PUBLIC HEALTH NURS 340 Notes week 1 Latest 2023 WEEK 1 Chapter 1: - Public health is population focused; prevention emphasis o Increases life expectancy o Decreases death from stroke, CHD, canc... er o Declines death rates of children and adults - US healthcare works on care rather than prevention o CDC, legislation, Department of Health in charge based on monetary rather than health of population o Medical treatment can only save 10% ; prevention can save 70% - Community Based Nursing: providing services at a hospital/clinical for what the current diagnosis is to help get better o “illness care” - Community-oriented nursing: PUBLIC HEALTH, focus is entire community o Quality of life o Health care of entire community o Goal to prevent disease, promote and protect health - Public Health Core Functions: o Assessment ▪ Community needs, health status of pop, environmental/behavioral risks ▪ Priority health needs ▪ Adequacy of resources o Policy development ▪ Core intervention ▪ Healthy people 2020 o Assurance ▪ Ensure activities meet goals/plans ▪ Develop partnerships ▪ Promote knowledge and behaviors to improve health RESEARCH IS ALWAYS PRESENT IN PUBLIC HEALTH - Levels of health care services: o Population based o Clinical preventive o Primary health care ▪ Prevention ▪ education o Secondary health care ▪ Screening o Tertiary health care ▪ Treatment - Essential services: o Assess: ▪ Monitor health status ▪ Diagnose and investigate ▪ Inform, educate, empower o Policy: This study source was downlo▪aded Mby o10b0i0l0i0z8e02p5a31r2t6n9efrrosmhCipousrseHero.com on 02-27-2023 13:50:14 GMT -06:00 ▪ Develop policies ▪ Enforce laws o Assurance: ▪ Link people to services ▪ Ensure competent health care ▪ Evaluate effectiveness - ALL RESEARCH - Population focused nursing o Population o Subpopulations o Focused practice - Public health nursing : “practice of promoting and protecting the health of populations using knowledge from nursing, social and public health sciences” - Types of practice focus o Individual, family, group ▪ Providing services to individuals rather than population ▪ Maintains appreciation for the values of community • Ex: developmental screening tests of children o Population ▪ Emphasized health protection and disease prevention • Look at all the children to see if the program is beneficial to all children - Community based nursing: o Goal: manage acute and chronic conditions o Focus on “illness care” o A setting specific practice - Community oriented nursing: o Goal: prevent disease and promote health o Focus on “health care” of community o Promote quality of life o Community diagnosis, monitoring - Public health nursing practice: o Goal: prevent disease and disability to promote and protect the community as a whole Chapter 12: - Community: people and relationships that emerge as they use common services and the physical location o People/residents o Geographical place and time dimension o Function of activities - Community as a client o Location of the practice is in the community, but focuses on the individual or family (community based) o Requires improved health of community is overall goal (community oriented) o Direct care, population focused practice o Key concepts ▪ Community health ▪ Partnership for community health - Ethical Concepts o Utilitarianism ▪ Greatest good for greatest number of people o Distributive justice ▪ Treating people fairly, distributes resources and burdens equally to members of community o Social Justice ▪ Ensuring vulnerable groups are included in distribution of reosurces • (BLM) - Goals of community-oriented practice o Nurse and community seek healthful change together o Community health ▪ Status: physical (mortality), emotional (satisfaction), social components (crime rates) ▪ Structure: services and resources ▪ Process: effective community functioning/ problem solving - Community as a partner framework o System approach with focus on partnership to effect change - Community focused Nursing Process: o Assessing community health ▪ Data collection/ interpretation ▪ Data gathering ▪ Data generation ▪ Composite database analysis • Collection of direct data • Collection of reported data ▪ Community reconnaisaance (web search) o Assessment issues ▪ Community problems o Planning community health • Analyzing problems • Problem priorities o Criteria • Establishing goals/objectives • Identifying intervention activities o Implementing ▪ Factors influencing ▪ Nurses role • Social change process o Evaluating intervention ▪ Role of outcomes - Windshield Survey o Method of simple observation ▪ Overview of community ▪ Generating data to identify community trends, stability, and changes ▪ Walking streets provides information as well o Things to observe ▪ Common characteristics of people, neighborhood gathering places, rhythm of community life, housing quality, geographic boundaries - Personal Safety o Awareness of community and common sense o Sources about a community ▪ Other nurse, social workers, health care providers familiar with area ▪ Community members ▪ Own observation - Why community assessment o To learn about ▪ Community needs ▪ Community strengths ▪ Locating confirmation data to address problem - Nursing process with community as client o Establishment of partnership o Assessment phase o Nursing diagnosis o Planning phase o Implementation phase o Evaluation phase RENEGOTIATE AS NEEDED Chapter 2 - History is important in order to improve strategies that have/ have not worked with previous dilemmas - Late 1800’s public health o Sanitation o Control of communicable diseases o Education o Prevention o Care of the sick/elderly - Global nature of health threats (present day) o Emissions of vehicles o Overcrowded garbage dumps o Polluted soil, air and water - Early public health o All cultures concerns revolve around the birth of its people, deaths and illnesses ▪ Ancient Babylon- understand need for hygiene, had some medical skill ▪ Egypt- pharmaceutical preparation, public drainage system, earth privies ▪ Elizabethan Poor Law of 1601- guaranteed assistance for the poor, blind, aged, mentally ill ▪ Industrial Revolution- creation of nursing institutions and homes - America’s Colonial Period + New Republic o Previously informal care by the female head of the household during sickness and childbirth ▪ Became insufficient due to growing population ▪ Based systems of care on Elizabethan Poor Law of 1601 ▪ Township gov was responsible to its residents and provided almshouses only for its residents o Pennsylvania Hospital first hospital in 1751 o Shattuck Report (1850) ▪ Massachusetts’s Sanitary commission • Modern approach of public health ▪ Broad range to improve the public’s health • Establishment of state health dept and local health boards in every town • Sanitary survey, collection of vital stats • Environmental sanitation • Food, drug, communicable disease control • Well childcare • Health education • Tobacco and alcohol control • Disease prevention - Nightingale and Trained nursing o Florence Nightingale influenced modern nursing and public health ▪ 1851 studied nursing in Germany ▪ Returned to England in 1856 to educate nursing in hospital for trained nurses o William Rathbone founded first district nursing association (1859) o First nursing school based on Nightingale model in America in 1870 ▪ First graduates were private nurses or hospital admin/instructors o Community nursing began to meet disadvantaged needs o 1877 NYC- cared for multiple families (Francis) o Visiting nurse association 1885 in Boston ▪ Home visits ▪ Well baby visits ▪ Selective treatments ▪ Keep temp records o Lillian Wald and Mary Brewster established nursing settlement as Henry Street Settlement in 1893 - Origins of Trained Nursing o Jessie Sleet Scales- first African American public health nurse o American Red Cross initiated home nursing care in rural homes by Rural Nursing Service (Lillian Wald) ▪ Improved living conditions ▪ Care to the sick ▪ Instruction of sanitation and hygiene o Occupational health nursing (industrial nursing) ▪ 1895- Ada Mayo Stewart • Obst care • Post surgical care • Work related injury care o School Nursing ▪ Lina Rogers- first school nurse • Made home visits • Teach parents/follow up - Growth in Public health o Lillian Wald was president of National Organization of Public Health Nursing o 1914- Mary Adelaide Nutting began first post training course similar to todays curriculum o American Public Health Association est 1872 ▪ Sewage ▪ Garbage disposal ▪ Occupational injuries ▪ STD o Late 1800s local health dept formed ▪ Environmental hazards of crowded living conditions and dirty streets ▪ Regulate public baths, slaughter houses, pig sties ▪ 1910- targeting infectious and parasitic diseases ▪ 1922 Public Health nurses positon - 20th century o WWI o 1918 Spanish Flu o 1909- Metropolitan Life Insurance Company created a program using visiting nurses organization to provide care for sick policy holders o 1921- Sheppard Towner Act ▪ Children’s Bureau (1912) ▪ Maternity and Infancy Act o 1925 Frontier Nursing Services ▪ Mary Breckinridge ▪ Influenced health care of rural areas - African American Nurses o Segregated until 1960’s o Lower salaries o National Health Circle for Colored People (1919) to promote PH work in the South by providing scholarships - Economic Depression o Decreased funding o Federal emergency relief admin (FERA) ▪ Supported nurse employment through increased grants in aid for state programs in home medical care o Civil Works Admin ▪ More than 10k nurses working for agencies o 1933 Pearl McIver ▪ First nurse employed by US public health Service • Consult to state health dept o Social Security Act of 1935 ▪ Title 6- funding for expanded opportunities for health protection and promotion through education and employment of public health nurses • 8 MIL for health services • 2 MIL for research of diseases - WWII-1970 o Americans living longer o Immunization campaign o Improved medication, better housing o Critical care services o 1950- PHN required for baccalaureate nursing o 1952- nursing education programs began in community colleges o Bedside nurses 2 year programs to help with the shortage - 1970’s o Hospice o Birthing centers o Rehab - Affordable care act of 2010 [Show More]
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