ATI Community Health Focus PDF

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Summary

For ATI Community end of semester test....

Description

ATI Community Health Focus Review  Nightingale’s Environment Theory:  Emphasized prevention care.  Washing hands  Sterilizing instruments

 Health Belief Model

 Assumes that preventive health behaviors are taken primarily for the purpose of avoiding disease.  Describes the likelihood of taking an action to avoid disease based on:  Susceptibility, seriousness, and threat of disease  Modifying factors  Demographics  Knowledge level  Age  Race  Cues to action  Media  Disease effect on ppl  Recommendations from health care professionals  Perceived benefits minus perceived barriers to taking action

 Goals of community health nursing:

 Promote, preserve, and maintain health of populations by delivery of services to individuals, families, and groups to influence community health  Who is the client in community health nursing?  The community or population  BOTH COMMUNITY ORIENTED NURSING AND COMMUNITY BASED NURSING

 Public Health Nursing

 Also known as Community-Oriented Nursing  Population focused  Goal:

 Promoting health  Preventing disease  No illness cares  Key Principles:  Emphasize primary prevention  Greatest good for largest number of individuals  Client is partner in health  Use resources wisely to promote best outcomes

 Community-oriented Nursing:

 Focus of Care:  Aggregates  Communities  Populations (public health)  At-risk or unserved individuals and families  Primary Goal:  Health promotion and disease prevention  Education  Nursing Activities:  Indirect (programmed management)  Can include direct care of at-risk individuals and populations

 Community-based Nursing

 Focus of care:  Individuals and families  Management of acute or chronic conditions  Direct (one-on-one)  Illness care:  School nurse  Camp nurse  Prison nurse

 Ethical principles to community health nursing    

Autonomy Nonmaleficence Beneficence Justice

 Community Health Education

 Obstacles:  Age  Cultural barriers  Poor read comprehension  Language  Lack of motivation  Effective health education requires planning

 Learning Styles

 Visual  Auditory  Tactile-kinesthetic

 Epidemiological triangle

 Agent  Causes disease  Drugs  Toxins  Noise  Temperature  Viruses  bacteria  Host  Being affected  Age  Gender  Genetics  Ethnicity  Immunological status  Physiological state  Occupation  Environment  Physical Environment  Geography  Water/food supply  Presence of reservoirs/vectors  Social Environment  Access to health care

 High-risk working conditions  Poverty

 Incidence

 Number of NEW cases in specific time frame

 Prevalence

 Number of NEW AND EXISTING cases in specific time frame

 Health People 2020

 Goals:  Based on issues that are considered major risks to health and wellness  Educate on DM, cancer, older adult health, and LGBT health

 Primary Prevention

 Prevent initial occurrence of disease or injury  Education  Immunizations  Advocation for access to health care

 Secondary Prevention

 Early detection  Limiting severity  Screenings  Disease surveillance  Control of outbreaks

 Tertiary Prevention

 Maximize recovery after an injury or illness  Rehabilitation  Case management  Support groups  Nutrition counseling for management of Crohn’s disease.

 When to assess cultural beliefs and practices?  When developing plan of care

 Acculturation  Process of merging with or adopting the traits of a different culture

 Ethnocentrism

 Belief that your current beliefs or cultural is superior and better

 Cultural Assessment Parameters         

Ethnic background Religious preferences Language and literacy needs Communication needs Education Cultural values Food patterns Health practices Always include pt preferences in assessment/plan of care

 Using an interpreter    

They should have knowledge of health-related terms NEVER use family members Consider preferences of age and gender Should NOT be from same community as pt

 Environmental Risks

 Toxins  Lead  Pesticides  Asbestos  Radon  Air pollution  Carbon monoxide  Tobacco smoke  Lead  Sulfur dioxide  Water pollution  Wastes  Erosion after mining  Run-off from chemicals added to soil  Contamination  Food and food products with bacteria, pesticides, radiation, and meds

 Key questions for health history

 What is the condition of the residence?  Age and location  What is the pt’s occupation?  Do you smoke in the home?  Are you exposed to second-hand smoke?  What is the source/quality of drinking water?  Is there any presence of mold or fungi?  What temperature is the water heater set on?  Should be 65 y.o and receiving Social Security/disability for 2 yrs  Part A  Hospital care  Home care  Hospice  Limited skilled nursing care for 100 days/yr  Part B  Health care provider  Outpatient care  Home health  Diagnostic services  Physiotherapy  Durable medical equipment  Ambulance service  Mental health  Preventive services  Part C  Known as Medicare Advantage Plan  Combination of A & B  Provided through private insurance  Part D  Prescriptions  THINK D FOR DRUGS

 Medicaid

 Provides health care to pt’s of low socioeconomic status and children through the combined efforts of federal and state governments  Eligibility based on:  Household size  Income  Priority given to children  Pregnant  Disability

 State Health Agencies

 State department of health  Manages WIC  Oversees CHIP  Provides health coverage to uninsured children  Responsible for administration of Medicaid program  Reports communicable diseases within state to CDC  State boards of nursing  Development and oversight of state’s nurse practice act  Licensure of RN and LPN  Oversight of state’s schools of nursing

 Community assessment components  People  Demographic  Distribution  Mobility  Density  Census data  Biological factors  Health and disease status  Genetics  Race  Age  Gender  Cause of death  Social factors  Occupation

 Activities  Marital status  Education  Income  Crime rates  Recreation  Industry  Cultural Factors  Ethnohistory  Hierarchy  Language  Religion  Values  Customs  Norms  Place or environment  Physical factors  Geography  Terrain  Community  Location of health services  Housing  Animal control  Environmental factors  Geography  Climate  Flora  Fauna  Topography  Toxic substances  Vectors  Pollutants

 Data Collection

 Informant interviews  Direct discussion  Community forum



   

 Open public meeting Secondary data  Existing data  Death stats  Birth stats  Census data  Mortality  Morbidity  Health records  Prior health surveys Participant observation  Observation of formal or informal community activities Focus groups  Directed talk with a representative sample Surveys  Specific questions asked in a written format Windshield surveys  Descriptive approach that assess several community components by driving through a community  Survey Components  What is their general appearance?  Age  Dress  Well-nourished  Obese  Frail  Unkept  What is the origin, ethnicity, or race of people?  Is there any evidence of substance use, violence, disease, mental illness?  Is there easy access to health care?  Are there grocery stores which provide fresh produce, or is this a “food desert”?  Is the housing of acceptable quality?  Is the housing in good repair or not?  Is there vacant housing?

 Is there public transportation?  What grocery stores or other stores within community?

 Preplanning

 Brainstorming

 Assessment

 Collect data

 Diagnosis

 Prioritize health needs of the community  Analyze data to determine health needs

 Planning    

Develop interventions to meet identified outcomes Establish goals and objectives for the selected solution Identify who will assume responsibility for each intervention Determine funding opportunities for needed intervention and develop budgets

 Implementation

 Carry out the plan

 Evaluation

 Examine the success of the interventions  Determine achievement of desired outcomes

 Lead Poisoning  Important to ask a pt when house was built? ...