Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
72 Cards in this Set
- Front
- Back
|
Health policy |
Action taken by the public and private agencies to promote health Reflection of the values held in society and can greatly influence the health of citizens overall |
|
|
Legislation |
Laws that regulate health care and promote health Nursing practice and care provided is impacted by policy and legislation |
|
|
4 examples of federal legislation that has influenced the health of adults and their lives in communities |
Older Americans Act 1965 Americans with disabilities act of 1990 Family and medical leave act 1993 Personal Responsibility and Work Opportunity Reconciliation Act 1996 |
|
|
Older Americans Act 1965
|
Established the Administration on Aging and state agencies to provide for the social service needs of older people Mission of AOA is to help older adults maintain dignity and live independently in their communities through a comprehensive and coordinated network across US Money they receive goes to support state and community grants for social and nutritional service programs Services available to those age 60 and over, targeted to greatest economic & social need - Funding for agencies that provide supportive and nutritional services, family caregiver support, disease prevention & health promo activities |
|
|
Americans with disabilities act of 1990
|
Provides protection against discrimination to Americans with disabilities Legislation requires gov't and businesses to provide disabled individuals with equal opportunities for jobs, education, access to transportation, and public buildings Accommodations for both physical and metal limitations Modification and accommodations generally doesn't cost a lot of money in comparison to economic gain Disabled, non disabled, businesses benefited from the changes |
|
|
Family and medical leave act 1993
|
Provides job protection and continuous health benefits where applicable for eligible employees who need extended leave for their own illness or to care for a family member Act amended in 2008 to increase military family entitlements Freq caregivers provide unpaid care for their family members, adults struggle to balance work and caring for a family member Caregivers multiple roles and responsibilities are frequently coupled w/ financial strain, can lead them to experience caregiver burden |
|
|
Personal Responsibility and Work Opportunity Reconciliation Act 1996
|
AKA 'Welfare reform" Law targeted women who received public assistance and changed the previous Aid to Families with Dependent Children to TANF TANF - a work program that mandates that women heads of household find employment to retain their benefits Administration of Children and Families is responsible for federal programs such as TANF that promote the economic and social well being of families, children, individuals, and communities |
|
|
be able to articulate how policy along with othersystem factors can be incorporated into planning patient care.
|
? |
|
|
Legal and ethical issues and legislation for OAs |
Most common issues involve decision making - assessment of the ability of the client to make decisions, appropriate surrogate decision maker, level of care needed on the basis of function, termination of tx at EOL |
|
|
Abuse is another issue that is frequently overlooked: abuse encompasses physical, emotional, sexual abuse, as well as exploitation, neglect, and abandonment ID of abuse involves recognizing: willful infliction of physical pain or injury infiction of debilitating mental anguish or fear Theft or mismanagement of money/ resources Unreasonable confinement or the depriving of services |
Elder abuse is a mandatory reporting event that is required by law |
|
|
Neglect refusal or failure to fulfill any part of a person's obligations or duties to an elder Neglect if the person has a fiduciary responsiblity to pay for items or necessary home care services or on the part of the in home service provider to provide care OA can make independent choices with which others may disagree Right to self determination can be taken away from them if they are declared incompetent |
Financial exploitation Illegal or improper act or process of an individual using resources of an older individual for monetary or personal benefit, profit, or gain |
|
|
During assessment process, RN needs to be aware of contraindications between injuries and the explanation of their cause, co dependency issues btw client and caregiver Key role in reducing elder abuse |
Patient self determination Act - Providers recieving medicare and medicaid funds to give clients written information about their legal options for tx choices if they become incapacitated |
|
|
Routine discussion of advanced medical directives can help ease difficult decisions faced by HCP, families, and clients |
2 parts of advanced directives: Living will - allows client to express wishes regarding use of medical tx in the event of a terminal illness Durable medical power of attorney- legal way for the client to designate someone else to make HC decisions when pt is unable to do so DNR order- specific order from a physician not to use CPR |
|
|
Health status indicators: |
The qualitative or quantitative measures used to describe the level of well being or illness present in a defined population or to describe related attributes or RFs Can be rep in the form of date (mortality & morbidity), proportions, percentatges of a given pop that receive immunizations |
|
|
Mortality |
Life expectancy is a measure that is often used to gauge the overall health of a population US spends $ on HC, but other countries have longer life expectancy for both genders Mortality from heart disease, stroke, cancer has continued to decline in recent years Mortality from chronic respiratory diseases and unintentional injury has not seen this decline Life expectancy and mortality rates vary among ethnic / racial groups in US Gap in life expectancy btw white and african americans |
|
|
Morbidity |
Healthy years of life are increased, longer life spans are generally considered desirable Increasing prevalence of chronic diseases and other conditions associated w/ aging can increase functional limitations and affect QOL Gender leads to different socialization, expectations, lifestyles that affect and interact w/ health in complex ways High prevalence of adults w/ RFs such as tobacco use, high cholesterol, obesity, insufficient exercise habits, which are associated w/ chronic disease Decreased CHO levels because of drug therapy Obesity rates remain high Prevalence of heart conditions, DM, HTN is strongly associated w/ poverty status In lower income populations, modifiable RFs for these diseases were more common |
|
|
Women live longer than men, are more likely to use health services and report greater rates of disability |
x |
|
|
Chronic disease burden |
Chronic illness has become a public health problem of great proportions Most common and costly chronic diseases are heart disease, diabetes, stroke, cancer, arthritis Chronic disease is the leading cause of preventable deaths, disability, decreased QOL Costs account for more than 75% of medical spending |
|
|
Wagner's chronic care model
|
CCM identifies essential elements of a HCS that encourages high quality chronic disease care Elements are : The community The health care system Self management support Delivery system design decision support Clinical information systems Evidenced based change concepts for each element foster productive interactions btw informed clients who take an active part in their care and providers with resources and expertise CCM is implemented by using EHRs, provider reminders for key evidence based care components, interprofessional teams communicating regularly, community health classes to educate people with chronic diseases * Programs that train families in supportive communication techniques have improved health behaviors and client symptom management |
|
|
Prevention strategies for adults |
Dental health: Regular dental exams Floss, brush w/ fluoride toothpaste Health screening: BP height & weight Nutritional screening (obesity) Lipid disorders (men 35+, women 45+) Papanicolaou (pap) test Colorectal cancer Mammogram Osteoporosis Problem drinking Depression screening Tobacco use / tobacco causing diseases Rubella serology or vaccination Chalamydia Testicular cancer Coronary heart disease screening Syphillus screening - At risk only DM Chemoprophylaxis: Multivitamin / folic acid Asprin prevention (CAD at risk adults) Immunizations: Tetanus-diptheria Rubella Pneumococcal vaccine Influenza vaccine |
|
|
Health Disparities Among Populations, RelevantHealth Statistics for Chronic Disease
|
Health disparities are continuing and persistent gap in health status btw genders, ethnicity, economic status, and those that represent the majority of populations Complex causes, two major factors are inadequate access to care and substandard quality of care Factors that also contribute are education poverty insurance status segregation immigration status health behaviors lifestyle choices HCP behavior Employment |
|
|
Adults of color |
This population experiences many of the same health issues that their white counterparts do African Americans experience disparities in new AIDS cases despite decreases in other groups Hospital admissions for lower ext amputations in clients w/ DM and lack of prenatal care for pregnant women in their first trimester are the largest disparities for AA *Population focused nurses are positioned to advocate for cultural sensitive and gender sensitive programs necessary in communities where adults of color may reside |
|
|
Incarcerated adults |
An increase in the number of prison releases has led to offenders being released to the community w/o supervision Greatest pop is african american and men Incarcerated populations w/ major psychiatric disorders (major depressive disorder, bipolar, schizophrenia) have an increased risk of multiple incarcerations Greatest increase may be among bipolar disorders RN can support and deliver continuity of care reentry programs to help those who are mentally ill connect w/ community based mental health programs at the time of release from prision to decrease recidivism rates |
|
|
Gay/Lesbian adults |
Hidden special population because of social stigma associated with homosexuality and discrimination Men who have sex with men are at a higher risk of contracting HIV and other STDs Sexual orientation may be an unrecognized RF for psychiatric morbidity, alcohol use, illicit drug use, cigarette smoking, challenges w/ HC Lesbian & gay report higher levels of psychological distress, associated with higher levels of chronic conditions, health limitations, poorer physical health satus To improve their health, services thatt address their unique needs are warranted, safe places to seek tx, |
|
|
Adults with physical and mental disabilities |
Concerns w/ health, aging, civil rights, abuse, and independent living are a few of the problems facing this pop Those in poor physical and mental health face additional challenges in accessing care in the community setting, can lead to worse health outcomes Women are more likely to seek treatment for most diseases, esp potentially stigmatized diseases (mental health) Those with disabilities are less likely to engage in preventative health screenings Persons with disabilities are more likely to have multiple comorbidities as a result of their disability (obesity,etc..) RN recognize the physical barriers that prevent disabled adults from accessing HC, such as structures that are not accessible Developing health promo programs targeted at this vulnerable group can assist in overall well being |
|
|
Impoverished and uninsured adults |
Poverty rate increased Poverty affects acute and chronic conditions, accumulates over the life course, is transmitted across generations Limits education, employment opportunities, leaves individuals susceptible to weaker social integration, low control, depressive symptoms Stress of poverty can lead to poor dietary habits and tobacco use, inconsistent personal hygiene This pop suffers from an increased burden of disease and greater morbidity and mortality than the general population lack of insurance determines the type of care that one can access |
|
|
Frail elderly |
US experienced a 15% increase in the pop of 65 years of age and older Most OA have atleast one chronic condition and many have multiple conditions, putting them at risk of experiencing frailty while living in the community setting Frailty puts OA at risk for adverse health outcomes: falls, worsening disability, institutionalization, death |
|
|
Population level intervention |
Welcome home ministries program developed in southern CA by nurse/minister to ease the transition for women from jail (population) to life on the "outside" RN and former incarcerated women help others recently released make this adjustment Program based on research in which women reported hx of poverty, physical/emo abuse, addiction (meth) and repeated incarceration Program includes a protocol of jail visitations to women prisoners by formerly incarcerated women and transporation of newly released women to new homes ALL women encouraged to participate in gatherings where they support & encourage eachother Struggles of transitions and successes are shared, goals are set to help women remain healthy and drug free |
|
|
Cultural Competency and Chronic DiseaseManagement
|
Cultural competency can be viewed as a strategy to combat health disparities RN working with adults with health disparities needs K,S,A that honor diversity Need to continually engage in self reflective activities that assess his or her world views and values regarding oppression, discrimination, and working w/ diverse individuals |
|
|
Cultural and linguistic competence |
A set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross cultural situations Culture refers to integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups Competence is having the capacity to function effectively as an individual and an organization w/n context of cultural beliefs, behaviors, and needs presented by consumers and their communitites |
|
|
Elements of the CCM:
the community the health system self-management support delivery system design decision support clinical information systems |
|
|
Refinements to the CCM Model elucidates the elements required to improve chronic illness care This model promotes more productive interactions btw the patient and the care team Also represents a conceptual foundation for innovative approaches to addressing MCC |
Patient Safety (in Health System)
Cultural competency (in Delivery System Design) Care coordination (in Health System and ClinicalInformation Systems) Community policies (in Community Resources andPolicies) Case management (in Delivery System Design) |
|
|
Chronic disease self management and the triple aim |
Emerging health care reform initiatives are of growingimportance amidst concerns about providing care to increasing numbers of adultswith multiple chronic conditions.
Evidence-based self-management strategies are recognized as central tomanaging a variety of chronic diseases by improving the medical, emotional, andsocial role management demands of chronic conditions Triple Aim-related outcome measures: better health (eg,self-reported health, pain, fatigue, depression), better health care (eg,patient-physician communication, medication compliance, confidence completingmedical forms), and better value [eg, reductions in emergency room (ER) visits andhospitalizations in the past 6 mo]. Research documented in peer-reviewed literature isdemonstrating successful translation of chronic disease self management intowidespread practice. |
|
|
Multiple Chronic Conditions and Strategic Framework |
Multiple Chronic Conditions (MCC) - major publichealth and medical challenge
associated with suboptimal health outcomes and risinghealth-care expenses the delivery of health services has continued to employoutmoded “siloed” approaches that focus on individual chronic diseases Health and human Services strategic framework foraddressing MCC Framework’s potential can be optimized through some ofthe provisions of the Affordable Care Act Parekh, A. et al. (2011) ManagingMultiple Chronic Conditions A Strategic Framework PUBLICHEALTH REPORTS |
|
|
Managing Multiple Chronic Conditions: Framework Article |
Escalating problem of multiple chronic conditions (MCC) among Americans is now a major public health and medical challenge associated with suboptimal health outcomes and rising health care expenses Action oriented framework developed by DHHS with input from stakeholder organizations that outines national strategies for maximixing care coordination and improving health and QOL for individuals w/ MCC MCC >2 chronic conditions, enhanced attention on this population is critical to improve health care cost and quality Current delivery of community health and services has focused on individual chronic diseases Chronic disease among medicare beneficiaries is a key factor driving the overall increased growth in spending in the traditional medicare program |
|
|
Chronic Disease self management |
The Stanford Chronic Disease Self Management program is a community based self management program that helps people w/ chronic illness gain self confidence in their ability to control their symptoms and manage how their health problems will affect their lives Important roles played by families and other caregivers must be recognized and supported |
|
|
MCC Strategic Framework goals |
Vision: Optimum health and QOL for individuals with MCC 1) Foster health care and public health system changes to improve the health of individuals with MCC (MEDICAL CARE COORDINATION) 2) Maximize the use of proven self care management and other services by individuals w/ MCC 3) Provide better tools and info to HC, public health, and social services workers who deliver care to individuals with MCC 4) Facilitate research to fill knowledge gaps about, interventions and systems to benefit, individuals w/ MCC |
|
|
Examples of Care Management Programs |
|
|
|
Programs in which care managers had in person interactions with patients and coordinated closely with physicians were more likely to reduce hospital admissions |
Disease management: A system of coordinated health care interventions and communications to help patients address chronic disease and other health conditions DM programs are intended to be holisitic and integrative, addressing the care needs of the entire person rather than just their primary chronic condition |
|
|
Complex case management |
The systemic coordination and assessment of care and services provided to members who have experienced a critical event or diagnosis that requires the extensive use of resources and who need help navigating the system to facilitate appropriate delivery of care and services CCM is considered a more intensive type of intervention than DM, involves a high touch relationship btw case managers and the patient, requires increased care coordination among multiple providers |
|
|
Historical and Current Perspectives |
US at beginning of 20th century, infectious diseases were the leading cause of death 2000 - improvements in nutrition and discovery of abx, development of vaccines put an end to infectious disease epidemics like diphtheria and typhoid fever 1900 Resp & diarrheal diseases were major killers As individuals live longer, chronic diseases -- heart disease, cancer, stroke have replaced infectious diseases as the leading causes of death Downward trend in infectious diseases, but HIV increasing with resistance of abx Causative organisms of h. pylori causing peptic ulcer disease and HPV causing cervical cancer 21st century, infectious diseases have become a means of terrorism (anthrax letters) HIV has become a chronic disease with advancements in drug therapies that slow the progression of the disease Variant creutzfeldt Jakob disease attacks the brain with fatal results is the human disease thought to result from eating beef infected with the transmissible agent causing BSE VRSA case first reported in 1997 MRSA becoming a community associated disease more commonly found in school and prison populations H1N1 largely spreads through direct contact with infected poultry or infected surfaces SARS outbreak with rapid spread of previously unknown cause and no definitive tx contributed to the creation of a perception of risk of infection far greater than actually existed worldwide, infectious diseases are the leading killer of children and young adults and are responsible for almost half of all deaths in developing countries 6 leading causes of death: Acute respiratory infections, diarrheal diseases, malaria, measles, TB, HIV Economic burden of infectious diseases is staggering, costs the system billions of dollars |
|
|
Transmission of Communicable Diseases andEpidemiological Triangle |
transmission of communicable diseases depends on the successful interaction of the infectious agent, host, environment Epi triangle: host, agent, environment Changes in the characteristics of any of these factors may result in disease transmission Abx therapy may eliminate a pathogen, but also alter the balance of normally occuring organisms in the body |
|
|
Agent factor |
Bacteria Fungi Parasites Viruses The individual may be described by its ability to cause disease and by the nature and the severity of the disease |
|
|
Host factor |
A human or animal host can harbor an infectious agent The characteristics of the host that may influence the spread of disease are host resistance, immunity, herd immunity, infectiousness of the host Resistance- ability of the host to withstand infection, and it may involve natural or acquired immunity Natural immunity- species determined, innate resistance to an infectious agent Acquired immunity- resistance acquired by a host as a result of previous nat'l exposure to an infectious agent. Can be active or passive Active immunization- immunization of an individual by admin of an antigen and is usu characterized by the presence of antibody produced by the individual host |
|
|
passive immunization- immunization through the transfer of a specific antibody from an immunized individual to a non immunized individual (transfer of ab from mother to infant or by admin of an ab containing prep) Passive immunity from immunoglobulin is almost immediate but short lived Herd immunity- refers to the immunity of a group or community. It is resistance of a group of people to invasion and spread of infectious agent. Estimation of what percentage of the pop needs to be vaccinated in order for protection of the entire community against the disease Infectiousness- measure of the potential ability of an infected host to transmit the infection to other hosts |
X |
|
|
Environment factor |
Everything that is external to the human host These enviro factors facilitate the transmission of an infectious agent from an infected host to other susceptible hosts Reduction in communicable disease risk can be achieved by altering these enviro factors (usuing mosquito nets and repellants to avoid bug bites, installing sewage systems to prevent fecal contamination of water, washing utensils after contact w/ raw meat) |
|
|
Modes of transmission |
Vertical transmission: passing of infection from parent to offspring via sperm, placenta, milk, or contact w/ vaginal canal at birth ex: transplacental transmission of HIV and syphilis Horizontal tranmission: person to person spread of infection thru direct or indirect contact, common vehicle, airborne, or vector borne Common vehicle is transportation of the infected agent from an infected host via food, water, milk, blood, serum, saliva, or plasma Vectors- arthropods such as ticks and mosquitos that transmit the infectious agent by depositing the infective material near the host |
|
|
Infectious disease surveillance |
A good surveillance system systematically collects, organizes, analyzes current, accurate, and complete data for a defined disease condition The info is released promptly to those who need it for effective planning, implementation, and evaluation of disease prevention and control programs |
|
|
Ten basic data elements of surveillance |
Mortality registration Morbidity reporting Epidemic reporting Epidemic field investigation Laboratory reporting Individual case investigation Surveys Utilization of biologic agents and drugs Distribution of animal reservoirs and vectors Demographic and environmental data |
|
|
Surveillance of agents of bio terrorism |
since 9/11 increased emphasis on surveillance of any disease that may be associated with the intentional release of a biologic agent Concern that covert release would go unrecognized and without response for some time if the resulting outbreak closely resembles a naturally occuring one BE ALERT TO: 1) temporal or geographic clustering of illnesses esp with S/S of those that resemble an infectious disease outbreak previously health people with unexplained fever accompanied by sepsis, pneumonia, rash, flaccid paralysis 2) Unusual age distribution for common disease (chickenpox like disease in adults w/o a child source) |
|
|
Systems for surveillance incorporate factors such as temporal and geographic clustering and unusual age distributions with groups of disease symptoms with the goal of detecting early signs of diseases that could result from a bioterrorism related attack |
Syndromic surveillance systems include tracking ED visits sorted by syndrome symptoms as well as other indicators of illness including school absenteeism and sales of selected OTC meds Heightened surveillance can warn of a community salmonella or influenza outbreak RN collects data, makes dg, investigating and reporting cases and providing info to the general public |
|
|
Reportable diseases |
A noftifiabe disease is one in which regular, frequent and timely info regarding individual of cases is considered necessary for the prevention and control of the disease Requirements for the reporting are mandated by state rather than federal law and vary state to state State health departments on a voluntary basis, report cases of selected diseases to the CDC thru the National Notifiable Diseases Surveillance System State PH officials collaborate w. the CDC to determine which diseases should be nationally notifiable |
|
|
Anthrax Botulism Chanchroid Chlamydia Cholera Cyclosporidiosis Dengue Diptheria Gonorrhea Hepatitis Leprosy HIV infection Lyme disease Malaria Measles Mumps Meningococcal disease |
Syphilis Pertussis Rabies Rubella Salmonellosis SARS Shigellosis Small pox Tetanus Toxic shock syndrome TB VISA VRSA Yellow fever |
|
|
Emerging Infectious Diseases and Factors that caninfluence the Emergence of new infectious diseases
|
Emerging infectious diseases are those in which the incidence has actually increased in the past several decades or has the potential to increase in the near future Ebola and marburg are examples of new viruses that may appear as civilization intrudes into previously uninhabited natural environments, changing the landscape and distributing ecological balances that have existed unaltered previously |
|
|
Hauntavirus pulmonary syndrome in four corners area via aerosolization of rodent excretement mild winter lead to an unusual increase in rodent pop and more people than usual were exposed to a virus |
Several factors can influence the emergence of these diseases Most of emergence factors are consequences of activities and behavior of the human hosts and of environmental changes such as deforestation, urbanization, and industrialization Rise in childcare has increased the incidence in diarrheal diseases large AC systems has contributed to legionellosis Travel, immigration, |
|
|
CDC Preventing Emerging Infectious Diseases |
Plan suggests prevention and control of emerging diseases will require education to change behaviors and the development of effective drugs and vaccines Current surveillance systems must be strengthened and expanded to improve detection and tracking |
|
|
Factors that influence the emergence of new infectious diseases |
Societal events- ecomomic impoverishment, war or civil conflict, pop growth and migration, urban decay Health care- New med devices, organ or tissue transplant, immunosupressants, widespread use of abx Food production- Globalization of food supplies, changes in food processing or packaging Human behavior- sexual behavior, drug use, travel, diet, outdoor rec, use of childcare facilities Environmental- Deforestation/reforestation, changes in water ecosystems, flood/drought, famine, global changes (warming) Public health- Curtailment or reduction in preventable programs, inadequate communicable disease infrastructure surveillance, lack of trained personnel Microbial adaptation- Changes in virulence and toxin production, development of drug resistance, microbes as co-factors in chronic disease |
|
|
Prevention and Control Strategies for TB and STI’s
|
X |
|
|
Prevention levels and infectious disease prevention and control |
Goal of prevention and control programs is to reduce the prevalence of a disease to a level at which it no longer poses a major PH problem Elimination is removal of a disease from a large geographic area such as a country or region of the world Eradication is removing a disease worldwide by ending all transmission of infection through the complete extermination of the infectious agent Importation of cases resulting from the ease of worldwide travel or breakdowns in coverage in a neighboring country has led to outbreaks in nonendemic countries several times in the last 10 years outbreaks point to the necessity of maintaining mass vaccination campaigns in polio free countries to protect against cases imported from endemic areas Challenges to eradication are political instability, sporatic violence, cultural beliefs about immunization, religious fears, distrust of immunization |
|
|
primary prevention |
PP seeks to reduce the incidence of disease by preventing occurrence, and this effort is often assisted by the gov't Vaccinations Mandatory immunization laws Population based because of public health mandate |
|
|
Secondary prevention |
Goal is to prevent the spread of infection and/or disease once it occurs Rapid ID of potential contracts to a reported case PH disease control laws also assist in secondary prevention because they require investigation and prevention measures for individuals affected by a communicable disease report or outbreak |
|
|
Tertiary prevention |
Works to reduce complications and disabilities through treatment and rehabilitation |
|
|
Multisystem Approach to Control
|
Given the many factors that can disrupt the agent host environment relationship, a multisystem approach to control of communicable diseases must be developed - Improve host resistance to infectious agents and other environmental hazards : Hygiene, nut, exercise, increased immunization, drugs for prevention and treatment, stress control, improved mental health -Improve safety of the environment : Sanitation, clean water, air, proper cooking and food storage, control vectors and animal reservoir hosts -Improve public health systems : Increased access to HC, appropriate health education, improved surveillance systems - Facilitate social and political change to ensure better health for all people : Individual, organizational, community action, legislation |
|
|
Vaccine preventable diseases |
pg.299 --> |
|
|
Nurse's role in providing preventative care for communicable diseases |
Primary prevention: Activities to keep people healthy before the onset of disease Begins with assessing for risk behavior and providing relevant intervention through education on how to avoid infection Assessment of the hx that focuses on risk behaviors and potential exposure ex: provide community education about prevention of communicable diseases to well populations, vaccinations, provide community outreach for education and needle exchange "How many sex or drug partners have you had over the past 6 months?" to assess for risk |
|
|
Interventions |
To prevent infection are aimed at preventing specific infections education on how to prevent infection or the avail of vaccines Nursing interventions focus on contracting with clients to change behavior and reduce their risk in regard to sexual practice *info about proper use and how to communicate about them with partner is necessary *teach pt not to share needles and if it is to be shared it should be in contact with full strength bleach for 30 seconds, then rinsed with water several times
*Nurses work to establish programs with communities because of the opportunities for counseling on the prevention of HIV or other sTDS are increased by bringing services to the neighborhood at risk |
|
|
Evaluation |
Based on the extent of vaccination w/n a population, whether risky behavior has changed to safe behavior, and ultimately whether illness is prevented Condom use can be evaluated for consistency of use |
|
|
Secondary prevention |
Includes screening for diseases to ensure early ID, tx, and follow up with contacts to prevent further spread Routine HIV testing for all clients age 13-64 High risk pt should be tested annually Testing enables clients to benefit from early detection and treatment, as well as risk reduction education Posttest counseling - pt w/ negative test should be counseled about risk reduction activities to prevent any future transmission Partner notification is often done by the nurse if the patient doesnt want to tell themselves |
|
|
Partner notification, aka contact tracing is a population level intervention aimed at controlling communicable diseases Involves confidentially ID and notifying exposed individuals who are found to have reportable diseases |
XXX |
|
|
Tertiary prevention |
Effort on managing symptoms and maintaining psychosocial support DOT- programs for TB medication nurses observe and document individual clients taking their TB drugs ensures pt have adequate medication to prevent TB resistance to the meds Case management for AIDS pt * Teaching families about managing symptomatic illness by preventing deteriorating conditions such as diarrhea, skin breakdown, and inadequate nutrition *Teaching family to adhere to standard precautions |
|
|
Nurse serves as an educator about the modes of transmission and as a role model for how to behave toward and provide care for those with HIV infection Nurses must ID the trends of HIV infection in the populations they serve so that they can screen clients who may be at risk and can adequately plan prevention programs and illness care resources It is important to ID persons infected with HIV before symptomatic AIDS develops so that treatment can begin as early as needed HIV testing indicates the presence of the antibody to HIV Routine HIV testing on prenatal care and that all women be tested for HIV HIV prevention in women is the primary focus of efforts to reduce pediatric HIV infection |
Nurse teaches families, and others about personal care and hygiene, medication administration, standard precautions to ensure infection control, and healthy lifestyle behaviors such as adequate rest, balanced nut, exercise Nurses educate clients about accurate med administration since HAART admin has to be consistent to be effective Nurse can ID resources such as social and financial support services and interpret school and work policies |
|
|
TB Tuberculin skin test is mantoux test used for initial screening A blood test is available and is increasingly used for providing clinical care Diagnosis is made via stained sputum smears and other body fluids to determine the presence of acid fast bacilli Culture of tubercle bacilli for definitive diagnosis |
Client w/ TB treated promptly with the appropriate combination of multiple antimicrobial drugs Isonazid and rifampin Tx failure due to the pt's poor adherence in taking the drugs can lead to drug resistance Nurses admin TSTs and provide education on the importance of compliance w/ LT therapy/ engage in DOT and contact investigations of cases in the community |
