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
