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Occupational and School Health: Initiatives for Employee and Student Well-being, Exams of Health sciences

Various initiatives companies and schools can implement to promote employee and student health and wellness. Topics include occupational health, disaster management, health education programs, and environmental health. The document also touches upon the roles of nurses in these areas.

Typology: Exams

2023/2024

Available from 04/05/2024

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Study guide for Community final exam:
1. tertiary prevention for occupational health nursing
organization (a guidebook for clinic workers). Health promotion and illness and injury
prevention is a function that the OHN performs along a continuum for the worker population.
The objective is to create an environment for the worker that provides a sense of balance among
work, family, personal, health, and psychosocial concerns. The actual prevention activities
performed at any given time are a result of many changing variables in the organization, and a
balance among primary, secondary, and tertiary prevention efforts is essential. For example, the
nurse who is concentrating on developing strategies to pre-vent work site injuries and disease
(primary prevention) may have little time or resources for testing individual employees for risk
factors that increase the potential for illness or injury
(secondary prevention).
2. Spiritual care assessment for a hospice care nurse. What is the point of it?
Nurses must be confident in their clinical skills when caring for the dying—awareness of the
ethical, spiritual, and legal issues they may confront while providing end-of-life care is essential.
Many nurses believe that the first step in the process is confronting their own personal fears
about death and dying. By addressing their own fears, nurses are better able to help patients and
families when they are confronted with impending death. The nurse may then more objectively
recognize and respect the patient and family’s values and choices which guide their decisions at
the end of life.
3. End of life care (nursing intervention – “it’s the same across the board”)
The role of the community health nurse in providing quality end-of-life care for seriously ill
patients and their families. (go to page 508-510 chp.24)
4. Know diff between man-made disaster and natural disaster
Major natural emergencies are fires, floods, hurricanes, tornadoes, earthquakes, and
winter storms. Human-made or technologic events include fires, violence, bomb threats
transportation accidents, industrial accidents, civil disturbance, radiation, and
unintentional or intentional release of chemicals or infectious organisms (bioterrorism)
oNatural – sunami, meteor, tornado, etc.
oMan – made: accidental and terrorist attack.
Japan’s nuclear plant melt down after the tsunami was deemed a human
made disaster.
5. Hospice – how are you approved for hospice care?
Begins after treatment of disease is stopped and it is clear that person is not going to survive the
illness. Patient is eligible for Medicare part A, physician and hospice medical director
certify patient is terminally ill and has 6 months or less to live if illness runs it course,
patient signs a statement choosing hospice care, patient receive care from a Medicare
approved hospice program
6. HP 2020 and their objectives
oNew: adolescent health, blood disorders and blood safety, dementias (including
AD), early and middle childhood, genomics, global health, health-related quality
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Study guide for Community final exam:

  1. tertiary prevention for occupational health nursing organization (a guidebook for clinic workers). Health promotion and illness and injury prevention is a function that the OHN performs along a continuum for the worker population. The objective is to create an environment for the worker that provides a sense of balance among work, family, personal, health, and psychosocial concerns. The actual prevention activities performed at any given time are a result of many changing variables in the organization, and a balance among primary, secondary, and tertiary prevention efforts is essential. For example, the nurse who is concentrating on developing strategies to pre-vent work site injuries and disease (primary prevention) may have little time or resources for testing individual employees for risk factors that increase the potential for illness or injury (secondary prevention).
  2. Spiritual care assessment for a hospice care nurse. What is the point of it? Nurses must be confident in their clinical skills when caring for the dying—awareness of the ethical, spiritual, and legal issues they may confront while providing end-of-life care is essential. Many nurses believe that the first step in the process is confronting their own personal fears about death and dying. By addressing their own fears, nurses are better able to help patients and families when they are confronted with impending death. The nurse may then more objectively recognize and respect the patient and family’s values and choices which guide their decisions at the end of life.
  3. End of life care (nursing intervention – “it’s the same across the board”) The role of the community health nurse in providing quality end-of-life care for seriously ill patients and their families. (go to page 508-510 chp.24)
  4. Know diff between man-made disaster and natural disaster Major natural emergencies are fires, floods, hurricanes, tornadoes, earthquakes, and winter storms. Human-made or technologic events include fires, violence, bomb threats transportation accidents, industrial accidents, civil disturbance, radiation, and unintentional or intentional release of chemicals or infectious organisms (bioterrorism) o Natural – sunami, meteor, tornado, etc. o Man – made: accidental and terrorist attack.  Japan’s nuclear plant melt down after the tsunami was deemed a human made disaster.
  5. Hospice – how are you approved for hospice care? Begins after treatment of disease is stopped and it is clear that person is not going to survive the illness. Patient is eligible for Medicare part A, physician and hospice medical director certify patient is terminally ill and has 6 months or less to live if illness runs it course, patient signs a statement choosing hospice care, patient receive care from a Medicare approved hospice program
  6. HP 2020 and their objectives o New: adolescent health, blood disorders and blood safety, dementias (including AD), early and middle childhood, genomics, global health, health-related quality

of life and well-being, healthcare associated infections, LBGT health, older adults, preparedness, sleep health, social determinants of health.

  1. School nurse – student with asthma. What kind of teaching can this school nurse give?
  2. CDC – youth risk behavior. How often do the CDC conduct youth risk behavior? Twice a year-biannual report
  3. Occupational health nurse doing a walk through in the hospital. What are some of the things she’s looking for? Define occupational health nursing and describe the role of the occupational health nurse.  Specialty practice which provides for and delivers health and safety programs and services to workers, worker populations, and community groups o Focuses on promotion and restoration of health, prevention of injury, and illness, and protection from occupational and environmental hazards o Prevent work and non-work-related health problems and to restore and maintain health of workers  Assessments of hazards, surveillance of workers and workplace, investigation of illness and monitoring events that lead to an injury  The specialty of occupational health focuses on the identification and control of risks to health which occur as a result of physical, chemical, and other workplace hazards. The goal is to establish and maintain a safe and healthy environment for workers. What sorts of initiatives can companies pursue to improve employee health and wellness?  Protecting employees from pollution and environmental exposure, reduce stress, increase job satisfaction  Engineering (ex., design of spaces, equipment…)  Altering work practices  Workplace monitoring/surveillance/assessment  Site walk-throughs (Box 25.3 p. 537)  Job task analysis  Health screening  Education to prevent future injuries  Employee Assistance Programs (EAPs)  Provide personal protective equipment (PPE) Why is workplace health so important? What Healthy People 2020 topics and objectives relate to workplace health?
  • Reduce fatalities from pneumoconiosis (lung disorders related to inorganic dust), homicide, assaults
  • Reduce non-fatal injuries
  • Especially those r/t overexertion or repetitive motion
  • Hearing loss
  1. Know what a walk-through is. Workplace walk-through: A complete survey of the workplace, inside and outside, compiling information as to the presence of hazards, the location of entries and exits, the availability of emergency equipment, and potential trouble spots. is a technique for an assess- ment of the workplace. This process leads to an understand- ing of the work process, the requirements for the various jobs, the materials involved, the presence of actual or poten- tial hazards, and the work practices of the employees
  2. Elderly abuse – what can that consist of? Elder mistreatment (abuse and neglect) elder abuse - >65 yo, Intentional actions that cause harm or create a serious risk of harm (intended or not) to a vulnerable elder by a caregiver in a trusting relationship to the elder. Includes failure to satisfy basic needs or to protect the elder from harm. child maltreatment /child neglect- unexplained injuries, physical or emotional, sex abuse, exploitation of children  Understand violence prevention strategies in regards to the levels of prevention. o Primary-Teach conflict resolution, anger management, parenting classes, promote understanding of abuse and violence, secondary- identify and screen for abusers, advocate for legislation to protect victims, tertiary- provide support, crisis plan, dial 911, shelters  Review gun violence in the U.S.  Understand the risk factors, safety measures and the required safety measures indicated for Intimate partner violence. o Low self-esteem, low income, young age, aggressive behavior as a child. Depression, anger, antisocial, borderline, physical abused history, few friends / isolation, desire for power, economic stress, martial conflicts, poverty, overcrowding, weak community sanctions, traditional gender roles  Understand the role of the Forensic Nurse as related to violence, specifically intentional crimes. o Forensic nursing encompasses a body of specialty professions that serve unique and critical roles to the health care and judicial systems. Forensic nurses might treat assault victims, investigate crime scenes or provide health care in a correctional facility.  Violence - act carried out by a person against another person when there is a conscious choice to act in violent manner  Intimate partner violence - pattern of assaultive and coercive behaviors which may include infected physical injury, psychological abuse sexual assault, social isolation, intimidation, deprivation and threats perpetrated by someone who is was or wishes to be involved in an intimate or dating relationship with the person and want to establish control over the other
  3. Know the color-coding system for the START triage system. What is the responsibility of the Registered Nurse in disaster management?  Assess the needs of the community as events unfold (risk assessment)

 Conduct surveillance for communicable disease and unmet needs  Prevent control and spread of disease  Maintain communication channels to ensure accurate dissemination of info  Organize and manage points of distribution centers and mass immunization sites  Provide on-site triage  Manage behavioral response to stress, ensure health and safety and document events and interventions

  1. Lyllian Wald and Lena rogers. What role did they play in school nursing? o Lillian Wald – Henry Street Settlement. o Lina Rogers was the first public school nurse, due to Wald’s lobbying on the school system. She was the first school nurse hired by the NYC public school system.
  2. Health education interventions for a school nurse. (3rd^ question on this.) The Role of the School Nurse – help encourage positive response to normal development, promote health and safety, solve actual and potential problems, provide case management services, work with others to develop student and family capacity for adaptation and self- management What are the three health service visits that require nursing assessment skills?  Acute illness- vomiting, fever, headache, and playground injury o Nurse use physical assessment skills and knowledge of first aid to address issue  Typical screenings- immunizations and may be continued as child grows and is at risk for problems that may impact learning such as vision. Maintain health records.  Counseling- students may seek out school nurse for advice and support regarding daily stressors encountered in social framework of school, being picked on or bullied What are some health Education programs the school Nurse may implement?  Comprehensive school health programs  K-12 health education programs should discuss personal health, family health, community health, consumer health, environmental health  K-12 physical education program - should promote optimum physical, mental emotional and social development as well as activities and sports that all children can enjoy  Health services- ensure nutritious access and appealing meals  Health promotion for staff- encourage staff to pursue healthy lifestyle that contributes to their improved health status, morale, personal commitment to the schools overall coordinated health program  Counseling and psychology services- should include individual and group assessments, interventions and referrals  Healthy and safe school environment- physical, emotional and social conditions that affect well- being of student and staff  Family community involvement- should include school health advisory councils, coalitions and constituencies for school health
  3. SATA – environmental health – what’s included? Exposure- the total amount of contaminants that comes in direct contact with the body

 Review common environmental health risks today. Lead-  Most common source: paint in home before 1978, on windows, walls and outside of home  Media of transport- as paint deteriorates it can chip and create dust that contains lead  Most common point of exposure- inside the house as chips or dust. Soil outside the house  Route of exposure- ingestion  Population of most concern- children frequently have greater exposures b/c they put their hands-on objects and in their mouths and play in the soil  Health effects- children brain and nervous system are sensitive to damage by lead, learning problems and hyperactivity. Blood lead level of 5 ug/d is at a level which action is need to stop exposure. Neurological damage in children and developmentally delayed. Healthy housing- age and condition of housing can expose people to contaminants Access to portable water- public water are tested frequently but private water are not; both can be contaminated with bacteria but public is faster to be identified. Sanitation and waste remove Green spaces- Ambient air Indoor air Abandoned building Access to healthy and safe foods Access to physical activity Location of schools and public transportation Animals Vectors Access to health care Climate Nose UV Subsistence- food captured or gathered as a supplement locally Cultural practices and tradition Natural and human made hazards Community concerns Recreational waters

  1. The role of a faith community nurse. What is it? o Teacher said Volunteering What is faith community nursing?  Focuses on supporting the mission of faith in the community during health promotion, screening, and teaching  Focus on holistic  Ask about god’s role during health challenges  Inclusion of spiritual practices

 No direct skilled care like injections or dressing changes  DO NOT REPLACE WORK OF OTHER CPH NURSES OR HOME CARE  Integrator of faith and health o Spiritual care, assessment, sharing scripture, therapeutic listening  Personal health counselor o therapeutic communication, emotional distress, assessing for suicide  Health educator o Individual health teaching, group, provider of health resources  Referral agent o Maintaining list of local providers/agencies and communicating w/ referrals  Coordinator of volunteers o Assessing for needs for volunteer services, recruit and train volunteers, scheduling and commission  Assessing and developing support groups o Referring congregation members to seek existing support groups or develop support groups  health advocate o empowerment of members of congregation (organized group of people who share religious beliefs. Has internal governance structure and may be independent or affiliated to local or national denominations, community within larger community) to improve health of community Review various models of faith community nursing practice.  Based in congregation- paid and based in congregation o Unpaid- volunteer and based in congregation  Based in health system- paid and affiliated with health system o Unpaid- volunteer and affiliated with health system  If unpaid- community nurses have to be creative in securing resources to support program  If paid- nurse is employed by health system or hospital and nurse serve as an ambassador and referral agent for institution.

  1. You have a victim of domestic violence – what is one of the first things that a parish nurse should do? o Safety – make sure they are safe, have a place they can go. The most validated and used instrument to assess for safety is the tool developed by Jacquelyn Campbell (1986), the Lethality Assessment tool. It is a 20-item tool available on the Internet in English, Spanish, Portuguese, and French Creole. Campbell developed this instrument to identify women at risk of being murdered by their intimate partner. It often heightens women’s awareness about her safety. Once the safety issues are identified, the healthcare provider can present intervention options to the client. Safety planning involves nurse suggestions and client choices (e.g., does the client feel she is able to keep herself safe? Does she has friends or family members who could help… components for safety planning include a crisis/disaster plan, a place to go, how to get there, and other considerations (e.g., if the abused victim stays and the abuser leaves, if victim and the abuser stay together, or if the victim decides to leave). Safety planning involves discussing measures that the client may not have considered. For example, if an argument occurs at home, the woman should stay away from… carry her cell phone with 911 set

The patient will receive care from a Medicare-approved hospice program

  1. What are some non-pharm treatments for end of life and hospice care for pain? Some nonpharmacologic approaches to reducing pain may include providing a glass of warm milk to promote sleep, a back rub, a change of position, a favorite peaceful musical selection, spending time listening to the patient, and/or visits from a priest, minister, or rabbi to meet spiritual needs. Nonpharmacologic methods can be used with pharmacologic therapy, and often augment the therapeutic effects of the drugs, resulting in the use of smaller doses.
  2. Substance abuse and use is a co-morbidity for which factor? o Cardio vasc disease, chronic mental illness, terminal illness, end-stage renal? Which of these four is it? o Substance abuse goes hand in hand with which one of those?
  3. Common screening tool for alcohol abuse? Cage was the right answer The USPSTF issued a national recommendation that all adults in primary care should be routinely screened for alcohol use with the AUDIT-C or CAGE questionnaires The AUDIT-C, CAGE, and SMAST-G screening instruments are now available in a pocket-sized brochure to facilitate use in all primary care settings. Screening for substance use is the first step in assessing whether a person has substance use disorder. AUDIT-C and CAGE Screening Instruments for Alcohol Abuse
  4. Know the difference between palliative care and hospice care. o Biggest dif is that you do not have to be terminal to be on palliative. o If Ejection fraction is 30%, you can still go on palliative care, because you are not yet terminal. o Ejection fraction would have to be less than 20% to go on hospice. Define palliative care-improve quality of life for patients with serious illness  Relieve suffering in patients and their families. Physical, social, emotional and spiritual needs are met. CAN BEGIN AT THE TIME OF DIAGNOSIS with treatment.  Enhance QOL, reduce pain and suffering, optimize functionality, promote appropriate goal setting and decision making  Focus on pain and symptom control Define hospice -end of life care for those entering the last phase of life, less than 6 months  Pain management and comfort is key. Holistic care. Manage pain, control symptoms and assess patient and family coping mechanisms, available resources to care for the patient, the patient’s wishes, and support systems in place.
  5. Most common mental health disorder that are found in children and adolescents? Depression is the right answer. Attention-deficit/hyperactivity disorders (ADHD) and/or emotional disorders such as autism and autism spectrum disorder (ASD )
  6. Look up medicate and some of the things that they can reimburse for school age children in a school setting. Services Reimbursable by Medicaid Speech/language therapy and evaluations Occupational therapy and evaluations

Physical therapy and evaluations Psychological evaluations Psychotherapy services

  1. Look up American disability act – look up Early Pediatric SDT and IDEA. Know what they do. The Individuals with Disabilities Education Act (IDEA), originally the Education for all Handicapped Children Act, has undergone several legislative amendments in recent years. Lawmakers made these changes to accommodate the changing climate for disabled people in the United States and to promote the belief that “improving educational results for children with disabilities is an essential element of our national policy of ensuring equality of opportunity, full participation, independent living, and economic self-sufficiency for individuals with disabilities” (Individuals with Disabilities Education Improvement Act of 2004). The IDEA website gives more information about provisions of the act. The most recent change came in 2004 to align with the No Child Left Behind Act of 2003, which attempts to ensure success by focusing on the best teaching and learning strategies for the disabled. Reforms to these standards were enacted in 2009 and continue to the present time.
  2. Look up youth risk behavior surveillance survey (YRBSS) What is the purpose of the Youth Risk Behavior Surveillance Survey (YRBSS)?  Biennial report of common risk behaviors influencing youth’s health. Identified because of their potential impact on long term health and well being of youth  Includes unintentional injury, violence, tobacco use, alcohol use, drug use, sexual behaviors, unhealthy dietary behaviors, physical inactivity the Youth Risk Behavior Surveillance Survey (YRBSS), is a biannual report of the common risk behaviors influencing the health of the nation’s youth. These risk behaviors are identified because of their potential impact on the long-term health and well-being of youth. Survey risk behaviors categories -Unintentional injury -Violence -Tobacco use -Alcohol use -Drug use -Sexual behaviors -Unhealthy dietary behaviors -Physical inactivity
  3. Look up the purpose and definition of an IEP Today, it is not uncommon for school nurses to record up to 100 visits in a single day. With these complex diagnoses came the need for high-tech skills to perform procedures such as tube feedings, catheterizations, and suctioning. The impact of these requirements on school nursing has been considerable, given that historically, the scope of school health services was often the function of public health nurses contracted through municipal health departments. The inclusion of children with special needs led to a change in the EPSDT program. The School Health- Related Services Plan of the Social Security Act (the Act) requires that any medically necessary healthcare service listed in Section 1905(a) of the Act be provided to an EPSDT recipient even if
  1. Constipation at the end of life – pharm and non-pharm treatments. Enema is pharmacological  Treat constipation with prune juice, senna, lactulose, do not allow the patient to go longer than 3 days without a bowel movement. Most opioid analgesics slow the movement of material in the intestinal tract and result in poor bowel elimination. Constipation may contribute to increased pain in dying patients, and it is extremely important that the nurse monitor the bowels carefully. It is necessary to initiate a prophylactic bowel regimen when using opioid analgesics. This includes the use of stool softeners (e.g., docusate sodium) and bowel stimulants (e.g., senna). Senna tea and fruits may also be helpful, and nurses should encourage patients to increase their fluid intake, if possible. Patients should avoid using bulking agents (e.g., psyllium) to prevent fecal impaction.
  2. End of life patient – scenario where this patient has three things – treat patient for everything. Don’t gear treatment toward someone’s history. (Past heroine user still gets opioids)
  3. SATA - Know what questions should be asked for a pain assessment. Pain assessment, including a thorough history, guides the development of a comprehensive pain management plan. Pain is a subjective experience, with self-report being the gold standard by which pain is measured. Accurate pain assessment is the basis of pain treatment, and physicians or nurses should perform it in a systematic and ongoing manner. Helpful questions may include the following: How bad is the pain? (It may help to use the facility pain indicator such as smiley face or rate the pain on a scale of 1 to 10.) How would you describe the pain (e.g., sharp, shooting, or dull)? Is the pain accompanied by other troublesome symptoms such as nausea or diarrhea? What makes the pain go away? Where does it hurt the most? Does the pain interfere with your ability to eat and sleep? What do you think is causing your pain? What have you done to alleviate the pain in the past?
  4. Med-math question. ml/kg – what are you going to give in mg. Just know the conversion.
  5. Look up Louis Pasteur. Know what he’s known for.

o In particular – what vaccine did he develop? She’s going to email with more information about some of these questions she doesn’t like. 42.Know what staging area (know the definition of it) is in disaster planning. 43.Know the criteria for to be a member of Alcoholic anonymous 44.Know that the most common mental disorder in children and adolescent is depression 45.Know what IEP and what does it do 46.Know that the first line of treatment for major depression is SSRIS 47.Know the daily max limit of aspirin, ibuprofen, naproxen and Tylenol. 48.Know risk factors for addiction and abuse. 49.know that louis Pasteur is a microbiologist and a chemist who discovered vaccines for rabies and anthrax. True 50.know that substance abuse and mental health are correlated.(comorbidities of Substance abuse =Chronic Mental health) 51.Both Lyllian Wald and Lena rogers involved in school nurse. TRUE