ATI Community Health Study PDF

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Summary

A study guide with practice questions and answers along with all the information from the ATI book and comprehensive book: community health chapter....

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Community Health

Community Nurse Referrals: -

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Assist in linking the community resource with the client to provide holistic care; must have thorough knowledge of resource individuals and organizations. use computerized records, databases, and telecommunication technologies for physical, audio, and visual data. Responsible for coordination, providing continuity of care, and evaluating the outcome. Examples of community nursing referrals o Psychological services o Support groups o Medical equipment providers o Meal delivery services o Transportation services o Life care planner Examples of community health nurse practice settings o home health nurse o Hospice nurse o Occupational health nurse o Parish nurse o School nurse o Case managers

Community health nursing -goal is to preserve, protect, promote, and maintain health of individuals, families, and groups in the community. - Vulnerable groups Migrant workers and immigrants Born homeless persons Victims of violence or abuse Substance users Severely mentally ill individuals Older adults Pregnant and license Individuals with communicable diseases Disaster planning A serious disruption of them functioning of a community that causes widespread human, material, economic, or environmental losses that exceed the ability of the affected community or society to cope with using its own resources. Prevention, preparedness, response, and recovery are the four stages of disaster management. -

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Internal disasters are events in the health care facility that threaten to disrupt the care environment o Structural (fire, loss of power) o Personal – related (strike, high absenteeism) External disasters are events outside of the health care facility and may be human - made or natural o human made disasters

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 transportation - related incidences (car, train, plane, and subway crashes)  terrorist attacks, including bombs and bioterrorism  industrial accidents  Chemical spills or toxic gas leaks  Structural fires Natural disasters  extreme weather conditions, including blizzards, ice storms, hurricanes, tornadoes, and floods  ecological disasters, including earthquakes, landslides, tsunami's, volcanoes, and forest fires  microbial disasters such as epidemics and pandemics  a combined internal/external disaster situation can arise when an external disaster, such as a severe weather condition, causes mass casualties and prevents healthcare providers from getting to the facility, perhaps due to traffic or road conditions

disaster prevention -

reduce risk from natural and human made hazzards o Protecting buildings and infrastructures o Improving security and public health awareness

disaster preparedness -

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Occurs at the national, state, and local levels Interagency cooperation within the community is essential in a disaster and requires: o community wide planning for emergencies and or hazards that may affect the local areas o Coordination between community emergency system and health care facilities o Developing a local emergency communications plan and or network o Identification of potential emergency public shelters role of the nurse o in the health care facility  the Joint Commission mandate specifically standards for hospital preparedness, including an emergency operation plan (EOP)  an LP includes training for personnel, criteria for activation, and specific actions for various emergency/disaster scenarios  Disaster trails should be conducted at least twice annually: one involving community wide resources and actual or stimulated clients o in the community  education provided to families about disaster plans  a family disaster plan should include o what to do in an evacuation o Plans for family pets o Where to meet in case of emergency  A family disaster kit should include o A flashlight was extra batteries o A patory powered radio o A non perishable food that requires no cooking (along with a non electric can opener) o one gallon of water per person o Basic first aid supplies o Matches in a waterproof container o Household liquid bleach for disinfection o Emergency blanket and or sleeping bag and pillow o Rain gear o Clothing and sturdy footwear

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Prescription and over the counter medications Toiletries Important documents and money

nursing interventions  assess community for risks

Disaster response -

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Emergency Management system o Provides public access to immediate health care (911) o dispatch communication center o Trained first responders: emergency medical technicians o Transportation to medical resources: ground (ambulance) and or helicopter declarations of a disaster o disaster area: local officials request that the governor of the state take appropriate action under state law and the state's emergency plan and declared disaster area. o Federal disaster area: the government of the affected state request declaration of a disaster area by the president to qualify the affected area for federal disaster relief period o internal disaster: the nursing or administrative supervisor made it clear the internal disaster in case of faculty related issue disaster relief organisations o Federal Emergency Management agency (FEMA)  FEMA is part of EU S Department of Homeland security  managers federal response and recovery efforts o American Red Cross  not a government agency, but authorized by the government to provide disaster relief  The American Red Cross provides:  shelter and food to address basic human needs  Health mental services  food to emergency and relief workers  Blood and blood products to disaster victims  The American Red Cross also handles inquiries from concerned family members outside the disaster area o hazardous material response team (hazmat)  hazardous materials may be radioactive, flammable, explosive, toxic, corrosive, or bio hazardous, or may have other characteristics that make them hazardous in specific circumstances.  Hazmat team membersare specially trained to respond to these situations and wear protective equipment  In toxic exposure disaster, hazmat will coordinate and decontamination effort. o Other agencies include U.S. Department of Homeland Security, Center for Disease Control, and office of Emergency Management Role of a nurse o triage: process of prioritizing which clients should receive care first  Non mass casualty situation: the nurse prioritizes client care so that clients who have conditions of the highest acuity are evaluated and treated first period emergency services are presented with a large number of casualties however they are still functional and able to provide care to victims on all three levels  emergent: immediate threat to life: critically injured  Urgent: major injuries that require immediate treatment  Non urgent: minor injuries that do not require immediate treatment: slightly injured  mass casualty disaster triage: the field and or emergency services are presented with a number of casualties and or ground conditions and are unable to treat everyone.

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The staff must provide the greatest good for the greatest number. Consists of four levels:  emergent or Class 1 (red tag): immediate threat to life: do not delay treatment  urgent or Class 2 (yellow tag): major injuries that require treatment: can delay treatment 30 minutes to two hours  nonurgent or class 3 (green tag): minor injuries that do not require immediate treatment, can delay treatment two to four hours  expectant or class 4 (black tag): expected and allowed to die; prepare for morgue Health care facility disaster plan  in nurse or administrative supervisor may implement the disaster plan due to extreme weather conditions or an anticipation of mass casualties.  Plans to implement  Establishment of an incident command center  Premature discharge of clients who are stable from the facility  Transfer of clients who are stable from the intensive care unit  Postponement of scheduled admissions and elective operations  Mobilization of personnel (call in off duty individuals)  protection of personnel and visitors  Evacuation plan  role of the charge nurse during disaster  preparation of discharge list that features clients who can safely and quickly be discharged, such as the most stable, non bedridden clients (client submitted for observation, scheduled for diagnostic test, or those who can be cared for at home or at a rehab facility)  personnel sent to the command center, if required  Off duty personnel called in, if requested  Disaster victims were paired for admittance

Disaster recovery -

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begins when danger no longer exists and the stand down order has been given crisis intervention o mental health response team employs advanced crisis intervention techniques to help victims, survivors, and their families better handle the powerful emotional reactions associated with crisis and disasters o goals  reduce the intensity of an individual emotional reaction  Assistant individuals and recovering from their crisis  Help to prevent serious long term problems from developing post traumatic stress disorder: a mental health condition that can develop following any traumatic or catastrophic life experience o PTSD symptoms can develop in survivors for a disaster weeks, months or even years following the catastrophic events critical incident stress debriefing and administrative review o health care providers who respond to a highly stressful event that is extremely traumatic or overwhelming may experience significant stress reactions o The critical incident stress debriefing process is designed to prevent the development of post traumatic stress among first responders and health care professionals  defusing: discussion of feeling shortly after the disaster/critical incident (such as the end of shift)  formal debriefing: discussion some hours or days after the disaster/critical incident, in a large group setting, with mental health teams of peer support personnel serving as a leaders

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administrative review to identify areas of agency response plan that were effective and areas that need improvement

agents of bioterrorism -

three categories of priority based on ease of transmission and morbidity and mortality rates o category 8: highest priority and threat to national security because agents are easily transmitted and have high mortality rates. Include smallpox, Botulism, anthrax, tularemia, hemorrhagic viral fevers (ebloa), and plague o Category B: second highest priority, agents are moderately easy to disseminate and have moderate mobility rates and low mortality rates. Include typhus fever, rice and toxin, diarrheagenic E coli, and West Nile virus o category C: third highest priority, emerging pathogens that could be engineered for mass decimated nation. Agents are easy to produce and have a potential for high morbidity and mortality rates. Include hantavirus, influenza virus, tuberculosis, and rabies virus.

Culturally competent care Cultural care -

culture: knowledge, beliefs, values and traditions that are shared by a group of people about life and the world, which passes to the next generation. Cultural competence: the ability to provide care that respect integrates aspects of culture to meet client needs. Cultural humility: continuing self-reflection and awareness of cultural biases, assumptions, and values: better knowing of oneself that results in better care

Cultural competence -

There are 12 standards to serve as a guide for providing cultural competent care o Social justice, critical reflection, knowledge of cultures, culturally competent practice, cultural competence in healthcare systems and organisations, client advocacy and empowerment, multicultural workforce, education and training in cultural competent care, cross cultural communication, cross cultural leadership, policy development, and evidence based practice and research

cultural assessment -

assessment to identify values, beliefs, meaning and behavior of clients what is the clients ethnic affiliation and what is its importance in the client's daily life? Does the client speak, right, read, and understand English? What dietary preferences or prohibitions does the client follow? Are there rituals or customs that the client wishes to keep related to transition such as birth and death? Client want or need to have family involved in care? Is the client using herbal or other traditional remedies? What behaviors or views are important to the spirituality of the client?

Cultural factors affecting health -

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Time orientation o Past: cultures that focus on past orientation look to the past provide direction for current situations. Review weekly progress to assist clients with health promotion and disease prevention. o present: place greater value on quality of life and view present time as being more important than future time period focus on immediate benefit versus long term outcomes as an effective approach when discussing disease prevention. o Future: delays immediate gratification until future goals are met. Focused on long term goals. Language and communication: verbal and nonverbal

speak in a low, moderate voice. Discuss one topic at a time I contact in the use of touch varies among cultural groups Language and communication barriers may impact the clients utilization of healthcare Recognize nonverbal cures of poor understanding  Blank expression  Inappropriate laughter  Absence of questions Space: preferred distance between individuals o take cues from the client and be aware of spatial distance preferences o clients remove closer or farther away from the nurse depending on personal space preference Beliefs and practices: an individual's beliefs regarding health effects actions taken to treat and prevent disease o biomedical beliefs: focus on identifying A cause for every effect on the body. This is the basis for the current United States health system o naturalistic beliefs: relates to individual as a part of nature or creation. An imbalance in nature is believed to cause disease, such as an eastern medicine. o Magical - religious beliefs: illness and health are linked to supernatural forces. Some Christian religions share this belief as faith healing o Focalor beliefs clients may seek help from a spiritual healer, folk doctor, or shaman o o o o o

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Nursing Interventions -

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Address the client by their last name, unless the client gives permission to use another name. Recognize individual uniqueness and the diversity within cultures. Respect the clients values, beliefs and practices Remain sensitive to the clients spiritual beliefs o Spirituality is a sugjective concept that implies connectedness o Spirituality may or may not include religion o Addressing clients spiritual needs required for all health care facilities by the joint commission. Provide a diet the is consistent with clients customs and preferences. Allow family to be involved in care, if desired Review the client’s herbal and/or alternative methods to provide client education and prevent interactions with currently prescribed medications or treatments. Consider cultural factors that affect health when providing care, such as time orientation, language and communication, space, and beliefs and practices. Provide a qualified interpreter if necessary

National CL AS standards -

the youth Department of Health and Human Services has identified cultural and linguistically appropriate services standards to promote equitable care and improve quality of health services. CLAS standards include: o offering language and communication assistance to those who limited proficiency in English at no charge to the individual and ensuring that they are informed regardless availability of services o ensuring that only qualified people provide language assistance o Providing written materials in the language of commonly served populations o And shrink continuous quality improvement and accountability and the implementation of CALAS standards o Partner with the local community to establish and implement services that ensure cultural and linguistic appropriateness

using an interpreter

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the nurse should use a qualified interpreter when it is difficult for a nurse or client to understand the other's language o observe the client for non verbal messages o Address the client, as well as the interpreter o Interpreter should have knowledge of health related terminology o Have the interpreter translate written materials into the client's primary language o Consider client preferences when selecting the age and gender of an interpreter o Federal government mandates require agencies to have a plan that will approve access to federal health care programs for individuals who have limited English proficiency o Review the material with the client to ensure that nothing has been missed or misunderstood o Thank you sove family members as interpreters should be avoided because clients may need privacy and discussing sensitive matters. Family members can have difficulty understanding medical terminology

Buddhism -

birth practices: believe in reincarnation. Contraception to prevent conception is acceptable Death practices: ensure a com, peaceful environment. Chanting is common. Monk delivers last rites. Organ donation is encouraged. Cremation is common. Dietary restrictions: vegetarian diet practice by money. Avoidance of alcohol. Health practices: a quiet, peaceful environment allows client to rest and practice meditation and prayer. May refuse care on holy days

Catholicism -

birth practices: contraception, abortion, and sterilization are prohibited. Baptism is required. Death practices: priest administers last rites. Organ donation is acceptable. Suicide may prevent burial in Catholic cemetery. Dietary restrictions: some may abstain from eating meat on Ash Wednesday and on Fridays during lent. Health practices: most want to see a priest when hospitalized. may request communion or confession to aid in healing.They wear cross or metal or display religious statues.

Christian Science -

birth practices: abortion is prohibited. A client may choose to give birth at home. Death practices: unlikely to seek medical help to prolong life. Organ donation is discouraged. Dietary restrictions: must have seen from alcohol. Health practices: medications and blood products are avoided. Healing ministers practice spiritual healing and do not use medical or physiological techniques.

Hinduism -

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birth practices: contraception is acceptable. Abortion may be prohibited. Males are not circumcised. Child is not named until the 10th day for life. Death practices: believe in reincarnation. Allowing a natural death as traditional. Client may want to lie on floor while dying. A thread is placed around the neck / wrist. Organ donation is acceptable. Prefer cremation. Dietary restrictions: vegetarian diet is encouraged. Most abstain from beef and pork. Right hand is used for eating a left hand is used for toileting and hygiene. Several days of year are set aside for fasting. Health practices: personal hygiene is very important period future lives are influenced by how one faces illness, disability, and death.

Islam (Muslim)

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first practice is: contraception is acceptable. Abortion is permitted in certain circumstances. A prayer is said into the infant ear at birth. Circumcision is customary. death practices: client may want to confess sins prior to death. A client died may wish to be placed facing Mecca (usually east). organ donation and autopsy is acceptable by some. Devout Muslims may refuse both, fearing desecration of the dead. Rituals include traditional divi...