like preventative care and treatment for chronic illnesses. o Interventions to increase access to health care professionals and improve communication can help more people get the care they need
Medicare Part B
· May be purchased for a monthly fee if you qualify for part A · Part B is medical insurance that helps pay out of pocket costs for physician services, hospital outpatient care, durable medical equipment, and other services like some home health care. · Premiums are prorated based on income
Major Affordable Care Act Info
· Required coverage of dependent adult children up to age 26 · Cannot be denied coverage if you have a preexisting condition o Key provisions · Establishes high-risk pools to provide health coverage to individuals with preexisting conditions · Prohibits insurers from placing lifetime limits on the dollar value of coverage · Prohibits insurers from disallowing coverage to those with preexisting conditions or dropping policy holders when they get sick · Required health plans to provide some types of preventative care and screenings without consumer cost-sharing
Planning (Health Planning Model)
· Select one health problem or need · Identify the ultimate goal of the intervention · Identify measurable, specific objectives
Evaluation (health planning model)
· blank the plan, objectives, and outcomes of the intervention(s) · Include the GROUP'S evaluation of your project as well · Make recommendations for further action based on the evaluation
Transitional Care
· preparing a patient with discharge going back to the home with a high chance of being readmitted to the hospital in a short amount of time (within a defined period of 7-14 days); this includes seeing their PCP as soon as possible post discharge and frequently · Patients are educated about new meds, condition specific processes, and discharge instructions. · Goal is to improve patient outcomes, increase understanding of condition specific issues, and decrease hospital readmissions.
Chronic Care Management
· the nurses that work with this population can o Monitor client in community o Monitor medication management o Assessing clients to identify problems early o Intervening with physicians to modify therapy · They can also reduce the need for hospitalization or shortened stays at hospital · Patient with two or more chronic conditions that put the patient at high risk of functional decline or death within the next 12 months · Work to improve self-management of the disease process via support and education and coordinate care to empower patients to access care
