Community Nursing - Discussion questions...
MR25
Chapter1.pptChapter 1
Opening the Door to Health Care in the Community
Forces for Change
- Public health needs in response to:
- Bioterrorist threats
- Natural disasters
- Community-driven system
- Nursing shortage
Health
- Defined by World Health Organization (WHO)
- Originally defined in 1948 as a “state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity”
- WHO expanded the definition in 1986 to include a community concept, “the extent to which an individual or group is able on the one hand, to realize aspirations and satisfy needs; and on the other hand, to change or cope with the environment”
Historical Insights
- Florence Nightingale
- Founder of modern professional nursing
- Developed first school of nursing
- Directive was to manipulate the patient’s environment to allow nature to take its course in the healing process
- Mid to late 1800s
- Process of contagion between human hosts and the environment better understood
Historical Insights (cont.)
- 20th century
- Medical discoveries and interventions
- Late 20th century
- Obligation to providing healthy environment for all
- U.S. healthcare system considered sophisticated despite:
- High infant mortality rates
- 25th in life expectancy
- Limited access to health care
- Only industrialized nation without guarantee of access to health care
Historical Insights (cont.)
- 21st century
- Focus on quality and efficiency
- Affordable Care Act of 2010
- Essentials of Baccalaureate Nursing Education for Entry Level Community/Public Health Nursing Practice
- Recommendations regarding entry level in community health nursing practice
Public Health Versus
Community Health
- Roles for nurses in the community
- Public health nursing
- Community health nursing
- Quad Council of Public Health Nursing Organization
- American Public Health Association
- Association of Community Health Nurse Educators
Communities & Populations Defined
- Community
- Group of people who share something in common and interact with one another who may exhibit a commitment with one another and may share a geographic boundary
- Population
- Group of people who have at least one thing in common and who may or may not interact with one another
Acute Care Versus Community Health Nursing
- Acute care setting
- Provider control
- Predictable routine
- Maintenance of hospital policy
- Resource availability
- Collegial collaboration and consultation
- Controlled patient compliance
- Standardization of care
Acute Care Versus Community Health Nursing (cont.)
- Community based
- Familiar and comfortable environment
- Routine less determined by the nurse or health professional
- Diverse resources
- Autonomy and choice in health decisions
Healthcare Reform and Reinvention of Systems of Care
- President Truman proposed national health insurance
- 1960s introduced Medicare and Medicaid
- Nursing’s Agenda for Health Care Reform
- Managed care
- Care management
- Transition planning
From Hospital to Community
- Move back to community setting
- Home care
- Hospice
- Outpatient treatment clinics
- Outpatient surgeries
- Identified connection between prevention and keeping population healthy
Cure and Prevention
- Centers for Disease Control and Prevention (CDC)
- 1977 analysis
- Health field elements identified:
- Lifestyle
- Human biology
- Environment
- Health care
- Benefit versus cost
Cure and Prevention (cont.)
- Healthy People
- Two overarching goals
- Increase years of healthy life
- Eliminate health disparities
- Four enabling goals
- Promoting healthful behaviors
- Protecting health
- Achieving access to quality health care
- Strengthening community prevention
Influences on Community Health
- Culture
- Leininger
- Giger & Davidhizar
- Purnell & Paulanka
- Environment
- Nightingale Notes on Nursing
- Ethics
- ANA Code of Ethics for Nurses with Interpretive Statements
Epidemiology
- Science of public health
- Epidemiological model or triangle
- Host
- Agent
- Environment
- Levels of prevention
- Primary
- Secondary
- Tertiary
Epidemiology (cont.)
- Measuring a community’s health
- Health statistics
- Birth rates
- Infant mortality rates
- Incidence and prevalence rates for various disease and age groups
