Understand the differences between: CBN, CON, and PHN
Community-Based Nursing:
-Goal: to manage (acute or chronic care)
-Focus: (illness oriented)
-Who: (Individuals and Families)
-Where: live, work, school (home or community settings)
-What: Philosophy: (comprehensive, coordinated and continuous care.)
-Tre
Community Oriented Nursing
CON Includes:
A: Public Health Nursing - focuses on health care of the community or populations.
B: Community Health Nursing - (Primarily focused on individuals, family, and groups in the community.)
Community Oriented Nursing
Goal: preserve, protect, & p
Public Health defined
Public Health is a
-scientific discipline including epidemiology
-stats,
-assessment (behav, cultural, econ)
-Promotion of quality of life
-"the greatest good for the greatest number
(Part A of CON) Public Health Nursing Practice
Goal: Prevention (disease and disability) Promotion & Protection community's health
Focus: Health promotion/disease prevention
(Who: community/populations)
What: Impact community's health status (resources) on the health of individuals, families, and grou
(Part B of CON) Community Health Nursing
Combination of Nursing & PH
Goal: Preserve, protect, promote, or maintain health of individuals, families, and groups in a community.
Focus: Health of (individuals/families/groups)
Main difference between CBN and CON
The key difference between CBN and CON is:
CBN deals primarily with "illness oriented care" and
CON "provide healthcare to promote quality of life
Demographic Data in a Community
1. Age of residents
2. Gender distribution of the residents
3. Socioeconomic characteristics
4. Racial distributions
5. Vital Statistics, including selected mortality and morbidity data
6. Community institutions, including health care organizations and th
Role of the Key Informant (when conducting a community assessment)
p.224-225 Informant Interviews consist of directed talks with selected members of a community about community members or groups and events. This is a critical component of the community assessment. They are not always people who hold official titles. They
Function of the Windshield Survery
p.225 WS - A short and simple community assessment. *
best to do it twice, at different times of day
*
- WS are the motorized equivalent of simple observation.
-They involve the collection of data that will help define the community, the trends, stability
Public Health did this:
- Dramatically increased life expectancy
-Decreased death rates of adults and children
decreased deaths from STROKE, Coronary Heart Disease, and Cancer
-Population-focused PH approaches could help prevent up to 70% of early deaths in America, compared wit
The Key Developments in the 20th Century that aided in life expectancy
p. 134
10 Great Public Health Achievements of 20th Century:
1. Vaccination
2. Motor Vehicle Safety
3. Safer Workplaces
4. **Control of Infectious Diseases
5. **Decline in Deaths from Coronary Heart Diseases and Stroke + cancer
6. Safter and Healthier Food
Primary, Secondary, and Tertiary Prevention Examples
Examples related to Public Health:
PRIMARY PREVENTION:
The public health nurse develops a health education program for a population of school-age children that teaches them about the effects of smoking on health.
SECONDARY PREVENTION
The public health nur
Examples R/T Public Health Care System
Levels of Prevention
Related to the Public Health Care System
PRIMARY PREVENTION
Counsel clients in health behaviors related to lifestyle.
SECONDARY PREVENTION
Implement a family-planning program to prevent unintended pregnancies for young couples who att
Examples related to Ethics
PRIMARY PREVENTION
Use the Code of Ethics for Nurses to guide your nursing practice.
SECONDARY PREVENTION
If you are unable to behave in accordance with the Code of Ethics for Nurses (e.g., you speak in a way that does not communicate respect for a patien
Related to Cultural Differences (Hypertension, Stroke, and Heart Disease)
Levels of Prevention
Related to Cultural Differences (Hypertension, Stroke, and Heart Disease)
PRIMARY PREVENTION
Provide health teaching about balanced diet and exercise.
SECONDARY PREVENTION
Teach clients and/or family to monitor blood pressure. Teach a
Economic Prevention Strategies
Levels of Prevention
Economic Prevention Strategies
PRIMARY PREVENTION
Work with legislators and insurance companies to provide coverage for health promotion to reduce the risk of diseases.
SECONDARY PREVENTION
Encourage clients who are pregnant to partic
Example: Using Evidence-Based Practice
Levels of Prevention
Using Evidence-Based Practice
According to evidence collected and averaged by the Task Force on Community Preventive Services, the following are interventions supported by the literature at each level of prevention:
PRIMARY PREVENTION
Levels of Prevention: Primary
Primary Prevention:
Refers to prevention of health problems before they occur.
-Pre-disease - health promotion and specific protection
Action taken prior to the onset of disease, removes the possibility that the disease will ever occur.
Signifies interven
Secondary Prevention
Secondary Prevention:
Begins when pathology is involved and is aimed at early detection and treatment (screening)
-Latent Disease - Pre-symptomatic Diagnosis and treatment
- attempts to arrest the disease process, restore health by seeking out unrecognize
Tertiary Prevention
Tertiary Prevention: Activities designed around rehabilitation when a permanent, irreversible condition exists.
-Symptomatic Disease
-Disability limitation for early symptomatic disease
-rehabilitation for late symptomatic disease
-It is used when the dis
Determinants of a community's health status
p.221 Indicators of Health Status Outcome
1. Race-specific and ethnicity-specific infant mortality, as measured by the rate (per 1000 live births) of deaths among infants less than 1 year of age
Death Rates (per 100,000 Population)� for:
2. Motor vehicle
Classification of Health Indicators
Mortality Indicators
Morbidity Indicators
Disability rates
Nutritional status indicators
Health Care Delivery indicators
Utilization Rates
Indicators of social and mental health
Environmental indicators
Socio-economic indicators
Health policy indicators
I
Shattuck Report
Shattuck Report - the first attempt to describe a model approach to the organization of public health.
(The colonial period)
1850 by the Massachusetts Sanitary Comission
- Establishment of State Health Departments
-Establish local Health Boards
-Sanitary
Henry Street Settlement
Lillian Wald believed poor people should have access to health care.
Lillian Wald and Mary Brewster organized a "visiting nursing service" for the poor of New York, which later became the Henry Street Nurses Settlement.
The two women occupied the top floo
Contributions Lillian Wald Made to PHN
-Mother of PHN
-Recognized 20% of children would miss any given day of school.
Made school nurses "Lina Rogers, a Henry Street Settlement resident became the first school nurse."
-Responsible for taking lice out of hair
-By 1918, Lillian Wald was integran
Demographics changed healthcare delivery?
The Aging population
Hispanics
- single parent head of household families have grown
- changing lifestayle, growing appreciation for healthy lifestyle and QOL.
-AMericans spend money on healthcare, nutrition, and fitness.
- Greater emphasis on alternative
A Systematic Review (of Literature)
a method of identifying, appraising, and synthesizing all available research that is relevant to a particular research question."
-A systematic review is usually done by more than one person and describes themethods used to search for and evaluate the ev
Evidence-Based Practice
The best available evidence from a variety of sources, including research studies, evidence from nursing experience and expertise, and evidence from community leaders.