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225 Cards in this Set
- Front
- Back
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What was the time period where child labor was common, personal hygiene and public health was ignored and health assissting positions were held by the untrained servancts? PS HIgh mortality with short life span as well.
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1700's -1900's
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This was a time where families card for ill at home, superstition and folk medicine were used. There were no public seware and convents held hospitals within
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500-1600 AD
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What society provided charitable assistance to the poor and sick in 1813?
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Lady's Benevolent Society of Charleston SC
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What law granted medical care to the poor, blind, lame etc.
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Elizabethan Law
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What was the forerunner of US public health policy, that created state and local boards of health, and what influenced its existance?
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Shattuck Report of 1850
influenced by Chadwick Report of 1492 |
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Who founded the first district nursing association?
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William Rathbone
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Who established the Henry Street Settlement?
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Lillian Wald
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Who was the first public health nurse?
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Lillian Wald
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In the late 1800's the frontier Nurses were established by whom and for what purpose?
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Mary Brekenridge
To act as midwives and to tx pregos, kids and babies |
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Who was nursing's first moral leader and community oriented nurse?
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Florence Nightengale
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What were the first code of ethics that were written by Lystra Gretter?
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1893 Nightengale pledge
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What association reccommended that all nursing education be held in institutes of higher education?
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ANA
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What is ethical decision making?
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Making decisions in an orderly process that considers ethical principles, client values, and professional obligations, must address ethnic diversity and growing multiculturalism in American society.
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What are the moral challenges that face our profession?
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Ethical Issues
ex. how to prepare an adequate and ethical workforce |
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What are puzzeling moral problems in which a person group or community can envision morally justified reasons for both taking and not taking a certain course of action?
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Ethical Delemma
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How to allocate Limited resources to two equally needy populations would be an example of what?
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ethical dilemma
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What are the two types of classic theories?
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Utilitarianism
Deontology |
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What theory believes that a person should do what is right because of the outcome?
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Utilitarianism
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What theory believes that one must do what is right regardless of the reward or outcome?
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Deotonology
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What is the theory of prinicpilism composed of?
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The primary principles of ethics including; respect for autonomy, nonmalefiencence, beneficence, distributive justice
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What is the def of beneficence?
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Do good
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What is the def of distributive justice?
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Be fair
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What is the definition of non-maleficence?
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do no harm
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What are the 3 parts associated with the core functions of ethics?
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Assessment- compentency in research, virtue ethics, moral character
Policy Development- Acieve public good, service to others and self, what is ethical is foundations of the policy Assurance- ALl persons should receive essential health services, providers should be competent |
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What contains 9 statements that address the moral standards that delineate nursing's values gorals and obligation?
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2001 Nursing Code of Ethics
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What contains 12 statements that address the moral standards that delineate public health values, goals and obligations?
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2001 Public Health Code of Ethics
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What is the act of pleading for or supporting a course of action on behalf of a person, group or community?
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Advocacy
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In dealing with the components of the Public Health Advocacy what are the end products?
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Decreased mortality and morbidity
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In dealing with the componenents of Public Health Advocacy what are the processes involved?
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Problem Identification
Research and data gathering Professional and clinical education Development and promotion of regulations and legistlation Endorsements of regs and leg via elections Enforcement of effective policies Policy process and outcome eval |
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What is involved with the conceptual framework for advocacy?
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Information Stage- gathering data about public health problems
Strategy Stage- simplify info to lay people and professionsal, building and funding coalitions, working with legistlators Action Stage- implementing strategies through lobbying testifying issuing press releases passing lawas and voting |
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What are the ethical principles for effective advocay?
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Act in client's best interest
Act according to their wishes Keep them informed Carry out instructions with competence Give non biased advice Maintain confidentiality |
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What is the title of a person who is not a citizen but is allowed to work in the US?
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Legal Immigrant
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Are unauthorized immigrants eligible for emergency services?
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YEs
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What is the set of assumptions about life that are widely held among a group of people and that are transmitted across generations
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Culture
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What is a bilogical designation whereby group members share features
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Race
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What are the shared feelings of peoplehoood among a group of individuals (belongings, customs, religion)
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Ethnicity
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What are the 4 principles of Cultural competence in nursing?
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Care is designed for specific client
Care is based on uniqueness of the person's culture and includes cultural norms and values Care includes sel-empowerment to help client make informed decisions for self Sensitivity provided |
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What is a combination of culturally congruent behaviors, practice attitudes, abd policies that allow nurses to work effectively in cross-cultural situations
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cultural competence
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There are two main principles in developing cultural competence what are they?
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Maintain a broad, objective and open attitude toward individuals and their cultures
Avoid seeing all individuals as being alike |
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def: explore belief of sel
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cultural awareness
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Def: learn about other cultures
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Cultural knowledge
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Def: use of cultural awareness and knowledge
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Cultural skill
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Def: interactions with others cultures
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cultural encounter
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Def: being open minded to other cultures
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cultural desire
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Def: Nurse supports and facilitates culture
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Cultural preservation
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Def: nurse facilitate with practice for patient
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cultural accomodation
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Def: Nurse changes and modify's culture if harmful
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Cultural repattering
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Def: nurse sdvocates with patient and stadd (negotiates)
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Cultural negotiation
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Examples of inhibitors to culturally competent care
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ignorance
pressure stereotyping prejudice racism ethnocentrism cultural imposition cultural conflice cultural shock |
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When performing a cultural nursing assessment the nurse would ask about:
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ehtnic background
religious preference family patterns food patterns health practices |
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Although they are different with each, all cultures possess the same basic organizing factors of:
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Personal space
Social organization time perception environmental control biological variations |
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whi was the mother of biostatistics?
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Florence Nightengale
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What is the freedom from injury or illness related to exposure to toxic agents and other environmental conditions that are potentially detromental to human health
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Environmental health
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What are the goals for Healthy people 2010?
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Healthy people, health environment
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what is the basic science that studies the health affects associated with chemical exposures?
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toxicology
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What is the science that helps us understand the strength of the association between exposures and health effects in human populations"
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epidemiology
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What is the epidemiology triangle composed of?
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Agent
Host Environment |
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Four Environmental Principles are
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Everything's connected
Everything has to go somewhere The solution to pollution is dilution Today's solution may be tomorrow's problem |
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WHen taking the environmental health assessment: what is involved with the mneumotic IPREPARE?
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It is environmental exposure history
Iinvestigate potential exposure Present work Residence Environmental concerns Past work Activities Referrals and Resources Educate |
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What is risk communication?
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right to know the right info at the right time
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These agencies manage the environmental exposures through the development and enforcements of standards and regs
Educates public about risks and risk reduction |
Governmental Protection Agency
ex Food and Drug Ad Dept of Agriculture Local health dept |
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What is the equal protection from environmental hazards for ind, groups or communities regardless of race, age, ehtnicity, or economic status?
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environmentla justice
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What are the roles of the nurse in environmental health?
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Community involvment and participation
Individual and popluation risk assessment risk communications epidemiologic investigations policy development |
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Phases of the Health System:
First Phase 1800-1900 |
health concerns r/t social and public health issues
Family and friends provided care in home |
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Phases of Health System:
Second Phase 1900-1945 |
Focus on control of infectious disease
growth of hospitals and health dept |
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Phases of Health System:
Third Phase 1945-1984 |
Shift away from acute infections to health problems
Major technological advances |
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Phases of Health System 1984- Present
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Enphasis on controlling costs, restricting growth in the health care industry
reorganizing care delivery |
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What influences health care costs?
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Price inflation
Demographics (aging population) Technology and intensity of services Chronic Illness |
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How is health care financed?
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Public Support- Marine Hospital Medicare Medicaid
Private Support- Insurance Employers, Managed Care |
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What payment system does Medicaid use
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Capitation
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What is it called when you pay for services up front?
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Prospective
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The environment and biology account for how much percentage of all illness?
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70%
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What is the form of epidemiology that describes disease according to person place and time
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Descriptive
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Analytic Epidemiology
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A form of epidemiology that investigares causes and associtations between factors and events and health.
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How do nurses use epidemiology?
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Look at health disease and causation and how to prevent both disease and treat illness
Nurseas are invloved with surveillance and monitoring od disease trends |
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Def: look at how many occurances out of 100 or 1,000 or 10,000
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proportion
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Def: concept of epidemiology that looks at how rapidly disease is developing in a population
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rate
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Def: how likely it will occur over time
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risk
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Reflects the number of new cases
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incidence
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Reflects the amount of population at risk for actually experiencing the event or illness at some point
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Incidence proportion
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Number of existing cases divided by the current population
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Prevalence proportion
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The proportion of persons who are exposed to an agentand develop the disease
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attack rate
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Number of persons who are dx with a particular disorder who die within a specified time
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case fatality
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the proportion of all deaths due to specific causes
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proportionate mortality rate
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What are the characteristics of African American Culture
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ask personal?'s of first time met person is improper and intrusive; direct eye contact (good) hair touching (bad) women play key role in home
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A program that establishes systems and monitors the health status of individuals, families and groups the program or process develops planning and intervention activities as well as targeted evaluation outcomes for the client and programs.
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care management
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Def: All interventions in health care that should be based on best currently acaliable evidence, preferrably scientific evicence, represnts the clinical application of particular nursing intervention, documented cleient and outcome data
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Evidenced- Based Practice
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What are the components of Evidence Based Practice?
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Theories of Practice
Expert Opinions Clinical Knowledge and judgement Research studies of all types |
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Bariers to evidence based practice:
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Misommunications between nursing leadrs about process involved
Inferior quality of avaliable research data Inability to assess and use research data Unwilligness of organizations to fund research and make decisions based on evidence Concerne that EBP will cause a cookbook approach to nursing while ignoring indiv. |
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What is the first priority concerning care of the patient?
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To do what's best for the patient with EBP based on evidence, clinical and scientific knowledge regardless of age, culture or ethnicity.
Cost for health care is never 1 priority. |
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What is the goal of the community as a client
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improved heakth of the communty
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All knowledge derived from experience - Goal is to understand complex issues via experience
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Empiracism
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Educator is attempting to make a personal involvement and audience better to remember ex teach class to pregos
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Interpretivism
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All knowledge is beneficial focus is on practical point of chance behavior or learn a particular skill
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Pragmatism
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Behaviors that can be observed and measured (children) Rewards and consequences positive and negative reinforcement
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Behavioral Therapy
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Seeks to change thought patterns and give a lot of info
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Cognitive Theory
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Convo is ongoing dialogue patients will educate and learn
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Critical Theory
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Lerning happens with alignment of develop mental stage p[atient is in
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Developmental Theory
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Want learners to examine values/ feelings give right info pt will make decision
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Humanistic Theory
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More specific to goal that builds off of Humanistic Theory look at 1) achieve goal 2) How they are going to do it
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Social Learning Theory
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What is the cognitive domain
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recall
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What is affective domain
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gave info
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Psychomotor domain
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skills
observe action practice practice skill skill to be taught to others eveluate on effectiveness |
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ability to recall info
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knowledge
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combines with recall and understanding
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comprehension
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new info taken in and used in a different way; values the info
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application
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looks at communication in two parts to understand both; makes sense of info
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analysis
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builds on prior levels by assembling them into a unified whole; organizes info
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synthesis
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value of what is learned; adopt beahviors that are consistent with new values
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evaluation
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What are the events of Instruction
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1. Gain attention
2. Inform the learner of the objectives of instruction 3. Stimulate recall of prior learning 4. Present material 5. Provide learning guidance 6. Elicit performance 7. Provide feedback 8. Assess performance 9. Enhance retention and transfer of knowledge |
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The effective educator does what?
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1. Send a clear message
2. Select the learning format 3. Create the best learning environment 4. Organize the learning experince 5. Encourage participatory learning 6. Provide evalution and feedback |
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What are barriers to learning?
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Educator- realted barriers
Learner related barriers- language and learning |
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The educational Process
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1. Indentify
2. Establish goals obj 3. Select appropriate educational methods 4.Implement the educational plan 5. Evalute the educational process |
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What is the educational product?
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the outcome of the educational process which is measured both
Quantatively and Qualitatively. Evaluated short and long term and the objectives are related to improving heatlh and prmoting behaviorla changes |
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What is the establishment and arrangement of events to facilitate learning including providing knowledge and skills?
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EDUCATION
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What is the process of gaining knowledge and skills that lead to behavioral changes?
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Learning
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What is case Management?
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Includes the activites implemented with individual clients in the system. Case manager builds on basic functions of the traditional role and adapts new competencies for managing transition from one part of the system to another or to home
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What is the #1 role of the case manager?
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Advocacy
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What are the building blocks for case managers?
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Risk analysis
Data mapping data monitoring for health processes, indicators and unexpected illness Epidemeologic investigation of unexpected illness Multidisciplinary develop of action plans and programs Identifying case management triggers or events that promote earlier referrals of high-risk clients when prevention could have dramatic results |
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What are the components of a care map?
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1. index of problems with itermediate and outcome criteria
2. Timeline 3. Critical path 4. Variance record |
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This is a program or process that establishes system and monitors health of individuals families and other groups. Includes planning, evlauation of outcomes
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care management
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Def: Activities for the purpose of proetecting rights of others while supporting the client's responsibility for self- determination
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Advocacy
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Populations or defined groups
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aggregate
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What does advocacy involve?
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Informing
Supporting Affirming client's self-determination in health care decisions |
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This includes the activities implemented with individual clients in the system. It invloves building on basic functions of the traditional role and adapts to new competencies for managing a transition from one part of the system to antoher
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Case Manager
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What are some of the roles of a case manager?
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Broker
Consultant Coordinator Educator Facilitator Liason Mentor Monitor Negotiator advocate Researcher Allocator |
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Def: CM role acts as an agent fpr provider services that are needed by clients to stay within coverage according to budget and cost limits of health care plan
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Broker
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def: case manager who works with providers, suppliers and the community and other case managers to provide case management expertise in programmatic and individual applications
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Consultant
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Def: CM role that Arranges, regulates and coordinated needed health care services for clients at all necessarty points of service
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Coordinator
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educates clients family and providers abnout case management process, delivery system, community health resources and benefit coverage so that informed decisions can be made by all parties
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educator
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CM role: Supports all parties in work toward mutual goal
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facilitator
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CM role: provides a formal communication link among all parties concerning the plan of care management
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liasion
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Cm role: counsels and guides the dev of the practice of new CM
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Mentor
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CM role: provides info to parties on status of member and situations affecting patient safety, care quality and patient outcome on factors that alter costs and liability
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Monitor/ Reporter
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CM role: negotiates the plan of care, service and payment arrangements with providerss
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negotiator
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CM role: acts as a advocate, provides info and supports benefits changes that assist member, family, primary provider and capitated system
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patient advocate
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CM role : utilizes and applies evidenced based practice
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Researcher
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DM role: distribues limited halth care resources according to plan or rationale
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Systems Allocator
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Are care maps evidenced based?
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Not always
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Rosas def of care map
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Cause and effect grid Id's expected behaviors of family and staff against a timeline
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CareMap: What is the timeline?
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landmark of episodes of health or illness...marks the good and bad
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CareMap: What is the variance
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Differnce of what is expected and what is occuring
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What is the goal of collaboration skills with Case Managers?
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to promote respect understand and accuracy of communication of all team members points of view
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For a Case Manager to have Collaboration Skills they must have knowledge and skills about:***********
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Clients
Health status Resources Treatments Community Providers Clients and families complex needs Intrapersonal, interpersonal, medical, nursing and social dimensions Team member and leadership skills |
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Def: one attributes certain beliefs and behaviors about a group to an individual without giving adequate attention to individual differences
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Stereotyping
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Def: the emotional reaction to deeply held beliefs about other groups. Usually negative feelings
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Prejudice
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Def: a form of prejudice and refers to the belief that persons born to a particular group are inferior
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Racist
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"All asian people are hardworkers" is an example of what?
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Sterotyping
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The tendency to ignore differences between cultures and to act as if there is no difference
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cultural blindness
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The process of imposing one's culture on another
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cultural imposition
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A perceived threat that may arise from a misunderstanding of expectations between clients and nurses when either group is npt aware of cultural differences
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cultural conflict
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the feeling of helplessness discomfort and disorientation ecperienced by an individual attempting to understand or effectively adapt to another cultural group that differs in practices, values, and beliefs
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cultural shock
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Def: Negotiating with clients to include aspects of their folk practices with the traditional health care system to implement essential treatment plans
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Cultural accomodation
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An appreciation of and sensitivity to a clients values, beliefs, practices, lifestyles and problem-solving strategies
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cultural awareness
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Advocating mediating, negotating and intervening between the client's culture and biomedical health care on behalf of the client
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cultural brokering
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an interplay of factors that motivate persons to develop knowledge, skills and ability to care for others
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cultural competence
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The nurses intrinsic motivation to provide culturally competent care
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cultural desire
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the information neccessary to provide nurses with an understanding of the organized elements of culture and to provide effective nursing care
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cultural knowledge
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Use by clients of those aspects of their culture that promote healthy behaviors
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cultural preservation
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working with the clients to make changes in health practices when the cultural behaviors are harmful
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cultural repattering
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the integration of cultural knowledge and awareness to meet clients needs
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cultural skill
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What are the three common characteristics of community health?
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Status Structure and Process
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In regards to community health, what does the STATUS include?
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physical (morbidity and mortality) emotional (cleint satisfication), and social (crime rates)
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In regards to community health, what does the Structure include?
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services and resources in the community
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In regards to community health, what does the PROCESS include?
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effective community functioning or problem solving
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What is the goal of Community Oriented nursing:
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seek helpful change together
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The active participation and involvement of the community or its representatives in healthful change is
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Community partnerships
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What is the biggest problem in making a change in the community?
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Being accepted into the community
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What are the characteristics of effective partnerships?
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Equality in decidion making
A shared vision Agreement on specific goals A plan of action to meet those goals |
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What are the steps involved in the community-focused nursing process?
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1. Assessment
2.Identify problems 3. Prioritze problems 4. Implementation 5. Evaluation |
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With the community focused nursing process what is involved with the assessment?
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data collection
windhield surverys informant interview Participate in observation role by intergrating into community Secondary data- marriage license, divorce, birth cert Surveys Focus group- discuss particular set of problems |
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How do you decipher problem prioritization with community focused nursing?**********
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Community awareness
community motivation nurse's ability to influence problem solution avaliable experts severity of outcomes without intervention how quickly can it be solved |
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When does evalutaion occur?
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In the planning phase
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What are the two best guidlines for judgement in community practice?
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Awarness of community and common sense
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A collection of individuals who have a common purpose
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Group
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The ways the group members behavior and relate toward each other
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member Interaction
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The reason two or more people came together may be subtle or obvious and easily started by members
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group purpose
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Attraction of group members to one another and to the group
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cohesion
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standars that guide, regulate and control, are unwritten and often unspoken
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norms
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Influencing others to achieve a goal is taking an active role in
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Leadership
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the particular arrangement of group parts that constitute a whole
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group structure
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Seeks and accepts the authority or direction of others
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follower
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Controls access to group
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gatekeeper
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Offers physical and physcological support
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Maintenace specialist
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Offers conflict resoluction
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Peacemaker
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Focuses and directs movement toward main work of the group
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task specialist
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A nurse fills what main role in a group?
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Mediator
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What is the best group # for change?
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8-25 people
25 or more for community |
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What are stategies for change in a group
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Analyze problem
Maintian motivation for change Support during vulnerabilities Provide Feedback |
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How would a nurse work toward problem resolution of a group?
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devulge certain opinions and irritations in a calm way.
Listen ----> Clarify--> give viewpoint Leader will help to solve conflicts |
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How does a nurse evaluate the groups progress?
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Are goals achieved?
Work together to achieve goals? Is there a group bond? Open communication? |
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What are two aspects of team cohesiveness?
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coordination, collaboration
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The social system depends on groups for:
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governing
making policy determining community needs taking steps to alleviate needs evaluate outcome |
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How would a nurse help a group work towards a goal?
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Keep group focused
maintain members through recongnization and encouragement Maintaining member self-esteem during conflict and confrontation evaluating progress |
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The study of family structure or the characteristics of who makes up a family untis and the events that alter that structure *******
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Family demographics
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A group of two or more individuals realted by blood, marriage adoption or an emotional committments that rely on each other for physical, emotional or financial support
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Family
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Consists of nurses and families working together to ensure the success of the family and its memebres in adapting to responses to health an illness
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Family nursing
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Characteristics and demographics (sex age and number) of individuals who make up family units
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family structure
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What are the historic family functions. (6)
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Financial survivial
reproduction protection to pass along culture education and socialization status |
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Family nursing: A traditional focus that places the individual first and the family second
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Family as the context or structure
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Family nursing: Family is first and individuals are second
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Family as the client
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Family nursing: Focus is on the family as the client simultaneously focuses on ind members and th family as a whole
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Family as a system
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Family Nursing:" family is seen as one of many institutions in scoiety
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family as a component of society
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An open family
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accepts help when needed
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A closed family
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keeps to themselves
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Def: The family as a social system that interacts with other social systems. Emphasis is on examining interacting functions of society and the family, considers family structure and how a family structure affects its function
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Structure Theory
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What is the Focus of Structure Theory?
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Analysis of family interaction between social systems such as school, work, health care and the transactions between family members
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This theory is that a family is that the whole is greater than the sum of its parts
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Systems Theory
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the Focus of Systems Theory
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the clients are participatins members of the family...whatever affects one portion of the system will effect the other
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Theory that looks at the family system over time through predictable developmental and life tasks
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Developmental Theory
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The focus of the Developmental Theory
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Family tasks that need to be met for each stage of family dev
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Theory that sees family as a unit of interacting personalities within which individual family members occupy a position
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Interactionist Theory
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What is the focus of interactionist theory>
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focuses on the way that the family relates to each other but does not look at the interaction with society
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What family theory is a closed system?
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Interactionist theory
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This model emphasizes organizing care around what is called the keystone issue that is challenging family health; is an outcome-driven model of care: fmily sory, cue logic, framing, present state and outcome testing, intervention and decision making, clinical judgement, reflection
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Care Outcome Present State Testing Model
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This model takes a microscopic apprach to family assessment, views the family as a whole and as part of the society, and as an interactionist system
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Friedman Family Assessment Model
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What is cue logic?
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Id problems, issues and nursing dx
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Witht his model the nurse assess when the family is subject to outside stressors and how well they adapt
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Family Assessment Interventions Model
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What are 2 Significant Barriers to family nursing?
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The narrow definition of family used by health care providers and social policy makers
The lack of consensus of what a healthy family is |
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The factors that determine or influence whether disease or other unhealthy results occur
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Health Risks
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Process of ID and analyzinf an individuals prognostic sharacteristics of health and comparing with standard age groups
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Health Risk Appraisal
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Application fo selected interventions to conteol or reduce risk factors and minimize the incidence of associated diease and premature mortality
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Health risk reducation
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Age-related risk to a person's health that often occur during transitions from one deve stage to antoher
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Life event risks
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Situation where the demands of the situation exceed resourced and coping cpacity of the family
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Family crisis
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What is a genogram used for?
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Gather basic info about the family, relationships withing the family and health and illness patterns
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