Public Health 3

Palliative

relieving or soothing the symptoms of a disease or disorder without effecting a cure quality experience making a therapeutic relationship

Human-induced disaster

result from human actions or technological failures Examples- industrial explosions or chemical release, oil spills, and transportation incidents

Tiered Response

A basic premise of the framework is that incidents are generally handled at the lowest jurisdictional level possible.

public health impact of disasters

A disaster may impact several areas of public health, including the environment, health care infrastructure, and availability of resources. It may also cause sudden increases in mortality and morbidity and impact populations through displacement and increased vulnerability.

Medicaid

A federal and state assistance program that pays for health care services for people who cannot afford them. Income based Varies state-state low-income, pregnant, disabled more people are becoming eligible

Medicare

Age based payroll deduction >65 The original program included Part A (Hospital insurance) and Part B (Medical Insurance)

Scalable, flexible, and adaptable operational capabilities

As incidents change in size, scope, and complexity, the response must adapt to meet requirements.

Federal government

Biggest funder of healthcare

disaster

CDC- a serious disruption of the functioning of society, causing widespread human, material, or environmental losses that exceeds the local capacity to respond and calls for external assistance Public Health - what they do to people, otherwise they are simply interesting geological or meteorological phenomena

Community Mental Health Nursing

Case management-assessing & coordinating care Negotiate with state agencies, criminal system, substance use disorder, housing, supportive housing, employment Social Security Administration, Medicare, Medicaid Advocacy at the state level to ensure policies, programs, & funding that support community mental health

ICS Organization

Command Operations Planning Logistics Finance/Administration

Mitigation

Continue follow-up studies and research, provide evidence-based data to policy-makers to help inform new policies (note: the epidemiologists role is most limited during this phase)

Recovery

Continue necessary surveillance and/or monitoring activities, conduct investigations and/or research on causes or increases of disaster-related morbidity and mortality, evaluate interventions, develop follow-up studies to help identify prevention strategies for future

Part C of Medicare

Medicare Advantage Plans Includes all of Part A and B and Additional benefits supplemental insurance optional

Palliative and end-of-life care

Emphasis on therapeutic communication, pain/symptom management to foster comfort, dignity, for seriously ill. Decrease unnecessary hospitalizations & prevent administration of futile aggressive end-of-life care Care for the person and family: physical, emotional, spiritual, and social needs Stages of dying Kubler-Ross-Denial, Anger, Bargaining, Acceptance. "CMO" Comfort measures only Advanced directives Caring for the care giver,

Epidemiologic studies

Epidemiologic research employs descriptive and analytical techniques to better understand issues resulting from needs assessments or surveillance, and to establish determinants for adverse health outcomes so that interventions may be designed and implemented to prevent further morbidity and mortality. The goal is to identify associations between disaster-related exposures and mortality or morbidity.

Faith-Based Nursing

Faith community sees faith as a source of healing Parish nurses Goals: health promotion, health screening, teaching, caring for parishioners/families, grief and loss Makes referrals and advocates for the faith community Can be volunteer or paid position Faith nurses should have a job description (advisory board), paid or unpaid. Functions more independently Religious sites often serve the general public versus congregation ( AA-12 step) Faith nurses maybe the 1st to notice s/s of abuse and violence with the community ANA Standards of Care for Faith Community Nursing Practice Certification ANCC, for Faith Community Nursing

Occupational Health Nurse

Focus-how the environment (work site) impacts health Disease management, environmental health, emergency preparedness, disaster planning, in response to natural disasters, hazards in the work-place (eye-wash) Embedded roles: Case manager, root cause analysis, Counselor/consultant, health promotion specialist, manger/administrator, OSHA compliance, epidemiology, pre-employment PE, assess risk in the work environment, surveillance, ergonomics, first aid and prevention

Risk

Hazard x Vulnerability

Part A of Medicare

Hospital Coverage Inpatient care in Hospital skilled nursing care hospice care limited home health-care services how hospital gets $

Homeland Security Presidential Directive 5

Management of Domestic Incidents, was issued February 28, 2003. HSPD 5 enhanced the ability to manage domestic incidents by establishing a single, comprehensive national incident management system. Specifically, HSPD 5 did the following: Identified steps to improve federal, state, and local incident coordination Directed the Secretary of Homeland Security to create a National Response Plan and National Incident Management System

Destruction of the Healthcare Infrastructure

Many disasters affect the ability of the healthcare sector to provide care.

Part B of Medicare

Medical Insurance Doctor visits - outpatient Certain tests and screenings. Flu Shots Mental health care Alcohol use counseling Chemotherapy. Physical Therapy Diabetes screenings Durable medical equipment, wheelchairs How doctors get $

1 and 750

National Association of School Nurses recommends ___ nurse for every ____ students

Homeland Security Presidential Directive 8

National Preparedness, is a companion directive to HSPD 5, issued in December 2003. HSPD 8 established policies to strengthen preparedness to prevent and respond to threatened or actual domestic terrorist attacks, major disasters, and other emergencies. It includes National domestic all-hazards preparedness goal that included "measurable readiness priorities and targets" and "readiness metrics and elements" Financial and technical support to states First responder equipment standards Training programs to meet national preparedness goals

41

Only ___% of schools have a school nurse, some schools share

Part D of Medicare

Prescription Drug Plans Available in standalone plans or as part of Medicare Advantage plans paying for pills and prescription

Homeland Security Presidential Directive 21

Public Health and Medical Preparedness, was issued October 18, 2007. It provides for development of a national strategy for public health and medical preparedness and builds upon principles set forth in Biodefense for the 21st Century (April 2004) to protect the health of the people against all disasters through the following activities: Biosurveillance Countermeasure distribution Mass casualty care Community resilience

Readiness to act

Readiness is a collective responsibility. Effective national response depends on our readiness to act.

School Health Nurse

Scope of role promoting wellness, administrative, educational, clerical, supportive responsibilities, child health advocate Catchment area: School age children and their families Types of visits• Acute illness-injuries (playground or anaphylaxis and the need for an epi-pen)•Screenings-immunization status, hearing, scoliosis, BMI•Counseling-support, stressors, social framework (bullying) School nurse also prepares for emergencies (active shooter, fires, and disaster) Some education areas : Drugs & ETOH, Smoking, Teen pregnancy, STDs, Nutrition, Violence, Cyber issues School nurse skills: autonomous practice & independent decision making

Response

Support immediate response efforts, employ scientific data collection and analysis methods, make suggestions based on data to aid in response

Robert T. Stafford Disaster Relieve and Emergency Assistance Act

The Stafford Act became law November 23, 1988. It amended the Disaster Relief Act of 1974. It authorizes delivery of federal technical, financial, logistical, and other assistance to states and localities during declared major disasters or emergencies.

Health Insurance Portability and Accountability Act (HIPAA) Exclusion

The privacy rule, known as HIPAA, has a specific exception for disclosure of protected health information (PHI) in emergencies. HIPAA allows covered entities to disclose PHI they believe is necessary to prevent or lessen a serious and imminent threat to a person or the public, when such disclosure is made to someone they believe can prevent or lessen the threat (including the target of the threat). HHS notes that PHI can be released, without notifying individuals, to public officials responding to a bioterrorism or other public health threat or emergency.

Engages Partnership

To be successful, key partnerships need to be engaged early and often

True

True or false. An all-hazards plan should inform the various personnel involved in disaster response what their role is.

True

True or false. The National Response Framework is focused on response and short-term recovery.

Unity of effort through unified command

Unity of effort through Unified Command enables coordination between agencies and jurisdictions. This helps to ensure effective planning and interaction, allowing for mutual awareness and understanding of tactics, priorities, and restrictions without compromising agency authority.

D Logistics

Which component of ICS provides IT and communications support to responders during a disaster?

Stafford Act

Which of the following statutes allows FEMA to coordinate government response to disasters?

A B C (federal, state, local) Federal departments and agencies, as well as State and local organizations, are required to comply with NIMS. This compliance is tied to grant eligibility and preparedness assistance funds. Private entities, including non-profit and for-profit organizations, are encouraged to use the same principles.

Who is required to comply with NIMS? Select all that apply

Hospice

a home providing care for the sick, especially the terminally ill. CMO - comfort measures only

Incident command system

a model tool for command, control, and coordination of a response. It provides a means to coordinate the efforts of individual agencies through a common goal of stabilizing the incident and protecting life, property, and the environment.

Primary Environmental Hazards from Disasters

a result of the disaster itself and involve direct physical forces such as flooding, fire, or structural damage

Secondary Environmental Hazards

a significant effect on the environment. Secondary hazards occur only because a primary effect has caused them. These hazards include, but are not limited to, the following: Contaminant/chemical releases Ecosystem change Vectors and pests Infrastructure damage Solid waste and debris

Homeopathic

adj. Naturalistic in medical treatment; Overly emotional Alternative ways to pay for medicare

Complex emergency

can be slow to take effect and can extend over a long period, such as war, drought, and famine Categorized by displacements of populations, widespread damage to societies and economies; need for large-scale, multifaceted humanitarian assistance; hindrance or prevention of humanitarian assistance by political and military constraints; and extensive violence and loss of life

Direct health impacts

caused by the disaster's physical forces and typically occur during the disaster When considering whether a health impact is direct, ask the following questions: Was the death/injury caused by the environmental forces of the disaster (e.g., wind, rain, flood, earthquake, blast wave)? Was the death/injury caused by the direct consequences of these forces (e.g., flying debris, chemical spill, structural collapse)? Examples of direct impacts include the following: Drowning in a hurricane, flood, or tsunami Injury from flying debris in tornado or hurricane Suffocation by ash or toxic gases from volcanic eruption Radiation poisoning from improvised nuclear device (IND)

Indirect health impacts

caused by unsafe or unhealthy conditions that develop because of the effects of the disaster or anticipation of the disaster. When considering whether a health consequence is indirect, ask the following questions: Did unsafe or unhealthy conditions from the environmental forces of the disaster (e.g., loss or disruption of usual services) contribute to the death, injury, or illness? Did the forces lead to temporary or permanent displacement, property damage, or other personal loss or stress that contributed to the death, injury, or illness? Would the person likely be unharmed if the disaster had not occurred?

social vulnerabilities

characteristics of a person or group in terms of their capacity to anticipate, cope with, resist, and recover from the impact of a discrete and identifiable disaster event.

impact of disasters on ecosystems

complex and may be positive or negative.

Preparedness

conduct hazard mapping and vulnerability analysis, educate community, prepare guidelines for response

vectors and pests

disasters displace and provide breeding grounds for pests and vectors.

Indirect health consequences may occur during any phase of the disaster

during preparation during cleanup after the disaster

Most disaster related deaths

earthquakes (55.6%)

Pets Evacuations and Transportation Standards (PETS) Act

enacted in October 2006. It amended the Stafford Act to ensure state and local emergency preparedness operational plans address the needs of individuals with household pets and service animals following a major disaster or emergency. The PETS Act authorizes FEMA to provide rescue, care, shelter, and essential needs for individuals with household pets and service animals and to household pets/animals themselves following a disaster.

Disaster-related economic losses

higher in the developed world than in less developed countries

the ripple effect

indirect effects of a disaster Example: sanitation

vulnerable populations

individuals or groups of people who may not be able to access and use the standard resources offered in emergency preparedness, response, and recovery

Emergency support Functions

mechanisms to group and provide federal resources and capabilities to support state and local responders

Disaster types

natural hazard human-induced complex emergency

National Response Framework

part of a larger strategy for Homeland Security. Its focus is on response and short-term recovery rather than on of all phases of incident management. ensures all response partners understand domestic incident response roles, responsibilities, and relationships, and respond effectively to any type of incident.

Hazard

potential source of harm and loss

risk

probability that things of value (e.g lives, property) will be lost, taking into account both likelihood and consequences

Vulnerability

properties or characteristics of individuals, groups, and social and physical systems that indicate the potential for harm or loss

Mortality rate

the incidence of death in a population, scaled to the size of the population, during a given time period. May be total or cause-specific

Morbidity rate

the incidence of illness in a population, scaled to the size of that population, or prevalence of illness in a population during a given time period

Mortality

the state of being dead

Morbidity

the state of being ill or diseased

Natural hazard

threats of a naturally occurring phenomenon that will have a negative effect on people or the environment Examples- hurricanes, forest fires, floods, tornados, earthquakes, landslides, ice storms, and volcanic eruptions. Many natural hazards are interrelated, for example, earthquakes can cause tsunamis and hurricanes can cause floods.

Disaster epidemiology

uses core public health capabilities to assist leaders and decision-makers by providing timely information to the right people. The goal is to characterize the short- and long-term public health consequences of disasters