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Public Health Exam I
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Terms in this set (147)
Aggregate population group with common characteristics Competencies unique capabilities required for the practice of public health nursing District nurses public health nurses in England who provide visiting nursing services; historically, they cared for the people in the poorest parish districts Electronic Health Records (EHRs) digital computerized versions of patients' paper medical records Epidemiology study of the distribution and determinants of states of health and illness in human populations; used both as a research methodology used to study states of health and illness and as a body of knowledge that results from the study of a specific state of health or illness Evidence-based nursing integration of the best evidence available with clinical expertise and the values of the client to increase the quality of care Evidence-based public health a public health endeavor where there is judicious use of evidence derived from a variety of science and social science research
Healthcare disparities gaps in healthcare experienced by one population compared with another Health Information Technology (HIT) comprehensive management of health information and its secure exchange between consumers, providers, government, and quality entities, and insurers Public health what society does collectively to ensure that conditions exist in which people can be healthy Public health interventions actions taken on behalf of individuals, families, communities, and systems to protect or improve health status Telehealth use of electronic information and telecommunications technologies to support:
- long-distance clinical healthcare
- patient and professional health-related education
- public health
- health administration Social determinants of health conditions that have an impact on the extent to which a person or community possesses the physical, social, and personal resources necessary to attain and maintain healthcare
What was Clara Barton's contribution to public health? Clara Barton convinced the U.S. to establish the American Red Cross with an extended mission to provide aid for natural disasters What was Lillian Wald's contribution to public health? Lillian Wald is the founder of public health nursing; she established the Henry Street Settlement in New York City for the sick and poor (Harkness, 16) What was Mary Breckinridge's contribution to public health? Mary Breckinridge founded the Frontier Nursing Service in the United States to provide access to healthcare in remote Appalachian regions in southeastern Kentucky; founded Frontier Graduate School for Midwifery How did Florence Nightingale contribute to epidemiology? Nightingale statistically documented her successes saving lives through prevention of infections and improving environmental conditions
Florence Nightingale is considered the founder of nursing. What are her accomplishments related to epidemiology? A. formed a team of nurses to care for soldiers during the Crimean War B. taught patients and families about cleanliness and ventilation C. established the Red Cross of London to provide aid in natural disasters D. documented prevention of infections through improving environmental conditions Answer: D Rationale: D describes Florence Nightingale's contribution to epidemiology. Answer A is an action of Nightingale's but does not relate specifically to epidemiology. Answers B & D are not her accomplishments. Federal healthcare initiatives of the early 20th century
- increased funding for public and military hospitals
- Social Security Act of 1935 provided increased funding for underserved populations, disease prevention, and health promotion
- 1966 Medicare for elderly established in the United States
- 1967 Medicaid for the medically indigent established in the United States
What challenges do public health nurses (PHNs) face in the 21st century?
- helping eliminate health disparities in underserved populations
- demonstrating cultural competence
- planning for community change
- contribution to a safe and healthy environment
- responding to emergencies, disasters, and terrorism
- responding to the global environment (immunization education, pandemics, poverty, cardiovascular disease, obesity, tobacco use)
- health promotion (prevention, health education, identifying and addressing health risks - risk reduction, developing individual health plans, health screenings, and immunizations) Harkness, 19- What is the role of government in health care? Three core functions: (1) assesses healthcare problems, (2) intervenes by developing relevant health care policy that provides access to services, and (3) ensures that services are delivered and outcomes are achieved What are the goals of the Patient Protection and Affordable Care Act (PPACA)? (1) provide affordable health insurance coverage, (2) improve access to primary care, and (3) lower costs
What are the Healthy People 2020 goals for public health? eliminate preventable disease, disability, injury, and premature death achieve health equity, eliminate disparities, and improve the health of all groups create social and physical environments that promote good health for all promote healthy development and healthy behaviors across every stage of life create. achieve. promote. eliminate. What is one of the core functions of government in healthcare? A. to provide affordable healthcare insurance coverage B. to improve access to primary care C. to lower costs D. to assess healthcare problems Answer: D Rationale: Three core functions are to assess healthcare problems, intervene by developing relevant healthcare policy that provides access to services, and ensures that services are delivered and outcomes are achieved. Answers A,B,C, are goals of the Patient Protection and Affordable Care Act (PPACA).
Which of the following most accurately reflects one of the Healthy People 2020 goals? A. design a comprehensive patient-focused plan of care B. promote healthy behaviors across every stage of life C. encourage community organization D. increase cultural competency within all healthcare environments Answer: B Rationale: HP 2020 incorporates 4 goals, one of them includes promoting health across every stage of life. The other 3 selections are not HP 2020 goals but may reflect community health goals in general. True or false: Healthcare has been evolving toward a multifaceted system that empowers patients and clients rather than providers. Answer: True. What is considered in patient/client-centered care?
- cultural traditions
- personal preferences
- values
- families
- lifestyles
What are benefits of health information technology for patient/client care?
- improved coordination of care
- support of evidence-based practice
- elimination of paperwork
- reduced error
- expanded access to affordable care
- decreased health care costs
- improved overall health outcomes in both individual people and populations How has health information technology (HIT) benefited public health?
- increased prevention of disease and disability
- earlier detection of infectious disease outbreaks
- improved tracking of chronic disease management
- increased availability of health care evaluation measures
- more accurate assessments of the disease and disability burden in the community What are the principles of public health? Box 1.3 p. 9, Harkness (1) focus on the aggregate, (2) promote prevention, (3) encourage community organization, (4) practice the ethical theory of the greater good, (5) model leadership in health, and (6) use epidemiological knowledge and methods Public health nursing population-based practice combines nursing and public health
- preventing disease and disability
- promoting and protecting the health of the entire community Community-based nursing minor acute and chronic care that is comprehensive and coordinated where people work, live, or attend school; illness care provided outside the acute care setting (ex. home health care)
PHN Intervention: Referral and follow-up Assists in identifying and accessing necessary resources to prevent or resolve concern PHN Intervention: Case- management Coordination of a plan or process to bring health services, and the self-care capabilities of the client, together as a common whole in a cost-effective way PHN Intervention: Delegation Direct care tasks an RN entrusts to other appropriate personnel PHN Intervention: Teaching Develop and health education plan and teach clients and other caregivers leading to behavior change PHN Intervention: Counseling Develops an interpersonal relationship with the client to increase their capabilities to address or solve issues PHN Intervention: Consultation Seeks information and generates solutions to health problems or issues through interactive problem- solving PHN Intervention: Collaboration Work with people or representatives of organizations to achieve a common goal PHN Intervention: Coalition building Foster, mobilize, and participate in community-wide alliances to achieve a specific goal PHN Intervention: Community organizing Help community groups to identify common problems or goals, mobilize resources, and develop and implement strategies for reaching those goals
PHN Intervention: Advocacy Act of behalf of clients who have lost control of factors that affect their health and a need is unmet; strengthen client's' capacity to act PHN Intervention: Social marketing Use marketing principles and technology to design programs to address needs of the client PHN Intervention: Policy development Promote beneficial social changes that influence the health or groups and populations PHN Intervention: Policy enforcement Compels others to comply with the laws, rules, regulations, and ordinances created in conjunction with policy development What is the public health approach to problem-solving? Problem -> Response (1) Surveillance - What's the problem? (2) Risk Factor Identification - What's the cause? (3) Intervention Evaluation - What works? (4) Implementation - How do you do it? Illustrated in Figure 1.8 p. 17, Harkness Public Health Nursing: Scope and Standards of Practice defines the essentials of public health nursing, the activities, and the accountabilities that are characteristic of practice at all levels and settings; legal standard of practice set by the profession this scope and standards document can be used by PHNs from entry-level to senior management
Public health nursing is distinguishable from other specialties by adherence to eight principles. Which is one of the eight domains of public health nursing practice? A. analytic assessment skills B. investigation of disease C. referral and follow-up D. case management Answer: A Technological advancemences in public health rapidly advancing forms of technology are dramatically improving lives; many new ideas for new technology are emerging (an average of 32 medical devices are approved each year) "Although massive investments in medical research have been made, there has been an underinvestment in both research and the infrastructure necessary to translate basic research into results," (Harkness, 7) In the United States, which office is the principal federal entity responsible for the coordination and safety of information technology issues? The Office of the National Coordinator for Health Information Technology (ONC)
Where is the Office of the National Coordinator for Health Information Technology located? within the Office of the Secretary for the U.S. HHS True or false: The ONC has developed SAFER guides for EHRs. Answer: True. Department of Health and Human Services (USDHHS) U.S. branch of government responsible for health and welfare of citizens and refugees Healthy People 2020 a U.S. national consensus plan with specific health goals Philanthropic organization an organization that uses endowments or private funding to address the needs of individuals, families, and populations Refugee a person who leaves his or her place of origin and cannot return because of a well-founded fear of being persecuted for reasons that include race, religion, nationality, membership of a particular social group, or political opinion World Health Organization (WHO) an international center that collects data, advances, initiatives, and offers support related to public health
Healthcare System in the United Kingdom
- universal health plan (similar to Canada)
- about 36% of clients wait for hospital admission for treatment of nonacute conditions, and emergencies are immediately addressed
- medications are paid either by a flat rate or through capped charges (Harkness, 39-40) Is the following statement true or false? The United States has found the most efficient and effective ways to care for all by decreasing health disparities and giving access to care equally. Answer: False. Rationale: Despite the economic strength of the United States and other industrialized nations, many countries have found more efficient and effective ways to care for all by decreasing health disparities and giving access to care equally Nongovernmental Organization (NGO) an agency that acquires resources from private (vs public) sources to help others (ie. private health insurance) Philanthropic Organization one that uses endowed funds or private fund-raising to address the needs of individuals, families, and populations Governmental Organizations (Public Agencies) public healthcare does not focus on the health of the individual person, but on the population as a whole (ie. Medicare and Medicaid)
What is Medicare? health insurance program for people 65 years or older, under 65 with disabilities, and any who have End of Stage Renal Disease Who governs Medicare? federal government What does Medicare cover? Part A: care received as an inpatient Part B: care received as an outpatient Part C: Part A and Part B (and usually D combined) Part D: prescription drugs What does Medicare cost? depends on the plan (costs may include premiums, deductibles, co-pays, and coinsurance) How does one get Medicare? many people are enrolled in Parts A & B automatically at the age of 65 (contact social security office for eligibility) What is Medicaid? a program that helps pay health care costs for people with limited income/resources Who governs Medicaid? state government What does Medicaid cover? each state creates their own, but mandatory benefits include care and services in a hospital, skilled nursing facility, federally-qualified health center, rural health clinic, freestanding birth center, doctor/midwife/certified peds and family NP services and more
