NURS 332: Comm Assessment

Community based nursing
minor acute & chronic care that is comprehensive, coordinated, and delivered outside the institutional setting (work, school, home)

Public Health nursing
population based practice focusing on disease and disability prevention as well as health promotion of the entire community

Community Health Nursing
nursing care in the community setting that comines the practice of community based nursing and public health nursing

-Promotion of health
-Prevention of disease
-Provision of health care services
-Rehabilitaiton from injury or disease

Achieve objectives by: Assesment
regular systematic assessment of the health needs of the community

Achieve objectives by: Policy development
creating public policies that address the community’s needs

Achieve objectives by: Service
ensures that necessary services are available to meet needs identifies during assessment

Early civilization
-Hiipocrates credited with being the 1st to document the influence of enviroment, diet, and work on health and disease.
-Hebrew writings in the Old Testament link cleanliness and diet with health.

Early civilization
-Greeks document the 1st communicable disease on record (malaria).
-Greek mythology reflects their cultural values of cleanliness and sanitation.
-Egyptians developed pharmaceuticals and public sewer systems.

Early Christian/Roman Era
-Romans developed public sewer system and aqueducts.
-Romans were the 1st to document worker health, specifically that of the air quality for miners.

Early Christian/Roman Era
-Romans adopted Christianity as a religion which promoted a caring/social community.
-Fabiola and Paula (2 Christian women in Rome) created hospitals and homes for the sick.

Middle Ages
-Roman Empire declines and with it goes their values of health and hygiene.
-Poor sanitation and hygiene practices are present resulting in epidemics.

Middle Ages
-Care of ill was haphazard and provided within the home.
-Few hospitals that did exist were located in monasteries and convents. Care was provided by monks and nuns primarily for the residents of the monasteries and the wealthy.

Middle Ages
-Influenza, small pox, and the bubonic plague (which killed approx. 1/4 of the pop.) spread across Europe.
-Military nursing orders developed during the Crusades.

-Characterized by scientific thought and social consciousness.
-Universities established.
-Dissection of the dead became an accepted practice.

-Statistical data collected on cause of death marking the beggining of the fields of public health and epidemiology.
-Cleanliness and sanitation rules developed for towns.
-Formal training for physicians developed.

-English Poor Law of 1601 is the beginning of government provided care to the poor.
-Sister’s (or Daughter’s) of Charity founded (still active today).
-Hospitals established however, fatality rates were poor. They were referred to as “death houses” and care was provided by “ward maids”, the equivalent of housekeepers.

Small Pox Vaccine
-Discovered by Edward Jenner.
-Becomes 1st compulsory vaccine for an infectious disease in England.

Louis Pasteur
Introduces the “germ theory”.

Joseph Lister
Institutes asepsis technique with surgical instruments and hand washing.

Florence Nightingale
-Considered “Mother of Modern Nursing”.
-During Crimean War, she documented statistics and notes on the # oof patients she cared for, her interventions and the patient’s outcomes. She is also considered the 1st nurse epidemiologist.
-Published writings emphasizing the need for formal nursing training.
-In 1859, established the district nursing association in Liverpool, England. This was the 1st formal group of public health nurses to visit sick patients in their homes and work with the community.
-Opened 1st school of nursing.

Clara Barton
Established Red Cross in U.S. in 1864.

Francis Root
1st trained nurse in the U.S. to work as a visiting nurse in 1887.

Lillian Wald
-Coined term “public health nursing” and is considered to be “Mother of Public Health Nursing”. Worked to improve education of public health nurses.
-Advocate for better housing and for occupational health nursing.
-Worked to change child labor laws.
-Founded national Organization of Public Health Nursing which set practice standards and guidelines.
-Assisted the Red Cross to establish visiting nurses services in rural areas.
-In 1909 secured 1st paymeny for visiting nurses for Met Life Insurance Company signifying the 1st incidence of paymeny from an insurance company for nursing.

Top 10 Achievements of 20th Century
-Immunization: mass inmmunization to control spread of commnuicable diseases.
-Motor Vehicle Safety: use of seatbelts and improves design focusing on safety decrease injury and death.
-Workplace Safety: labor union movements and occupational safety legislation improve work environments.
-Control of Infectious Disease: antibiotic use, immunizations and increase knowledge contain the spread of infectious disease.
-Decline in death from cardivascular disease and stroke: improved medical managment, technology, surgical techniques and development of medicines.

Top 10 Achievements of 20th Century
-Healthier food sources: regulation and inspection of meats and produce.
-Improved health for mother and baby: prenatal care and new born care.
-Family Planning
-Fluoridation of drinking water: decreased incidence of dental disease.
-Tobacco recognized as a health hazard.

Health care delivery system
how health care is provided (and financed) to a population.

Cultural Diversity
-According to the US Census Bureau, the population of the US will become more diverse.
-The Hispanic population will be the largest group and Asian/Pacific Islanders will show the largest growth in population.

Is the intergrated world economy marked by free trade, free flow or capital and cheaper foreign labor markets.

Positive effects of globalizaton
-Free trade allows for the import of low cost cunsumer goods(this keeps the cost down for the consumer).
-Technology and innovations are available to a broader range of areas.
-Increased living standards.

Negative effects of globalization
-Adoption of unhealthy Western lifestyles.
-Faster transmission of communicable diseases.
-Loss of ideology and cultural indetification for some countries.
-Rich countries get richer, poor countries remain poor.
-Lax trade policies have a negative impact on consumers.
-Companies are moving manufacturing to areas that have lower labor costs resulting in loss of jos in the US.

Nursing Process
-A model for nursing practice.
-A systematic, organized method used to identify and manage patient health problems.
-Based on nursing theory developed by Ida Jean Orlando in 1958.

Nursing Process: 5 steps

-Determine basline or “normal”.
-Identify the presence of actual and potential problems.
-Includes data collection and review.
-Includes data analysis.

-Statement that describes an actual or protential health problem that requires interventions.
-is the basis for the nursing care plan.
-Reflects the nurse’s clinical judgement about the client’s health conditions or needs.

-Based on the assessment and diagnosis, the nurse sets goals for the patient.
-The goals must measuable and achievable.
-Short term and lang term goals are set.
-These goals are also referred to as “outcomes”.

-Plan is carried out.
-Care given is based ont the care plan formulated during the planning phase.

-Nurse determines if the goals were met.
-If goals are not met, the determine why ther were not met.
-whole process may start over if goals are not achieved.

Nursing Models
-An abstract or general statment about concepts that organize ideas or provide a framework ofr practice.
-4 concepts: person, environment, health, and nursing.
-Includes health promotion and holistic aspects of care.

Community-As-Partner Model
-Based on Neuman’s Systems Model.
-Developed by Elizabeth T. Anderson and Judith M. McFarlane.
-Includes community core and 8 subsystems.

Normal Lines of Defense
-Represented by a solid line around the community cirlce.
-Represents level of health of the communtiy.
-Example: low infant mortality,high median household income, how community copes with daily stress and problem solving.

Flexible Lines of Defense
-Represented by broken lines within the community assessment wheel.
-Also referred to as Buffer Zone.
-Level of health occuring after temporary response to a stressor.
-Examples: Tetanus shots, food and clean water after natural disaster.

Lines of Resistance
-Represented by broken lines within the community assessment wheel.
-Strengths of the community
-Presented in all 8 subsystems of the community.
-They are the defenses in place to fight stressors.
-Example: free pregnancy clinic in community with high teen pregnancy rates.

-Represented by stars on the community assessment wheel.
-Stimulus that threatens the balance of the community.
-Stressors penetrate the flexible and normal lines of defense.
-Examples: loss of major employer (internal), air pollution from neighboring town (external).

8 Subsystems
-Physical environment
-Safety and Transportation
-Politics and Governement
-Health and Social Services

6 Phases to Community Assessment
-Establish contract/partnership

Community Assessment
-Collect subjective and objective data.
-Group or cluster pieces of related data.
-Compare data.
-Draw inferences from the data analysis to create a diagnosis.

Community Diagnosis
-Describes the community’s response to need regaurding a specific health issue.

Community Planning
-Develop goals and interventions.
-Primary interventions: immunizations
-Secondary interventions: B/P screening
-Tertiary interventions: Counseling school after school shooting.

Communtiy Implementation
Interventions created during the planning phase are put into action.

Community Evaluation
-Based on feedback from the community.

-study of distribution and determinants of states of health and illness in human population (Harkness).
-study of cause, distribution, and control of disease within a population.

Descriptive epidemiology
-Occurence of disease.
-Explains: person, place, and time

Analytic epidemiology
-Cause of disease.
-Explains: how and why

statistical study of populations focusing on size and density, distribution, and vital signs.

Size of population, density, age, gender, race, income levels, etc.

Vital Statistics
births, deaths, marriages, divorces.

-Primary measure used to describe the occurence of a state of health.
-2 most common rates are incidence and prevalence.
-Rates take into account the factor of time.

Rates: How they are calculated
-Numerator: all events being measures
-Denominator: everyone at risk
-Rate=(number of conditions or events within a designated time period/population @ risk during the same time period) X base multiple of 10

Incidence Rate
-The number of people in a specific population who develop a disease over a time.
-AKA occurence or attack rate.
-Numerator: new cases that have occured during specific time frame.
-Denominator: total population at risk

Prevalence Rate
-The number of people in a given population who have a specific existing condition at a givin point in time.

3 types of Rates

Crude Rates
General or summary rates that measure occurence of the disease in the entire population.

Specific Rates
More detailed and calculated for subgroups of the population.

Adjusted Rates
Statistical procedures that remove the effects of differences in the composition of a population such as age, when comparing 1 to another.

Presence of disease or illness.

Death rate.

Endemic Level
usual frequency of a disease within a population. considered to be norm or baseline.

Several cases of disease in short period of time in specific geopgraphical location. Unexpected occurence.

Unexpected high rate of disease in a population over an extended period of time.

Steady occurence of a disease across a geographic area or worldwide.

Epidemiology Triangle
-Host:the population at risk
-Environment:external factors that influence the agent and the host
-Agent: organism or factor whose presence, excessive presence or absence causes disease. (physical, chemical. nutritional, psychosocial, biological)

the ability of an organis or agent to produce disease.

ability of an agent to lodge and multiply in a host.

Data Analysis
identify current and potential stressors and determin impact stressors have on health of the community.

Sources of Data
-Direct observation: windshield survey
-Qualitative: interviews
-Quantitative: numerical or statistical data, facts

4 Steps for Data Analysis
-Comparison: identify gaps
-Inference elaboration:draw conclusions, develop problem list, cluster data, nursing diagnosis

Community Health Diagnosis
-Problem, population at risk, etiology, evidence to support problem.
-Risk of _________among_______related to __________as evidenced by ___________.

Planning: Goals and Interventions
-Community goals are developed and interventions to achieve the goals are established.
-Goal: what the community will achieve, not what the nurse will achieve.
-Interventions: things the nurse will do to help the community achieve goals.

4 Criteria for Goals
-Must be achievable and realistic
-Must be measurable
-Must be time oriented
-Must be community based (client centered)

Change Thoery
Kurt Lewin theorized a 3 stage model of change. Prior learning in rejected and replaced.

Unfreezing stage
-process where people let go of old patterns that are counterproductive/harmful. Resistance to change is overcome.
-community becomes aware of problem and realizes a need for change.

Moving Stage
-process in which changes in thoughts, feelings and or behaviors change.
-action is taken and interventions are implemented that bring about change.

Refreezing stage
the change is accepted as the norm. This prevents old patterns from re-emerging.
-driving forces help bring about change and restraining forces hinder change.

expanded on Lewin’s theory. 7 steps are outlined to initiate and guide planned change.

Quad Council of Public Health
-Ass. of Comm. Health Nurse Educators (ACHNE)
-ANA’s Congress of Nursing Practice & Economics (CNPE)
-American Public Health Ass. (APHA)
-Ass. of State & Territorial DONs (ASTDN)

Nursing Assessment Collecting data Using a systematic and ongoing process Categorizing data Recording data Assessment is the systematic gathering of information related to the physical, mental, spiritual, socioeconomic, and cultural status of an individual, group, or community WE WILL WRITE …

History, Examination, Documentation Three primary components of health assessment subjective symptoms are what kind of data WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY FOR YOU FOR ONLY $13.90/PAGE Write my sample objective signs are what kind …

what is pediatric nursing? nursing care of children from birth through adolescence; includes health promotion, illness management and health restoration top causes of mortality for children under 12 months – birth defects – prematurity/low birth weight – SIDS – complications …

“what we, as society, do collectively to assure the conditions in which people can be heathy IOM definition of public health Assessment Policy Development Assurance Essential PH services WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY FOR …

Nursing Process a way of thinking and acting based on scientific method Nursing Process a tool for identifying patients problems or potential problems and an organized method for meeting patients needs WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY …

nursing process definition The nursing process is a professional nurse’s approach to identifying, diagnosing, and treating human response to health and illness nursing process steps Assessment Diagnosis Planning Implementation Evaluation WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC …

David from Healtheappointments:

Hi there, would you like to get such a paper? How about receiving a customized one? Check it out