PUBLIC HEALTH NURS 340 Notes week 1 Latest 2023
WEEK 1
Chapter 1:
- Public health is population focused; prevention emphasis
o Increases life
... [Show More] expectancy
o Decreases death from stroke, CHD, cancer
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:
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▪ 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 Less]