Term
| rurality is a subjective concept because |
|
Definition
Depends on what person is used to
Concept has changed over years--> differences between urban and rural less obvious as there are now urban influences in rural areas can be defined in terms of geographic location and population density, or by distance from the city
some equate rural with farms, others with peaceful place (retirement community, resort in mtns or by lake for recreation), others with poverty
no “typical rural town” –all are different |
|
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Term
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Definition
| Residency outside area zones as “city limits”; usually infers involvement in agriculture |
|
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Term
| mobility and self care limitations that are more common in rural adults |
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Definition
Isolation from care facilities
Poverty/ uninsured
Poorer perception of overall health and preventative health measures
Participate in more risky behaviors (alcohol, more obese, less likely to exercise during
leisure time, less likely to wear seatbelts and have regular screenings (BP, pap, breast, colorectal))--> ends up limiting function
More likely to have chronic illnesses that impact mobility and self care
More physical limitations (walking 1 block etc) |
|
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Term
| health seeking behaviors of rural adults |
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Definition
Less likely to seek preventative care
Less likely to receive medical treatment for life-threatening illness and chronic
conditions
May only seek care when problem is bad |
|
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Term
| barriers/issues to health care access for rural adults |
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Definition
Income often less
Transportation- availability & costs
Distances to HC centers
Availability of HC centers in area
Less likely to have a PCP (which makes them more likely to get care and have regular
preventative care than to not have one)
More likely to receive care from a general practitioner or APRN than medical specialist
Areas lacking in enough HCP (HCPSA –HCP shortage area) |
|
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Term
| National Center for Farmworker Health description of pregnant women that are of particular risk for poor pregnancy outcomes |
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Definition
Women who live on/near Indian reservations
Migrant workers
African-American descent residing in southeastern states |
|
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Term
|
Definition
Mental health associated with rural living--> associated with the economic downturn in
the agricultural industry as it impacts an individual, family or community. |
|
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Term
| characteristics of rural nursing practice |
|
Definition
Available
Whether health services exist along with necessary HC personnel
Affordable
Associated with both availability and accessibility of care
Infers that services are of reasonable cost and that family has sufficient resources to purchase these when needed.
Accessible
Whether or not person has logistical access to and ability to access needed services.
Acceptable
Means that a particular service is appropriate and offered in a manner that is congruent with the values of a target population (influenced by client’s cultural preference and urban orientation of HCP) |
|
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Term
| case management model of care |
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Definition
Client-professional relationship that can be used to arrange a continuum of care for
rural clients, with the case manager tailoring and blending formal and informal resources
Collaborative relationship-->client participates in care |
|
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Term
| age distribution, income and insurance trends in respect to population characteristics |
|
Definition
age distribution
higher proportion of younger and older residents (less middle-aged adults proportionally)
income
generally poorer than urban counterparts
¼ of rural Americans at or near poverty level
insurance trends
less likely to be insured than urban counterparts
esp working poor like migrant workers that can’t afford health insurance but make too much to receive public assistance
higher proportion self-employed (no health insurance w/ job)
more part-time/ seasonal work (construction, farm laborer)
less likely to have private insurance & more likely to receive public assistance (Medicare/Medicaid) or be uninsured |
|
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Term
| health status of rural adults in respect to chronic illness and physical limitations |
|
Definition
more chronic illness than urban (heart disease, COPD, HTN, arthritis, diabetes…)
(nearly half of rural adult pop has chronic condition vs ¼ of urban)
higher prevalence of diabetes (7/100 vs 5/100 urban)
more likely to have cancer (7% vs 5%)
more failure to participate in health-promotion behaviors (check-ups, screenings, seat
belts, exercise) results in higher rates of physical limitations than urban
also failure to treat chronic diseases results in more physical limitations |
|
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Term
| role of the nurse in infectious disease management |
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Definition
| Although not the leading cause of death in the US, it is around the world, and as we globalize, we are all at risk! “Nurses must know about these diseased to effectively participate in diagnosis, treatment, prevention, and control |
|
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Term
| factors that affect the emergence of new infectious diseases |
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Definition
| Terrorism, drug resistance, new viral strains forming, and people not taking them seriously as a threat |
|
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Term
| nurse’s role in increasing increase immunization coverage of infants and toddlers |
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Definition
| Nurses should oversee the delivery of immunizations at these ages and monitor the immunization status in clinics, day-cares, homes |
|
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Term
|
Definition
| infiltration of pathogenic agent into the food (like bacterial salmonella infection) |
|
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Term
|
Definition
| caused by toxins, chemical contaminants, etc. (like pesticides, botulism, mercury poisoning) |
|
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Term
| health education that a public health nurse would provide to prevent and manage intestinal parasitic infections |
|
Definition
| Intestinal parasites are found in 20% of stool samples. If fecal matter is not properly disposed of, or if handwashing is not done someone else is at risk. Sanitation initiatives are hugely important, and drug therapy cures 90%-100% of cases. |
|
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Term
|
Definition
| is species-determined, innate resistance to an infectious agent. |
|
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Term
|
Definition
| is the resistance obtained by a host as a result of previous natural exposure. |
|
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Term
|
Definition
| the collective resistance had by a group of hosts. This makes “invasion” of an agent much less likely, and is the aim behind immunizations, etc |
|
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Term
|
Definition
| the immunization of an individual by administration of an antigen (infectious agent or vaccine). |
|
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Term
| Passive immunization is when |
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Definition
| the transfer of a specific antibody from an immunized individual to a non-immunized individual (like mother’s breast milk to baby). |
|
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Term
|
Definition
| the ability of the host to withstand infection. Infectivity: the ability to enter and multiply in the host. |
|
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Term
|
Definition
| the ability to produce a severe pathological reaction. |
|
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Term
| intervention efforts that focus on the environment factor |
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Definition
| improved sanitation, provision of safe water and clean air, proper cooking and storage of food, control of vectors and animal reservoir hosts. |
|
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Term
|
Definition
| is the passing of infection from parent to offspring, like via birth transmission of HIV or syphilis. |
|
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Term
|
Definition
| is the person to person spread. Common vehicle means how the infectious agent was spread: saliva, blood, water, milk, plasma, etc. |
|
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Term
|
Definition
| are arthropods such as ticks and mosquitoes that transmit the infectious agent by biting or depositing the infective material near the host. |
|
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Term
|
Definition
| The time interval between invasion of an infectious agent and the first appearance of symptoms of the disease. |
|
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Term
|
Definition
| the constant presence of a disease within a geographic area or population, US example being pertussis. |
|
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Term
|
Definition
| the occurrence of a disease in a community or region in excess of normal expectancy. |
|
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Term
|
Definition
| an epidemic occurring worldwide and affecting large populations, like HIV/AIDS, or SARS. |
|
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Term
| how the requirements for disease reporting are determined |
|
Definition
| State and federal governments determine what diseases qualify as necessary to be reported based need to prevent and control it. |
|
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Term
| population is at greatest risk for contracting anthrax |
|
Definition
| Those who work with dying animals, or who handle animal products (hair, wool… get it… woolhandler’s disease… meat, bones). This is because anthrax takes on spore form when its host begins to die, where it can hibernate until another host comes along. Spores are incredibly impermeable and animals pick them up from the land they’re buried in, and then pass infection on to humans as they die. Human to human infection is rare |
|
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Term
| why is small pox is considered one of the leading candidate agents for bioterrorism. |
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Definition
| It’s been eradicated since 1979, with the exception of a secret Russian stock that is feared to fall into the wrong hands. Susceptibility is 100% if not vaccinated (and since it’s eradicated… that’s most people), and the fatality is 20-40% or higher. |
|
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Term
|
Definition
| are illnesses for which the infectious agent is transmitted by a carrier, usually an arthropod (mosquito, tick, fly). |
|
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Term
| where Rocky Mountain Spotted Fever most commonly occurs in the U.S.Why this location? |
|
Definition
| Oklahoma, Kansas, and Missouri due to the specific type of tick that carries it and lives in this region. |
|
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Term
|
Definition
| Includes wellness and health promotion, illness prevention, acute and sub-acute care, rehabilitation, end-of-life care, and care coordination |
|
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Term
| focus of integrated health systems |
|
Definition
population health management across the continuum, rather than on episodes of illness for an individual.
shifted from inpatient care as the point of management to primary care providers as points of entry
Care management services and programs provide access and accountability for the continuum of health
Successful outcomes are measured by systems performance—rather than limited to individual provider performance—to meet the needs of populations
Contemporary focus defines the nature of the client as a population rather than an individual |
|
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Term
|
Definition
Tools that specify activities providers may use in a timely sequence to achieve desired outcomes for care.
Outcomes are measurable and pathway tools strive to reduce differences in client care
Case management services are used for clients with specific diagnoses who may have high-use patterns, noncompliance issues, cost caps, or threshold expenses |
|
|
Term
|
Definition
Target chronic and chostly disease conditions that require long-term care interventions
These strategies are an acceptable approach to organizing services for a specific population across a continuum of primary, secondary, and tertiary prevention interventions and self-care management activity
Disease management information systems use treatment guidelines to streamline the process, avoid unnecessary care, and act proactively to slow or reduce the effects or complications of the disease process of populations |
|
|
Term
| “five rights” of cases management |
|
Definition
Right care
Right time
Right provider
Right setting
Right price |
|
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Term
| knowledge domains for case management |
|
Definition
Knowledge of health care financial environment and dimension of client populations managed by nurses
Clinical knowldge
Care resources
Transition planning
Management/communication skills
Teaching/counseling
program evaluation and research
performance improvement
peer consulatation
Requirement of eligibility and benefits
Legal issues
Information systems
Health care legislation/policy
Technical information
Outcomes management |
|
|
Term
|
Definition
Assesses the current and future needs of a client for catastrophic or chronic disease over a life span; Also used to set financial rewards
Is customized, medically based document that provides assessment of all present and future needs
Phase one—
Includes a thorough assessment of the client
Financial/billing agreements
Information release signed by the client
Targeted date for completion
Phase two-
Development of the plan
Plan includes projected costs and resources needed for the frequency and duration of treatments, equipment and supplies
Seeks to portray the needs of a client that are consistent with the changes in a client’s life over the predicted life span |
|
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Term
| examples of case managed conditions |
|
Definition
AIDS
Amputations
CVA
Chronic diseases and disabilities
Coma
High-risk neonates
Multiple fractures/severe burns/severe head trauma
Spinal cord injury
Substance abuse
Transplantation
Ventilator dependency
Work-related injuries
Terminal illness |
|
|
Term
|
Definition
| Tools that specify activities that providers may use in a timely sequence to achieve desired outcomes. These pathways strive to reduce differences in patient care. |
|
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Term
|
Definition
| Population manager establishes systems and processes to monitor the health status, resources, and outcomes for a targeted aggregate of the population. |
|
|
Term
|
Definition
| Promotes optimal use of services to redirect care and monitor the appropriate use of provider care/treatment services for both acute and community/ambulatory services. |
|
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Term
|
Definition
| seeks to control use by providing clients with correct information and education strategies to make healthy choices, to use healthy and health-seeking behaviors to improve their health status, and to make fewer demands on the health care system. |
|
|
Term
Nursing process and case management
Assessment |
|
Definition
Case finding
Identifcation of incentives for target popuation
Screening and intake
Determination of eligibility
Assessment |
|
|
Term
Nursing process and case management
Diagnosis |
|
Definition
| Identification of problem |
|
|
Term
Nursing process and case management
Planning/outcome |
|
Definition
Problem prioritizing
Planning to address care needs |
|
|
Term
Nursing process and case management
Implementation |
|
Definition
| Advocating of client's interests |
|
|
Term
Nursing process and case management
Evaluations |
|
Definition
Arrangement of delivery of service
Monitoring of clients during service
Reassessment |
|
|
Term
roles of the case manager:
Broker |
|
Definition
| Agent for provider services that are needed to stay within coverage according to budget and cost limits of HC plan |
|
|
Term
roles of the case manager:
Consultant |
|
Definition
| Works with providers, suppliers, the community, and other case managers to provide case management expertise in programmatic and individual applications |
|
|
Term
roles of the case manager:
Coordinator |
|
Definition
| Arranges, regulates, and coordinates needed HC services for clients at all necessary points of service |
|
|
Term
roles of the case manager:
Educator |
|
Definition
| Educates client, family, and providers about case management process, delivery system, community health resources, and benefit coverage so that informed decisions can be made by all parties |
|
|
Term
roles of the case manager:
Facilitator |
|
Definition
| Supports all parties in work toward mutual goals |
|
|
Term
roles of the case manager:
Liaison |
|
Definition
| Provides a formal communication link among all parties concerning the plan of care management |
|
|
Term
roles of the case manager:
Mentor |
|
Definition
| Counsels and guides the development of the practice of new case managers |
|
|
Term
roles of the case manager:
Monitor/reporter |
|
Definition
| Provides info to parties on status of member and situations affection client safety, care quality, and client outcome, and on factors that alter cost and liability |
|
|
Term
roles of the case manager:
Negotiator |
|
Definition
Negotiates the plan of care, services, and payment arrangements with providers
Uses effective collaboration and team strategies |
|
|
Term
roles of the case manager:
Client advocate |
|
Definition
| Acts as advocate, provides info, and supports benefit changes that assist member, family, PCP, and capitated systems |
|
|
Term
roles of the case manager:
Researcher |
|
Definition
Uses and applies EBP for programmatic and individual interventions with clients and communities
Participates in protection of clients in research studies
Initiates/collaborates in research programs and studies |
|
|
Term
roles of the case manager:
Standardization monitor |
|
Definition
Formulates and monitors specific, time-sequences critical path and care map plans and disease management protocols that guide the type and timing of care to comply with predicted treatment outcomes for the specific client and conditions
Attempts to reduce variation in resource use
Targets deviations from standards so adjustments can occur in a timely manner |
|
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Term
roles of the case manager:
Systems allocator |
|
Definition
| Distributes limited HC resources according to plan of rationale |
|
|
Term
| system focused models of case management |
|
Definition
|
|
Term
| client focused models of case management |
|
Definition
|
|
Term
| social service models of case management |
|
Definition
|
|
Term
advocacy process:
Informing |
|
Definition
Letting clients know about the nature of their choices, the content of those choices, and the consequences to the client
Information exchange process is composed of interactions that reflect three sub-processes: amplifying, clarifying, and verifying
Goal is to promote client self-determination
Information exchange is a critical process for advocacy |
|
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Term
advocacy process:
Amplifying |
|
Definition
Occurs between the nurse and the client to assess the needs and demands that will eventually frame the client’s decision
Tone of this process can direct the remainder of the info exchange |
|
|
Term
advocacy process:
Clarifying |
|
Definition
Nurse and client strive to understand meanings in a common way
During this process, misunderstandings and confusions are examined
The goal is to avoid confusion between the nurse and the client |
|
|
Term
advocacy process:
Verifying |
|
Definition
Establishes accuracy and reality in the informing process
If the client is misinformed, you will return to the clarifying or amplifying stage and begin the process again
Verifying produces the change for the advocate and client to examine “truth” from their points of view |
|
|
Term
advocacy process:
Supporting |
|
Definition
Upholding a client’s right to make a choice and to act on it
Three groups of people who are aware of clients’ decisions
o Supporters approve and support clients’ actions
o Dissenters do not approve and do not support clients
o Obstructers cause difficulties when clients try to implement their decisions |
|
|
Term
advocacy process:
Affirming |
|
Definition
Advocate validates that the client’s behavior is purposeful and consistent with the choice that was made
Advocate expresses a dedication to the client’s mission, and a purposeful exchange of new info may occur so that the client’s choice remains possible
Critical in promoting client self-determination
Review the conflict management section. Describe what is meant by the terms negotiating, assertiveness and cooperation. |
|
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Term
|
Definition
| Strategic process used to move conflicting parties toward an outcome |
|
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Term
|
Definition
Distributive outcomes
One party gains benefit at the others’ expense
Integrative outcomes
Mutual advantages override individual gains
Usually based on problem-solving and solution-generating techniques |
|
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Term
|
Definition
| Ability to present one’s own needs |
|
|
Term
|
Definition
| Ability to understand and meet the needs of others |
|
|
Term
| barriers that may prevent nurses from fully engaging in relationships with people who come from different socioeconomic and cultural back grounds |
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Definition
| a. Personal beliefs, social values, personal experience, cultural attitudes, media portrayals, and historical factors influence our understanding of poverty. |
|
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Term
| how nurses can break down the barriers between the nurse and people who live in poverty |
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Definition
| a. To be effective, nurses must recognize and acknowledge the beliefs, values, and knowledge that form their worldviews and influence the way they practice. |
|
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Term
| Uses of Federal Income Guidelines |
|
Definition
| a. Are issued by the U.S. Department of health and Human Services. They are used to determine whether a person or family is financially eligible for assistance or services from various federal programs. Eligibility for federal housing subsidies |
|
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Term
|
Definition
| Persons whose income is inadequate are called near poor. |
|
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Term
|
Definition
| refers to individuals and families who remain poor for long periods and whose poverty is multigenerational |
|
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Term
| Reaseons violence is a community health nursing concern |
|
Definition
| a. Medical nursing, psychology, and social services professionals have been slow to develop a response to violence that is part of their daily professional lives. As a result, the estimated 3.5 million victims of violence annually may not receive the best care possible. Nurses can take a more active role in the development of community responses to violence, public policy, and needed resources. |
|
|
Term
| starting point for the development of community programs to prevent violence |
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Definition
| a. Many factors in a community can support or minimize violence. Changing social conditions, multiple demands on people, economic conditions, and social institutions influence the level of violence and human abuse. |
|
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Term
| link between unemployment and violence both within and outside the home |
|
Definition
| a. Work can be fulfilling and contribute to a sense of well-being; it can also be frustrating and unfulfilling, contributing to stress that may lead to aggression and violence. The inability to secure or keep a job may lead to feelings of inadequacy, guilt, boredom, dissatisfaction, and frustration. Unemployed males has led to an increase of risk of murder. |
|
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Term
| role of the nurse in working with rape survivors |
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Definition
| a. Nurses trained in sexual assault examination perform the physical examination in the emergency department to gather evidence (i.e. hair samples, skin fragments beneath the victims fingernails, evidence from pelvic exams using colposcopy) for criminal prosecution of sexual assault. Nursing efforts are directed toward helping victims cope with the stress and disruption of their lives caused by the attack. Counseling focuses on the crisis and the concomitant fears, feelings, and issues involved. Nurses can help survivors learn how to regroup personal strengths. |
|
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Term
| signs of older adult maltreatment |
|
Definition
Financial mismanagement
Withdrawal and passivity
Depression
Fear of relative or caregiver
Unexplained or repeated physical injuries
Untreated health problems such as decubitus ulcers
Poor nutrition
Unexplained genital infections
Physical neglect and unmet basic needs
Social isolation
Rejection of assistance by caregiver
Lack of compliance to health regimens |
|
|
Term
| Individual Factors when assessing for violence in a community context |
|
Definition
Signs of physical abuse (e.g., abrasions, contusions, burns)
Physical symptoms related to emotional distress Developmental and behavioral difficulties Presence of physical disability Social isolation Decreased role performance within the family, and in job or school-related activities Mental health problems such as depression, low self-esteem, and anxiety Fear of intimate others Substance abuse |
|
|
Term
| Familial Factors when assessing for violence in a community context |
|
Definition
| Economic stressors, Presence of some form of family violence. Poor communication, Problems with child rearing, Lack of family cohesion, Recurrent familial conflict, Lack of social support networks, Poor social integration into the community, Multiple changes of residence, Access to guns, homelessness |
|
|
Term
| Community Characteristics when assessing for violence in a community context |
|
Definition
| High crime rate, High levels of unemployment, Lack of neighborhood resources and support systems, Lack of community cohesiveness |
|
|
Term
| the population group with the highest rate of violence |
|
Definition
| Homicide rates are highest among young adults followed by adolescents (14 -17 years old). Homicide is the leading cause of death for young African American women ages 15-34 years. Potential for violence tends to increase among highly diverse population. Highly divergent groups may not communicate effectively and neither accept nor understand one another. |
|
|
Term
| greatest risk factor for suicide among adult women |
|
Definition
|
|
Term
|
Definition
| ranges from violent physical attacks to passive neglect. Violence such as beating, burning, kicking, or shaking may lead to severe physical injuries. Emotional abuse such as yelling at or continually demeaning and criticizing the child. Passive neglect may result in insidious malnutrition or other problems. |
|
|
Term
|
Definition
| includes physical, emotional, medical, and educational neglect. Physical neglect is failure to provide adequate food, proper clothing, shelter, hygiene, or necessary medical care and is most often associated with extreme poverty. Emotional neglect is the lack of the basic nurturing, acceptance, and caring essential for healthy personal development. |
|
|
Term
| injuries that are characteristic of domestic abuse |
|
Definition
Bruises and lacerations of the face, head, and trunk of the body
Often carefully inflicted on parts of the body that are disguised by clothing
Bruises or lacerations showing various staging of healing |
|
|
Term
| After ending an abusive relationship, describe the normal response of the person who ended the relationship |
|
Definition
| Women tend to exhibit low self-esteem (minimize what happened to them, blame themselves) and depression. They have more physical health problems than other women, such as chronic pain, neurological problems, problems sleeping, gynecological symptoms, urinary tract infections, and chronic gastrointestinal problems. |
|
|
Term
|
Definition
| pertaining to the law. Currently, forensic specialists evaluate and assess victims of rape, drug and alcohol addiction, domestic violence, assaults, automobile or pedestrian accidents, incest, child abuse, medical malpractice, and the injuries associated with food and drug tampering. Much of the work in forensic nursing occurs in the emergency department, but there is clearly a community nursing role in primary prevention as well as in the follow-up of clients seen. |
|
|
Term
| why it is important for nurses to understand environmental health. |
|
Definition
| As nurses, who are one of the most trusted conveyors of information to the public, it is our responsibility to understand as much as possible about these risks- how to assess them, how to eliminate/reduce them, how to communicate and educate about them, and how to advocate for policies that support healthy environments. |
|
|
Term
| how chemical, biological and radiological exposures contribute to health risks |
|
Definition
| via the air we breathe, the water we drink, and the food we eat, and /or the products we use. Therefore nurses must understand how to assess the health risks posed by the environment and develop educational and other preventive interventions to help our individual clients and their families as well as communities understand, and when possible, decrease their risks. |
|
|
Term
| general environmental health competencies for nurses |
|
Definition
| a. Basic knowledge and concepts – all nurses should understand the scientific principles and underpinnings of the relationship between individuals or populations and the environment (including the work environment). This understanding includes the basic mechanism and pathways of exposure to environmental health hazards, basic prevention and control strategies, the interdisciplinary nature of effective interventions, and the role of research. |
|
|
Term
| routes by which drugs and pollutants enter the body |
|
Definition
| a. Pollution can enter our body via the lungs (inhalation), GI tract (ingestion), skin, and even mucous membranes (dermal absorption). Most chemicals cross the placental barrier and affect the fetus, just as most chemicals cross the blood-brain barrier. |
|
|
Term
| why chemicals are grouped into “families”. |
|
Definition
| a. Chemicals are often grouped into categories or “families” so that it is possible to understand the actions and risks associated with those groupings. Examples are metals and metallic compounds (such as arsenic, cadmium, chromium, lead, mercury); hydrocarbons (for example, benzene, toluene, ketones, formaldehyde, trichloroethylene); irritant gases (such as ammonia, hydrochloric acid, sulfur dioxide, chlorine); chemical asphyxiants (such as carbon monoxide, hydrogen sulfide, cyanides); and pesticides (for example, organophosphates, carbamates, chlorinated hydrocarbons). |
|
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Term
|
Definition
| May include chemical mixtures (i.e. more than one agent) |
|
|
Term
|
Definition
May include dynamic factors such as air, water, soil, and food, as well as temperature, humidity, and wind
, biological and radiological exposures contribute to health risks |
|
|
Term
|
Definition
| May refer to a community spanning multiple ages, genders, ethnicities, cultures, and disease states |
|
|
Term
|
Definition
| the basic science applied to understandings the health effects associated with chemical exposures. Only the negative effects of chemical exposures are studied. |
|
|
Term
|
Definition
I – INVESTIGATE POTENTIAL EXPOSURES: Ask have you ever felt sick after coming in contact with a chemical, such as pesticide or other substances; Do you have any symptoms that improve when you are away from your home or work?
P – PRESENT WORK: Are you exposed to solvents, dusts, fumes, radiation, loud noise, pesticides, or other chemicals; do you know where to find material safety data; do you wear personal protective equipment; are your work clothes worn home; do co-workers have similar health problems?
R – RESIDENCE: When was your residence built; what type of heating do you have; have you recently remodeled; what chemicals are stored on your property; where is the source of your drinking water?
E – ENVIRONMENTAL CONCERNS: Are they in your neighborhood; what type of industries or farms are near your home; do you live hear a hazardous waste site?
P –PAST WORK: What are your past work experiences; what job did you have for the longest period of time?
A – ACTIVITIES: What activities and hobbies do you and your family pursue; do you burn/solder/melt any products; do you garden/fish/hunt; do you eat what you catch or grow; do you use pesticides; do you engage in any alternative healing or cultural practices?
R – REFERRALS AND RESOURCES
E – EDUCATE: Are materials available to educate the client; are alternatives available to minimize the risk of exposure; have prevention strategies been discussed; what is the plan for follow-up? |
|
|
Term
| The greatest single source of air pollution in the U.S. is |
|
Definition
| from mobile sources such as cars and trucks. |
|
|
Term
| This standard requires employers (including hospitals) to maintain a list of all of the hazardous chemicals that are used on-site. |
|
Definition
| Employees have the “right to know’ about the hazardous chemicals with which they work through the federal Hazard Communication Standard. |
|
|
Term
| four phases of a risk assessment |
|
Definition
1) Determining if a chemical is known to be associated with negative health effects (in animals or humans)
2) Determining whether the chemical has been released into the environment – into the air, water, soil, or food.
3) Estimate how much and by which route of entry the chemical might enter the human body – inhalation, ingestion, dermally, or in utero exposure.
4) Characterizing the risk assessment process and taking into account all three of the previous steps – the final synthesis attempts to predict the potential for harm based on the estimated exposure. |
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Term
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Definition
| individual, identifiable sources such as smoke stacks. They are sometimes referred to as fixed sites. |
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Term
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Definition
| come from more diffuse exposures. For instance, the largest non-point sources of air pollution are from mobile sources such as cars and trucks. |
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Term
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Definition
| describe a permitted level of emissions, a maximum contaminant level (MCL), an action level for environmental clean-up, or a risk-based calculation; environmental standards are required to address health risks. It is the responsibility of potential polluters to operate within the standards. |
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Term
| How National reporting began in the U.S. |
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Definition
By 1925, the US began national reporting of morbidity causes.
By 1935, the 1st national health survey had been conducted
In 1949, the National Office of Vital Statistics published weekly mortality and morbidity statistics in Journal of Public Health Reports.
The activity was later transferred to the Centers for Disease Control and Prevention, who began publishing the Morbidity and Mortality Weekly Report in 1961. |
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Term
| police powers” of local health departments as provided by the U.S. Constitution |
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Definition
| necessary to preserve health safety as well as other events. These powers include public health surveillance. State and local “police powers” also provide for surveillance activities. Health departments usually have legal authority to investigate unusual clusters of illness as well. |
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Term
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Definition
| focus on what is done (ie services provided or protocols for health care). |
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Term
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Definition
| focus on changes in health status. |
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Term
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Definition
| defined as “an intentional release or viruses, bacteria, or their toxins for the purpose of harming or killing.... citizens” |
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Term
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Definition
| the intentional release of hazardous chemicals into the environment for the purpose of harming or killing. |
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Term
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Definition
| It is organized and planned; is the principle means by which a population’s health status is assessed; involves ongoing collection of specific data; involves analyzing data on a regular basis; requires sharing the results with others; requires broad and repeated contact with the public about personal health issues; motivates public health action as a result of data analyses to: reduce morbidity, reduce mortality, improve health |
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Term
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Definition
Assess public health status- helps public health departments identify trends and unusual disease patterns
Define public health priorities- assessment, policy development and assurance
Plan public health programs- priorities for using scare resources
Evaluate interventions and programs for commonly occurring and universally occurring disease or events.
Stimulate research |
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Term
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Definition
| will ensure that disease and event patters improve rather than deteriorate. It can also make it possible to study whether the clinical protocols and public health policies that are in place can be enhanced based on current science so disease rates actually decline. |
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Term
| role of collaboration among partners in surveillance |
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Definition
| promotes the development of a comprehensive plan and a directory of emergency responses and contacts for effective communication and information sharing. The type of information to be shared includes the following: How to use algorithms to identify which events should be investigated; How to investigate; who to contact; how and to whom information is to be disseminated; who is responsible for appropriate action |
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Term
| the seven basic steps of the surveillance for nurses to follow as outlined by the Minnesota Model of Public Health Interventions: Applications for Public Health Nursing Practice |
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Definition
1.Consider whether surveillance as an intervention is appropriate for the situation
2.Organize the knowledge of the problem, its natural course of history, and its aftermath
3.Establish clear criteria for what constitutes a case
4.Collect sufficient data from multiple valid sources
5.Analyze data
6.Interpret data and disseminate to decision makers
7.Evaluate the impact of the surveillance system |
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Term
| sources of morbidity data |
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Definition
•notifiable disease reports
•lab reports
•hospital discharge reports
•billing data
•outpatient health care data
•specialized disease registries
•injury surveillance systems
•environmental surveys
•sentinel surveillance systems |
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Term
| why the CDC assembled the first standard case definition list for notifiable diseases |
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Definition
| Before the standard case definition list came along, most departments were using different criteria, which made the data less useful than it could have been because it could not be compared across health departments or states. |
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Term
| how States handle notifying the federal government of notifiable diseases |
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Definition
| Legal reporting: states compile disease incidence data (new cases) and transmit the data electronically, weekly, to the CDC through the National Electronic Telecommunications System for Surveillance (NETSS). To determine which of the national notifiable diseases are reportable in your state, go to your state health department website. |
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Term
| criteria for defining cases of different diseases (case definitions). |
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Definition
• Suspected
• Probable
• Confirmed
This depends on the strength of the evidence supporting the case criteria. The case definition should not be used as the only criteria for clinical diagnosis, quality assurance, standards for reimbursement, or taking public health action. |
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Term
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Definition
| the public health nurse, as an employee of the health department, may begin a search for cases through contacts with local health providers and health care agencies. The nurse names the disease/event and gathers data about existing cases to try to determine the magnitude of the problem (how widespread it is) |
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Term
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Definition
| case reports are sent to local health departments by health care providers or lab reports of disease occurrence are sent to the local health department. |
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Term
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Definition
| trends in commonly occurring diseases or key health indicators are monitored. A disease/event may be the sentinel or a population may be the sentinel |
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Term
| Special surveillance system: |
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Definition
| developed for collecting particular types of data and may be a combination of active, passive, and/or sentinel systems; designed to provide data for early recognition and investigation of food borne outbreaks in all 50 states. |
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Term
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Definition
| there is persistently (usually) high number of cases; ex: is the high cholera incidence rate among Asians/Pacific Islanders. |
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Term
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Definition
| the occurrence of a disease within an area is clearly in excess of expected levels (endemic) for a given time period. This is often called outbreak. |
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Term
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Definition
| implies a highly prevalent problem found in a population commonly acquired early in life. The prevalence of this problem decreases as age increases. |
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Term
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Definition
| refers to the epidemic spread of the problem over several countries or continents (such as the SARS outbreak). |
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Term
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Definition
| outbreak refers to a group exposed to a common noxious influence such as the release of noxious gases (for example, ricin in the Japanese subway system several years ago). |
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Term
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Definition
| outbreak involves all persons exposed becoming ill at the same time, during one incubation period. |
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Term
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Definition
| is a common source followed by secondary exposures related to person to person contact, as in the spreading of influenza. |
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Term
| intermittent or continuous source: |
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Definition
| cases may be exposed over a period of days or weeks, as in the recent food poisonings at a restaurant chain throughout the United States as a result of the restaurant’s purchase of contaminated green onions. |
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Term
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Definition
| does not have a common source and spreads gradually from person to person over more than one incubation period, such as the spread of tuberculosis from one person to another. |
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Term
|
Definition
| Bacteria (e.g., tuberculosis, salmonellosis, streptococcal infections); Viruses (e.g., hepatitis A, herpes); Fungi (e.g. tinea capitis, blastomycosis); Parasites (protozoa causing malaria, giardiasis, helminthes [roundworms, pinworms], arthropods [mosquitoes, ticks, flies, mites]) |
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Term
|
Definition
|
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Term
|
Definition
| Pollutants; Medications/drugs |
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Term
|
Definition
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Term
|
Definition
| stress; isolation; social support |
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Term
| administration of immune globulin (IG) for Hepatitis A virus |
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Definition
-Anyone in household or who has sexual contact with persons with HAV
-All staff of day-care centers if a case of HAV occurs among children or staff
-Household members whose diapered children attend a day-care center where three or more families are infected
-Staff and residents of prisons or institutions for developmentally disabled persons, if they have close contact with persons with HAV
-Hospital employees if exposed to feces of infected patients
-Food handlers who have a co-worker infected with HAV; patrons only in limited circumstances |
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Term
| various treatments related to tuberculosis |
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Definition
-usually a combination of multiple antimicrobial drugs
-current regimens include isoniazid and rifampin
-latent regimens are often different from those for people with active TB |
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Term
| why is it important for the nurse to be able to discuss sexual behaviors? |
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Definition
to be able to assess risks factors, certain sexual practices are more likely to result in exposure to and transmission of STD’s. Drug use is also linked to STD transmission; in that drug and alcohol abuse often lower inhibitions. Addictions can cause individuals to provide sexual favors in exchange for drugs.
-Remain supportive and open to facilitate honesty
-use terms the client will understand (be prepared to suggest multiple terms)
-Speak candidly so the client will feel comfortable talking
-Ask questions in a nonthreatening and nonjudgmental manner
-acknowledge that many people are uneasy disclosing personal information |
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Term
| risks associated with injection drug use |
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Definition
| High potential for injecting blood borne pathogens such as HIV and HBV exists when needles and syringes are shared. |
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Term
preventions strategies with regard to HIV:
PRIMARY- |
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Definition
| Provide community education about prevention to well populations. Provide community outreach for education and needle exchange. |
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Term
preventions strategies with regard to HIV:
SECONDARY- |
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Definition
| Test and counsel for HIV. Notify partners and trace contacts |
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Term
preventions strategies with regard to HIV:
TERTIARY- |
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Definition
| Educate caregivers of persons with HIV about standard precautions. Identify community resources for providing supportive care (e.g. funds for purchasing medications). |
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Term
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Definition
| adopted term that includes parish nurses (nurses who work for faith communities), congregational nurses, health ministry nurses, crescent nurses, or health and wellness nurses. |
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Term
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Definition
| groups of people that gather in churches, congregations, parishes, synagogues, temples, or mosques and acknowledge common values, beliefs, and practices |
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Term
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Definition
| activities and programs in faith communities organized around health and healing focuses to promote wholeness in health across the lifespan. |
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Term
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Definition
| the nurse is usually autonomous, with the development of this health ministry generally resulting from an individual community of faith. The nurse then is accountable to the congregation and its governing body. |
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Term
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Definition
| includes greater collaboration and partnership; the nurse may be in a contractual relationship with hospitals, medical centers, long term care establishments, or educational institutions. |
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Term
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Definition
development that involved faith communities and highlighted the role of nurses with the faith community in health and wellness promotion.
emphasized a team approach to total care, including family and clergy and focused on responsibility for health and encouraged preventive health practices
Parish nursing in the 1980s built on the strengths of these centers and focused on the nurse-clergy team working with individuals and families. |
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Term
| phases of parish nurse program development |
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Definition
oRecognizing- Nurses describe a calling and desire to have a holistic practice
oPreparing- Personal development: seek information and affirmation; Professional development: educational preparation; Coalition building: paving the way with the faith community
oPlanning- Assess community needs, market ideas, elicit volunteers, set goals; Work with leaders, determine available resources, partner
oImplementing- Team building, support and manage volunteers, self-development
oEvaluation- Record keeping, outcome summaries |
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Term
| roles of the parish nurse |
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Definition
oIntegrator of faith and health- assists clients to connect issues of faith and health to achieve wellness
oHealth educator- provides opportunities to learn about health issues, individually and in groups
oHealth counselor- available to discuss health concerns and encourage healthy lifestyle choices
oReferral advisor- provides referral to health care and social services
oHealth advocate- helps clients in the community obtain health-related services
oDeveloper of support groups- facilitates programs to bring clients together for support and encouragement
oVolunteer coordinator- recruits, prepares, and oversees faith community volunteers to assist others |
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Term
| interventions and activities of the parish nurse |
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Definition
oSharing the joys of a new member in a family; sharing sorrows of losses
oAnticipating changes in health status or in growth and development
oBeing present for questions that seem difficult or unacceptable to ask the health care provider
oExplaining and assisting in considering choices when new living and care arrangements must be made
oListening to the concerns of a youngster anticipating diagnostic procedures
oPraying with the spouse of a dying parishioner
oHelping individuals and families make decisions regarding advance directives in light of faith beliefs
oHelping teens consider options when overwhelmed with serious life issues
oProviding information, support, and prayer regarding advance directives
oSeeking community resources/opportunities for fitness and nutrition classes
oWorking with the wellness committee to ensure that fellowship meals meet nutritional and spiritual needs of older adults
oOffering educational opportunities about the health care legislation changes and its influence on the congregation and community
oAccompany a faith community member to a 12-step meeting
oParticipating in worship leadership with pastoral staff |
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Term
| parish nurses role as a liaison and facilitator |
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Definition
liaisons between resources in the faith community and the local community, creating awareness of them and helping people match resources; linking people to services.
links congregational needs to the establishment of support groups or refers to existing support groups. Facilitation also occurs when the nurse helps to increase the accessibility of physically or mentally challenged.
may also link people to services like meal arrangement for homebound clients. As a facilitator the nurse can also act as a catalyst for building community partnerships. |
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Term
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Definition
things that make a population more likely to develop health problems.
poor and homeless, pregnant adolescents, migrant workers/immigrants, severely mentally ill individuals, substance abusers, abused and victims of violence, those with communicable disease, those at risk, HIV positive, hepatitis B virus, or sexually transmitted disease. |
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Term
| Web of causation model of health and illness |
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Definition
| the interaction between numerous causal variables creates a more potent combination of factors predisposing an individual to illness. In other words when more of these variables affect you, or you fit into more than one subgroup, you are more likely to become ill exponentially. More independent variables are present and each variable can interact with any and all other variables resulting in a higher probability of illness. The whole is greater than the sum of its parts. |
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Term
| vulnerable population group |
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Definition
| is a subgroup of the population that is more likely to develop health problems as a result of exposure to risk or to have worse outcomes from these health problems than the rest of the populations. When individuals have more than one of the risk factors (bolded above) their relative risk for illness or poor health outcome is even greater. The vulnerable are those that are at greater risk for poor health status and health care access. |
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Term
| differential vulnerability hypothesis |
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Definition
| takes into account that there are people who are at risk but not as likely to develop a specific health problem, they are said to be more resilient. Being at risk for a certain health problem is not sufficient to say the problem will develop. |
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Term
| Priority population groups |
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Definition
targeted by national governments for special emphasis in health care goals because their health status is particularly poor.
Examples the book used are:
Canada Aboriginal Indians and people who live in remote rural areas of northern Canada.
Used to back this example was infant mortality rate: Canada as a whole has 5.2 deaths per 1000 births, Nunavut people 16.9 deaths per 1000 births.
New Zealand’s Maori people suffer poorer health status which is thought to result from socioeconomic and environmental conditions. |
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Term
| the importance of “one stop services” |
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Definition
| This model provides multiple services in a single clinic, i.e. all immunizations are provided along with well child examinations. Social assistance, interdisciplinary treatments, all provided together can be more responsive to the health of vulnerable population groups. One stop can eliminate the need for multiple different doctor appointments, eliminating excess transportation needs, and scheduling dilemmas for a family already in social and economic stress. These clinics are thought of as safety net providers because they increase access to health and social service for vulnerable populations. |
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Term
|
Definition
refers to providing humane care and social supports for the most disadvantaged members of society.
Book’s examples are: Nurses who advocate for and facilitate change in public policy are intervening to promote social justice.
Nurses who provide cultural and linguistically appropriate health care. |
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Term
| examples of barriers to access |
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Definition
Clinic hours are limited to weekdays 8 to 5 which limits access to working people and their families.
Lack of insurance or underinsured results in inability to pay for care
Transportation to HCP unavailable or expensive/excessively inconvenient
Language of service providers is not that of the population they serve
Lack of cultural understanding prevents some members of the population from seeking care
Inadequate number of HCP for the population occurs in rural area and some urban areas
Subconscious discrimination against racial populations or against certain diseases. |
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Term
| nursing roles when working with vulnerable population groups |
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Definition
Case finder - identifies vulnerable individuals and families through outreach
Health educator – teaching vulnerable clients/groups to prevent illness and promote health
Counselor- counseling about ways to increase client sense of personal power – identify strengths and resources
Direct care provider- provides direct primary or specialty care to clients in various locations
Population health advocate- work with local state, or national groups to develop and implement public policy
Community assessor and developer- collaborate with local groups developing programs that respond to needs of community groups
Monitor and evaluator of care
Case manager – making referrals and linking clients with community services
Advocate- referring to other agencies, working to develop health programs, influence legislation and policy
Health program planner
Participant in developing health policies |
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Term
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Definition
racial or ethnic differences in the quality of care that are not due to access-related factors or clinical needs, preferences, and appropriateness or interventions.
-Lower quality care or poorer outcomes. -May result from
patient –level factors such as mistrust, or
provider-level factors such as conscious or unconscious stereotyping or prejudice.
Social and political factors play a major role in disparities. |
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Term
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Definition
| When comprehensive health services and social and economic services are provided together |
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Term
|
Definition
| are health centers or clinics where multidisciplinary health services are provided at a single place and in the same visit. |
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Term
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Definition
| is an approach to making health care more easily available to certain populations by implementing health education, counseling, or support services in places where people normally congregate, such as places of worship, schools, workplaces, and community centers. Case finding occurs when nurses design methods for finding populations and individuals especially in need of services. In some cases, lay health workers assist with outreach or case finding. |
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Term
| primary cause of vulnerability |
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Definition
| often have limited access to health insurance coverage, or they live in poverty or medically underserved areas. In 2004 17.9% of the population was uninsured and vulnerable to health risks. I am sure that number has greatly increased |
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Term
|
Definition
| a measure of patients’ ability to read, comprehend and act on medical instructions. Poor health literacy is common among racial and ethnic minorities, older adults, and patients with chronic conditions, particularly in public sector settings. |
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Term
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Definition
| refers to the individual using the drug, as well as that the individual’s expectations, including expectations. This includes current health status, genetic disposition, chemical makeup, and underlying mood disorders or other mental illness. |
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Term
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Definition
| The influence of the physical, social and cultural environments within which the use occurs. |
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Term
| ‘just say no’ along with others like ‘zero tolerance,’ |
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Definition
| approach, is based on stereotype, misinformation, and punishment. It is message that vilifies the drug user or addict. Also, 3 reasons! Children are naturally curious and will experiment as a part of normal development, children from dysfunctional homes often use drugs to get attention or escape an intolerable environment, and this approach doesn’t address the influence of peer pressure. |
|
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Term
| interventions using the FRAMES acronym |
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Definition
F – Feedback (provide the client direct feedback about the potential or actually personal risk or impairment related to drug use)
R – Responsibility (emphasize personal responsibility for change)
A – Advice (Provide clear advice to change risky behavior)
M – Menu (Provide a menu of option or choices for changing behavior)
E – Empathy (Provide a warm, reflective, empathetic, and understanding approach)
S – Self-efficacy (Provide encouragement and belief in the client’s ability to change) |
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Term
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Definition
| The public health model is based on the understanding that addiction is a health problem, that any psychoactive drug can be abused, that accurate information can help persons make responsible decisions about drug use and that persons who have ATOD problems can be helped. |
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Term
|
Definition
| Pattern of abuse characterized by an overwhelming preoccupation with the use (compulsive use) of a drug, securing its supply, and a high tendency to relapse if the drug is removed. Not necessarily drug dependent but can be….also adds a psychological component that causes intense cravings and subsequent relapse. |
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Term
|
Definition
| a state of neuroadaptation (physiologic change in CNS caused by chronic, regular administration of a drug). In drug dependence, continued use of the drug becomes necessary to prevent withdrawal symptoms. |
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Term
| the oldest and most widely used psychoactive drug in the world. |
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Definition
|
|
Term
| Life expectancy of an alcoholic is |
|
Definition
|
|
Term
| the number one national health problem causing more deaths, illnesses, and disabilities than any other health condition. |
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Definition
|
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Term
|
Definition
| are used to feel more alert or energetic, activating or exciting the nervous system. They are addictive and cause paranoia. They do not GIVE the person more energy but rather make the body expend it’s energy faster and in greater quantities than normal. Ex: nicotine, cocaine, bath salts, amphetamines |
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Term
| most widely used illicit drug in the United States |
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Definition
|
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Term
|
Definition
| Use of drugs from different categories used together or at different times to regulate how they feel. Ex: drink alcohol when snorting cocaine to ‘take the edge off’ |
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Term
| level of prevention of the program “Project DARE” (i.e. primary, secondary or tertiary). Primary: |
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Definition
| Promotion of healthy lifestyles and resiliency factors, drug education. Secondary: Assessing for ATOD problems, drug testing, high-risk groups, codependency and family involvement. Tertiary: Detoxification, addiction treatment, smoking cessation programs, support groups |
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Term
| the “4 Hs” to ask when assessing drug use patterns. |
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Definition
| How take (route), How much, How often, How long |
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Term
| primary symptom of addiction. |
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Definition
| DENIAL was the primary symptom of addiction. Methods of denial – lying about use, minimizing use patterns, blaming or rationalizing, intellectualizing, changing the subject, using anger or humor, and ‘going with flow’ |
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Term
| Greatest influence of substance abuse for adolescents |
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Definition
| is family-related factors (genetics, family stress, parenting styles, child victimization). Then co-occurrence with psychiatric disorders and behavioral problems. Peer influence/pressure is an important but lesser influence. |
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Term
|
Definition
| Does not intend to change in the foreseeable future….unaware of any problem. Resistance to recognizing or modifying a problem! |
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Term
|
Definition
| Aware that a problem exists and is seriously thinking about overcoming it but has not yet made a commitment to take action. Nurse can encourage the individual to weigh the pros/cons of the prob and the solution to the problem. |
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Term
|
Definition
| ‘decision-making’ Individual is prepped for action and may reduce the problem behavior but has not yet taken effective action. |
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Term
|
Definition
| Individual modifies behavior, experiences, or environment to overcome the problem. Requires considerable time and energy. Modification of the target behavior to an acceptable criterion and significant over efforts to change are the hallmarks of action. |
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Term
|
Definition
| Individual works to prevent relapse and consolidate the gains attained during action…stabilizing behavior change and avoiding relapse are the hallmarks of marintenance. |
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