Define public health according to the Institute of Medicine
“What we as a society do collectively to assure the conditions in which people can be healthy”
Define Public health nursing according to APHA PHN
…the practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences.
According to Karen, name three positive components of APHA PHN Public health nursing definition
1. Places an emphasis on multiple disciplines 2. Supports a cooperative effort 3. Involves many disciplines and sciences.
According to Karen, how is home health different from public health?
Home health focuses on individual and illness while public health focuses on family and wellness. Also, unlike home health, public health is given even if it is known the family can’t pay for the services.
Define Population-focused practice per the ANA
Emphasizes the promotion of health and wellness; the prevention of disease, disability, and early death; and the creation of conditionsin which all people can be healthy.
Name the 3 essential functions of public health nursing
1. Assessment 2. Policy development 3. Assurance
Define Assessment as a component of the essential functions of PHN
Assessment is looking at and determining health status and determinants of health
Define Policy development as a component of the essential functions of PHN
Planning and implementing policy and programs.
Define Assurance as a component of the essential functions of PHN
Incorporating ethical standing. Has to do with “assuring” that everyone gets access to care. Mitigating disparities.
There are several determinants of health. Name 6.
1. Health inequalities 2. Health disparities 3. Income/SES 4. Employment 5. Biology/Hereditiy 6. Personal choices
What is the difference between inequity and disparity?
Health inequities are disparities that are avoidable. Disparity example is that women have more breast cancer than men – can’t do anything about that. Inequity is that infant mortality is higher in blacks that other races – why is this? We can avoid this.
When and where was the Henry Street settelment created and who created it?
1893 in NYC by Lillian Wald
Name the 3 levels of public health nursing practice
1. Population based individual focused 2. Population based community focused 3. Population based systems focused
What is the goal of Population based community focused nursing.
To elicit change in community norms, attitudes, awareness practices and behaviors
What is the goal of Population based systems focused nursing.
Changes organizations, policies, laws and power structures
What is the goal of Population based individual focused nursing.
Changes knowledge, attitude beliefs and practices of an individual.
Name the 2 principles of public health
1. Levels of prevention 2. Prevention strategies
Name the 3 tools of PHN and the emphasized goal
1. Principles of public health 2. Epidemiology 3. Public Health Nursing Interventions Wheel. PHN practice emphasizes prevention
While not every event is preventable, _______ ______ _______ a ___________ ___________
While not every event is preventable, every event has a preventable component.
What are the 3 levels of prevention?
Primary, secondary, tertiary
Name the 3 prevention strategies used in prevention
1. Education 2. Engineering 3. Enforcement
How is Education used as a prevention strategy?
Provide information to facilitate change to promote prevention
How is Engineering used as a prevention strategy?
Managing variables by using technology
How is Enforcement used as a prevention strategy?
Utilizing policies and laws for prevention. Seatbelt law.
The intervention wheel encompasses 17 interventions, what population types are the red, green and blue wedges mostly used for?
Individuals, families, classes and groups
what levels of public health nursing practice are the orange and yellow wedges on the intervention wheel mostly used for?
Population based community focused nursing and Population based systems focused nursing
What is the primary tool for evidence based nursing in community health
What are the three components and explain the relationship between the components of the epidemiologic triad
Host, agent, environment. There is a complex interrelationship of numerous factors interacting to affect the risk and development of disease
Name the 6 different types of agents
Physical, chemical, infectious, nutritious, genetics and psychological
Name the 4 different factors that can affect the susceptibility of the host
General susceptibility, Immutable characteristics, acquired characteristics and lifestyle factors
Give 2 examples of immutable characteristics
What is meant by acquired characteristics
Give three examples of lifestyle factors
diet, excercise, sex practices
Give 5 examples of Environment that affect the epidemiologic triad
climate, plant & animal life, human population, Socioeconomic factors, working conditions
Explain the Ecological model
Also called a web of causation – considers multiple levels of factors that affect health and disease. Think beyond this.
Name the 5 levels of factors in the ecological model
1. Innate 2. individual behavior 3. Social, family and community networks 4. Living and working conditions 5. Broad social, economic, cultural, health and environment conditions and policies at the global, national, state and local levels.
In the ecological model, what is meant by the innate level
Individual traits such as age, sex, race and biological factors (host factors)
Name the top 5 causes of death in the US in 1900 for all ages
1. Pneumonia/flu 2. TB 3. Heart disease 4. Stroke 5. Diptheria
Name the top 5 causes of death in the US in 2007 for all ages
1. Heart disease 2. cancer 3. Stroke 4. Chronic lower respiratory diseases 5. Accidents
What three health achievements were on the list of Public Health Achievements in the 1900s that are no long on the list in 2000s
Safer and healthier foods, family planning and Fluoridation of drinking water
What three current health achievements were not on the 1900s Public Health Achievements list.
Cancer prevention, childhood lead poisoning prevention and Public health preparedness and response (Think 9/11 and Hurricane Katrina)
What is the biggest difference in the list of health achievements for the 1900s compared to the current list
The 1900s list focused more on secondary and tertiary care while the 2000s list focuses more on primary care.
There are several epidemologic demographics used as common measurements to compare populations. Name 6 epidemology demographics utilitized.
1. Age 2. Race 3. Income 4. Education 5. Gender 6. Geography (for issues like vitamin D or radiation)
Name 3 other common measurements, besides demographics, used to compare populations
1. Mortality rate 2. Age specific mortality 3. Infant mortality rate
What is the purpose of mortality rates
Used to describe deaths in various categories by number of people in a particular group
What is the equation for Age Specific mortality?
(Number of deaths among people of certain age/population estimate for that age group) x 100,000
Infant mortality rate is considered the key measurement of health of a population. This equation is different, what is it?
(Number of infant deaths under 1 year of age/number of live births in the same year) x 1000
Name three medical interventions that have helped decrease infant mortality rates
1. Drugs for surfactant ability 2. Sanitation 3. Back to sleep
What race has the highest infant mortality rate suggesting a grave disparity
How does the US infant mortality rate compare to other industrialized countries?
The infant mortality rate is higher in US. We are ranked 26 out of the 29 countries in 2010. We are the richest country in the world and we rank 26.
Name one country that is much poorer than the US, spends less on health care, yet has a better infant mortality rate.
Name 3 reasons why Japan may have a lower infant mortality rate then US
1. Universal access to care 2. Social health programs 3. Focus on children
Proportion of the population that has the disease/condition at a given time
Number of new cases developingin a population at risk during a specific time.
Why is morbidity data important to know about
Helps define the disease studying
What is the relationship between incidence and prevalence
The two are positively correlated so as one goes up the other does too.
What is descriptive epidemiology
Focuses on distribution of frequencies and patterns of health events with groups in a pooulation. Looks at person, place, time
What is Analytic Epidemiology
Seeks to identify associations between a particular disease or health problem and its ediology.
List 4 types of analytic epidemiology
1 Cohort studies 2. Case-control studies 3. Cross-sectional studies 4. Ecological studies
PHN practice is grounded in a set of values and beliefs called
Cornerstones of PHN
The Intervention Wheel defines the ________ & _______ of PHN practice while the cornerstones define the __________.
Intervention wheel defiens what and how
Cornerstones define why
Cornerstones define why
The cornerstones synthesize what two things from public health and nursing
foundational values and beliefs
The cornerstones of PHN focus on what?
The health of the entire population
What does the cornerstone of PHN reflect?
community priorities and needs
The Cornerstones of public health nursing establish caring relationships with which 4 populations?
communities, systems, individuals and families
What 6 aspects of health do the cornerstones of PHN encompass?
mental, physical, emotional, social, spiritual and environmental
The Cornerstones of public health nursing are grounded in which four values
socail justice, compassion, sensitivity to diversity and respect for the worth of all people, especially the vulnberable
The Cornerstones of public health nursing promotes health how?
Through strategies driven by epidemiological evidence
One cornerstone of PHN states that PHN will collaborate with who?
Collaborates with community resources to achieve strategies driven by epidemiological evidence, but will work alone if necessary
What is responsive use of self?
This basically means think outside yourself – really listen to the client, help them with what they think is the priority, not with what you think they need.
Why is responsive use of self so important?
Because the skill crucial to developing a partnership between the PHN and client
what is meant by “Responsiveness to the other?”
Responsiveness to the other enables the PHN to gain a “situated understanding” of the clients’ lives and to cultivate clients’ strengths and connections to a responsive community.