ATI RN Community Health Nursing Study Guide F

ATI RN Community Health Nursing Study Guide Systems thinking Ans- Studies how an individual, or unit, interacts with other organizations or systems Upstream thinking Ans- Is used to focus on interventions that promote health or prevent illness, as opposed to medical treatment models that focus on care after an individual becomes ill Nightingale's Environmental Theory Ans- -Highlights the relationship between an individual's environment and health -Depicts health as a continuum -Emphasizes preventive care Health Belief Model Ans- -Purpose is to predict health behaviors -Emphasizes change at the individual level -Assumes that the preventive health behaviors are taken primarily for the purpose of avoiding disease Milio's Framework for Prevention Ans- -Emphasizes change at the community level -Identifies relationship between health deficits and availability of health-promoting resources Pender's Health Promotion Model Ans- -Does not consider health risk as a factor that provokes change -Examines factors that affect individuals actions like: personal factors, feelings, benefits, barriers, attitudes of others, and abilities Determinants of Health Ans- Factors that influence that client's health. -- nutrition, stress, education, environment, finances, and social status Health Indicators Ans- Describe the health status of a community and serve as targets for the improvement of a community's health -- mortality rates, disease prevalence, levels of physical activity, obesity, tobacco, or other substance use Community Ans- -A group of people and institutions that share geographic, civic, and/or social parameters -The "community is the client" in community health nursing Goals of Community Health Nursing Ans- Promote, preserve, and maintain the health of populations by the delivery of health services to individuals, families, and groups in order to influence "community health" Public Health Nursing Ans- -It is population-focused, and involves a combination of nursing knowledge along with social and public health sciences -GOAL: promote health and preventing disease PHN: Assessment Ans- -Using systematic methods to monitor the health of a population --Monitor health status to identify community health problems --Diagnose and investigate health problems/hazards in the community PHN: Policy Development Ans- Developing laws and practices to promote the health of a population based on scientific evidence PHN: Assurance Ans- Making sure adequate health care personnel and services are accessible, especially to those who might not normally have them Population-focused Nursing Ans- -Includes assessing to determine needs, intervening to protect and promote health, and preventing disease within a specific population Key Principles of PHN: Ans- -Emphasize primary prevention -Work to achieve the greatest good for the largest number of individuals -Recognize that the client is a partner in health -Use resources wisely to promote the best outcomes Ethics Ans- Preventing harm, doing no harm, promoting good, respecting both individual and community rights, respecting autonomy and diversity, and providing confidentiality, competency, trustworthiness, and advocacy Advocacy Ans- The nurse plays the role of informer, supporter, and mediator for the client Evidence-Based Practice Ans- -Involves using the best practices, expert opinion, and client preferences to change the delivery of client care -GOAL: improve client outcomes EBP: Data Ans- The nurse should appraise data collected from research to measure whether bias was minimal (quality), the number of studies, participants, or strength of effect (quantity) and whether the results are repeatable (consistency) Quality Ans- Quality assurance, improvement, and management are part of improvement of health care Total quality management (TQM) Ans- Approach that seeks to improve quality and performance which meets or exceeds expectations Continuous quality improvement (CQI) Ans- Approach to quality management that emphasizes the organization and its processes and systems and uses objective data to analyze and improve processes Community Health Education Ans- -Nurses regularly provide health education in order to promote, maintain, and restore the health of populations -Nurses must take in account the barriers that make learning difficult like: age, cultural beliefs, poor reading skills, and language barriers -Effective community health education requires planning Learning Theories: Behavioral Theory Ans- Use of reinforcement methods to change learners' behavior Learning Theories: Cognitive Theory Ans- Use of sensory input and repetition to change learners' patterns of thought, thereby changing behaviors Learning Theories: Critical Theory Ans- Use of ongoing discussion and inquiry to increase learners' depth of knowledge, thereby changing thinking and behaviors Learning Theories: Developmental Theory Ans- Use of techniques specific to learners' developmental stages to determine readiness to learn, and to impart knowledge Learning Theories: Humanistic Theory Ans- Assists learners to grow by emphasizing emotions and relationships and believing that free choice will prompt actions that are in their own best interest Learning Theories: Social Learning Theory Ans- Links information to beliefs and values to change or shift the learners' expectations Domains of Learning: Cognitive Ans- Involves knowledge and the development of intellectual skills Domains of Learning: Affective Ans- Involves a change in attitude and development of values Domains of Learning: Psychomotor Ans- Involves the performance of a skill Development of a Community Health Education Plan Ans- -First, identify population-specific learning needs -Design the educational program -Implement the educational program -Evaluate the achievement of learning objectives Epidemiology Ans- The study of health-related trends in populations for the purposes of disease prevention, health maintenance, and health protection Epidemiology Process Ans- A systematic method of targeting a specific health need with the goal of improving health --Provides a broad understanding of the spread, transmission, and incidence of disease and injury Epidemiological Triangle Ans- -Epidemiology involves the study of the relationships among an agent, host, and environment -Their interaction determines the development and cessation of communicable diseases, as they form a web of causality, which increases or decreases the risk for disease -- Agent: the physical, infectious, or chemical factor that causes disease -- Host: the living being that an agent or the environment influences -- Environment: the setting or surrounding that sustains the host Epidemiological Calculations Ans- -Incidence rate: Number of new cases in the population at a specific time / population total -Prevalence rate: Number of existing cases in the population at a specific time / population total -Mortality rate: provide information about cause of death -- Crude mortality rate: overall death rates -- Cause-specific rate: death from specific cause -- Infant/age: specific to lifespan -Attack rate: Number of people exposed to a specific agent who develop the disease / total number of people exposed -- Endemic when there is a moderate, ongoing occurrence in a given location -- Epidemic: rate of disease exceeds the usual level of the condition in a population -- Pandemic: condition occurs when an epidemic occurs in multiple countries or continents Health Promotion Ans- -National health goals are derived from scientific data and trends collected during the prior decade -- Healthy people 2020 Disease Prevention: Primary Ans- Prevention of the initial occurrence of disease or injury -- Nutrition education, family planning and sex education, smoking cessation, communicable disease prevention education, safety education, prenatal classes, immunizations, and advocating for access to health care and healthy environments Disease Prevention: Secondary Ans- Early detection and treatment of disease with the goal of limiting severity and adverse effects -- community assessment, screenings, surveillance, and control of outbreaks Disease Prevention: Tertiary Ans- Maximization of recovery after an injury or illness (rehabilitation) --PT and OT, support groups, and case management Cultural Care Ans- -Culturally and linguistically appropriate services (CLAS) -- STANDARDS: promote development of a healthcare workforce that can respond effectively to the needs of a diverse client population, providing language and information to a client in their preferred language throughout the delivery of care, and promote ongoing improvement and accountability for culturally appropriate care -- It is important to assess cultural beliefs and practices when developing a plan of care -- Nurses should: be familiar with cultures represented in the local community, consider the uniqueness of each client, and consider that there are variations within each culture Acculturation Ans- The process of merging with or adopting the traits of a different culture -- Adapting to a new culture requires changes in daily living practices like: language, education, and social experience Cultural Awareness Ans- Includes self-awareness of one's own cultural background, biases, and differences Cultural Needs Ans- -Cultural needs of a client are just as important as physical and psychosocial needs -The nurse should avoid imposing personal cultural values on the client Cultural Competence Ans- Involves respecting personal dignity and preferences, as well as acknowledging cultural differences -- Requires nurses to be responsive to the needs of clients from different cultures -- Guided by four divisions: 1. Cultural Preservation: allowing preservation of the client's traditional values 2. Cultural Accommodation: supporting and facilitating the client's use of cultural practices that are beneficial to the client's health 3. Cultural Repatterning: assisting the client to modify cultural practices that are not beneficial to the client's health 4. Cultural Brokering: advocating, mediating, negotiating, and intervening between the client's culture and health care culture on behalf of the client Cultural Assessment Ans- Provides information to the HCP about the effect of culture on communication, space and physical contact, time, social organization, and environmental control factors -- Environmental control: indicates the belief in how the environment affects the individual EX: harmony with the environment = more likely to use alternative medicine and spirituality to promote balance in health status -- Time orientation: describes whether an individual places more value on the past, the present, or the future EX: little interest in health promotion behaviors -- Social organization: describes the significance of individual members of a family or the family as a whole EX: single family member that is not the client might be the decision maker in the family; an individual might forgo her own health care needs for the sake of the good of the family -- Health beliefs and practices: whatever an individual believes is the cause of impaired health will affect actions the individual will take to treat or prevent disease - Biomedical belief: Focus on identifying the cause for every effect on the body; That the body functions like a machine -Naturalistic belief: Relate the individual as a part of nature or creation; An imbalance in nature is believed to cause disease; Eastern or Chinese medicine; Mexican culture follow the hot-cold theory of balance -Magico-religious belief: Link health to supernatural forces, or good and evil; Belief in faith healing used by some christian religions; Voodoo and whichcraft practices used in Caribbean nations Biological variations in health Ans- Linked to genetic ties from biological relatives Using an Interpreter Ans- -Use an interpreter when it is difficult for a nurse or client to understand the others language -Interpreters should have knowledge of health-related terminology -The use of family members as interpreters is not advisable because clients might need privacy, family members can lack objectivity, and family members can have difficulty understanding medical terminology -Nurse should consider the clients preferences when selecting the age and gender of an interpreter -Interpreters should not be from the same community as the client Conveying Cultural Sensitivity Ans- -Address clients by their last name unless the client gives permission to use other names -Introduce yourself by name and position -Be authentic and honest -Use culturally sensitive language -Find out what the client knows about their health problems and treatment -Incorporate clients' preferences and practices -Do not make assumptions about clients -Encourage clients to ask about anything they are unsure about -Respect clients' values, beliefs, and practices -Show respect for clients' support systems -Provide health teaching materials in the client's primary language Environmental Health Ans- Relates to the quality of the air, lans, water, and other surroundings to which people come into contact with -- Nurses identify environmental health risk, participate in research, and use advocacy to improve environmental quality -- Nurses engage in environmentally friendly practices and use of material as well as providing information to the public about environmental health -- Nurse use toxicological information to understand the specific effects that environmental hazards have on populations at risk or following an exposure (Toxicology considers how exposure to chemicals can have negative effects on health) Environmental Risks Ans- -Toxins: lead, pesticides, mercury, solvents, asbestos, and radon -Air pollution: carbon monoxide, particulate matter, ozone, lead, aerosols, nitrogen dioxide, sulfur dioxide, and tobacco smoke -Water pollution: wastes, erosion after mining or timbering, and run-off from chemicals added to the soil -Contamination: food and food products with bacteria, pesticides, radiation, and medication (growth hormones or antibiotics) Environmental Health: Role for Nurses Ans- -Facilitate public participation in measures to improve the environment -Perform individual and population risk assessments -Implement risk communication -Conduct epidemiological investigations -Policy development Environmental Health: Assessment Ans- "I PREPARE" is a method of determining current and past environmental exposures -- I: Investigate potential expostures -- P: Present work: exposures, use of PPE, location of safety data sheets (SDS), hazardous materials brought home on clothing from work, trends -- R: Residence: age of home, heating, recent remodeling, chemical storage, water -- E: Environmental concerns: air, water, soil, industries in neighborhoods, waste site or landfill nearby -- P: Past work: exposures, farm work, military, volunteer, seasonal, length of work -- A: Activities: hobbies, activities, gardening, fishing, hunting, soldering, melting, burning, eating, pesticides, alternative medicines/healing -- R: Referrals and Resources: Environmental Protection Agency, SDS, OSHA, local health dep -- E: Educate: risk reduction, prevention, follow up National Health Care Goals Ans- Reductions: -- toxic air emissions, waterborne disease outbreaks, per capita domestic water use, blood lead levels in kids, pesticide exposures, indoor allergen levels, homes with lead-based paint, exposure to chemicals and pollutants, risks posed by hazardous sites, schools near highways Increases: -- use of alternative modes of transportations for work, number of days beaches are open and safe for swimming, recycling, testing for lead-based paint in houses, monitoring for diseases Environmental Health: Primary Prevention Ans- Individual: -- Educate individuals to reduce environmental hazards Community: -- Educate groups, advocate for safe water and air, support programs for waste reduction and recycling, advocate for effective waste management Environmental Health: Secondary Prevention Ans- Individual: -- Survey for health conditions related to environment and work, obtain environmental health histories, monitor workers for levels of chemical exposures, screen children 6 months to 5 years for blood lead levels Community: -- Survey for health conditions, assess neighbors, schools, work sites, and the community for environmental hazards Environmental Health: Tertiary Prevention Ans- Individual: -- Refer homeowners to lead abatement resources, educate clients who have asthma about environmental triggers Community: -- Become active in consumer and health-related organizations and legislation related to environmental health issues, support cleanup of toxic waste sites and removal of other hazards Global Health Ans- -Global health initiatives can be used to improve health status worldwide, and promote equity in treatment -Health for all in the 21st century (HFA21) outlines goals to promote productivity though adequate healthcare services around the globe -Examining the years of life lost from early death and disability provides information about the global burden of disease Influences on Global Health Ans- Wars and political unrest, natural and man-made disasters, limited resources and structure in lesser-developed nations, international travel (increase spread of disease), sanitation practice, climate change, maternal health, nutrition