Population Health Exam 1 Study guide PDF

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memegPopulation Health Exam 1 Study Guide Fall 2019 Term 1 Community assessment—what is included— 3 steps of community assessment include gathering relevant date, develop a composite data base, and interpreting the data. This is a systemic process as serves as the initial phase in the nursing process. Always connect w/ the community 1st and foremost

What/why would you do a windshield survey? How do you do a windshield survey? A windshield survey is a source of direct data to gain an understanding of the environmental lay out and look at the community as a whole. Gives nurses a change to observe people in their community. Drive and look out the window. DON’T TALK JUST OBSERVE

Most important aspect of community assessment and planning—ie who needs to be involved. Involve the community and ask them what they think they need as a community

How do you find demographic data? health facilities interview groups, conduct windshield surveys vital statistics census, look at data bases values  hold interviews w/ community members -

Existing surveys and school records

How do you know the population’s perspective? Hold interviews w/ community members, surveys

When completing a community assessment and verifying findings, who should the nurse interview? The community

Be able to differentiate the nursing process for community/populations ? Microscopic is when the individual is the focus of change and macroscopic is when society is the focus of change

Different steps for the nursing process Establish goals and objectives, develop strategies to meet the objectives such as risks and behaviors, incorporate levels of prevention Develop goals and objectives smart goals Implementation  nurses role, type of problem selected, readiness of the community, social change process Evaluation  shows weather the program is meeting its purpose.. clients knowledge or epidemiological data

How do you gain the community’s trust; how do you determine the community’s perspective of their needs? You want to let them know the goals, talk in clear language and be open yourself, become a partner with individuals, community and populations You can ask them their prior knowledge on their needs or survey them to see what they think Respect their culture

What is the purpose of interviewing key people in the community? Key people in the community may know more of what is going on or will more willing to help the nurse make a change Direct data through interviews

Why is it important to involve the population/community in all aspects of assessment/planning/intervention and evaluation? Produce a healthful change!! More likely to follow through w/ the change

Differentiate what population health is and is not. Population health is preventing illness and identifying risks Health of a specific population or group of people not just one person!

Population-focused health care is experiencing a rebirth, and the community as client is important to nursing practice for several reasons. When focusing on the community as client, direct clinical care can be a part of population-focused community health practice (Sidorov and Romney, 2016). For example, sometimes direct nursing care is provided to individuals and family members because their health needs are common communityrelated problems. Changes in their health will affect the health of their communities (Lathrop and Hodnicki, 2014).

What is the difference between community based and community oriented nursing? CBN  focuses more on illness care and how to manage health CON  focuses on disease prevention * more ideal

What is the focus of population Health nursing? Preventing illness and risks by looking at society as a whole

What are the core functions of public health nursing? Be able to identify examples of population focused nursing interventions. Assessment  keep track of data for the community Policy development effort to develop policies that support health funds for certain programs Assurance  essential community programs Interventions are all at a community level  providing mobile health units, screening programs, vaccinations

What is a population/aggregate? What is subpopulation--be able to identify Population  collection of people who share a common trait; Duquesne Students Subpopulation  share similar characteristics, (women w/ cancer who have brown hair)

What was the impact of urbanization on public health? Increase in epidemics… yellow fever which created the boards of health basics for departments of health, more unsanitary hospitals, and living conditions unfavorable

Define refugee, legal immigrant, nonimmigrant and unauthorized immigrant? What are the consequences of not providing culturally competent care? Refugee  admitted outside normal quota based on fear due to race/ religion, a person forced to leave their homeland due to fear or prosecution Legal immigrant  not a citizen, but allowed to live and work in the U.S have a green card, allowed to Nonimmigrant  admitted to the US during a specific limited time, student or tourist Unauthorized immigrant  may have crossed border illegally or legal permission expired; eligible for emergency medical services only

Some consequences of not providing culturally competent care may include patient dissatisfaction, and lack of communication to patients, and they will no longer seek care

What are the relative impact of personal behaviors, environmental factors, human biology and healthcare systems on health? What has the most impact? the least? Lifestyle has the biggest impact, and health care system has the least impact Personal behavior language barrier, culture, previous knowledge, previous experience, mental health Environmental  clean air, safe water, aedquate food/ shelter Human biology  health disparities, pre-existing conditions Health care systems  lack of access

The role of African American nurses in public health nursing and purpose of the National Health Circle for Colored People The purpose of the circle was to promote public health work in black communities . One strategy

adopted was providing scholarships to assist African American nurses in pursuing university-level public health nursing education. Bessie M. Hawes, the first recipient of the scholarship, completed the program at Columbia University (New York) and was then sent by the Circle to Palatka, Florida. In this small, isolated lumber town, Hawes’s first project was to recruit schoolgirls to promote health by dressing as nurses and marching in a parade while singing community songs. She conducted mass meetings, led clubs for mothers, provided school health education, and visited the homes of the sick. Eventually she gained the community’s trust, overcame opposition, and built a health center for nursing care and treatment (Thoms, 1929). Only people who could see colored individuals!

United States health care system: In general, how does it compare to other countries regarding costs and quality as defined by indicators of health; Trends relating to the following and how it impacts quality, cost and access to care as discussed in class and/or in book: Technology, culture as it relates to immigration (book and notes), demographics, labor/work force, healthcare work force, climate including populations most vulnerable to changes, environment including what is environmental justice; U.S health care is the least accessible out of all other countries and it’s not mandatory. The cost is expected to increase 6.4% due to the increasing medicate population and aging baby boomers Affordable care ACT. We spend more on treating the problem rather than preventing it

Private vs Public care. Those who can pay for health care are viewed as superior we have a large pop of uninsured peeps, they receive less preventive care and are diagnosed w/ advanced diseases HER  reduce costs but require more training, privacy issues Culture  more immigrants coming over to work Work  increase in population younger generations take over increase in production Demographics  baby boomers make up 20% of the population increased Medicare as population increases Environmental justice act equal protection from environmental hazards clean water and smoke Vulnerable pop  African Americans due to living near industries, older homes w/ led, poor, homeless, uninsured

Why does the US federal government have the right to be involved in health care?

They pay for it! An important agency and a recent addition to the federal government, the US Department of Homeland Security (USDHS, or simply DHS), was created in 2003 (USDHS, 2014). The mission of the DHS is to prevent and deter terrorist attacks and protect against and respond to threats and hazards to the nation. The goals for the department include awareness, prevention, protection, response, and recovery. The DHS works with first responders throughout the United States, and through the development of programs such as the Community Emergency Response Team (CERT), it trains people to be better prepared to respond to emergency situations in their communities. Nurses working in state and local public health departments and those employed in hospitals and other health facilities may be called on to respond to acts of terrorism or natural disasters in the course of their careers, and the DHS, along with the Food and Drug Administration (FDA) and CDC, is developing programs to ready nurses and other health care providers for an uncertain future (USDHS, 2014).

What is the role of the states in health care: think regulation of nursing practice and Medicaid programs. Disease prevention and response, provides funding for Medicaid, disease education, est. health codes, H1N1 epidemic

What types of things are covered under Medicare part A? Part B? Part D? A  hospital insurance B  docs. Medical supplies D  prescriptions

How is Medicare Funded? Federal government

What is private insurance? How does it work? Who is eligible? How is it funded it? Employers private market place, employers pay out of pocket or through monthly premiums

What is Medicaid? Chip? Who is eligible? Helps people w/ limited access, children, elderly, pregnant woman Administered by the state and fed. Government Chip is = kids

How does Veteran’s insurance work? Covers any care that’ll promote or restore health such as treatments, procedures, supplies … must be under active duty VHA under government

What is COBRA how/when is it used? The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a health insurance program that allows an eligible employee and his or her dependents the continued benefits of health insurance coverage in the case that employee loses his or her job or experiences a reduction of work hours.

What is uninsured? Underinsured? Under  have health care but it’s just not enough Un  less than required company refuses to pay for what they need

What is the local health department responsible for--think immunizations and direct care

Increase in emergency preparedness, needs of the local community immunizations

Basic information on Canadin healthcare system

No out of pocket fees, but have long wait times to see doctors. Their care is paid for by taxes and is approximately $6,839

What is environmental injustice? Who is most impacted by environmental injustice? global warming? Environmental injustice is the disparities people have due to their race to the environment think of the African Americans Clean air, safe drinking water, aedquate food, secure shelter I  investigate P  work R  residence issues w/ satisfaction E  environmental concerns P  past A  activities R  referral E  educate

What is the Sheppard Towner Act--what did it do? Federally funded state maternal and child health division departments

What is the Elizabethan Poor Law--why was it important? Required early township/ county responsible for care

What is the Environmental Justice Act? Why is it important? Provided equal protection from environmental hazards

Where does the Affordable Care Act place the focus of healthcare--preventive or treatment? Prevention  to prevention and wellness to reduce the burden and incidence of death and disparity

How is the population of the United States changing? Mortality has declined and the population is continuing to become older as the baby boomers age

Parts of the epidemiological triangle--what are they? be able to identify examples of each

What is thinking upstream? Macroscopic? Microscopic? Downstream? Critical interactionism? Differentiate with examples Micro  individual focus of change downstream Macro  society is the focus of change upstream Critical interactionism change needed in knowledge and skill to change the issue. Effective programs w/ attention to policy and program values Workplace violence example!!

Difference between the levels of prevention primary, secondary, tertiary intervention. Be able to identify from examples Primary  more coverage for health promotion; prevention Secondary  prenatal care; early detection of the potential for development Tertiary-  giving home visits to a mom who doesn’t have the resources to take care of her children; treatment

Difference between incidence and prevalence—when would you use each—what do they tell you—what to include in the numerator and how to determine the denominator. Why would incidence decrease and prevalence increase? When would prevalence increase? Decrease? Differentiate which disease would have the largest or smallest prevalence rate

Incidence: Number of new cases/ the number of individuals at risk during the same time, excludes those who already had the disease! Prevalence: existing disease in a pop at a specific time. Total number. Number of individuals who have the disease/ the number of people in the pop. They develop a treatment for the disease incidence is increasing but prevalence is decreasing Shorter duration the lower the prevalence

What is RR and OR? What do they determine? How do you interpret a result using RR and OR Relative Ratio rate of those exposed over those who are not exposed *both have the disease One group smokes other group did not, but both have lung cancer!! If RR is greater than 1 then the underlying dieses was due to exposure Odds ratio the odds the cases were exposed to the odds the controls were exposed Exposed and have the disease/ exposed and do not have the disease

**What is Attributable fraction? What does it determine? How do you interpret results? Portion of a specific disease that can be attributed to a exposure AR/AF is the amount of disease that could be prevented if the risk was eliminated

Descriptive versus analytical studies: general information on what the difference is between the two and basic information on cohort studies (prospective and retrospective), case control studies and

experimental studies, descriptive studies(read in book) Be able to identify which type of study if given an example Descriptive  who, what, when, where Analytic  the how and why of health event, forces on cause and associations Cohort  looking at a group of people over time, type of analytic Prospective  follow forward in time Retrospective  go backwards Case control do not have outcome of interest Experimental studies assigned to an experimental or control group Descriptive studies observational studies which describes the patterns of disease relating to person place and time

Teaching/Learning: Tips to ensure successful teaching in the community; Learning goals/objectives—be able to select which are written correctly—ie specific, measurable, participant will……..;When should learning goals/objectives be determined/written? Who should determine the teaching goals/objectives; Assessment of motivation and ability to learn; Health issues related to low literacy. How to write something in plain language—be able to identify an example of plan language; what is the relationship between literacy and health literacy? Learning is individualized and should be a systemic process based on what the community needs!! Should be in simple terms, and w/ bullet points. Goals should be est. at the beginning Motivation  attention set, readiness, willingness Literacy  ability to read write and speak English, vs the relationship to apply this to a heath context Identify plain language -4th grade level reading

Nursing Process for health promotion programs—assess, plan, implement, evaluate—know how to do steps in process and sequence for doing them.

How to evaluate health programs, screening programs and health education programs—be able to identify the best way to identify a program or health education program given an example The participants achieve learning objectives, repeat what was taught, learning demonstration

Population health nursing diagnosis—how to write correctly—be able to identify an example of diagnosis written correctly (powerpoint slides); How to determine the priority nursing diagnosis;

Increased risk of…. among…. r/t………. as demonstrated in………

Assessing a community’s determinants of health--what are the determinants of health? Poor, where they are living, do they have a clean house and clean water access

Health Belief model--what is it? Key points? Wants to predict why people engage in prevention activities Perceived susceptibly, severity, befits, barriers Cues to action ready to change Self efficacy confidence to take action...