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ATI RN Community Health Nursing Study
Guide Exam 100% Pass
Systems thinking - answer Studies how an individual, or unit, interacts with other organizations or systems Upstream thinking - answer 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 - answer -Highlights the relationship between an individual's environment and health -Depicts health as a continuum -Emphasizes preventive care Health Belief Model - answer -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 - answer -Emphasizes change at the community level -Identifies relationship between health deficits and availability of health-promoting resources Pender's Health Promotion Model - answer -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 - answer Factors that influence that client's health. --> nutrition, stress, education, environment, finances, and social status Health Indicators - answer 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 - answer -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 - answer 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 - answer -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 - answer -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 - answer Developing laws and practices to promote the health of a population based on scientific evidence PHN: Assurance - answer Making sure adequate health care personnel and services are accessible, especially to those who might not normally have them Population-focused Nursing - answer -Includes assessing to determine needs, intervening to protect and promote health, and preventing disease within a specific population Key Principles of PHN: - answer -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 - answer Preventing harm, doing no harm, promoting good, respecting both
Learning Theories: Critical Theory - answer Use of ongoing discussion and inquiry to increase learners' depth of knowledge, thereby changing thinking and behaviors Learning Theories: Developmental Theory - answer Use of techniques specific to learners' developmental stages to determine readiness to learn, and to impart knowledge Learning Theories: Humanistic Theory - answer 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 - answer Links information to beliefs and values to change or shift the learners' expectations Domains of Learning: Cognitive - answer Involves knowledge and the development of intellectual skills Domains of Learning: Affective - answer Involves a change in attitude and development of values Domains of Learning: Psychomotor - answer Involves the performance of a skill Development of a Community Health Education Plan - answer -First, identify population- specific learning needs -Design the educational program -Implement the educational program -Evaluate the achievement of learning objectives
Epidemiology - answer The study of health-related trends in populations for the purposes of disease prevention, health maintenance, and health protection Epidemiology Process - answer 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 - answer -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 - answer -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
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 - answer 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 - answer Includes self-awareness of one's own cultural background, biases, and differences Cultural Needs - answer -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 - answer 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:
- Cultural Preservation: allowing preservation of the client's traditional values
- Cultural Accommodation: supporting and facilitating the client's use of cultural practices that are beneficial to the client's health
- Cultural Repatterning: assisting the client to modify cultural practices that are not beneficial to the client's health
- Cultural Brokering: advocating, mediating, negotiating, and intervening between the
client's culture and health care culture on behalf of the client Cultural Assessment - answer 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 - answer Linked to genetic ties from biological relatives
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 - answer -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 - answer -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 - answer "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 - answer 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 - answer 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
called for more developed nations to contribute resources to improve conditions in lesser- developed countries, making global health a responsibility of nations around the world. --> Eradicating hunger and extreme poverty, making primary education available worldwide, promoting empowerment of women and gender equality, reducing child mortality, fostering maternal health, reducing malaria, HIV/AIDS, and other communicable diseases, promoting a sustainable environment, developing global partnerships Global Health: Nursing Interventions - answer -Support the development of health care roles in countries that lack health care professionals -Promote the benefits of nursing as a distinct profession in health promotion and disease prevention and reducing health care costs -Promote the rights of nurses -Foster programs that promote environmental sustainability ("go green") -Act as mentors or consultants to address health of individuals and communities in other countries Access to Health Care - answer The goal of a primary health care system is to make health care available in close proximity to people who need it, and to ensure that it be comprehensive with flexible cost to accommodate the income variations of the individuals who use those services --> PHN advocate for improved access to health care services --> PHN can help shift the focus of the health care system from acute treatment of disease to primary prevention measures, in order to decrease costs Barriers to health care - answer Inadequate health care insurance, inability to pay for services, language barriers, cultural barriers, lack of providers in a community, geographic and social isolation, lack of communication tools (cell phone) and transportation, inconvenient hours, attitudes of HCP towards clients of low income socioeconomic status or those with different ethnic backgrounds, eligibility requirements for state/federal assistance programs
Organizations and Financing - answer Good health status positively affects the economy by increasing the individual's potential for productivity and wage-earning Microeconomic Theory - answer Examines individual preference and finances, and how those actions affect cost of care and resource distribution Macroeconomic Theory - answer -Focuses on aggregate behaviors, economic growth, and employment
- The cost associated with health care is a barrier to care for many become some providers ration health care, and only offer services to individuals with certain coverage types -The U.S government is involved in providing direct health care services, providing information and protection to the public, setting policies, and assisting providers and the public with finances Affordable Care Act - answer - It was created to help make health insurance affordable for all people and decreases the amount of federal spending on health care
- It affects the way medicare benefits are implemented and the way private insurance companies supply coverage
- IMPORTANT ELEMENTS: --> Extending eligibility for dependents to remain on parent's insurance until age 26 --> Prohibiting health plans from denying benefits for preexisting coverage to children under age 19 --> Banning lifetime limits on benefit coverage --> Covering preventive care services Organizations - answer The health care system in the U.S. is influences by federal and
--> National Institutes of Health (NIH) --> Substance Abuse and Mental Health Services Administration (SAMHSA) State: State Departments of Health - answer Obtain funding from state legislature and federal public health agencies --> Manages Women, Infant and Children (WIC), which promotes nutrition for women, infants, and children up to age 5 who are of low socioeconomic status --> Oversees Children's Health Insurance Program (CHIP), which offers expanded health coverage to uninsured children whose families do not qualify for Medicaid --> Establishes public health policies --> Provides assistance/support for local health departments --> Responsible for the administration of the Medicaid program --> Reports notifiable diseases to the CDC State: State Boards of Nursing - answer - Development and oversight of the state's nurse practice act
- Licensure of RN's and LPN's
- Oversight of the state's schools of nursing Local Health Department - answer - Receives funds from the state level to implement community level programs
- Primary focus is to offer various services and programs
- Responsible for identifying and intervening to meet health needs of the local community
- Work closely with local officials, businesses, and stakeholders
- Report notifiable diseases to the state department of health
- Funded though local taxes with support from federal and state funds
Private Funding - answer Health Insurance and Employer Benefits -Managed care: Bases on using a case management approach with a specific group of providers in an attempt to contain the cost of care Private Funding: Health maintenance organizations (HMOs) - answer Comprehensive care is provided to members by a set of designated providers Private Funding: Preferred provider organizations (PPOs) - answer Predetermined rates are set for services delivered to members --> Financial incentives are in place to promote use of PPO providers Private Funding: Medical savings accounts - answer Untaxed money is put in an account for use for medical expenses Self pay - answer Individuals are responsible for payment --> Offer sliding scale payment where the payment is based off on the individuals income Community Health Program Planning - answer - Role of PHN: collaborative leadership role
- Community health program planning should reflect the priorities set as a result of analysis of community assessment data
- Priorities are established based on: --> The extent of the problem (percent of the community affected) --> The relevance of the problem to the public (degree of risk) --> The estimated effect of intervention (improvement of health outcome, adverse effects)
Data Collection - answer - A critical community health nursing function
- Identify the health needs of the local community
- It is essential to combine several methods of data collection to have the best outcome Data Collection: Informant Interviews - answer Direct discussion with community members for the purpose of obtaining ideas and opinions from key informants
- STRENGTHS: --> Minimal cost, offers insight into beliefs and attitudes, no reading/writing of participants
- LIMITATIONS: --> Built-in bias, meeting time and place Data Collection: Community Forum - answer Open public meeting
- STRENGTHS: --> Opportunity for community input, minimal cost
- LIMITATIONS: --> Difficulty finding time/place, potential to drift from the issue, participation Data Collection: Secondary Data - answer Use of existing data to assess problems; Websites with .edu, .org, and .gov are reliable
- STRENGTHS: --> Database of prior concerns/needs, ability to trend health issues over time
- LIMITATIONS: --> Data might not represent correctly, time consuming
Data Collection: Participant Observation - answer Observation of formal or informal community activities
- STRENGTHS: --> Identification of power structures, indication of community priorities, environmental profile
- LIMITATIONS: --> Bias, time consuming, inability to ask participant questions Data Collection: Focus Groups - answer Directed talk with a representative sample
- STRENGTHS: --> Participants being potential supporters, provides insight into community support, reading/writing of participants not required
- LIMITATIONS: --> Discussion of irrelevant issues, getting participants, ensuring the sample is truly represented, time consuming Data Collection: Surveys - answer Specific questions asked in a written format
- STRENGTHS: --> Data collected on client population and problems, random sampling, available written or online, contact with people isn't required
- LIMITATIONS: --> Low response rate, expensive, time consuming, collection of superficial data, requires reading/writing of participants Data Collection: Windshield Survey - answer Descriptive approach that assesses several
