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NUR 150: Community-Based Nursing Mid-term Study Guide

Chapter 1: Community-Oriented Nursing and Community-Based Nursing

 Define Public Health

 Know the three core functions of public health:
o Assessment,
o Policy development and
o Assurance

 Differentiate between the following:
o Community-based nursing,
o Community-oriented nursing,
o community health and public health nursing practice

 Define key terms in Public Health Nursing:
o population/aggregate,
o subpopulation,
o primary, secondary and tertiary prevention

Chapter 2: The History of Public and Community Health and Nursing

 Relate the contributions of the following Nursing Pioneers:
o Florence Nightingale,
o Lillian Wald, and
o Mary Breckinridge

Chapter 3: The U.S. Health and Public Health Care Systems

 Events and trends that influence the status of the health care system.
o Demographic changes
o Health workforce trends
o Technological trends

 Identify current health care system problems associated with cost, quality, and access
to care.

 Organization of the health care system

virtue ethics. whether psychological or physical o Situations in which ethnic cultural standards conflict with professional standards o Situations in which the greater community’s values are jeopardized by specific ethnic values o Situations in which specific ethnic community customs are annoying but not problematic for the greater community  Theories and principles of ethics: o Autonomy: o Nonmaleficence o Beneficence o Distributive justice  Discuss the relationship between ethics and Community Health Nursing  Ethics and public health nursing core functions o Assessment. o Evaluate the decision and the action. analysis. ethic of care. o Reformulate ethical issues and dilemmas. o Obtain all relevant facts. and dissemination . principlism. Three ethical tenets relate to assessment:  Competency related to knowledge development.  Four situations in which ethical diversity can be judged in relation to cultural standards: o Situations that place persons at direct risk for harm. o Identify the ethical issues and dilemmas. o Place them within a meaningful context. deontology. o Make decision and take action. 1-2 o Private or personal care component o Public health component  The federal system (DHHS)  The state system  The local health department  Define Primary health care (PHC) and Primary care Chapter 4: Ethics in Community-Oriented Nursing Practice  The steps in the ethical decision-making processes. if needed. o Consider appropriate approaches to actions or options (utilitarianism. feminist ethics).

Assurance. o What is ethical is also good policy. o Service to others over self is a necessary condition of a good or right policy. Two ethical tenets are related to assurance: o All persons should receive essential personal health services. o Providers of public health services should be competent and available. Three ethical tenets relate to policy development: o An important goal of both policy and ethics is to achieve the public good. 1-3  Virtue ethics or moral character  Do no harm. Chapter 5: Cultural Influences in Nursing in Community Health  Describe methods for developing cultural competence. which is part of the concept of citizenship. o Cultural awareness o Cultural knowledge o Cultural skill o Engaging in cultural encounters o Cultural desire  Strategies used by culturally competent nurses to provide care that reflects the clients’ values are: o Cultural preservation o Cultural accommodation o Cultural repatterning o Cultural brokering  Inhibitors to developing cultural competence o Stereotyping o Prejudice o Racism o Ethnocentrism or cultural prejudice o Cultural blindness o Cultural imposition o Cultural conflict o Cultural shock  Differences among cultural groups o Communication. .  Policy development. o Space.

1-4 o Social organization o Time perception o Environmental control o Biological variations o Nutrition. Dietary practices o Socioeconomic factors and culture .

 Environmental health assessment. o individual and population risk assessment. o epidemiologic investigations. and o the education of others Chapter 9: Epidemiologic Applications  Define Epidemiology o Descriptive epidemiology o Analytic epidemiology  Basic concepts in epidemiology o Measures of morbidity and mortality  Proportion  Rates  Incidence and Prevalence . o Air o Water o Food o Public right to know o Risk assessment  Reducing environmental health risks o Risk communication: Education is a key primary prevention strategy  The right information  To the right people  At the right time o Government environmental protection  Roles for nurses: o community and public participation. o policy development. A windshield survey is a helpful first step in assessment. 1-5 Chapter 6: Environmental Health Environmental health sciences o Toxicology is the basic science that studies the health effects associated with chemical exposures. o Epidemiology is the science that tries to understand the strength of the association between exposures and health effects in human populations. o risk communication.

 Place  Time o Analytic epidemiology  Cohort studies  Case-control studies  Cross-sectional studies  Ecological studies Chapter 10: Evidence-Based Practice Explain how nurses use epidemiology in community health practice. report.  The web of causality  Basic methods in epidemiology o Descriptive epidemiology  Person. Nurses in the community are involved in surveillance and monitoring of disease trends and can identify patterns of disease in a group. such as time. o The environment is everything internal or external to a given host or agent and that is influenced and influences the host and/or agent. and communicate epidemiologic data as part of their daily practice. analyze. funding. o The host is a living species capable of being infected or affected by an agent. interpret. 1-6 The epidemiologic triangle o The agent is a factor that must be present or lacking for a disease or condition to develop. Nursing documentation on patient charts and records is an important source of data for epidemiologic reviews. computer resources. and knowledge o Lack of nurses’ necessary skills to identify and evaluate the latest evidence o Reluctance of nurses to accept the findings o Nurses’ feelings of being threatened when long-established practices are questioned . Barriers to implementing evidence-based practice in nursing o Misunderstood communication among nursing leaders about the process involved o Inferior quality of available research evidence o Inability to assess and use research evidence o Unwillingness of organizations to fund research and make decisions based on evidence o Concern that EBP will lead to a cookbook approach to nursing while ignoring individual client needs and the nurse’s ability to make clinical decisions o Lack of resources needed by community-based nursing agencies for its implementation in the clinical setting. Nurses collect.

1-7  Implementing evidence-based practice in nursing: Community-oriented nurses consider EBP as a process to improve practice and outcomes. and people usually consider the responses of others when making decisions regarding personal welfare. needs. Through community groups. linking individuals to the larger social system.  Educational issues o Population considerations . nurses help people identify priority health needs and capabilities and make valuable community changes. Groups within a community help identify community problems and are important in managing interactions within the community and between the community and the larger society.  Promoting health through group work. Understanding the community and assessing its health begin by identifying groups and their place in the community structure. The first step toward implementing EBP in nursing is recognizing the current status of one’s own practice and believing that care based on the best evidence will lead to improved client outcomes. and they use evidence to influence policies that will improve the health of communities. Health behavior is influenced by the groups to which people belong. o Established groups o Selected membership groups  Community groups and their contributions to community life. and o psychomotor  Six basic principles that guide the effective educator o Send a clear message o Select the learning format o Create the best learning environment o Organize learning experiences o Encourage participatory learning o Provide evaluation and feedback  Group concepts. Chapter 11: Using Health Education and Group Process in the Community  Three domains of learning o cognitive. Community groups represent the collective interests. and values of individuals. o affective.

adults. o Pedagogy is a set of learning strategies for children and individuals with little knowledge about a particular topic. o Select appropriate educational methods o Implement the educational plan. Common characteristics include: o status. o Andragogy is a system of learning strategies for adults. clarify problems. older adults. Chapter 12: Community Assessment and Evaluation  Define Community  The goal of community-oriented practice is community health. Multilinguistic presentation of materials needs to be available to provide culturally competent health education  The educational process: o Identify educational needs. and o process  Most changes aimed at improving community health involve partnerships between health care providers and community residents. Children. Community assessment helps to identify community needs. and individuals with some knowledge about a topic. Community assessment is the process of critically thinking about the community and involves getting to know and understand the community client as partner. Education should be related to the cultural background of the client. o Culture. o structure. 1-8  Age. Community partnership is crucial because community members and professionals who are active participants have a vested interest in the success of efforts to improve the health of their community  Assessing community health. and identify strengths and resources o Data gathering . and older adults have different learning needs and responses. o Evaluate the educational process. o Establish educational goals and objectives.

It begins in the planning phase of community action when goals and measurable objectives are established and goal-attaining activities are identified. Nurses have key roles in disaster preparedness to facilitate preparation in the community and in the workplace. Preparedness is advance preparation to cope with a disaster. Evaluation is the appraisal of the effects of some organized activity or program. improved surveillance and security operations. o advocating for a safe environment and assessing for and reporting environmental health hazards. isolation. or quarantine. This phase includes the work and activities aimed at achieving the goals and objectives  Evaluating intervention for community health. . public health and agricultural surveillance and testing processes. It includes: o Personal preparedness o Professional preparedness o Community knowledge and plans used to prevent or alleviate a disaster. and organize disaster drills. Chapter 14: Disaster Management Definition of disaster Prevention: Prevention activities may include: heightened inspections. o initiate or update the agency’s disaster plans. o Nurses should also understand what the available community resources will be after a disaster strikes and how the community will work together. Preparedness. 1-9 o Data generation o Database analysis  Identifying community problems The community problem consists of the following: o Clear identification of the specific problem faced by the community o Specifying the persons in the community affected by the problem o The factors that led to the problem  Planning for community health o Problem analysis and prioritization o Establishing goals and objectives o Identifying intervention activities  Implementing for community health. immunizations. o provide educational programs and materials regarding disasters specific to the area.

health consequences. Although nurses in community health have expertise in community assessment. and special interest. o duration. o magnitude and extent of damage. and location of the disaster. case finding and referring. health education. the American Red Cross and other voluntary agencies assist victims. and o disaster scope. such as single-family home fires. and preventive measures How communities are affected by disasters. and other voluntary organizations o The American Red Cross has three ways a disaster can be classified: o disaster type. and working with aggregates. o disaster level. The primary agencies involved in disaster response include: o The Federal Emergency Management Agency (FEMA): The level of disaster determines FEMA response. The five components to a comprehensive response to outbreaks of illness are the following: o Detecting the outbreak o Determining the cause o Identifying factors that place people at risk o 4Implementing measures to control the outbreak o Informing the medical and public communities about treatments. Biological or chemical terrorist attacks require a very different response. In these cases. Categories: o Red o Yellow o Green o Black . prevention. role in community preparedness. and o amount of warning provided The role of the nurse in disaster response depends a great deal on the nurse’s past experience. those skills will be set aside to deal with life-threatening problems first. FEMA’s assistance is not needed in many small disasters. The effects of disasters upon people depend on several things: o type. 1-10 Response is organized actions taken to deal with a disaster. surveillance. cause. Response to bioterrorism. o American Red Cross o the Salvation Army o many church denominations. Triage: the process of separating casualties and allocating treatment based on the victim’s potential for survival. specialized training.

or disease-carrying animals. lack of water or electricity. Case finding and referral are critical during the recovery phase and may continue for a long time. Nurses also need to observe for environmental health hazards during the recovery phase. Flexibility is essential in the recovery operation. . The role of the nurse in disaster recovery is varied. such as faulty housing structures. 1-11 Recovery is the stage of a disaster when all involved agencies pull together to restore the economic and civic life of a community.