Chapter 5 practice setting and nursing roles in the community

Model of spiritual care (c i r c l e)

C- caring, I- intuition, R-respect for religious beliefs and practices, C- caution, L- listening, E- emotional support

Steps of the Omaha system

Collecting and assessing data, stating the problem, identifying an admission problem rating using a problem classification scheme, planning and intervening, re-rating problems during the span of care delivery and at discharge, evaluating the end problem outcome

HOME HEALTH

Community health care nurses provide service to the client where they reside; include traditional homes, assisted living facilities and nursing home

OCCUPATIONAL HEALTH

Health care in the workplace seeks to both promote health and prevent occupational illness and disease through improvement and maintenance of health; which aim to decrease of sick time, fewer workers compensation claims and decrease use of group health coverage,

Components of coordinated school health programs

Health education, physical education, health service, nutritional services, counseling, psychological and social services, promotion of a healthy and safe school environment, health promotion for stuff, facilitation for family/community involvement, facilitating safety policies.

Host factor

Worker characteristics, job experience, age, pregnancy

10 essential public health services

1. Monitor community health and solve problems. 2. Diagnose and investigate health risks. 3. Provide education and empowerment health issues. 4. Facilitate community partnership 5. Developing comm. health plans and policies. 6. Enforce health regulations 7. Promote access to health care and services 8.Assuring a competent healthcare workforce 9. Evaluate personal and population-based health services. 10. Researching solutions to health problems.

Functions of a Parish Nurse include: (5)

1. Personal health counseling (health-risk appraisals, spiritual assessments, support for numerous acute and chronic, actual and potential health problems) 2. Health education (available resources, classes, individual and group teaching) 3. Liaison between faith community and local resources 4. Facilitating support groups 5. Spiritual support (help ID spiritual strengths for coping)

Levels of prevention: secondary

Assess children who become ill or injured at school (headaches, stomach pain, diarrhea, anxiety over being separated from parents, minor injuries(cuts, bruises), that occur at school) assess all children, faculty and stuff during emergencies ( emergency care, plan, emergency supply ready) perform screening for early detection of disease ( vision and hearing, height and weight, oral health, infestations), assess children health o detect child abuse or neglects, evidence of mental illness, suicide thoughts and violence, respond to school crisis and disasters ( crisis plan, drills, etc)

Levels of prevention: tertiary

Assess children who have disabilities( individual education plan), work to develope and achieve long- term outcome, children who have long-term needs, provide care to children who have chronic disorders(diabetes, asthma), ongoing care for adolescent who's pregnant( pregnancy identification, parenting education, preventing future pregnancies)

Agent factor

Biological agents: viruses, bacteria, fungi, blood-borne, airborne pathogens; Chemical agents: asbestos, smoke; Mechanical agents:musculoskeletal or other strains, from repetitive motions, poor workstation-worker fit, lifting heavy loads; Physical agent: temperature extremes, vibrations, noise, radiation, lightning; Psychosocial agent: threats to psychosocial or social wee-being resulting in work related stress, burnout, violence

Control strategies

Designed to reduce future exposures base upon results from investigations into work-related illness/injury

Control strategies include

Engineering, altering work practices, providing personal protective equipment and education to prevent future injuries, workplace monitoring, health screening, employee-assistance program, job-task analysis, design, risk management and emergency preparedness

Client education

Home health nurse provide follow up care after acute hospital stay, must educate client and family regarding complications or adverse reactions( when to contact the agency, ER or provider). Providing education encourage client to be independent and involved in their own care

Living environment

Home health nurse should evaluate living environment for safety(nonsecure rugs, electrical outlets, extension cords, the use of oxygen, low lightning, need for safety devices, the bathroom, and other potential environmental hazards)

susceptibility

In assessing risk for work related injuries and illness, the nurse should keep in mind the following factors affecting susceptibility to illness and injury (host factor, agent factor, environmental factor)

SCHOOL

Many roles: Case manager, community outreach, consultant, counselor, direct caregiver, health educator, researcher

Omaha System Model

Nurses caring for individuals, families, and communities under home health and hospice care often use this model to implement the nursing process; the framework is also used in many electronic health systems

Site walk through (survey), occupat. health nurse should focus on the following

Observation of works process and materials, Job requirements, Actual and potential always hazards, Employee work practices ( hygiene, waste disposal, housekeeping), Incidence/ prevalence of work-related injuries/illness, Control strategies to eliminate exposures

Environmental factors

Physical factors: heat, odor, ventilation, pollution Social factors: sanitation, overcrowding. Psychological factors: addictions, stress

Responsibilities occupat. health nurse

Primary prevention: teaching good nutrition and knowledge of health hazards, providing info. on immunizations and use of protective equipment. Secondary prevention: identifying workplace hazards, early detection through surveillance and screening, prompt treatment, counseling and referral, and preventing further limitations. Tertiary prevention: restoration of health through rehabilitation strategies and limited duty programs

Levels of prevention: primary

Primary: assess the knowledge base regarding health issues (hand hygiene and tooth brushing, -healthy food choice, injury prevention ( including seat belt use and bike, fire and water safety), -substance use prevention, -disease prevention), assess the immunization status of all children ( maintain current record of required immunizations)

Parish nurse

Promote the health and wellness of populations of faith communities, church members and individuals and groups in the geographical community, work closely with pastoral care staff, professional health care members and lay volunteers to provide a holistic approach to healing (body, mind and spirit)

Additional strategies (occupat. nursingh

Provide safety and health education programs to workers, Develop health policy focused on ensuring effective employee health and safety, Design strategies to prevent work-related accidents/ injuries

Protection from work-related injuries

Related to falls, environmental hazards, and burns. Nurse can use research and trend analysis to improve working conditions by eliminating or minimizing hazards and potential problems

Missionary nurse

Seeks to promote health and prevent disease by meeting spiritual, physical, and emotional needs of people across the globe. The nurses can be career missionaries, or can serve as short-term, volunteer, or part-time missionaries

Skilled survive include

Skilled assessment, wound care, laboratory draws, medication education and administration, parental nutrition, IV fluids and medication, central line care, urinary catheter insertion and maintenance; coordination, delegation, and supervision of various other participants in health service.

Protection from violence

Work can be frustrating and contribute to stress resulting in aggression to others (repetitive job, boring, physically or psychologically draining, jobs where workers might feel tired, angry and generally inadequate). Such workers could be refer to employee-assistance programs that provide confidential counseling and referrals to other professional services if needed

FAITH COMMUNITY NURSE

Works with individuals, families, and faith communities who share common faith traditions; which represent the entire lifespan and all family types; nurse works with a diverse population within the same setting, provide interventions to individuals in homes, congregat. meeting place, acute-long term care facilities and schools

HOSPICE

focuses on providing quality of life through palliative care, supporting client and family through dying process

PUBLIC HEALTH

nurser employed at federal, state, and local levels; the overall purpose of public health is to impact the health of population through disease prevention, health promotion, and actions that protects population health

Workers Compensation

state programs that provide benefits to workers who suffer work-related injuries or illnesses, or to their survivors