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45 Cards in this Set
- Front
- Back
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Canadian Health Act was developed in:
5 principles of this act are.... |
Developed in 1984
Principles are 1. Universality 2. Accessibility 3. Comprehensiveness 4. Portability 5. Public administration |
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Community Health Nurse
Work "with" the client not just "for" the client
Maintains a focus on health promotion and disease prevention |
Umbrella term used to define nursing specialties and applies to all nurses who work in and with the community in a variety of practice areas, such as public health, home health, occupational health and other fields.
Involves working with clients to preserve, protect, promote and maintain health. |
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Community may be defined as.... |
People and the relationships that emerge among them as they develop and commonly share agencies, institutions, or physical environment.
Can be defined in terms of geography or group who share a common interest |
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Population health refers to |
health of a population using as measurements the determinants of health and health status indicators. |
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Primary Prevention
Secondary Prevention
Tertiary Prevention |
Primary prevention seeks to prevent disease from the beginning before people have a disease. Examples immunizations, education about handwashing etc.
Secondary prevention seeks to detect disease in early progression before symptoms become apparent. Screening. Example screening for hearing or vision loss
Tertiary prevention begins once disease has become obvious, learning to live with disease. Cardiac rehab |
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Downstream Thinking
Upstream Thinking |
Downstream: curative focus, microscopic (health as absence of disease)
Upstream: looks at big picture, macroscopic (health in community health). Big picture, population focus, primary prevention perspective, population health approach |
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Canadian Community Health Nursing Standards of Practice |
1. Promoting Health 2. Building individual and community capacity 3. Building relationships 4. Facilitating access and equity 5. Demonstrating professional responsibility and accountability |
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Models of Health Care |
1970's Medical Model focused on treatment and cure in institutions 1974 The LaLonde Report shift in thinking toward population health promotion approach 1978 Alma Ata and WHO Health for all by 2000
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Primary Care
Primary Health Care |
Primary Care has narrow focus. refers to first contact between individuals and health care system usually relates to curative treatment of disease, rehab and preventative measures such as immunizations
Primary Health Care has broader focus. Comprehensive care including disease prevention, community development and wide spectrum of programs, working in interdisciplinary teams for public health policy |
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Social Justice |
Social Justice in context of primary health care refers to ensuring fairness and equality in health services so all members of society have equal access |
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Interdisciplinary Collaboration in Primary Health Care |
1. Patient/client engagement 2. Population Health Approach 3. Best possible care and services 4. Access 5. Trust and respect 6. Effective Communication |
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Framework of Health for All |
1. Basic needs, social and physical 2. Belonging and engagement 3. Healthy living 4. System for health
Public health: organized activity of society to promote, protect and improve and when necessary restore the health of individuals, specified groups or entire population. It is a combo of sciences, skills and values |
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Health Promotion
Empowerment
When clients are empowered the power shifts from health care providers to clients in identifying, prioritizing and addressing their own health concerns |
Health promotion is rocess of empowering people to increase control over and improve their health
Empowerment refers to actively engaging the client o gain greater control and involve political efficacy improved quality of community life and social justice |
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Public Health nursing primary focus is on
Home health nursing primary focus is on |
Public health nursing primary focus is on....Populations and the health of the community
Home health care tends to focus on the health of individuals and families |
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Levels of Prevention related to Public Health Nursing:
Primary Secondary Tertiary |
Primary: PHN's advocate for parliament to address mandatory seat belts, smoke free environments
Secondary: PHN's conduct screening for genetic disorders, tracing for individuals exposed to client with TB
Tertiary: PHN's provide case management that links clients with chronic illness to support services |
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Rural is defined... |
in terms of geographical location and population density or the distance from or the time needed (40km or 30 min) to commute to an urban center. |
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Community Health Nursing Process |
Assess Plan Intervene Evaluate |
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Disease refers to.....
Illness is an....
Primary Prevention = risk avoidance Secondary Prevention = risk reduction Tertiary Prevention = rehabilitation |
Disease refers to the presence of abnormal alterations in the structure or functioning of the body that fit within the medical model
Illness is an individual's personal experience of, perception or and reaction to a disease whereby he is unable to function at the desired "usual" level |
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Jake Epp (1986) proposed national framework for health promotion as strategy to achieve goal "health for all"
3 National Health Challenges Identified |
1. reduce health inequities between low and high income groups
2. increase prevention efforts by reducing or eliminating risks to decrease injuries, disease, chronic illness and related disabilities
3. enhance coping abilities especially helping people to manage chronic conditions, mental health problems and disabilities |
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Population Health Approach: The Organizing Framework
8 key elements |
1. focus on health of populations 2. address determinants of health 3. base decisions on evidence 4. increase upstream investments 5. apply multiple interventions and strategies 6. collaborate across sectors and levels 7. employ mechanisms for public involvement 8. demonstrate accountability for health outcomes |
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Health Promotion Approaches:
Biomedical
Behavioural
Socioenvironmental |
Biomedical: perception that health is absent of disease
Behavioural: perception health is result of lifestyle choices, specifically healthy ones
Socioenvironmental: perception is health is result of determinants of health, specifically social, economical and environmental |
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Levels of Prevention related to Ethics
Primary Secondary Tertiary |
Primary: CHN use CNA Code of Ethics to guide their nursing practice
Secondary: If CHN does not behave in accordance with code of ethics, then the CHN needs to take steps to correct behaviour. The CHN explains error to client and apologizes. It is important to reflect on ways to change unethical behavior
Tertiary: CHN treated client or staff in way inconsistent with ethical practices. Reflection on this and seeking guidance on other choices that could be made need to be taken |
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Ethical Principles for Effective Advocacy |
1. Act in clients best interests 2. Act in accordance with client's wishes 3. Keep client informed properly 4. Carry out instructions with diligence and competence. 5. Act impartially and offer frank, independent advice 6. Maintain client confidentiality |
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Ethical Principles |
Respect for autonomy
Nonmaleficence - do no harm
Beneficence - do good
Distributive Justice - fair distribution |
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Utilitarianism
Deontology
Principlism |
Utilitarianism: moral value of action is determined by overall benefit.
Deontology: based on premise that persons should be treated as ends in themselves and never as mear means to the end
Principlism: health care obligations can be interepreted in terms of a set of principles in bioethics |
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Epidemiology
*John Snow considered the "Father" of epidemiology |
investigates the distribution or patterns of health events in populations and the determinants or the factors that influence those patterns |
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Descriptive epidemiology
Analytical epidemiology |
Descriptive: distribution of disease, looks at health outcomes in terms of what, who, where and what...what is the disease, who is affected, where are they.....discusses disease in terms of person place and time.
Analytical: looks at the etiology, the how and why of disease and deals with determinants of health and disease |
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Morbidity:
Mortality: |
Morbidity: occurrence of disease in a population
Mortality: refers to number of deaths in population |
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Prevalence Rate:
Incidence Rate:
Population at Risk |
Prevalence: picture of specific disease process in given population at one point in time
Incidence: new cases of disease in a population over time
Population at risk: those for whom there is some finite probability of experiencing that event |
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Endemic
Epidemic
Pandemic
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Endemic: occurrence that is usual in population
Epidemic: exceeds usual level for that condition
Pandemic: geographically widespread, global |
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Epidemiological Triad |
Agent - the What - TB
Host - the who - Infected Person
Environment - where - House w/overcrowding |
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How CHN's use Epidemiology |
Surveillance and monitoring of disease trends Identify patterns of disease in group Documentation is important source of date for epidemiological reviews |
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Community has 3 dimensions |
3 dimentions: People: community residents Place: both geographical and time dimension Function: activities of the community
Community as Partner based on Betty Neuman incorporates 2 central concepts: nursing process and community as partner |
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3 common characteristics of community healh |
1. Status 2. Structure 3. Process |
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Community Health
Healthy community |
commonly accepted definition is process of involving the community in maintaining, improving, promoting and protecting its own health and well-being
one where people, organizations and local institutions work together to improve social, economic and environmental condition that make people health |
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Community Health Nurse
Public Health Nurse
Home Health Nurse |
CHN - focuses on population health promotion, disease prevention and health protection of populations "upstream thinking"
PHN - health prevention and promotion
HHN - focuses on prevention, health restoration, health maintenance or palliative care |
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5 Standards of Practice |
1. Promoting Health 2. Building individual and community capacity 3. Building relationships 4. Facilitating access and equity 5. Demonstrating professional responsibility and accountability |
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Healthcare Funding |
- funded at both provincial and federal levels - via taxation from both personal and corporate income taxes. - additional funds from other financial sources like sales tax, lottery - at federal level funds are allocated to provinces and territories via the Cnd Health and Social Transfer. Transfer payments are made as combination of tax transfers and cash contributions
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5 Criteria in order to get Government Funding |
1. Universality 2. Accessibility 3. Comprehensive 4. Portability 5. Publically administered |
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Health Program
Health Program Planning Process
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Health Program consists of variety of planned activities to address the assessed health concerns of clients over time
Planning process: organized approach to identifying and choosing interventions to meet specific goals and objectives that address client health concerns. Goal is to ensure that health care services are Acceptable, Equitable, Efficient and Effective |
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Evaluation of Health Program Planning Process should start immediately..... |
The systematic process of appraising all aspects of a program to determine its impact
Evaluation needs to start early and should therefore be designed at same time as the health program planning process |
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Strategic Health Planning
Operational Health Planning |
Strategic: huge, very broad, involves matching client health needs and client and provider strengths and competencies, with valuable resources.
Operational: smaller scale and starts with specific objective in relation to program planning |
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Health Program Planning Models:
Program Logic Model (PLM)
Precede-Procede Model |
PLM: communication tool that depicts the process and components of planning in diagrammatic form. Completion of model will clarify logical linkages
Precede-Proceed: Looks at changing health behaviour. Completx, comprehensive planning model. Has 9 phases |
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Health Program Management essential elements are....
Goals are.... Objectives are....
Objectives can be developed using SMART: Specific, Measurable, Achievable, Realistic, Time Frame |
Planning Implementation Evaluation
Goals are: broad statements that identify main purpose for health program
Objectives are: specific, measurable statements that identify steps planned to reach overall program goal |
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7 Aspects of Health Program Evaluation |
1. Relevance - need for program 2. Adequacy - does program address problem 3. Progress - monitor to meet objectives 4. Efficiency - program outcome vs costs 5. Effectiveness - objectives vs efforts 6. Impact - long-term changes, Gov will look at 7. Sustainability - enough resources to continue |
