NUR440 - Ch 9 Population-Based Public Health Nursing Practice: The Intervention Wheel

Assumption 1: Defining Public Health Nursing Practice

Public health nursing is defined as the practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences (APHA, 1996). The title "public health nurse" designates a registered nurse with educat

Assumption 2: Public Health Nursing Practice Focuses on Populations

The focus on populations as opposed to individuals is a key characteristic that differentiates public health nursing from other areas of nursing practice. A population is a collection of individuals who have one or more personal or environmental character

Assumption 3: Public Health Nursing Practice Considers the Determinants of Health

Health inequities are defined as health status inequalities that society deems to be avoidable or unnecessary (Kawachi, Subramanian, and Alemeida-Filho, 2002). Significant health disparities related to race, gender, age, and socioeconomic status exist wit

Assumption 4: Public Health Nursing Practice is Guided by Priorities Identified Through an Assessment of Community Health

In the context of the Intervention Wheel, a community is defined as "a social network of interacting individuals, usually concentrated in a defined territory" (Johnston et al, 2000).
Assessing the health status of the populations that comprise the communi

Assumption 5: Public Health Nursing Practice Emphasizes Prevention

Prevention is "anticipatory action taken to prevent the occurrence of an event or to minimize its effect after it has occurred" (Turnock, 2009, p 516). Prevention is customarily described as a continuum moving from primary to tertiary prevention (Leavell

Assumption 6: Public Health Nurses Intervene at All Levels of Practice

To improve population health, the work of PHNs is often carried out sequentially and/or simultaneously at three levels of prevention (see Figure 9-2).
Community-level practice changes community norms, community attitudes, community awareness, community pr

Assumption 7: Public Health Nursing Practice Uses the Nursing Process at All Levels of Practice

Although the components of the nursing process (assessment, diagnosis, planning, implementation, and evaluation) are integral to all nursing practice, PHNs must customize the process to the three levels of practice. Table 9-1 outlines the nursing process

Assumption 8: Public Health Nursing Practice Uses a Common Set of Interventions Regardless of Practice Setting

Interventions are "actions taken on behalf of communities, systems, individuals, and families to improve or protect health status" (ANA, 2010). The Intervention Wheel encompasses 17 interventions: surveillance, disease and other health investigation, outr

Assumption 9: Public Health Nursing Practice Contributes to the Achievement of the 10 Essential Services

mplementing the interventions ultimately contributes to the achievement of the 10 essential public health services (see Chapter 1). The 10 essential public health services describe what the public health system does to protect and promote the health of th

Assumption 10: Public Health Nursing Practice is Grounded in a Set of Values and Beliefs

The Cornerstones of Public Health Nursing (Box 9-1) were developed as a companion document to the Intervention Wheel. The Wheel defines the "what and how" of public health nursing practice; the Cornerstones define the "why." The Cornerstones synthesize fo

Component 1: The Model Is Population Based

The upper portion of the Intervention Wheel clearly illustrates that all levels of practice (community, systems, and individual/family) are population based. Public health nursing practice is population focused. It identifies populations of interest or po

Component 2: The Model Encompasses Three Levels of Practice

Public health nursing practice intervenes with communities, the individuals and families that comprise communities, and the systems that impact the health of communities. Interventions at each level of practice contribute to the overall goal of improving

Component 3: The Model Identifies and Defines 17 Public Health Interventions

The Intervention Wheel encompasses 17 interventions: surveillance, disease and other health investigation, outreach, screening, case finding, referral and follow-up, case management, delegated functions, health teaching, consultation, counseling, collabor

Systems Level of Practice

The goal of systems-level practice is to change the laws, policies, and practices that influence immunization rates, such as promoting population-based immunization registries and improving clinic and provider practices

Examples of Interventions Applied to Definition of Prevention: Primary Prevention

Primary prevention promotes health and protects against threats to health. It keeps problems from occurring in the first place. It promotes resiliency and protective factors or reduces susceptibility and exposure to risk factors. Primary prevention is imp

Examples of Interventions Applied to Definition of Prevention: Secondary Prevention

Secondary prevention detects and treats problems in their early stages. It keeps problems from causing serious or long-term effects or from affecting others. It identifies risk or hazards and modifies, removes, or treats them before a problem becomes more

Examples of Interventions Applied to Definition of Prevention: Tertiary Prevention

Tertiary prevention limits further negative effects from a problem. It keeps existing problems from getting worse. It alleviates the effects of disease and injury and restores individuals to their optimal level of functioning. Tertiary prevention is imple