Is there a difference between public health nursing (PHN) and community health nursing (CHN)?
Public health nursing is the practice of promoting and
... [Show More] protecting the health of populations using knowledge from nursing, social, and public health sciences.
Key concept = nurse focuses on the population as the client
Anywhere outside the hospital is community nursing (?)
The Board of Population Health and Public Health Practice (BPH)
Focuses on areas and issues affecting the public's health. In studies ranging from core principles and needs in the field to specific issues such as vaccine safety, pandemic preparedness issues, smoking cessation, health disparities, and reducing environmental and occupational hazards, BPH considers the best ways to ensure the health of the public. In order to improve the health of groups, communities, and populations, the Board explores topics such as cardiovascular and infectious disease prevention and control interventions and the capacity of federal, state, and local agencies to protect the health of the public.
How does a PHN begin to make a difference?
Let's ask the CDC
Go to Google and Search "5-level health services pyramid" (next card)
Health Impact Pyramid
The CDC Health Impact Pyramid has the factors with the largest impact on the bottom and the smallest impact on the top. The layers from largest impact to smallest impact are:
1. Socioeconomic factors (ex. poverty and education)
2. Change the Context (ex. tobacco taxes and health laws)
3. Long-lasting protective interventions (ex. smoking cessation treatments)
4. Clinical Interventions (ex. prescription for HTN and diabetes meds)
5. Counseling and Education (ex. eating healthy and physical education classes)
PHN Standards of Care (5)
Standard I: Assessment (health status of populations, data, resources, input, prof judgment)
Standard II: Diagnosis (analyzes data, w/people to attach meaning, id needs)
Standard III: Outcomes Identification (with partners, id outcomes)
Standard IV: Planning (promotes/supports programs, policies, svcs intervene to improve health of populations)
Standard V: Implementation (Coordination; Education & Promotion; Consultation; Regulatory Activities)
Standard VI: Evaluation (eval the health status of population)
Utilized Concepts
Epidemiology of populations: Interdisciplinary science provides structure for study of health, disease, and conditions related to the health status of the population
Statistics: Uses statistical concepts & methods which support data collection and analysis
Etiology: Study of etiology (cause/focal stim) & distribution of diseases & conditions in humans to positively influence the health of populations
Uniqueness
-"The Big Picture"
-Community is client
-Focus (Health Promotion,
Prevention)
-Holistic
-Generalist vs. Specialist
-Knowledge and Skills
-Communication
Generalist (BSN) vs. Specialist (MS)
-Wide variety of knowledge & skills
-Communication extremely critical
-Works within and with the system
-May develop new system
-Consistent with Public -Health Standards of -Nursing Practice
Community Based Care
-Non-acute settings (School nurses, Doctor's office, Home care, Clinics, Etc.)
-Individuals and family
-"Illness" focused
Influencing Factors of PHN
-Type of agency
-Community served
-Economic climate
-Technological advances
-Sociopolitical factors
More Current Impacts
9/11/2001
-Homeland Security
-Increase focus on public health and safety
-Re-funding of previous programs
2010- Health Care Reform (Affordable Care Act)
-Full impact yet to be determined
-Still working on it, will be a long process
Roles & Responsibilities -Generalist vs. Specialist
Communicator
Direct care
Referral & Advocacy
Teacher/Educator
Surveillance, Monitor, Evaluate
Policy Enforcement
Environmental Management
Case Management
Partnership/Collaboration (e.g. disasters)
Consultation
Social, Political, Economic Activities
Empowerment
Self-care & Development
Priorities
-Health Promotion
-Health Prevention
-Health Protection
-Continuity of Care
Levels of Health Prevention
Primary
-BEFORE occurrence of disease
Secondary
-early detection of POTENTIAL disease
Tertiary
-treatment of EXISTING disease
Thoughts to Ponder
How does the community affect the individual's ability to adapt to a health issue?
How does the family's situation affect the individual's ability to adapt to a health issue?
Who is on the Public Health Care team?
-C/PH nurses
-Public health officials/agencies
-Social service providers
-Businesses
-Legislators
-Hospitals
-Long term care
-Other agencies with focus on health
-CITIZENS OF THE COMMUNITY
Review of definitions
Community health nursing: focus of care is on health of the aggregate/ groups, individuals, and families in community; preserve, protect, promote, maintain health
Public health nursing: combine public health and nursing in care of health of group/community vs individual/family (Stanhope & Lancaster, p. 7)
Community based nursing: care provided outside the institution; "illness focused"; services for individuals, families
Population Health and ACA
-Improving Access
-Improving Quality
-Enhance prevention and promotion
-Development of new agencies [Show Less]