Community Study Guide for the Hesi Population Groups across the Lifespan Health Risks Infants Number 1 cause ca use of injury or death is suffocation followed by Motor Vehicle Vehicle Accident then Homicide. Sudden Infant Death Syndrome Infection is the most significant cause of illness in infants and children. Children Obesity – Healthy people objectives have addressed youth fitness and obesity Defined by using BMI which is a ratio of weight to height Risks for childhood obesity were related to obesity in the parents Obesity rates higher populations such as Native American, Hispanic, and African Americans Americans groups. Lower socioeconomic groups in urban settings have been associated with higher rates Injuries and Accidents - Number one cause of death in ages 1 – 24 yrs. yrs. Motor vehicles accidents are the leading cause of death among children and teenagers. Toddlers experience a large number of falls, poisonings, and motor vehicle accidents School age children has the lowest injury death rate; however, this group has difficulty judging speed and distance, placing them at risk for pedestrian and bicycle accidents. Adolescents injury accounts for 75% of all deaths and risk-taking becomes more conscious at this time especially among males. Suicide is the second leading cause of death among youths between the ages of 15 and 24. Suicide s the third leading cause of death among youth between the ages of 10 and 24 years. Acute Illness - also a significant cause of illness in children. Chronic Health Problems - improved medical technology has increased the number of children surviving with chronic health problems. Examples: Down Syndrome, Syndrome, spina bifida, cerebral palsy, asthma, diabetes, congenital he art disease, cancer, hemophilia, broncopulmonary dysplasia, and AIDS Routine immunizations have been very successful in preventing selected diseases.
Good nutrition is essential for healthy growth and dev elopment and influences disease prevention in later life. Women The women’s health movement was pivotal in bringing national recognition to women’s women’s health issues. Women have a longer life expectancy than men
Women are more likely to have acute and chronic conditions that require them to use more services than men. Women of color are more statistically more likely to have poor health outcomes because of poor understanding of health, lack of access to health care, and lifestyle practices. Heart disease leading cause of death in women Lung Cancer leading cause of cancer in women and 2nd leading cause of death Men Men are physiologically the more vulnerable gende r, shorter life span and higher infant mortality rate Life expectancy of men in the US is one of the lowest in the developed countries Men engage in more risk-taking behaviors than women Men tend to avoid diagnosis and treatment of illnesses that may result in serious health problems Elderly Steadily growing population Increase in chronic conditions, demand for services, and strained health care budgets More older adults live in the community Nurses address the chronic health concerns of elders with a focus on maintaining or improving self-care and preventing complications to maintain the highest possible quality of life. Assessing the elderly incorporates physical, psychological, social, and spiritual domains. Individual and community focused interventions involve all three levels of prevention through collaborative practice. U.S. Healthcare problems More than 43 million people in the United States are uninsured, and man y more simply lack access to adequate health care.
Health care reform measures seek to make changes in the cost, quality qua lity,, and access of the present system. The integration of primary care and public health is necessary for the future health of the nation To achieve the specific health goals of programs such as healthy People 2010, primary care and public health must work within the community for community-based care. The most sustainable individual and system changes come when people who live n the community have actively participated. Nurses are more than able to fill the gap between personal care and public health because they have skills in assessment, health promotion, and disease and injury prevention; knowledge of community resources; and ability to develop relationships with community members and leaders.
Home Visits- give a more accurate assessment of the following than do clinical visits: - the fa family st struct ucture - the the nat natur ural al or home home envi enviro ronm nmen entt - beha behavi vior or in that that envi enviro ronm nmen entt
Home visits provide opportunities to identify both barriers and supports for reaching family health promotion goals. Home visits afford the opportunity to gain a more accu rate assessment of the family structure and behavior in the natural environment. Home visits also provide opportunities to observe the home environment and to identify both barriers and supports to reducing health risks and reaching family health goals. Parish nurses : nurses who respond to health and wellness needs within the faith context of population of faith communities and are partners with the church in fulfilling the mission of health ministry. ministry. Parish nursing : a community-based and population-focused professional nursing practice with faith communities to promote whole person health to its parishioners usually focused on primary prevention. Parish nurse coordinator : a parish nurse who has completed co mpleted a certificate program designed to develop the nurse as a coordinator of a parish nursing service.
Parish nurse services respond to health, healing, and wholeness within the context of the church. Although the emphasis is on health promotion and disease prevention throughout throughout the life span, the spiritual dimension of nursing is cen tral to the practice. The parish nurse partners with the wellness committee and volunteers to plan programs and consider health-related concerns within faith co mmunities To promote a caring faith community, usual functions of the p arish nurse include personal health counseling, health teaching, facilitating linkages and referrals to congregation and community resources, advocating and encouraging support resources, and providing pastoral care. Parish nurses collaborate to plan, implement, and ev aluate health promotion activities considering the faith community’s beliefs, rituals, and polity. Healthy polity. Healthy People 2010 guidelines are basic to the partnering for the programs. Nurses working in the parish nursing specialty must seek to attain adequate educational and skill preparation for the accountability to those served and to those who have h ave entrusted the nurse to serve Nurses are encouraged to consider innovative approaches to creating caring communities. These may be in congregations con gregations as parish nurses, among several faith communities in a
single locale, or regionally; or in partnership with other community agencies or models such as block nursing. To sustain oneself as a parish nurse healer, hea ler, the nurse takes heed to heal and nurture nu rture self while supporting individuals, families, and congregation communities in their healing process. Hospice: palliative system of health care for terminally ill people; takes place in the home with family involvement under the direction d irection and supervision of health professionals, especially the the visiting nurse. Hospice care takes place in the the hospital when sever complications of terminal illness occur or when family becomes exh austed or does not fulfill commitments.
Professional Preparedness Requires nurses and other personnel to be aware of and understand unde rstand the disaster plans at their workplace and community- participate in mock drills Adequately prepared nurses will function in leadership capacity and assist towards smoother recovery phase Fieldwork, shelter management requires creativeness and willingness American Red Cross provides training for health professionals to adapt existing skills to disaster setting
Role of Community Health Nurse Can initiate or update disaster plans at workplace and community and ensure education, drill participation a vailable community resources Knowledge of vulnerable populations, available Assessing and reporting of environmental hazards, unsafe equ ipment, faulty structures, disease outbreaks, e.g., measles, flu Before anything happens: Prepare for Safety in a Disaster : Four steps 1. Find Find out out what what could could happe happen n to you: you: a. Determine Determine what what types types of disasters disasters are most most likely likely to to happen b. Learn Learn about about warnin warning g signal signalss in commu communit nity y c. Ask Ask abou aboutt car caree for for pets pets d. Review the disaster disaster plans at workplace, workplace, and and other places where families families spend time together e. Determ Determine ine how how to help help the elder elderly ly or disa disable bled d
2. Creat Createe a. b. c. d.
a disa disast ster er plan plan Discuss Discuss types types of disast disasters ers that that are likely likely to happen happen and review review what what to do Pick Pick 2 types types of places places to meet meet Choose Choose an an out-of out-of-st -state ate frie friend nd to contact contact Revi Review ew evac evac.. Pla Plans ns
3. Compl Complet etee this this chec checkl klis istt a. Post Post emer emergenc gency y numbe numbers rs next to phone phone b. Teach each how how to to call call 911 911 c. Determine Determine when when and how how to turn of of water water,, gas, and electric electricity ity d. Check Check adequ adequacy acy of insu insuran rance ce cover coverage age e. Locate Locate and and revie review w use of fire fire exti extingui nguishe shers rs f. Instal Installl and mainta maintain in smoke smoke detect detectors ors g. Condu Conduct ct a home home hazar hazard d hunt hunt h. Stoc Stock k emer emerge gency ncy suppl supplie iess i. CPR CPR cer certi tifficat icatiion j. j. Loca Locate te all all esc escap apee rou route tess k. Find ind saf safee spo spotts 4. Practi Practice ce and and maint maintain ain your your plan plan a. Revi Review ew ever every y 6 mos mos.. b. b. Cond Conduc uctt dril drills ls c. Replace stored stored water water every 3 mos. and stored stored food food every every 6 mos. d. Test and and rechar recharge ge fire fire extin extingui guishe sher r e. Test est smoke smoke dete detect ctor orss Personal Preparedness Nurses who are disaster victims themselves and provide care to others will experience considerable stress. American Red Cross and Federal Emergency Management Agency (FEMA) are two well known authorities on disaster preparedness, response, and recovery
Three levels 1st level – Personal Preparedness 2nd level- Professional Preparedness 3rd level- Community Preparedness Most states and counties have an Office of Emergency Management (OEM) that is responsible for developing and coordinating emergency response plans within their defined area. The state office supports local OEMs and other state agencies that participate in disaster response. It provides planning and training services to local governments, including financial and technical assistance. During an actual emergency or disaster, the state OEM coordinates a state response and recovery program if necessary. necessary. County OEMs are in charge of creating a comprehensive, allhazard plan that should address realistic dangers to the community and list available resources. **Nurses need to review the disaster history of community, including how past disasters have affected the health care delivery system, how their particular organizations fit into the plan, and what role they and their organizations are expected to play in a disaster.
Stages: Preparedness, Response, and Recovery Preparedness: Know who is at risk, Personal, Professional and Community Preparedness
Personal Preparedness Entails plan for keeping oneself ready for disaster, both mentally and physically community, job, Individuals not personally prepared will have less to give to family, community, and other disaster victims Nurses can be disaster victims- personal preparation needed to attend to patients Checklist helpful to prepare Professional Preparedness Requires nurses and other personnel to be aware of and understand unde rstand the disaster plans at their workplace and community- participate in mock drills Adequately prepared nurses will function in leadership capacity and assist towards smoother recovery phase Fieldwork, shelter management requires creativeness and willingness American Red Cross provides training for health professionals to adapt existing skills to disaster setting
Community Preparedness Level of preparedness only as high as people/ organizations in the community make it Well-prepared communities have written disaster plans, conduct drills, have adequate warning system, and backup evacuation plan Office of Emergency Management- state/ county office coordinating regional plans Understanding past disasters can influence planning for future, liabilities in resources Response
The primary objective of disaster response is to minimize morbidity and mortality. mortality. The level of disaster determines FEMA’ FEMA’s response. Levels are not determined by the number of casualties but by the amount of resources needed. FEMA Levels of Disaster Response Level III- a minor disaster, involves a minimal level of damage but cou ld result in the president declaring an emergency. A minimal request for federal help Level II- moderate disaster- likely to result in major disaster being declared. Regional federal resources engaged, other outside area may be called on Level I- massive disaster, severe damage or multistate scope. Full engagement of federal regional and national resources Citizens and health professionals must be attached to official agencies with disaster management responsibilities to avoid further risk
American Red Cross 3 ways to classify a disaster : Type- agent that caused the event, ev ent, such as hurricane, hazmat, transportation TypeLevel-
anticipated or actual Red Cross response and relief costs Level I. costs less than $10,000 Level II costs $10,000 or more, but less than $50,000 Level II costs $50,000 or more, but less than $250,000 Level IV costs $250,000 or more but less than $2.5 million Level V costs $2.5 million or more
Scope-
magnitude of the event, units affected and responding ,e.g., single-family, single-family, local, state, major, federally declared Single family – affects an individual or single family- occurs within the jurisdiction of a single Red Cross chapter Local Disaster - Affects Affects more than one o ne family, family, occurs within the jurisdiction of a single Red Cross chapter Affects multiple families, occurs within the jurisdiction of one or State Disaster - Affects More Red Cross chapters within a single state Major Disaster- has one or more of o f the following characteristics -coordinated response of multiple Red Cross units - affects more than a single state - creates national news - result in emergency or disaster declaration by the President etc. Presidentially Declared Disaster - requires full or partial implementation of the National Response Plan
The National Response Plan Once a federal emergency has been declared, the National Response Plan may take effect, depending on specific needs arising from the disaster. disaster. The NRP is a concerted effort effort to prevent terrorist attacks within the US; reduce American’s American’s vulnerability to terrorism, major disasters, and other emergencies; and minimize the damage and recover from attacks, major disasters, and other emergencies that occur. Role of the Nurse Role in disaster response depends on nurse’s past experience, role in community disaster preparedness, specialized training, special interest
Community health nurses valued for skills in community assessment, case finding, prevention, education, surveillance, working with aggregates
Plans for triage must begin as soon as rescue workers arrive- highest priority given to life-threatening injuries with high probability probab ility of survival- nurse’s accurate assessment info will help match available resources to population’ p opulation’ss emergency needs
Recovery The recovery stage of disaster occurs as all involved agencies pull together to restore the economic and civic life of the community. community. For example: the government takes the lead in rebuilding efforts whereas the business community tries to provide economic support. Nurse’s Role in Recovery Multifaceted responsibilities- flexibility required to assist in successful recovery Teaching health promotion, disease prevention, assessment of physical, psychological problems incurred in cleanup efforts, as well as threat of communicable disease Case finding, referral for mental distress Assessment and reporting of environmental health hazards resulting from event Get community back to normal, deal with emotional matters and after effects Assess what might be going on in community using primary, primary, secondary and tertiary care Terrorism Role of the Nurse: Help people cope with the aftermath of terrorism Allay public concerns and fears of bioterrorism Identify the feelings that you and others may be experiencing Assist victims to think positively and move to the future Prepare nursing personnel to be effective in a crisis situation
Nurses are concerned with anthrax and small pox and should have awareness of these diseases Need to have vaccine for small pox Levels of prevention r/t Disaster Management Primary Prevention - Participate in developing a disaster management plan for the community Secondary Prevention - Assess Assess disaster victims and triage for care Tertiary Prevention Prevent ion - Participate in home visits to uncover dangers that may cause additional injury to victim or cause other problems (e.g. house fires from faulty wiring). Population at Greatest Risk for Disruption After a Disaster Persons with disabilities Persons living on a low income, including includ ing the homeless Non-English speaking persons and refugees Persons living alone
Single-parent families Persons new to the area Institutionalized persons or those with chronic mental illness Previous disaster victims or victims of traumatic events People who are not citizens or legally documented immigrants Substance abusers The five components to a comprehensive public health response to outbreaks of illness are the following - Det Detecti ecting ng the the outb outbre reak ak - Det Determ ermini ining the the caus causee - Ident Identif ifyi ying ng fact factor orss that that pla place ce peop people le at at risk risk - Impl Impleme ement ntin ing g measu measure ress to cont contro roll the out outbr brea eak k - Inform Informing ing the the medica medicall and public public comm communit unities ies about about treat treatmen ments, ts, healt health h consequences, and preventative measures Triage: the process of separating casualties casualties and allocating treatment on the the basis of the victims’ potentials for survival. Highest priority is always given to victims who have life threatening injuries but who have a high probability of survival once stabilized Second priority is given to victims with injures that have systemic complications that are not yet life threatening and could wait 45 – 60 minutes for treatment Last priority is given to those victims with local injuries without immediate complications and who can wait several hours for medical attention.
Rationale from Saunders In an emergency department, triage is classifying clients according to their need for care and includes establishing priorities priorities of care. The kind of illness, the the severity of the problem, and the resources available govern the process. process. Clients with trauma, chest pain, severe respiratory distress or cardiac arrest, limb amputation, acute neurological deficits, and those who sustained chemical che mical splashes to the eyes are classified as emergent and are the number 1 priority. priority. Clients with conditions such as a simple fracture, asthma without respiratory distress, fever, hypertension, abdominal pain, or the client with a renal stone have urgen needs and are classified as number 2 priorities. Clients with conditions such as a minor laceration, sprain, or cold symptoms are classified as nonurgent and are the number nu mber 3 priority. priority. Older adult health risks Nutrition, safety, safety, social isolation, and depression Need to assess the health literacy of the client first
Program outcomes: smoking cessation, weight management, diabetic management - look look at the the eval evalua uati tion on of of the the speci specifi ficc outc outcom omee - Identifyin Identifying g changes changes in the client client’’s health health status status that result result from from nursing nursing care provides nursing data that demonstrate the contribution of nursing to the health care delivery system.
Research studies using the tracer or sentinel method to identify clients’ outcomes and client satisfaction surveys can be used to measure outcome standards. From data, strengths and weaknesses in nursing care delivery can be determined. The most common measurement methods are direct physical observations and interviews. Primary Care- refers to organized community efforts designed to prevent disease and promote health (education). Secondary Care - an intermediate level of health care that includes diagnosis and treatment. Screening. Tertiary Care- rehabilitation and return of a patient to a status of maximum usefulness and a minimum risk of recurrence of a physical or mental disorder Levels of Prevention Primary Prevention - Counsel clients in health behaviors related to lifestyle Secondary Prevention - Implement a family-planning program to prevent unintended pregnancies or young couples who attend the primary clinic Tertiary Prevention Prevent ion - Provide a self-management asthma program for children with chronic asthma to reduce their need n eed for hospitalization (prevent from getting worse) Federal Agencies
Many federal agencies are involved in government health care functions. The agency most directly involved with the health and welfare of Americans is the U.S. Department of Health and Human Services
U.S. Department of Health and Human Services (USDHHS) Largest health program in the world, its mission is to enhance the health and well-being of the American people through the following: - Alcoh Alcohol ol,, drug drug abuse abuse,, and and ment mental al heal health th pro progr grams ams - Dise Diseas asee tra tracki cking ng and iden identi tifi ficat catio ion n - Health care access for all and and integri integrity ty of of the nation’ nation’s health health entitlem entitlement ent and and safety net programs - Identi Identific ficati ation on and correc correctio tion n of of heal health th hazards hazards - Medical assistance after disasters - Medical re research - Promo Promoti tion on of of exer exerci cise se and and heal health thy y habi habits ts - Prote Protecti ction on of of the the nati nation’ on’ss food food and drug drug supp supply ly
The Health Resources and Services Administration of the USDHHS contains the Bureau of Health Professions, this bureau includes separate divisions for nursing, medicine, dentistry, dentistry, public health, and allied health professions The Division of Nursing administers nurse education legislation, interprets trends and nursing needs of the nation’s health care delivery system, and serves as a liaison with the nursing community and with international, state, regional, and local health interests Two other agencies agenc ies with the DHHS: The National Institute for Nursing Research (NINR) and Healthcare Research and Quality (AHRQ) This institution is the focal point of the nation’s nation’s nursing research activities. It promotes the growth and quality of research in nursing and patient care, provides important leadership, expands the pool of experienced nurse researchers, and serves as a point of interaction with other bases of health care research Nurses can apply for support for research, projects, or training from a variety of agencies within the federal government besides the NINR of the Division of Nursing. Other federal agencies: Dept. of Commerce, Dept. of Defense, Defense, Dept. of Labor (includes OSHA), Dept. of Agriculture (includes WIC), Dept. of Justice, Food and Drug Administration. Voluntary and Private Nonprofit Agencies Voluntary and private agencies are grouped together as nonprofit home health agencies, agenc ies, voluntary agencies are supported by charities such as United Way, Way, Medicare, Medicaid, other third-party payers, and client payment.
The amount of financial assistance the voluntary agency receives depends on the community it serves. With Medicare, Medicare, the private nonprofit agency emerged emerged as an alternative agency to the the public-supported program. These agencies included rehabilitation agencies, based in either rehabilitation facilities or skilled facilities.
Nurses use assessment skills to detect potential and actual expo sure pathways and outcomes for clients cared for in the acute, chronic, and healthy communities co mmunities of practice. Risk communication is an important skill and must ack nowledge the outrage factor experienced by communities with environmental hazards. Vulnerable populations - are those groups who have an increased risk to develop adverse health outcomes, vulnerable populations often experience multiple cumulative risks and they are particularly sensitive to the effects of those risks.
Vulnerable populations often are more likely than the general populations to suffer from health disparities . Examples of areas that show health disparities across populations groups are infant mortality, mortality, childhood immunization rates, and disease-specific mortality rates. Vulnerable Population Groups of Special Concern to Nurses - Poor oor and and home homelless ess peo peopl plee - Pregna egnant nt adol adoles esce cent ntss - Migr Migran antt work worker erss and and immi immigr gran ants ts - Sever Severely ely ment mental ally ly ill ill indi indivi vidua duals ls - Substance nce abusers - Abus Abused ed indi indivi vidua duals ls and and vic victi tims ms of of viol violen ence ce - Person Personss with with commu communic nicabl ablee disea disease se and and thos thosee at risk risk - Person Personss who are are human human immunod immunodefi eficie ciency ncy virus virus (HIV (HIV posi positiv tive) e) or have have Hep B or sexually transmitted disease. Behavioral (Lifestyle) Health Risk Assessment Families are the major source of factors that can promote or inhibit positive positive lifestyles. It is important to look at risks for the family as a unit.
Critical dimensions of lifestyle risks include the following: - Value alue plac placed ed on beha behavi vior or - Know Knowle ledg dgee of the the behav behavio iorr and its its con conse sequ quenc ences es - Effe Effect ct of the the beh behavi avior or on the the fam famil ily y - Effe Effect ct of the the beha behavi vior or on the the indi indivi vidu dual al - Barr Barrie iers rs to perf perfor ormi ming ng the the beha behavi vior or - Bene Benefi fitts of of the the beha behavi vior or It is important to assess the frequency, frequency, intensity, intensity, and regularity of specific behaviors. It also is important to evaluate the resources available to the family for implementing the behaviors.
Modifiable Risk and Unmodifiable Risks Risk factors that are "unmodifiable," are things that neither you nor your patients can do anything about. You You need to know the "unmodifiable" risk factors, because they help you to define high-risk individuals and groups for whom treating or controlling the "modifiable" risk factors is a priority.
Mmodifiable risks can be changed such as smoking. Epidemiology – how to calculate a rate The denominator includes the numerator •
Example Crude birth rate
Number of live births during 1 year X1000 Midyear population
Evaluating Outcomes Outcomes can be measured by looking at changes from before and after the intervention to solve the problems. problems. Changes in the followin following g can be used to see the outcomes outcomes of the interventions: - Demographics - Socio ocioec econ onom omiic fact factor orss - Envi Envirronm onmenta entall fact actors ors - Indi Indivi vidua duall and and com commu munit nity y heal health th stat status us - Use Use of heal healtth servi ervice cess
In the example of infant malnutrition, one would look for the number of cases of infant malnutrition in the community before providing education to other health providers about assessment assessment of infant development development.. A time period period for evaluation evaluation would be chosen and perhaps 1 year later (the time frame). frame). The number of cases of infant malnutrition malnutrition would be measured to see if a change had occurred and there were fewer cases. Incidence rate - the frequency or rate of new cases of an outcome in a populations; provi provide dess an esti estima mate te of the the risk risk of dise diseas asee in that that popu popula lati tion on over over the the perio period d of observation Prevalence : number of existing cases in a population at a given time Nursing Process - Always Always assess before starting an intervention Community assessment Most nurses are familia familiarr with the nur nursing sing process process as it applies applies to individu individually ally focused focused nursing nursing care. care. Using Using it to promote promote community community health health makes this same nursing process community focused. Community assessment - the process of critically thinking about the community and involves involves getting to know and underst understand and the community community as partner. partner. The community community
assessment phase involves a logical, systematic approach to the initial phase of the nursing process. Community assessment helps as follows: follows: - To ide ident ntif ify y com commu muni nity ty need needss - To cl clarify pr probl oblems ems - To iden identi tify fy stre strengt ngths hs and and res resou ourc rces es Assessing the community health requires the following three steps: - Gatheri Gathering ng relev relevant ant exis existin ting g data data and gener generati ating ng missi missing ng data data - Deve Develo lopi ping ng a com compo posi site te dat datab abas asee - Interpreti Interpreting ng the the composi composite te databas databasee to identify identify community community problems problems and strengt strengths hs Data Collection and Interpretation The primary goal of data collection is to get usable information about the community and its health. health. The system systemati aticc collec collectio tion n of data about community community health health requires requires the following: - Gath Gather erin ing g or or com compi pili ling ng exist existin ing g dat dataa - Gene Genera rati ting ng miss issing ing dat dataa - Inter nterpr pret etat atio ion n of of dat data Identifying community health problems and community abilities
Data gathering is the process of obtaining existing, readily available data. The following data usually describe the demography of a community - Age of residents - Gend Gender er dist distri ribut butio ion n of resi reside dent ntss - Soci Socioe oeco cono nomi micc char charac acte teri rist stic icss - Raci Racial al dis distrib tribut utiions ons - Vital ital statist statistics ics,, includi including ng select selected ed mortal mortality ity and and morbidi morbidity ty data data Identify needs, problems, strengths, resources and apply what you know. Windshield survey - are the motorized equivalent equivalent of simple simple observation. observation. They involve involve the collection of data that “will help define the community, the trends, stability, and changes that will affect the health of the community” School Nurse: Primary -The school nurse monitors the children for all of their state-mandated immunizations for school entry. - Secon Seconda dary ry-- Schoo Schooll nurs nursee is invol involve ved d in screen screenin ing g chil childr dren en for illnes illnesse sess and providing direct nursing care - Terti ertiar ary y – The The scho school ol nurs nursee care caress for for chil childr dren en with with long long-t -ter erm m heal health th need needs, s, including asthma and disabling conditions
School nurses carry out catheterizations, suctioning, gastrostomy tube feedings, and other skills in school.
The concern for health promotion of adolescents is safety because of their propensity to take part in risky behavior. To effe effectiv ctively ely reach reach a populati population on group group you must connect connect with someone someone in the community and establish trust. Occupational Exposure Job categories Exposure Farm Farm worke orkers rs pes pestici ticide dess, inf infecti ectiou ouss Agents, gases, sunlight
Chemical workers
solvents, cl cleansers, etc.
Work-related diseases and conditions HTN, HTN, mood mood diso disorrder ders, card cardiiovas ovascu cula lar r disease Cancer, et etc.
Complete list on page 637 in textbook Medicare Provides hospital insurance and medical insurance to persons ages 65 years and older, permanently disabled persons, and persons with end-stage renal failure Part A – covers: hospital care and home care (home care or hospice – can’t have both), skilled nursing care Part B- covers: (non-institutional care insurance) Medical care, diagnostic services and physiotherapy. Medicaid - Financial assistance to states and counties to pay for medical services for poor older adults, the blind, the disabled, and families with dependent children.
specia iall suppl suppleme ement ntal al food food progr program am admin adminis iste tere red d by the the Depa Depart rtme ment nt of WIC- a spec Agriculture through the state health departments; provides nutritious food that add to the diets diets of pregna pregnant nt and nursin nursing g women, women, infant infants, s, and childr children en younge youngerr than 5 years. years. Eligibility is based on income and nutritional risk as determined by a health professional Outreach Outreach worker: a health worker who makes a special, focused effort to find people with specific health problems for the purpose of increasing their access to health services - evaluate evaluate effecti effectiveness veness find out if if successf successful ul and and use ways to measur measuree success success Epidemiologic Epidemiologic triangle – agent, host, and environment – changes in one of the elements of the triangle can influence the occurrence of disease by increasing or decreasing a person’ person’ss risk for disease. disease. Risk is the probability probability that an individual individual will experience experience an event. Agent: an animate or inanimate factor that must be present or lacking for a disease or condition to develop Host: a living species (human or animal) capable of being infected or affected by an agent Environment - all that is internal or external to a given host or agent and that is influenced and influences the host and/or agent
Agent- an animate or inanimate factor that must be b e present or lacking for a disease or condition to develop - caus causiive – exam exampl ple: e: E. col coli - Infect Infectiou iouss agents agents (bact (bacteri eria, a, virus viruses, es, fungi fungi,, parasi parasites tes)) - Chemica Chemicall agents agents (heavy (heavy meta metal, l, toxic toxic chem chemical icals, s, pesti pesticid cides) es) - Physi Physical cal agents agents (radia (radiatio tion, n, heat heat,, cold, cold, machin machinery ery)) Host- a living species (human or animal) capable of being infected or affected by an agent - anythi anything ng capa capabl blee of of bein being g infe infect cted ed - Gene Geneti ticc sus susce cept ptib ibil ilit ity y - Immu Immuta tabl blee char charact acter eris isti tics cs (age (age,, sex sex)) - Acquir Acquired ed charact characteri eristi stics cs (immun (immunolo ologic gic status status)) - Life Lifest styl ylee fac facto tors rs (die (diet, t, exerc exercis ise) e) Environment - all that is internal or external to a given host or agent and that is influences the host and or agent - anyt nythin hing external nal - clim climat atee (tem (temper perat atur ure, e, rain rainfa fall ll)) - Plant Plant and and animal animal life life (agent (agentss or reser reservoi voirs rs or habi habitat tatss for agents) agents) - Human Human popul populati ation on distr distribu ibutio tion n (crowd (crowding ing,, social social suppo support) rt) - Socioec Socioeconom onomic ic facto factors rs (educa (educatio tion, n, resou resource rces, s, acces accesss to care) care) - Working orking condi conditio tions ns (level (levelss of stres stress, s, noise, noise, sati satisfa sfacti ction) on) Relationship between the above 3 cause disease, try to break the connection, if a break then there will be no disease. Web of Causality - complex interrelations of factors interacting with each other to influence the risk for or distribution outcomes. - recognizes recognizes the complex interrelat interrelationshi ionships ps of of many many factors factors interac interacting, ting, sometimes sometimes in subtle ways, to increase (or decrease) the risk of disease. - Associa Associatio tions ns are are sometim sometimes es mutual, mutual, with with line liness of causal causality ity goin going g in both both directions Family assessment Ecomap- represents the family’s interactions with other groups and organizations, accomplished by using a series of circles and lines. - It is repres represent ented ed by a circl circlee in the middle middle of the the page page - Other Other group groupss and org organi anizati zations ons are are then then indic indicate ated d by circl circles es - Lines representi representing ng the the flow flow of energy energy are are drawn drawn between between the family family circle circle and the circles representing other groups and organizations - An arrowhe arrowhead ad at the end end of each line line indicat indicates es the the directio direction n of the flow flow of of energy energy (into or out of the family) - The weig weight ht of the line line indi indicate catess the the intens intensity ity of the the energ energy y
Genogram - is a pictorial display of a person's family relationships and medical history. history. It goes beyond a traditional family tree by tree by allowing the user to visualize hereditary patterns and psychological factors that punctuate relationships. It can be used to identify repetitive patterns of behavior and to recognize hereditary tendencies. Prevention Strategies for Violence Individual and Family levels - Assess Assess during during routin routinee examina examinatio tion n (sec (second ondary ary)) - Asse Assess ss for for mar marit ital al dis disco cord rd (se (seco conda ndary ry)) - Educat Educatee on devel developm opment ental al stages stages and needs needs of child children ren (pri (primar mary) y) - Coun Counse sell for for at-r at-ris isk k pare parent ntss (sec (second ondar ary) y) - Teach each par paren enti ting ng tec techn hniq iques ues (pri (prima mary ry)) - Assi Assist st wit with h contr control olli ling ng anger anger (se (secon conda dary ry)) - Treat reat for for sub subst stan ance ce abu abuse se (te (tert rtia iary ry)) - Teach each stre stressss-red reducti uction on techni techniques ques (prima (primary) ry) Community Level - Develop policy - Cond Conduct uct comm communi unity ty reso resour urce ce mapp mappin ing g - Collabo Collaborat ratee with comm communi unity ty to devel develop op syste systemat matic ic respo response nse to to violence violence - Deve Develo lop p medi mediaa cam campai paign - Develo Develop p resou resource rcess such such as transi transitio tion n housin housing g and shelte shelters rs High school students and middle school students- steer away from violence and teach to work on their own skills and build their self-esteem.
