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118 Cards in this Set
- Front
- Back
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Why is Public Health Important?
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It is a part of our everyday life:
The water we drink The air we breathe The laws that protect us from injury Vaccines that keep us healthy |
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Public Health does
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Prevents epidemics and the spread of disease
Protects against environmental hazards Prevents injuries Promotes and encourages healthy behaviors Responds to disasters and assists communities in recovery Ensures the quality and accessibility of health services |
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People in retirement communities are 27% less likely to be hospitalized and nearly 1/2 as likely to die from
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flu or pneumonia related complications if they receive yearly flu vaccinations
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Children are more likely to bike/walk to school (increasing activity levels) in communities that have
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newly built or improved sidewalks, traffic lights, pedestrian crossing and bike paths
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Public Health Affects All Families Across All Generations…
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Family Planning
Prenatal Care Childcare classes Access to healthy nutritious foods Tobacco free laws Clean water Farmer’s Markets And the list goes on… |
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“He who has health, has hope. And he who has hope, has everything”
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Arabian Proverb
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“The first wealth is health”
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Ralph Waldo Emerson
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Institute of Medicine (IOM) stated that the aim of public health was to
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generate organized community effort to address the public interest by applying scientific and technical knowledge to prevent disease and promote health.
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Population wide public wide approaches
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Behavioral
Environmental |
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(IOM) Public health is best defined
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as “what we, as a society, do collectively to assure the conditions in which people can be healthy”
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Goals of Public Health
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Protect Health
Promote Health Prevent Disease and Disability |
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Historical gains in the health of the populations
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Provision of Safe Water
Sewage Disposal Safety and adequacy of food supply Dramatic gain in life expectancy 1900 life expectancy 50 years 1990 life expectancy 75 years Public Safety Anthrax Threats of Bioterrorism Small pox |
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The increase in life expectancy is attributed primarily to
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improvements in sanitation, control of diseases and the use of immunizations, and other public health influences
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Medical Treatment can prevent only about __% of early deaths
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10%
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Public Health has the potential to help prevent ___% of early deaths
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70%
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Benefits of Public Health
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Medical treatment prevents 10% of all early deaths.
Population focus public health approaches has the potential to prevents 70% of early deaths. Death rates for children declined by 50% |
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Public Health Mission
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The promotion of physical and mental health, and prevention of disease, injury and disability in communities and populations
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Public Health Obligations
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Prevent epidemics and the spread of disease
Protect against environmental hazards Prevent injuries Promote and encourage healthy behaviors Respond to disasters and assist communities in recovery Assure the quality and accessibility of health services |
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Why is Public Health Important?
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95% of all health expenses is medical treatment
Physician Services and Hospital care combined account for over half of health care expenditures Growing cost of heath care. Aging population |
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Core Public Health Functions
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Assessment
Policy Develop Assurance |
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Core Functions of Public Health Assessment
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Systematically collecting data on the population to monitor health
Diagnosis and investigate problems and hazards in the community |
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Core Functions of Public Health Policy Development
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Inform, educate, and empower people about health issues
Mobilize community partnerships to identify and solve health problems Develop policies and plans that protect health and ensure safety |
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Core Functions of Public Health Assurance
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Enforce laws and regulation that protect health and ensure safety
Link people to needed personal health services Assure competent public health workforce Evaluate effectiveness, accessibility and quality Research for new solutions to health problems |
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10 Essential Services of Public Health
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Monitor Health status
Diagnose & Investigate health problems and hazards Inform, Educate, Empower people about health issues Mobilize Community Partnerships Develop Policies Enforce Laws Link to the services Ensure Competent Workforce Evaluate effectiveness, accessibility, and quality health services Research for new insights and interventions |
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Population Defined:
population and aggregate used interchangeable |
A collection of individuals who share one or more personal or environmental characteristics
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Subpopulation Defined:
Groups with in the population or aggregate. |
Examples:
High risk infants under the age of 1 Unmarried pregnant adolescents Particular event such as chemical exposure Students in NRSG 441 |
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Characteristics of Public Health Nursing
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Focus on a population that is Free Living in the community vs. institutionalized
Community-oriented which interface between health status and environment Emphasis on Health Protection and Promotion Disease prevention Use the political processes to affect public policy Interventions are made at a community or population level |
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What is the Public Health Nurse Focus?
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Population Focused Practice
Emphasizes Promotion of Health Prevention of Disease and Disability Creation of Conditions/Environments that Promote Health |
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Population Center Nurses Presently and in the Past have been called a variety of names
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Public Health Nurses
District Nurses Visiting Nurses School Nurses Occupational Nurses Home Health Nurses |
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Epidemics of the Past
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Cholera
Typhoid Fever Bubonic Plague “Black Death” Tuberculosis |
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Epidemics of Today
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Tuberculosis
HIV/AIDS West Nile Virus Hepatitis Malaria |
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History: Mid 1800’s
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Society
Civil war Crimean war: England & France vs. Russia Health Problems General infection & injury related to war, Cholera, Small Pox, Typhoid Response to Problems 1847: AMA conducts sanitary survey. Est. infirmaries District health nursing come to the U.S. War was occurring…shift in priorities. Less focus on public health |
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History: Late 1800’s
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Society
Immigration creating surge in population Increased industrialization Unsafe factory working conditions Crowding in inner cities Health Problems TB, Typhoid, Scarlett Fever, Small Pox |
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History: early 1900’s society
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Polarization: Big gap between poor and rich
WW1 Immigration |
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History: early 1900’s Health Problems
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TB, Influenza, Typhoid, Scarlett Fever, Small Pox
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History: early 1900’s Response to problems
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Health education promoted nutrition, hygiene & sanitation
Immunizations Local state health departments established (38 at this time) U.S. redefined role of public health services |
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History: Mid 1900’s
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Society
Segregation/fight for equality Post World Wars Health Problems PTSD, Alcoholism, Chronic Illness Response to problems Primary care est. Nursing in rural areas Screening & Treatment of infections & communicable diseases |
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U.S. Historical Changes Influencing Public Health Care
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Industrialization
Immigration Urbanization War Depression Privatization of Insurance |
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History: late 1900’s
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Society
Globalization Disappearance of borders Urbanization Less family orientated Environmental concerns Baby boomers coming of retirement age Health Problems HIV/AIDS, Malaria, STD’s, Lack of health care/access, Obesity, Heart disease, Cancers, Drug/Alcohol abuse |
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1964 Economic Opportunity Act
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Provided funds for neighborhood health centers, Head Start, and other community access for health care
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1965 Congress makes changes amending the Social Security Act
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Medicare- Health insurance for older adults
Medicaid-Provided increased care for the poor |
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florence nightgale said
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“ The health of the unity is the health of the community. Unless you have the health of the unity you have not community.”
“Nurses tasks in to put constitution in such a state that it will have not disease.” |
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Florence Nightingale History
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District Nursing
Crimean War (1854-1856) 1856 Organized Hospital Nursing Practice and Hospital Based Nursing Education. 1870 First Nursing School opened in US using Florence’s model. |
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Florence Nightingale Mantra
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Proper nutrition, rest, sanitation, and hygiene necessary for health .
Nurses focused on health promotion, disease prevention, and the environment. Focus: individuals, families and communities. |
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Visiting Nursing
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Care of the sick poor in their homes
Attended several patients per day Visiting Nurse Association (VNA) 1885 Key role in preventing communicable disease |
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Settlement Houses
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Neighborhood Center
Hubs for health care, education, and social wealth fair centers. |
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Lillian Wald
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Founder Henry Street Settlement which later become the Visiting Nurse Services.
Cared for residents of the lower eastside of New York Invented the term “ Public Health Nursing” |
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Lilian Wald secured initial donations to support which agency
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Red Cross
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American Red Cross Nursing
Rural Nursing Service/Town and Country Nursing Services |
Home Nursing Outside Large Cities
Lillian Wald secure initial funding Improved living conditions in villages and isolated farms |
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Mary Breckenridge:
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Founder of Frontier Nursing Service provided care to rural areas Kentucky
Establishment of 1st Midwives Reduced pregnancy complications |
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Lina Rogers: First School Nurse
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New York City 1902 on a single day more than 20% of the children would be absent.
Found that children missing from school not because of health conditions but lack of shoes and clothing. |
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African-American Nurses in Public Health Nursing
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Segregation limited African-Americans to become nurse.
In 1935 only 435 African American public health nurses were employed. |
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Public Health Focus
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the health of the population
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Challenge of public health
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how does the focus remain in time of change
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Intervention Wheel: Population-based Public Health Practice
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Conceptual Framework
Minnesota Model or Wheel Depicts how public health improves populations through community interventions |
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Three levels of practice are
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community
systems individual/family |
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the intervention wheel is composed of three distinct elements of equal importance
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first, population based
second, encompasses 3 levels of practice third, identifies & defines 17 public health interventions |
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Interventions Implemented at 3 Levels
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Individuals (singly or in a group)
C0mmunities as a whole Systems that impact the health of the communities |
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Assumption Number 1:
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Defining Public Health Nursing Practice
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Assumption Number 1: Defining Public Health Nursing Practice
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“The practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health science”
(APHA, 2006) |
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Assumption Number 2:
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Public Health Nursing Practice focuses on population
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Population is defined as a
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collection of individuals who
share one or more personal or environmental characteristics. |
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Collection of individuals who have one or more personal or environmental characteristics in
common. |
population
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Smaller groups within the larger collective that have special needs or interests
Example: High risk infants under the age of 1, unmarried preg. teenagers |
subpopulation
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population at risk
Example: Under-immunized children are population at risk for contracting vaccine preventable diseases. |
A population with a common identified risk factor or risk exposure that poses a threat to health.
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Population of Interest
Example: First time parents of newborns are a population of interest that could benefit from a public health nursing home visit. |
A population that is essentially healthy but could improve factors that promote or protect health
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Assumption Number 3:
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Public Health Factors considers the determinates of health
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Public Health Factors considers the determinates of health
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personal behavior, biology, physical environment, social environment.
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Factors that influence individuals health status throughout all stages of life
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Can include:
Income Education Employment Social Support Biology and Genetics Environment Housing Personal Health Habits Transportation |
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Assumption Number 4:Practice is guided by assessment of the community’s health
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Comprehensive data collecting determines a community’s needs, readiness for change, attitudes, and opinions.
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Assumption Number 4
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Practice is guided by assessment of the community’s health
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Assumption Number 5: Emphasizes Prevention
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Prevention:
“Anticipatory action taken to prevent the occurrence of an event or to minimize the effect after it has occurred” Levels of Prevention: Primary Secondary Tertiary |
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Assumption Number 5
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Emphasizes Prevention
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Primary Prevention
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Aimed at the prevention of an illness/disease
Those who do not already have the disease/illness but may be at risk Keeps problems from occurring Example: Health fairs, Health Education |
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Secondary Prevention
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Aimed at limiting the progression of an existing/underlying disease and prevention of long term disability.
Those who have the disorder that may or may not be aware of it. Detects and treats problems in early stages. Implemented after problem has begun but before S/Sx appear. Targets populations that have risk factors in common. Example: Screenings |
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Tertiary Prevention
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Aimed at rehabilitation to decrease debilitating effects of the condition
Those who have an illness that resulted in decrease in “functioning” Limits further negative effects of the problem After the disease has occurred Example: Cardiac Rehab |
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Assumption Number 6: Public Health Nurses Intervene at ALL levels of Practice
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Individual Level changes knowledge, attitudes, beliefs, practices, and behaviors of individuals
Community Level changes community norms, attitude, awareness, practices and behaviors System Level changes organizations, policies, laws, and power structures within communities |
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Assumption Number 6:
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Public Health Nurses Intervene at ALL levels of Practice
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Individual Level changes
alone or part of a family, class or group |
knowledge, attitudes, beliefs, practices, and behaviors of individuals
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Community Level changes
entire population |
community norms, attitude, awareness, practices and behaviors
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System Level changes
systems that impact health Doing a compliance check to make sure no underage selling of alcohol |
organizations, policies, laws, and power structures within communities
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Assumption Number 7: Nursing Process is used at all levels (assessment, diagnosis, planning, implementation, and evaluation)
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Nursing process is customized to the three levels of practice:
Community System Individual |
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Assumption Number 7:
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Nursing Process is used at all levels (assessment, diagnosis, planning, implementation, and evaluation)
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Assumption Number 8: Nursing Practice uses a common set of interventions regardless of practice settings.
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Interventions are “actions
taken on behalf of communities, systems, individuals, and families to improve orprotect health status” |
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Assumption Number 8:
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Nursing Practice uses a common set of interventions regardless of practice settings.
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Assumption Number 9: Nursing Practice contributes to the achievement of the 10 essential public health services
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Assessment : Collection data and monitoring the population
Policy Development: Policies are in place the that supports the population Assurance: Making sure services are available |
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Assumption Number 9:
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Nursing Practice contributes to the achievement of the 10 essential public health services
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Assumption Number 10:
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Public Health Nursing is grounded in a set of values and beliefs
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Assumption Number 10: Public Health Nursing is grounded in a set of values and beliefs
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1. Population Based/Focused
2. Grounded in Social Justice 3. Focused on the Greater Good 4. Focused on Promotion and Disease Prevention 5. Does what others cannot or would not 6. Driven by the science of Epidemiology 7. Organizes Community Resources 8. Long Term Commitment to the Community |
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Component 1: Population Based
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Population-focused Free Living in the Community
Community-orientated Connection between health and the environment the population lives in Health and Preventative Focus Interventions made at the community/population level Identifies population of interest or at risk populations |
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Component 2: Three levels of Practice
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Individual Level changes knowledge, attitudes, beliefs, practices and behaviors of individuals
Community Level changes community norms, attitudes, awareness, practices and behaviors System Level changes organizations, policies, laws, and power structures |
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Component 3:Identifies and Defines 17 Public Health Interventions
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Surveillance
Investigation Outreach Screening Case findings Referral and follow-up Case management Delegated functions Health teaching Counseling Consultation Collaboration Coalition Building Community organization Advocacy Social marketing Policy development and enforcement |
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Public Health Components
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Population-based/focused
Grounded in social justice Focused on the “greater good” Focus on health promotion and disease prevention Driven by the science of epidemiology Organizes community resources |
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Nursing Component
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Relationship based
Grounded in an ethic of caring Sensitivity to diversity Holistic focus Independent practice Long term commitment to the community |
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Population-Based Practice defines the needs of populations through...
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assessment
Intervention consists of providing solutions such as developing policies for safer environments or behaviors or providing a preventative service for a group of individuals” |
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Population Based Practice
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Focuses on entire populations
Considers broad determinants of health Emphasizes all levels of prevention May be directed at entire systems, populations, and/or individuals and families within those populations |
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What is new in Healthy People 2020
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Emphasizing ideas of health equity that address social determinants of health and promote health across all stages of life
Replace the print publication with an interactive Web site Web site will allow users to tailor information to their needs |
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Healthy People Consortium
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Over 350 national membership organizations
250 State health, mental health, substance abuse and environmental agencies |
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The Development Process of healthy people 2020
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Healthy People Consortium
Over 350 national membership organizations 250 State health, mental health, substance abuse and environmental agencies Regional and National Meetings Interactive Website More than 11,000 public comments |
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Healthy People 2020 goals
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1. Attain high quality, long lives free of preventable disease, disability, injury, and premature death
2. Achieve health equality, eliminate disparities, and improve the health of all groups 3. Create Social and physical environments that promote good health for all 4. Promote quality of life, healthy development, and healthy behaviors across all life stages |
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Health People 2020 Mission
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Identify nationwide health improvement priorities.
Increase public awareness and understanding of the determinants of health, disease, and disability, and the opportunities for progress. Provide measureable objectives and goals that are applicable at the national, state, and local levels. Engage multiple sectors to take actions to strengthen policies and improve practices that are driven by the best available evidence and knowledge. Identify critical research, evaluation, and health behaviors across all life stages. |
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Healthy People 2020 will reflect
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assessments of major risks to health and wellness, changing public health priorities, and emerging issues related to our nation's health preparedness and prevention”
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Federal Public Health Agencies
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Develop regulations and policies formulated by Congress.
Provide funding to state and territorial agencies. Survey the nation’s health status. Set practices and standards. |
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State Public Health Agency
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Monitoring Health Status.
Enforcing Laws and Regulations. Implement public health interventions such as communicable disease programs. Distributes federal and state funds to local public health departments. |
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Local Public Health Agencies
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Implement programs at community level
“Local public health departments goal is to safeguard the public’s health and improve the community’s health status” |
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In 1902 Lillian Wald’s Henry Street Settlement nurse began entering homes and schools to assess children for the purpose of...
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Decrease the spread of disease
Increase of health knowledge |
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In 1900 main health problem was
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spread of infectious disease
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Focusing on the Health of Children: Then
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Decrease the spread of communicable disease
Health Education Screening for common health problems |
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By the 1950’s because of the increased us of immunizations and antibiotics the number of children with
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a communicable disease decreased.
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in 1950 school nursing turned to
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screening for common health problems
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Focusing on the Health of Children: Now
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Chronic Illness/Disability
Mainstreaming Acuity of Care in School Psychiatric Disorders Vulnerability |
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It is estimated that 10-15% of school children currently have a
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chronic condition, which is thought to be greatly underestimated
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Americans with Disabilities Act 1992 and PL 105-17 Individuals with Disabilities Education ACT (IDEA) 1997
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Required schools make allowance for special needs which included ensuring that the student’s school experience was in balance with their health care needs
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No Child Left Behind Act of 2001
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This meant that more children with HIV, AIDS, chronic Illnesses, or mental health problems were in the classroom and need more attention from the school nurse
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Role of the School Nurse
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Provide direct health care to students and staff
Provide leadership for the provision of health services Provides screening and referrals Promote a healthy school environment Promotes health Serves in leadership role for health policies and programs Serve as liason between school personnel, family, community, and health care providers |
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The Occupational Health Nurse
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Prevention of adverse health effects from occupational and environmental hazards.
Promotion and restoration of health within the context of safe and health environment. Delivers services to individual workers, worker population, and community groups. |
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Nursing care for workers began in
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1888 and was called industrial nursing
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Laws passed in 1960’s and 1970’s to protect worker’s safety and health
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Mine Safety and Health Act 1968 first time legislation required prevention programs for workers
Occupational Safety and Health Act (1970) created OSHA which is Occupational Safety and Health Administration: Focus on protecting workers from hazards in the work place. Occupational Institute for Occupational Safety and Health (NIOSH): Focus education and research |
