Community Health Nursing
Community types
geographic, common interest, community of solution
community of solution
group of people who come together to solve problems that affects all of them, ex: guidance counselors,
counties working for water pollution
common interest
collection of people with interest or goal that bind them together, ex: MADD, disabled community,
church groups, gay community
population
all the people occupying an area, or all those who share one more characteristic, may not necessarily
interact
aggregates
a mass or grouping of distinct individuals who are considered as a whole and are loosely associated with
each other, broader term then population; communities and populations are types
goal of community health nursing
health promotion, disease prevention, and health protection
promotion of health
health education, preventative care services, healthy people 2030, raise levels of wellness for individuals,
families, populations and communities
prevention of health problems
anticipating and averting problems or discovering them as early as possible to minimize potential
disability and impairment
primary prevention
to keep illness from occurring, hand rails, immunizations
secondary prevention
efforts to detect and treat existing health problems. Screenings: htn, drug abuse, breast exam, DM test;
to intervene to control or eradicate before morbidity becomes severe
tertiary prevention
attempts to reduce the extent and severity of health problems so as to minimize disability and restore or
reserve function: rehab after CVA.
tertiary prevention
someone that has an eating disorder, following up with counseling
treatment of disorders
focuses on illness by: direct service, indirect service, development of programs to correct unhealthy
conditions
evaluation
process by which the practice is analysis, judged, and improved according to established goals and
standards
research
investigation to discover facts affecting community health and community health practice, solve
problems, and explore improved methods of health science
determinant of health
biology, behavior, economy, housing, environment, policies and interventions
community health status
health of total population; measured by morbidity and mortality statistics, especially infant mortality
core public health functions
assessment, policy development, assurance
role of community health nurse
clinician, educator, advocate, collaborator, leader, researcher, case manager
clinician
most familiar role, ensures health services are provided
educator / teacher
client is not acutely ill, so can absorb information better, wide audience can be reached
advocate
2 goals: help clients gain greater independence or self determination; make the system more responsible
and relevant to the needs of clients. Every client has the right to receive just, equal and humane
treatment
collaborator
work jointly with others, need communication skills
leader
focuses on change, nurse becomes an agent of change, influence people to think and behave differently
about their health
researcher
evidence based practice, systematic investigation, collection, and analysis of data for solving problems
and enhancing community heath practice
case manager
has become the standard method of managing health care in delivery systems in US. Evaluates progress
to ensure that clients' multiple service needs are met in a cost-effective manner.
settings for community health nursing practice
homes, ambulatory services, schools, occupations health settings, hospice, parish, forensics, corrections
(prison)
ambulatory service settings
community health centers, clinics, day care centers, health departments, services for select groups such
as migrant camps, native american reservations, correctional facilities, parishes
Lillian Wald and Mary Brewster
started Henry Street Settlement to provide nursing and welfare services
societal influences on the the development of community health nursing
tech, progress in thinking, education, role of women, consumer movement, economic forces
Federal agencies
DHHS, Environmental Protection Agency (EPA), Homeland security, Dept of Agriculture, Dept of
Education, Veteran's Administration (VA), Public Health Service (PHS). Secretary of HHS and Assistant
Secretary (over the PHS) are appointed positions
State administered programs
Medicaid, CHIP
Local health department
carries out most state laws and policies, most direct/immediate care; structure varies by community
needs and resources
Indian health services
IHS: part of the U.S. Department of Health and Human Services and is responsible for the medical care
provided to Native Americans and Native Alaskans. Established in 1954 and provides health care.
medicare
A program added to the Social Security system in 1965 that provides hospitalization insurance for the
elderly and permits older Americans to purchase inexpensive coverage for doctor fees and other health
expenses.
medicaid
a federally aided, state operated program that provides medical benefits for low-income persons in need
of medical care
advantages of home health
convenience, access, relationship, cost, outcomes, teaching opportunities
multiplicity of problems
finding more then one problem
maintaining balance in professionalism
intimacy vs professional distance, risk and safety, assisting and devaluing client, dependence and
independence, cost containment and quality
I-Prepare
environmental assessment model: prevent, resident, environment, past work, activities, resources,
education
web of causation
the combination of factors that lead to a problem
toxic agent
poisonous substance in the environment
overpopulation
exceeds ability of it's ecosystem to either support needs; 4 factors (starvation, disease, wars, aide from
other countries)
air pollution
high in industrial areas
radon
odorless, colorless, causes cancer
lead poisoning
affects CNS, old paint, toxic to developing brains
psychological hazards
noise, overcrowding, lack of natural beauty
traditional nursing
work as part of team, acute setting, with other professionals
public health nursing
in the community, often alone, no monitors, labs, use non-tangible skills like listening, assessing,
planning
hospice
concept of palliative care for terminally ill patients,
nurse role overpopulation
teaching birth control, family planning, preventing high risk pregnancies, sex education
vectors
non-human, carry diseases such as mosquitoes, flies, ticks, roaches, fleas, rats, mice, and squirrels
motor vehicle accidents
3 billion injuries and >42,000 deaths per year
healthy people 2030 environmental health
Focuses: reduce toxic pollutants, increase adults and aerobic activity, reduce risks from hazardous sites,
reduce adults doing no physical activity, safe drinking water, schools with policies for health, technology
use in healthcare, reduce exposures to chemicals and metals, increase internet access
macroeconomic theory
branch of economics that deals with the total or aggregate of all individuals and organizations.; useful for
providing a global perspective; has led to abroad perspective on health care financing
microeconomic theory
concerned with supply and demand
Chain of Causation
factors involved in the development of a disease or injury, which may be the targets of an intervention to
prevent the disease or injury; includes an agent, a host, and the environment; more linear than web of
causation; not useful in describing nonifectious diseases like cancer and diabetes
