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UTA NURS 4462 Exam 1

UTA NURS 4462 Community Exam 1

Public Health Core Functions assessment, policy development, and assurance
Assessment Core Function systematically collecting data on the population, monitoring the population’s health status, and making information available about the health of the community.
Policy Development Core Function the need to provide leadership in developing policies that support the health of the population, including the use of the scientific knowledge base in making decisions about policy.
Assurance Core Function the role of public health in ensuring that essential community-oriented health services are available.
Assessment essential public health services Monitor health status to identify community health problems; Diagnose and investigate health problems and health hazards in the community.
Policy Development essential public health services Inform, educate, and empower about health issues; Mobilize community partnerships to identify and solve health problems; and develop policies and plans that support individual and community health efforts.
Assurance essential public health services Enforce laws and regulation r/t health and safety; Link people to needed health services and assure provision of care when unavailable; Assure a competent health care workforce; Evaluate effectiveness, accessibility, and quality of health services.
Essential public health services that serve all functions Research for new insights and innovative solutions to health problems.
Public health nursing specialists practice is community-oriented and uses population-focused strategies for carrying out the core public health functions
community-based public health nurses may be clinically oriented to the individual client, and who combine some population-focused strategies and direct care clinical strategies in programs serving specified populations
IOM definition of public health What society does collectively to ensure the conditions in which people can be healthy
Aggregate population or defined group.
Assessment (r/t public health) systematic data collection on the population, monitoring of the population's health status, and making information available on the health of the community.
Assurance ensuring that essential population-centered health services are available and making certain that a competent public health and personal health care workforce is available.
Capitation a payment system whereby one fee is charged to the client to pay for all services received or needed.
community-based nursing setting-specific practice in which care is provided for “sick” individuals and families where they live, work, and go to school. The emphasis of practice is acute and chronic care and the provision of comprehensive, coordinated, and continuous services.
Community Health Improvement Process (CHIP) a method for improving the health of the population on a communitywide basis. The CHIP method brings together key elements of the public health and personal health care systems in one framework.
community health nurses nurses who have received specialized education and training in the area of public health/community health nursing who use nursing and public health principles to promote and sustain the health of populations in neighborhood and community settings.
cottage industry an industry whose labor force is small or may consist of family units working at home with their own equipment; a single-purpose industry.
integrated systems provides a broad range of services for the population served.
managed care refers to integrating payment for services with delivery of services and emphasizing cost-effective service delivery along a continuum of care.
policy development developing policies that support the health of the population, including the use of the scientific knowledge base in making decisions about policy.
Population collection of individuals who have one or more personal or environmental characteristics in common.
population-focused practice problems and solutions are implemented for or with a defined population or subpopulation in mind.
public health core functions the core functions of public health are assessment, policy development, and assurance.
public health nursing the synthesis of nursing theory and public health theory applied to promoting and preserving the health of populations. The focus of practice is the community as a whole.
Quad Council a group of public health nursing organizations that has developed levels of skills to be obtained by public health nurses for each of the competencies.
Subpopulations particular segments of a population.
The most important contribution made by Florence Nightingale to community-oriented nursing Expansion of the role of nursing to include health-promotion practices
First trained nurse in the US Frances Root; she was hired in 1887 by the Women’s Board of the New York City Mission to provide care to sick persons at home.
Shattuck Report called for innovations: establishment of public health infrastructure; environmental sanitation; food, drug, & disease control; well-child care; health education; tobacco & alcohol control; urban planning; & preventive education in medical training
NOPHN major accomplishments university education in population-based care; health insurance reimbursement for nursing (e.g., postdischarge nursing care at home); Established public health nursing for military outposts in WWI; Responded to 1918 worldwide influenza pandemic in US
American Nurses Association the national professional association of registered nurses in the United States, founded in 1896.
American Public Health Association a national organization founded in 1872 to facilitate interdisciplinary efforts and to promote the health of the public.
American Red Cross a national organization that seeks to reduce human suffering through various health, safety, and disaster relief programs in affiliation with the International Committee of the Red Cross.
district nursing the style of public health nursing organization in which a nurse is assigned to a geographic area to provide a wide variety of nursing services; contrasts with a specialist approach in which several nurses may visit in the same home for different purposes
district nursing association a term used by William Rathbone for the organization that provided district nurses.
Nightingale, Florence considered to be the founder of nursing; led a mission to the Crimean War and developed nursing procedures and care in the British hospitals in Scutari. She wrote the first texts on nursing and founded a movement of Nightingale training schools for nurses
Frontier Nursing Service a rural nursing service founded in 1925 by Mary Breckinridge in Kentucky as the Kentucky Committee for Mothers and Babies. The FNS influenced the development of nurse midwifery in the United States.
Wald, Lillian first public health nurse in US and a social reformer whose influence established the context for community and public health nursing; founded the Henry Street Settlement in NY in 1893, whose health services later became the Visiting Nurse Service of NY
Breckinridge, Mary woman who established the Frontier Nursing Service (FNS) in 1925 to emulate systems of care used in the Highlands and islands of Scotland. Introduced the first nurse-midwives into the United States.
Metropolitan Life Insurance Company with assistance from Lillian Wald, instituted the first community health program for employees in 1909. It also began a cooperative program with visiting nurse associations to provide care for sick policy holders.
National League for Nursing a national organization for nurses that is composed of nurses and consumers and was created in 1952 with the closure of the National Organization for Public Health Nursing and other professional nursing organizations.
National Organization for Public Health Nursing (NOPHN) an early organization for public health nurses, founded in 1912. It was dissolved in 1952, and many of its functions were distributed primarily to the National League for Nursing.
official (health) agencies a government agency addressing health services, health planning, and/or health policy at the city, county, state, or federal level.
settlement houses neighborhood-based and population-centered services for health and social services, such as Chicago's Hull House, founded by Jane Addams. Many were built in urban areas to serve immigrant and poor working-class neighborhoods.
Sheppard-Towner Act Maternity & Infancy Act of 1921, provided federal matching funds to establish maternal & child health divisions in state health depts. Ended in 1929 d/t concerns it gave too much power to the federal government & too closely resembled socialized medicine.
Social Security Act of 1935 federal legislation that attempted to overcome national setbacks of the Depression. Title VI provided funding for health protection & promotion through education and employment of public health nurses & to establish & maintain adequate health services.
Town and Country Nursing Service the later name of the American Red Cross's Rural Nursing Service.
visiting nurse professional nurse who provides health promotion, disease prevention, screening, illness, and rehabilitation services in the home of individuals and families; usually as part of visiting nurse associations.
Rathbone, William a British philanthropist who founded the first district nursing association, in Liverpool, England. He and Florence Nightingale then spread the concept throughout England.
State health department responsibilities disaster prevention/response; health care financing (including Medicaid and CHIP); mental health and professional education; establishing health codes; licensing; regulating insurance; and providing assistance to local health departments.
Major barrio to achieving WHO’s objective of "Health for All in the 21st Century" Primary health care is not the primary delivery method for health care in the United States
The Health Resources and Services Administration responsibilities directing grant programs that improve the nation's health by expanding access to primary care for low-income and uninsured people, focusing on mothers and their children, people with HIV/AIDS, and residents of rural areas
greatest impact on the transformation of today’s health care system Increases in number of aging baby boomers, longevity of the elderly, advances in medical technology, and globalization with its associated need for increased surveillance of new and reemerging infectious diseases
features of the Affordable Health Care for America Act of 2010 requires most have insurance, expands Medicaid, subsidizes coverage for low- and middle-income, transforms system from sick care to health care, lowers mortality r/t preventable causes, increases access to affordable care and nursing workforce development
Expected national health spending growth rate In the years between 2010 and 2019, national health spending is expected to grow at an average annual rate of 6.1%, reaching $4.5 trillion by 2019.
Populations with greatest barriers to access Those who are poor, minority group members, and non-English speakers
agency most heavily involved with the health and welfare concerns of U.S. citizens The U.S. Department of Health and Human Services (HHS)
Public health nursing the practice of protecting and promoting the health of populations using knowledge from nursing, social, and public health sciences
Healthy people 2020 overarching goals Achieve health equity, eliminate disparities, improve the health of all groups; Eliminate preventable disease, disability, injury, premature death; Promote healthy development and behaviors; Create environments that promote good health for all
American Recovery and Reinvestment Act of 2009 economic stimulus designed to offset some of the losses related to the recession that provided 2 billion in additional funding for community health centers, including money for increased demand for services likely to occur in a time of rising unemployment
disease prevention activities that have as their goal the protection of people from becoming ill because of actual or potential health threats.
Disparities racial or ethnic differences in the quality of health care, not based on access or clinical needs, preferences, or appropriateness of an intervention.
electronic health record a computer-based client health record.
globalization a trend toward an increased flow of goods, services, money, and disease across national borders.
health care reform promotes a culture change in the thinking about health care, education and training of health care providers, and financing of our health care system.
Healthy People 2020 a set of principles comprised of a large number of objectives related to 38 topic areas. These objectives are designed to serve as a road map for improving the health of all people in the United States during the second decade of the twenty-first century.
Institute of Medicine a part of the National Academy of Sciences, and an organization whose purpose is to provide national advice on issues relating to biomedical science, medicine, and health.
managed care refers to integrating payment for services with delivery of services and emphasizing cost-effective service delivery along a continuum of care.
medically underserved areas health professional shortage areas in which there are fewer than the generally accepted minimum number of health care providers per thousand population. There are about 3960 designated health professional shortage areas across the United States.
primary health care the provision of integrated, accessible health care services by health care professionals; aim is to address the majority of personal health care needs, develop a sustained partnership with patients, and practice in the context of family and community.
public health system broad range of services, including basic health services, family planning, clean water supply, sanitation, immunization, & nutrition education; programs designed to be affordable for the recipients of the care and the governments that provide them.
sentinel event an unexpected occurrence involving death, severe physical or psychological injury, or the risk of injury or death.
World Health Organization (WHO) United Nations' specialized agency for health established. WHO's objective is the attainment by all people of the highest possible level of health (a state of complete physical, mental, and social well-being and not merely the absence of disease)
Seven-step EBP process Cultivating a spirit of inquiry; Asking clinical questions; Searching for best evidence; Critically appraising evidence; Integrating evidence with expertise and client preferences and values; Evaluating outcomes; Disseminating EBP results
Approaches to EBP systematic review, meta-analysis, integrative review, and narrative review
Intervention Wheel an example of a result of EBP; a population-based practice model for public health nursing that consists of 3 levels of practice at the community, systems, and individual/family levels and 17 public health interventions for improving population health.
EBP model that ensure the community’s perspective is included community development model
Most appropriate approach to establishing evidence in public health case-control studies
Barriers to adopting EBP in the community setting miscommunication abt implementation; inferior quality of evidence; inability to assess/use evidence; unwillingness to fund research/ make decisions; nurse's ability to make clinical decisions; resources, reluctance to accept, & resistance to change
evidence-based medicine being "aware of the evidence on which one's practice is based, the soundness of the evidence, and the strength of inference the evidence permits" (Guyatt and Rennie, 2002, p xiv).
evidence-based nursing "an integration of the best evidence available, nursing expertise, and the values and preferences of the individuals, families, and communities who are served" (Honor Society of Nursing, Sigma Theta Tau International, 2005).
evidence-based practice (EBP) includes the best available evidence from a variety of sources, including research studies, evidence from nursing experience and expertise, and evidence from community leaders.
evidence-based public health "a public health endeavor in which there is an informed, explicit, and judicious use of evidence that has been derived from any of a variety of science and social science research and evaluation methods" (Rychetnik et al, 2003, p 538).
grading the strength of evidence evidence is assigned a “grade” based on the number and type of well-designed studies, and the presence of similar findings in all of the studies.
meta-analysis "a specific method of statistical synthesis used in some systematic reviews, where the results from several studies are quantitatively combined and summarized" (Rychetnik et al, 2003, p 542).
randomized controlled trial (RCT) a clinical trial in which the subjects are randomly distributed into groups that are either subjected to the experimental procedure (as use of a drug) or that serve as controls.
research utilization "the process of transforming research knowledge into practice" (Stetler, 2001, p 272) and "the use of research to guide clinical practice" (Estabrooks, Winther, and Derksen, 2004, p 293).
systematic review a summary of the research evidence that relates to a specific question and to the effects of an intervention.
core functions of public health nursing (PHN) assessment, policy development, and assurance
Healthy People 2020 purpose provides the foundation for a national health promotion and disease-prevention strategy built on the two goals of increasing the “quality and years of healthy life” and eliminating “health disparities.”
Council on Linkages Between Academia and Public Health Practice defined competencies for the core functions of public health practice
Community Client The community is the client only when the nursing focus is on the collective or common good of the population instead of on individual health. Population-centered practice seeks healthful change for the whole community’s benefit.
Dimensions of communities (1) networks of interpersonal relationships that provide friendship and support to members, (2) residence in a common locality, and (3) shared values, interests, or concerns.
Communities of Place type of community where interactions occur within a specific geographic area (e.g. Neighborhood and face-to-face communities)
communities of special interest or resource communities cut across geographic areas; common concerns and interests, which can be long term or short term in nature, bring their members together (e.g., a group to support a smoke-free environment).
community of problem ecology created when environmental problems such as water pollution affect a widespread area.
communities defined by geographic and political boundaries school districts, townships, or counties.
community health assessment requirements gathering existing data, generating missing data, and interpreting the database.
Methods of collecting data informant interviews, participant observation, secondary analysis of existing data, surveys, and windshield surveys.
Biggest challenge in community assessment gaining entry or acceptance into the community. The nurse is usually an outsider and often represents an established health care system that is neither known nor trusted by community members, who may react with indifference or even active hostility.
Community health planning analyzing and establishing priorities among community health problems already identified, establishing goals and objectives, and identifying intervention activities that will accomplish the objectives.
Community health dimensions status, structure, and process
Community health status dimension involves biological (e.g. morbidity & mortality rates), emotional (e.g., consumer satisfaction and mental health indexes), and social parts (e.g., crime rates and functional levels)
Community Health Status Indicators (CHSI) project to provide an overview of key health indicators for local communities
Community health structure dimension defined in terms of services and resources (e.g., service use patterns, treatment data from various health agencies, and provider-to-client ratios) or demographics (e.g., ocioeconomic and racial distributions, age, and educational level)
Community health process dimension the process of effective community functioning or problem solving (e.g., community competence)
Essential conditions of community competence commitment; awareness of self & others; effective communication; conflict containment & mgmt; participation; mgmt of relations with larger society; machinery for facilitating interaction & decision making; social support; leadership development
Main characteristics of a successful partnership being informed; flexibility; and negotiation
phases of the nursing process that directly involve the community as client begin at the start of the contract or partnership and include assessing, diagnosing, planning, implementing, and evaluating.
Steps to assessing community health Step 1. Gathering relevant existing data and generating missing data; Step 2. Developing a composite database; Step 3. Interpreting the composite database to identify community problems and strengths; and Step 4. Analyzing the problem
Community diagnoses format Risk of [specific problem or health risk] Among [specific community client] Related to [characteristics of the community including motivation, knowledge, and skills of the community and its environment].
Problem priority criteria Community awareness of problem; Community motivation to resolve or manage; Nurse’s ability to influence solution; Availability of expertise to solve problem; Severity of outcomes if the problem is unresolved; Speed with which the problem can be solved
How to prioritize community health problems for each of the six criterion ask “How important is community awareness to each problem so it can be solved?” and “Can the partners influence or change the situation?” score both 1-10; multiply the weight and rating and total the ranking scores
How to prioritize community health intervention activities determine value to achieving objective (1-10) and probability of implementing activity (1-10); multiply for activity ranking.
aggregate a collection of individuals who have in common one or more personal or environmental characteristics.
Assessment Protocol for Excellence in Public Health (APEXPH) planning tool developed for local health officials to assess the organization and mgmt of the health dept, provide framework for assessing the health status of the community, and establish the leadership role of the health dept in the community.
change agent nursing role that facilitates change in client or agency behavior to more readily achieve goals. This role stresses gathering and analyzing facts and implementing programs.
change partner the nurse whose role is to act as an enabler-catalyst, teacher of problem-solving skills, and activist advocate with the client to create a positive outcome on the client's behalf.
community a locality-based entity composed of systems of formal organizations reflecting society's institutions, information groups, and aggregates and whose function or expressed intent is to meet a wide variety of collective needs.
community-as-partner model an assessment guide model that illustrates how communities change and grow best by full involvement and self-empowerment. It presents an assessment wheel with people in the center and 8 subsystems that affect and are affected by people surrounding them.
community assessment process of critically thinking about the community and getting to know and understand the community as a client. Assessments help identify community needs, clarify problems, and identify strengths and resources.
community competence process whereby the parts of a community—organizations, groups, and advocates—are able to collaborate effectively in identifying the problems and needs of the community, can achieve a working consensus on goals, and collaborate effectively
community health the meeting of collective needs by identifying problems and managing interactions within the community and the larger society; a function of the energy, the individuality, and the relationships of the community as a whole and of all its constituents.
community health problem actual or potential difficulties within a target population with identifiable causes and consequences in the environment.
community health strength resources available to meet a community health need.
community partnership collaborative decision-making process in which community members and professionals participate.
community reconnaissance the Web-based equivalent of a physical assessment for an individual; "reconnaissance" refers to the use of Web-based resources to collect community-related data.
confidentiality controlling the disclosure of personal information and limiting the access of others to sensitive information.
data collection the process of acquiring existing information or developing new information.
data gathering the process of obtaining existing, readily available data.
data generation the development of data, frequently qualitative rather than numerical, by the data collector.
database collection of gathered and generated data.
early adopters individuals and/or groups with cosmopolitan rather than local orientations, with abilities to adopt new ideas from mass media rather than face-to-face information sources, and with specialized rather than global interests.
empowerment helping people acquire the skills and information necessary for informed decision making and ensuring that they have the authority to make decisions that affect them.
evaluation determining whether a service is needed and can be used when conducted as planned, and whether the service actually helps people in need.
goals the end or terminal point toward which intervention efforts are directed.
implementation involves the work and activities aimed at achieving goals and objectives.
informant interviews directed conversation with selected members of a community about community members or groups and events. A direct method of assessment.
interacting groups a cluster of individuals who are linked by personal relationships. The links may be either primary, such as in family, or secondary, such as in a voluntary association.
interdependent the involvement between different groups or organizations within the community that are mutually reliant upon each other.
intervention activities the strategies used to meet the objectives, the ways change will be effected, and the ways the problem cycle will be broken.
late adopters individuals and/or groups who are the last to embrace change.
lay advisors individuals who are influential in approving or vetoing new ideas and from whom others seek advice and information about new ideas.
mass media newspapers, TV, radio, or other modes of communication to large audiences.
mediating structures act both to support and to prevent change efforts at the community and individual levels.
Mobilizing for Action through Planning and Partnerships (MAPP) facilitated by public health leaders, this framework helps communities apply strategic thinking to prioritize public health issues and identify resources to address them.
nominal groups groups in which individuals work in the presence of one another but do not interact.
objectives a precise behavioral statement of achievement that will accomplish partial or total realization of a goal. The date by which the achievement is expected is specified.
participant observation conscious and systematic sharing in the life activities and occasionally in the interests and effects of a group of persons; observational methods of assessment; a direct method of data collection.
partnership relationship between individuals, groups, or organizations in which the parties work together to achieve a joint goal; involve informed, flexible, and negotiated distribution of power among all participants in the process of change for community health.
Planned Approach to Community Health (PATCH) involves & enables members of a community to plan, implement, & evaluate health promotion & disease prevention programs; helps a community establish health promotion team, collect & use local data, set health priorities, & design & evaluate interventions
population-centered practice a clinical approach in which the nurse and community join in partnership and work together for healthful change.
probability likelihood that an intervention activity can be implemented.
problem analysis process of identifying problem correlates and interrelationships and sustaining them with relevant data.
problem correlates contributing factors to a problem.
problem prioritizing evaluation of problems and establishment of priorities according to predetermined criteria.
program planning model a program planning technique that uses normal groups to assess client problems and find ways to solve the problems.
role negotiation two or more persons deciding together which tasks, activities, or responsibilities each will accept in a defined situation.
secondary analysis method of assessment in which existing data are used.
surveys method of assessment in which data from a sample of persons are reported to the data collector.
target of practice the client to be served by the nurse, such as individual, family, group, community, or population. May also be called unit of service.
typologies the study of classification of communities by types.
value belief about how one should or should not behave. Beliefs about the worth or importance of what is right or esteemed. Values are organized into value systems, and individual value systems reflect culture, reference groups, and personal needs.
windshield surveys the motorized equivalent of a physical assessment for an individual; "windshield" refers to looking through the care windshield as the community health nurse drives through the community collecting data.
Superfund Amendments and Reauthorization Act (SARA) act that amended the Comprehensive Environmental Response, Compensation, and Liability Act with provisions for a broader community-level involvement and public health mission to address the effects of hazardous waste sites on people.
I PREPARE model Investigate Potential Exposures; Present Work; Residence; Environmental Concerns; Past Work; Activities; Referrals and Resources; Educate
single greatest source of air pollution in the United States burning of fossil fuels to power automobiles and buses and to generate electricity
Nursing process related to practice of environmental health follow the nursing process and note the environmental aspects of the problem in every step of the nursing process (e.g., in goal setting, should include outcome measures that relate to mitigation and elimination of the environmental factors)
Exposure to pesticides risk childhood leukemia (from prenatal exposure)
Exposure to lead based paint risk premature births, learning disabilities, HTN
influence of legislative and regulatory policies on the effect of environment on health The government manages environmental exposures through the promulgation and enforcement of standards and regulations that may limit a polluter’s ability to put hazardous chemicals into food, water, air, or soil.
agent causative factor invading a susceptible host through an environment favorable to produce disease, such as a biological or chemical agent.
bioaccumulated the accumulation of a substance (as a pesticide) in a living organism.
biomonitoring the testing of human fluids and tissues for the presence of potentially toxic chemicals.
climate change any long-term significant change in the weather patterns of an area; climate change can be natural or caused by changes people have made to the land or atmosphere.
compliance refers to the processes for ensuring that permit/standard requirements are met.
consumer confidence report An annual summary of the results of testing done on drinking water by water utility companies.
environment a concept that may include dynamic factors such as air, water, soil, and food, as well as temperature, humidity, and wind.
environmental justice a concept also known as environmental equality, in which many poor communities are striving to improve the unequal burden of environmental risks.
environmental standards principles that describe a permitted level of emissions, a maximum contaminant level (MCL), an action level for environmental clean-up, or a risk-based calculation; environmental standards are required to address health risks.
epidemiologic triangle a model made up of three major concepts—agent, host, and environment.
epidemiology the science that helps us understand the strength of the association between exposures and health effects.
epigenetics new biological study that focuses on the effects of changes to the DNA from chemical exposures that can change gene expression, which in turn can predict disease.
geographic information systems (GIS) a methodology that requires the coding of data so that it is related spatially to a place on earth; it is used as a research tool for environmental health studies.
global warming an increase in the earth's average atmospheric temperature that causes corresponding changes in climate and that may result from the greenhouse effect.
host a community with people of multiple ages, genders, ethnicities, cultures, and disease states.
indoor air quality a growing public health concern in office buildings, schools, and homes.
Industrial Hygiene Hierarchy of Controls a development by industrial hygienists targeted to avoid or minimize employee exposures to potentially hazardous chemicals.
methylmercury a toxic material to humans; it is formed when airborne mercury lands on water bodies (such as lakes, rivers, or oceans) and is converted by the microorganisms in the water.
monitoring inspecting or checking carefully to make sure environmental standards are upheld.
non–point sources sources that come from more diffuse exposures than point sources. For instance, the largest non–point source of air pollution is from mobile sources such as cars and trucks, which are the greatest single source of air pollution in the United States.
permit a legally binding document.
permitting a process by which the government places limits on the amount of pollution emitted into the air or water.
persistent bioaccumulative toxins (PBTs) synthetic chemicals that contaminate the environment and do not break down in air, water, or soil, or in the plant, animal, and human bodies to which they may be passed.
persistent organic pollutants (POPs) synthetic chemicals that contaminate the environment and do not break down in air, water, or soil, or in the plant, animal, and human bodies to which they may be passed.
point sources individual, identifiable sources such as smoke stacks; they are sometimes referred to as fixed sites.
precautionary principle basic tenet on which to guide the American Nurses Association's environmental advocacy work.
right to know a type of law that enables health professionals and community members to easily access key information by zip code regarding major sources of pollution that are being emitted into the air or water in their community.
risk assessment a process to determine the probability of a health threat associated with an exposure.
risk communication an area of practice and a skill that is a composite of two separate words: “risk” and “communication.”
risk management the selection and implementation of a strategy to eliminate or reduce risks. This can take many forms.
route of exposure : an element examined in risk assessment in environmental health.
toxicants poisonous substances that can cause harm.
toxicology the basic science applied to understanding the health effects associated with chemical exposures.
Major sources of error that can affect the reliability of measurement variation inherent in the train being measured; observer variation; and inconsistency in the instrument and the stability of the instrument over time
validity of a screening test is measured by sensitivity and specificity
Basic methods in epidemiology sources of data; rate adjustment; and comparison groups
Comparison groups Incidence or prevalence measures in groups that differ in some important characteristic must be compared to gain clues about which factors influence the distribution of disease (i.e., disease determinants or risk factors).
The father of epidemiology John Snow
John Snow accomplishments conducted one the most famous studies using a comparison group, the pivotal mid-nineteenth century investigation of cholera
general categories of bias Bias is a systematic error resulting from study design, study execution, or confounding
Confounding Bias resulting from the relationship of the outcome and the study factor with some third factor not accounted for in the study design
agent causative factor invading a susceptible host through an environment favorable to produce disease, such as a biological or chemical agent.
analytic epidemiology an epidemiological study designed to investigate associations between exposures or characteristics and health or disease outcomes, often with a goal of understanding the etiology (or origins and causal factors) of disease.
attack rate a type of incidence rate defined as the proportion of persons exposed to an agent who develop the disease, usually for a limited time in a specific population.
bias a systematic deviation of observed values from the true value.
case-control design can be viewed against the background of an underlying cohort; uses a sample from the cohort rather than following the entire cohort over time. Because it uses only samples of cases and noncases, it is a more efficient design
case-control study participants are enrolled because they are known to have the outcome of interest (cases) or they are known not to have the outcome of interest (controls).
case fatality rate (CFR) the proportion of persons diagnosed with a particular disorder (i.e., cases) that die within a specified period of time.
cohort study an epidemiological study in which subjects without an outcome of interest are classified according to past or present (or future) exposures or characteristics and followed over time to observe and compare the rates of some health outcome
cross-sectional study an epidemiological study in which health outcomes and exposures or characteristics of interest are simultaneously ascertained and examined for association in a population or sample, providing a picture of existing levels of all factors.
cumulative incidence rate reflects the cumulative effect of the incidence rate over the time period, whether it is a month, a year, or several years.
descriptive epidemiology an epidemiological study designed to describe the distribution of health outcomes according to person, place, and time.
determinants factors that influence the risk for or distribution of health outcomes.
distribution the pattern of a health outcome in a population; the frequencies of the outcome according to various personal characteristics, geographic regions, and time.
ecologic fallacy a bias that may occur in ecologic studies because associations observed at the group level may not hold true for the individuals that compose the groups, or associations that actually exist may be masked.
ecologic model this approach expands epidemiologic studies both upward to broader contexts (such as neighborhood characteristics and social context) and downward to the genetic and molecular level.
ecological model a model that looks toward many factors or combinations and levels of factors contributing to disease, such as the complex set of factors that cause cardiovascular disease.
ecologic study an epidemiologic study in which only aggregate or group data, such as population rates, are used rather than data on individuals.
environment all of those factors internal and external to the client that constitute the context in which the client lives and that influence and are influenced by the host and agent-host interactions.
epidemic occurrence of a disease within an area that is clearly in excess of expected levels (endemic) for a given time period.
epidemiologic triangle interaction among the host, agent, and environment.
epidemiology study of the distribution of disease, or other health-related states and events in human populations, as related to age, sex, occupation, ethnicity, and economic status in order to identify and alleviate health problems and promote better health.
health a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.
models of health clinical, absence of disease; role-performance, ability to satisfactorily perform one's social roles; adaptive, flexible adaptation to the environment; & eudaemonistic, self-actualization & the attainment of one's greatest human potential
host a living organism, human or animal, in which an infectious agent can exist under natural conditions.
incidence proportion the proportion of the population at risk who experience the event over some period of time.
incidence rate the frequency or rate of new cases of an outcome in a population; provides an estimate of the risk of disease in that population over the period of observation.
levels of prevention a three-level model of interventions based on the stages of disease, designed to prevent, halt, or reverse the process of pathological change as early as possible, thereby preventing damage.
mortality rates key epidemiological indicators of interest to nurses. Mortality rates are informative only for fatal diseases and do not provide direct information about either the level of existing disease in the population or the risk of getting any particular disease.
natural history of disease the course of a disease process from onset to resolution without intervention by humans.
negative predictive value proportion of persons with a negative test who are disease free.
point epidemic a concentration in space and time of a disease event, such that a graph of frequency of cases over time shows a sharp point, usually suggestive of a common exposure.
popular epidemiology a form of epidemiology in which laypeople gather scientific data as well as mobilize knowledge and resources of experts to understand the occurrence and distribution of a disease or injury.
positive predictive value the proportion of persons with a positive screening or diagnostic test who do have the disease (the proportion of "true positives" among all who test positive).
prevalence proportion a measure of existing disease in a population at a particular time (i.e., the number of existing cases divided by the current population).
proportion a type of ratio in which the denominator includes the numerator.
proportionate mortality ratio (PMR) the proportion of all deaths that are attributable to a specific cause.
rate measure of the frequency of a health event in a defined population during a specified period of time.
reliability the precision of the measure; its consistency or repeatability.
risk the probability of some event or outcome within a specified period of time.
screening identifies individuals with unrecognized health risk factors or asymptomatic disease conditions in populations.
secular trends long-term patterns of morbidity or mortality (i.e., over years or decades).
sensitivity the proportion of persons who actually have a disease who will have a positive screening or diagnostic test; or the probability that a person with a disease will be correctly classified by the test.
social epidemiology the branch of epidemiology that studies the social distribution and social determinants of health and disease (Berkman and Kawachi, 2000; Kawachi and Berkman, 2003; Krieger, 2001).
specificity the proportion of persons who do not have a disease and who will have a negative screening or diagnostic test, or the probability that a person without disease will be correctly classified by the test.
surveillance involves the systematic collection, analysis, and interpretation of data related to the occurrence of disease and the health status of a given population.
validity the accuracy of a test or measurement; how closely it measures what it claims to measure. In a screening test, validity is assessed in terms of the probability of correctly classifying an individual with regard to the disease or outcome of interest
web of causality the complex interrelations of factors interacting with each other to influence the risk for or distribution of health outcomes.
Public Health Function a broad public health activity needed to ensure a strong, flexible, accountable public health structure. It may require a multidisciplinary team to carry out.
Public Health Nurse Role the activity the public health nurse is responsible for, either alone or as a member of a team, to accomplish the stated public health function. This can be the public health nurse at the local level or at the state level.
State Role what public health nurses need from the state level to do their jobs (e.g., policy, aggregate data, training). This refers to any Central Office program or staff, not just nurses.
History of school nursing In the early 1900s, school nurses screened children for infectious diseases. By 2005, school nurses provided direct care, health education, counseling, case management, and community outreach.
School nursing primary prevention health promotion and education to prevent childhood injuries and substance abuse.
School nursing secondary prevention screening children for illnesses and providing direct nursing care.
School nursing tertiary prevention caring for children with long-term health needs, including asthma and disabling conditions.
Skills carried out by school catheterizations, suctioning, gastrostomy feedings, and others
Latest trends in substance abuse There has been an increase in the use of "club drugs" such as LSD, ketamine, GHB, Rohypnol, and ecstasy (MDMA)
Leading cause of children’s absence from school r/t a chronic illness asthma
Future of school nursing Health care in the schools is increasing. It will involve telehealth and telecounseling to teach health education. The internet will be used to work with children and parents. Teleclinics operated out of the schools will be seen more frequently.
The CDC funded federal school health program provides for Development of a health education curriculum that includes parents and community
National Association of School Nurses (NASN) and standards of practice for school nurses principles School nurses should have a bachelor's degree in nursing and a specialty certification. School nursing uses the nursing process. School nurses must ensure the safety of the children, including when delegating care
advanced practice nurses nurses with advanced education who are prepared to manage and deliver health care services; includes clinical nurse specialists, nurse practitioners, nurse- midwives, nurse anesthetists, and others.
American Academy of Pediatrics professional organization for pediatricians that sets policy statements for child health.
Americans with Disabilities Act (ADA) act providing protection against discrimination to Americans with disabilities; requires government and businesses to provide disabled individuals with equal opportunities for jobs, education, access to transportation and public buildings and other
case manager a role of a nurse who coordinates health care services for a client. In school nursing, this is specific to care for children with complex health problems
Centers for Disease Control and Prevention (CDC) the United States agency designated to investigate the nation's health.
Child Nutrition and WIC Reauthorization Act of 2004 This act designated that each local education agency (LEA) participating in federal school meal programs, such as the National School Lunch or Breakfast Program, must establish a local school wellness policy.
community outreach a role of a nurse who provides care outside one defined setting.
consultant one who provides professional advice, services, or information.
counselor a role of a nurse when mental health support is provided.
crisis team school staff designated to deal with crises at school.
direct caregiver a role of a nurse providing health care to the ill or injured.
do-not-resuscitate (DNR) orders physician's order that prohibits medical intervention when client is dying.
emergency plan procedures to effectively provide care in a crisis situation.
health educator a role of a nurse providing teaching on health topics.
Health Insurance Portability and Accountability Act of 1996 (HIPAA) federal law requiring confidentiality and privacy concerning health care records.
individualized education plans (IEPs) plans to decide educational accommodations for disabled children.
individualized health plans (IHPs) plans to decide health needs of disabled children in school.
National Association of School Nurses (NASN) professional organization for school nurses that sets standards and guidelines for school nurses.
No Child Left Behind Act of 2001 federal law requiring set educational and health standards in the schools.
PL 93-112 Section 504 of the Rehabilitation Act of 1973 federal law requiring services for persons with handicaps.
PL 94-142 Education for All Handicapped Children Act federal law requiring education for all children with handicaps.
PL 105-17 Individuals with Disabilities Education Act (IDEA) educational services must be provided for disabled children from birth through age 22 years.
primary prevention health promotion and education.
researchers nurses such as clinical nurse specialists and nurse practitioners who are trained in the research process and can conduct their own investigations.
Safe Kids Campaign federal program to provide education to children about safety.
school-based health centers federal program providing health care, dental care, and mental health care to children and families in schools.
School Health Policies and Programs Study 2006 (SHPPS 2006) a national survey periodically conducted to assess school health policies and practices at the state, district, school, and classroom levels.
school-linked program a school health program run by a community health agency.
secondary prevention screening and providing health care.
standard precautions procedures to prevent exposure to bloodborne diseases.
tertiary prevention continued long-term health care.
Make-up of the interprofessional occupational health team the occupational health nurse, occupational medicine physician, industrial hygienist, and safety specialist
Recent trends in the characteristics of the U.S. workforce that will present new challenges to protecting worker safety and health Increase in the numbers of people with chronic illness, women, and older workers, and increase in racial diversity
Host factors associated with increased risk of an adverse response to hazardous workplace exposure age, sex, health status, work practices, ethnicity, and lifestyle factors
Types of Workplace hazards exposure to biological, chemical, enviromechanical, physical, and psychosocial agents.
Biological agents living organisms whose excretions or parts are capable of causing human disease, usually by an infectious process.
Enviromechanical agents those that can potentially cause injury or illness in the workplace (e,g., repetitive motions, poor or unsafe workstation-worker fit, slippery floors, cluttered work areas, and lifting heavy loads)
Physical agents those that produce adverse health effects through the transfer of physical energy (e.g., temperature extremes, vibration, noise, laser, radiation, and electricity)
Psychosocial agents conditions that create a threat to the psychological and/or social well-being of individuals and groups (e.g., stress, burnout)
Control strategies to reduce workplace exposure engineering, work practice, administration, and personal protective equipment
agents causative factor invading a susceptible host through an environment favorable to produce disease, such as a biological or chemical agent.
Hazard Communication Standard known as the "right-to-know" law. This was developed because the working environments cannot eliminate all potentially toxic agents; therefore an important line of defense is an educated workforce.
host a living organism, human or animal, in which an infectious agent can exist under natural conditions.
National Institute for Occupational Safety and Health (NIOSH) established by the Occupational Safety and Health Act of 1970 and is part of the CDC. It is the main US federal agency responsible for conducting research into occupational safety and health matters.
Occupational Safety and Health Administration (OSHA) established by the Occupational Safety and Health Act of 1970 and is part of the CDC. It was created to develop and enforce workplace safety and health standards and regulations that regulate workers' exposure to potentially toxic substances.
National Occupational Research Agenda a partnership program to stimulate research and improve workplace practices.
occupational and environmental health nursing the specialty practice that focuses on the promotion, prevention, and restoration of health within the context of a safe and healthy environment. It includes the prevention of adverse health effects from occupational and environmental hazards.
occupational health hazards dangerous processes or materials within a work environment that result in harm to an employee.
occupational health history data a nurse may collect about a client's workplace, recognizing the possible relationship between health and occupational factors.
work-health interactions influence of work on health shown by statistics on illnesses, injuries, and deaths associated with employment.
workers' compensation compensation given to an employee for an injury that occurred while working.
worksite walk-through an on-site assessment of the workplace conducted by the nurse.
Focus of faith community nursing the “intentional care of the spirit”
Evolution of faith community nursing from roots of healing traditions in faith communities; early public health nursing efforts working with individuals, families, and populations in the community; and more recently the independent practice of nursing.
functions of the faith community nurse health counseling and teaching for individuals and groups, facilitating linkages and referrals to congregation and community resources, advocating and encouraging support resources, and providing spiritual care.
congregants people of the congregation of a church.
congregational model an individual community of faith where the nurse is accountable to the congregation and its governing body.
faith communities congregational communities that gather in churches, cathedrals, synagogues, or mosques and acknowledge faith traditions.
faith community nurse classification of nurses adopted by ANA's Scope and Standards that includes the parish nurse, congregational nurse, health ministry nurse, crescent nurse, or health and wellness nurse.
faith community nurse coordinators facilitate different arrangements with several faith communities of varying backgrounds (Hickman, 2006; Zurell and Solari-Twadell, 2006).
faith community nursing as adopted by the American Nurses Association (ANA) and the Health Ministries' Association (HMA), defines nursing practice with an intentional focus on spiritual care as central to promoting "wholistic" health and prevention of illness.
healing strengthening the inner spirit and choosing healthy lifestyles so that families and individuals can face life's circumstances.
health cabinet made up of a nurse and members of the congregation that supports healthy, spiritually fulfilling lives.
health ministries activities and programs in faith communities organized around health and healing foci to promote wholeness in health through life.
holistic care understanding the changes of the body, mind, and spirit of the congregation as a whole in an environment that is always changing.
holistic health center connects hospitals and faith communities and highlights the role of the nurse in health and wellness promotion. The centers emphasize a comprehensive team approach to holistic health care.
institutional model a nurse who is in a larger partnership. The nurse's contract would be with hospitals, medical centers, long term care facilities, or educational institutions.
parish nurse nurse who responds to health and wellness needs within the context of populations of faith communities and is a partner with the church in fulfilling the mission of health ministry.
parish nursing a nursing service provided by a church as a community outreach to its parishioners, usually focused on primary prevention.
pastoral care staff represents various aspects of the life of the congregational community and works closely with the congregational model or the institutional model.
polity the form or constitution of an organized unit.
wellness committee a health cabinet made up of a nurse and members of the congregation that supports healthy, spiritually fulfilling lives.
Federal public health agencies responsibilities develop regulations, provide funding to state and territorial health agencies, survey nation's health status and needs, set practices and standards, provide expertise that facilitates EBP, coordinate activities across state lines, and support research.
State public health agencies responsibilities monitoring health status and enforcing laws and regulations that protect and improve the public's health. They receive funding from federal agencies to implement public health initiatives.
Local public health agencies responsibilities implementing and enforcing local public health codes and ordinances and providing essential public health services to the community.
Public health nurse roles advocate, case manager, referral source, counselor, educator, outreach worker, disease surveillance expert, community mobilizer, and disaster responder
Case management a major tertiary prevention; assist clients in identifying services they need the most at the least cost and assist populations in identifying services that will improve the overall community health status
core public health competencies 8 domains analytical assessment; basic public health science; cultural competency; communication; community dimensions of practice; financial planning and management; leadership and systems thinking; and policy development/program planning
eight principles that distinguish the public health nursing specialty from other nursing specialties population-based; "greatest good for the greatest number"; clients as equal partners; primary prevention; strategies that create healthy conditions; obligation to reach out to all who might benefit; optimal use of available resources; and collaboration
incident commander person responsible for all aspects of an emergency response, including quickly developing incident objectives, managing all incident operations, application of resources, as well as responsibility for all persons involved.
local public health agencies the agency that is responsible for implementing and enforcing local, state, and federal public health codes and ordinances and providing essential public health programs to a community.
partnership “a close mutual cooperation between parties having common interests, responsibilities, privileges and power” (CCPH, 2006). Partnerships are built on trust, mutual respect, and the sharing of power.
public health organized community efforts designed to prevent disease and promote health.
The Genetic Information Nondiscrimination Act (GINA) in 2009 designed to prohibit the improper use of genetic information in health insurance and employment
Genetic nurse responsibilities identifying genetic risk factors, providing nursing interventions, making referrals, and providing health promotion education; APNs can provide/refer to genetic counseling and act as case manager for person with/at risk for a genetic disease
Molecular genetics practice impacts collection and use of health histories, learning and applying innovative biotechnologies, prevention and health education roles, and administration of new therapies
overarching themes conceptualized in the vision for the Human Genome Project biology, health, and society
genetic red flags family hx of multiple family members; onset at an early age; occurs in the gender that is least expected to have it; absence of known risk factors; ethnic predisposition to certain genetic disorders; and a close biological relationship between parents.
DNA the chemical inside the nucleus of a cell that has the genetic instructions for making living organisms.
family health history health history of a family that may involve diseases that have a genetic basis.
gene the DNA segments that carry the genetic information.
genetic susceptibility predisposition to a particular disease or sensitivity to a substance due to the presence of a specific allele or combination of alleles in an individual's genome.
genetics the study of the function and effect of single genes that are inherited by children from their parents.
genome the genetic material of an organism.
genomics refers to the study of individual genes in order to understand the structure of the genome, including the mapping of genes and sequencing the DNA.
Human Genome Project an international research project, funded by the U.S. Congress in 1988 and completed in 2003, that has mapped all of the approximately 25,000 genes in human DNA.
multifactorial disease disease caused by gene and environment interaction.
Mutation alteration in the usual sequence of bases that form a gene or a change in DNA or chromosomal structure.
Domains of learning cognitive, affective, and psychomotor.
principles associated with community health education gaining attention, informing learner of objectives, stimulating recall of prior learning, presenting the stimulus, providing learning guidance, eliciting performance, providing feedback, assessing performance, & enhancing retention & transfer of knowledge
Principles that guide the effective educator send a clear message, select the learning environment, create the best learning experience, organize the learning experience, encourage participatory learning, and provide evaluation and feedback.
Educational issues population considerations, barriers to learning, and technological issues
learner-related barriers low literacy, especially health literacy, and lack of motivation to learn information and make the needed changes
phases of the educational process identifying educational needs, establishing educational goals and objectives, selecting appropriate educational methods, implementing the educational plan, and evaluating the educational process and product
affective domain an arena of learning that includes changes in attitudes and the development of values. For affective learning, nurses consider and attempt to influence what individuals, families, communities, and populations feel, think, and value.
andragogy the art and science of teaching adults and individuals with some health-related knowledge about a topic.
cognitive domain a domain of learning that includes memory, recognition, understanding, reasoning, application, and problem solving and is divided into a hierarchical classification of behaviors.
cohesion attraction of group members to one another and to the group.
conflict the opposite of harmony; a state of interference that people want to guard against; antagonistic points of view.
democratic leadership position that is cooperative in nature and promotes and supports members' involvement in all aspects of decision making and planning.
education the establishment and arrangement of events to facilitate learning; emphasizes the provider of knowledge and skills.
established groups these types of groups are those in which membership ties already exist and the existing structure can be used.
evaluation provides a systematic and logical method for making decisions to improve an educational program (Babcock and Miller, 1994).
formal groups have a defined membership and a specific purpose.
group a collection of interacting individuals who have a common purpose(s).
group culture this is formed from group norms related to task, maintenance, and reality.
group purpose the reason that a group is formed; for example, groups may be formed in response to particular community needs, problems, or opportunities.
Health Belief Model (HBM) used in planning programs in which the motivation of learners is a concern.
health literacy “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” (Ratzan and Parker, 2000).
Healthy People 2020 educational objectives educating various populations about areas of unintentional injury, violence, suicide, tobacco use and addiction, alcohol or other drug use, unintended pregnancy, HIV/AIDS, and STD infection, unhealthy dietary patterns, and inadequate physical activity
informal groups in these types of groups the ties between members are multiple, and the purposes are unwritten yet understood by members.
leadership this consists of behaviors that guide or direct members and determine and influence group action.
learning this emphasizes the recipient of knowledge and skills and results in behavioral changes; it is considered to be the process of gaining knowledge and expertise.
long-term evaluation this is a type of follow-up that is designed to assess the lasting effects of the education program.
maintenance functions these serve to help members stay with the group and feel accepted and include the ability to help people resolve conflicts and ensure social and environmental comfort.
maintenance norms these create group pressures to affirm members and maintain their comfort.
member interaction each member influences and is in turn influenced by every other member to some extent.
motivation a motivating force, stimulus, or influence incentive, drive.
National Assessment of Adult Literacy (NAAL) the largest literacy study first conducted in the United States in 1992. The literacy scales used in the 2003 study included prose literacy, document literacy (including health literacy) and quantitative literacy.
norms standards that guide, control, and regulate individuals and communities; unwritten and often unspoken and serve to ensure group movement to a goal, to maintain the group, and to influence group members’ perceptions and interpretations of reality.
patriarchal leadership controlling members through rewards and threats, often keeping them in the dark about the goals and rationale behind prescribed actions.
pedagogy this is a term for learning strategies for children and individuals with little knowledge about a health-related topic.
Precaution Adoption Process Model (PAPM) a model dealing with change that occurs in stages and over time.
process evaluation examines the dynamic components of the educational program. It follows and assesses the movements and management of information transfer and attempts to make sure that the objectives are being met.
psychomotor domain this is an area of learning that includes the performance of skills that require some degree of neuromuscular coordination and emphasizes motor skills.
reality norms individuals look to others to reinforce or to challenge and correct their ideas of what is real. Groups serve to examine the life situations confronting individuals.
role structure refers to the expected ways in which members behave toward one another. The role that each person assumes serves a purpose in the group.
short-term evaluation immediate followup that is designed to assess the immediate health and behavioral effects of the health education program.
task function these are things that members do to deliberately contribute to the group's purpose, such as displaying problem-solving skills, providing access to material resources, and demonstrating skills in directing.
task norm the commitment to return to the group's central goals.
Transtheoretical Model (TTM) a model dealing with change that occurs in stages and over time.
Created by: camellia