Humanistic Nursing Theory
studies the existence of reality of nursing
Transcultural Nursing
comparison of differing cultures to understand their similarities and their differences across human groups
Culture
set of values, beliefs and traditions that are held by a specific group of people and that are handed down, generation to generation
Leininger
1. cultural preservation or maintenance
2. cultural care accommodations or negotiation
3. cultural care re-patterning or restructuring
Nightingale's 10 Canons
1. ventilation and warming
2. light and noise
3. cleanliness of the pt area
4.health of houses
5. bed and bedding
6. personal cleanliness
7. variety
8. offering hope and advice
9. food
10. observation
Primary prevention
patient assessment and intervention to identify and reduce possible risk factors
Secondary prevention
detection of symptoms that are a reaction to stressors, appropriately prioritizing interventions, and treatments that reduce the toxic effects of stressors
Health
seen as a dynamic, positive state and not just absence of disease
5 A's of Health Care Access
availability, accessibility, affordability, acceptability, and accommodation
Market justice
people are only entitled to what they can earn; the focus is on individual responsibility "minimal collective action and freedom from collective obligations except with respect to others fundamental rights
Vulnerable populations
low income, less education, homelessness, military veterans, immigrants, prisoners, migrant and seasonal farm workers and their families, chronic illness, mental illness
social determinants
are the circumstances in which people are born; grow up, live, work, and age as well as the systems put in place to deal with illness
Health disparities
difference in health outcomes between populations, social, demographic and geographic
Health inequities
modifiable associate with social inequalities and are considered unfair
Leininger- Transcultural Nursing
requires an awareness of self, sensitivity to others, respectful dialogue
Ethnocentric
tendency to believe others think the same was as "they do," have the same world view, culture
Altruism
putting others interests before one's own, being present is an example
Autonomy
PHN independent and responsible for actions - respects community and individual right to self-determination; maintain privacy, honesty, and fidelity
Beneficence
seek to do good, not harm
Common Good Perspective
good for the whole
Ethics
standards of behavior that tell us how we ought to act in various situations we encounter in life
Fairness Perspective
focuses on how fairly or unfairly actions affect a group - how benefits and burdens are distributed; requires consistency in the way people are treated
Non-maleficence
first do no harm - primum non nocere
Advance directive
legal document in which an individual conveys their decisions about end-of-life care
Health literacy
includes the ability to understand instructions on prescription drug bottles, appointment slips, medical education brochures, doctor's directions and consent forms and the ability to negotiate complex health care systems
Pre-crisis
planning and test messages
Initial
audience wants information NOW
Maintenance
on-going assessment of the situation
Resolution
community will not be ready to conduct risk reduction immediately after emergency
Evaluation
Crisis and emergency risk communication response
4 P's of Social Marketing
product, price, place, promotion
NICs
Nursing interventions classification
NOCs
nursing outcomes classification
Nursing minimum data set (NMDS)
standardizes the collection of nursing data; can provide accurate description of nursing dx, care and resources used to help define cost and quality of nursing care
Tele-Health
electronic technologies to support clinical health care, patient and practitioner education, public health and health administration by long distance
Right-to-Know" Laws
give people and communities the right to know about possible chemical exposures where they live and work
Infancy
trust vs. mistrust
Early childhood (18 mo-3 yrs)
autonomy vs. shame
play age (3-5 yrs)
initiative vs. guilt
Adolescence (12-16yrs)
Identity vs. inferiority diffusion
Middle adult (35-55/65 yrs)
generativity vs. self-absorption/stagnation
late adulthood (55/65- death)
integrity vs. despair/wisdom
Young adult (18-35 yrs)
intimacy vs. solidarity/isolation
Sensory-motor stage
birth to two
Pre-operational stage
about two to seven
concrete operational stage
ages seven to eleven
Formal operational stage
eleven years and older
Epidemiology
distribution and determinants of health related states/events in populations and the use of this study to control health problems
Prevalence
measures the proportion of the population affected by a specific condition in a specific time period
Incidence
measures the risk of developing a new condition (disease, injury, symptom, or death), over a specific period of time, such as a year
Mortality rate
also called death rate=an estimation of the proportion of a population that dies during a specified time period
Epidemic
rates exceed normal or expected frequency in a given population/community/region
Pandemic
worldwide epidemic (influenza and plague)
Chain of causation
chain of events where every event caused by the previous event; the sequence of stops that have been identified as linked to the disease
Web of causation
describes events that have multiple causative factors
Passive Immunity
newborns via maternal antibodies
Active immunity
acquired after exposure to a disease or via immunizations
Cross-immunity
immunity to one pathogen confers immunity to another such as cowpox providing immunity to smallpox
Herd-immunity
present in a population, the higher the immunity decreases risk of disease (use of immunizations); increasing immunizations reduces risk of exposure to disease of those not immunized
Primary prevention
used before the person gets the disease or condition to reduce the incidence and prevalence of the disease; includes health promotion (education) and protection (immunization)
Secondary prevention
applied after the disease has occurred but before signs are evident; focuses on early dx (screening) and prompt tx to limit disability
Tertiary prevention
applied when person already has the disease, focuses on preventing damage from the condition, slowing the process of the disease, preventing complications, and returning the person afflicted to their optimal level of health (rehabilitation)
Case Series and Case Reports
collection of reports; no control group, easy to understand and can be written quickly
Case Control Studies
compare those with the disease to those without. estimates odds of getting the disease or condition, less reliable than randomized control trials, works well for rare conditions
Cohort Studies
may be prospective or retrospective, used to establish causation or evaluate the impact of treatment when randomized control trials are not possible over time-- longitudinal; not good for rare conditions, requires large study group
Randomized Controlled studies
requires a treatment group and a control group, pts are randomly assigned to all groups, considered "gold standard" of medical research to determine cause and effect
double blind method
neither patient nor researcher knows if the subject is in the control or treatment group
meta-analysis
combines data from numerous studies and arrives at pooled estimates of treatment effectiveness and statistical significance
Descriptive studies
are observational studies that seek to describe phenomena
Qualitative studies
describe phenomena of interest; include participant observation, in-depth interviews and focus groups
Quantitative studies
seeks to confirm hypotheses about phenomena; uses more rigid style eliciting and categorizing responses
sulfur dioxide
product of industry produces acid rain and contributes to respiratory illness
nitrous oxide
combustion product contributes to illness of lungs, immune system and asthma
carbon monoxide
car exhaust reduces oxygen delivery at high concentrations
radon
naturally occurring radioactive gas that cannot be detected by our senses, but is the leading cause of lung cancer in non-smokers; it is the second cause of lung-cancer behind smoking
consultation
involves seeking advice or an opinion of an expert; the consultant does not solve the problems, but assists and guides the group seeking consultation to solve their own problems
collaboration
taking an active role in implementing the plan, this requires understanding of each party's perspectives, on-going communication and feedback
coalition-building
alliance or group of stakeholders with a common interest/goal
Advocacy
purpose is policy change; critical role for the public health nurse
Cognitive
thinking (comprehension, analysis, synthesis, application, evaluation); evaluate the level of the learner
affective
feeling (receptive, active participation, valuation, internalization), includes changes in attitude and values
psychomotor
acting - demonstrates performance skills
6 stages of disaster life cycle
prepare, respond, mitigate, reduce the risk, and prevent
natural disasters
due to weather or other natural occurrences
man-made disasters
intentional power outages, chemical spills, acts of bio terrorism
bacterial agents
anthrax, plague
viral agents
smallpox
Biological toxins-category A
considered high priority and pose national security threat-high morbidity and mortality
smallpox, anthrax, plague, Ebola, Lassa fever, Q fever, botulism, tularemia, hemorrhagic fever
Biological toxins-category B
moderate to low morbidity and mortality, difficult to detect
Bucellosis, clostridia toxin, staph enterotoxin, salmonella, shigella, e.coli, cholera
Biological toxins-category C
emerging pathogens such as yellow fever, drug resistant TB
Family disaster plan
encourage families to prepare a family emergency/disaster kit, they might be deployed to local disaster sites
Health outcomes
health promotion interventions there must be outcomes to measure analysis of proper structure and constructive process, operationalizing, outcomes (improved health = weight loss, lower blood sugars)
Health status & quality of life indicators
individual perception based on health, cultural background, education, moral and ethical values, difficult to asses because it is very subjective
Disparities
exist due to poverty, lower educational levels, unequal access to healthcare, language barriers, environmental conditions, racism
Health Belief Model (HBM)
predicts health related behavior and compliance to prevent diseases; health promotion empowers populations so they can have control over personal health and access resources; perception, attract positive value (health) and repel negative value (illness)
Transtheoretical Model (TTM)
five stages of progression (1) pre-contemplation- no thought of change (2) contemplation-owning the problem/evaluate options (3) preparation- plan of action (4) action-changes are attempted (5) maintenance-behavior sustained usually 6 mos or longer
Health Promotion Model (Pender)
actions to improve health using the following drivers-individual characteristics and experiences, behaviors, behavioral outcomes, health promotion, activities involve removing internal and external barriers and promoting public policy to remove barriers
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Motivation
moved from contemplation to action
Self-efficacy
belief about capabilities to produce effects
Self-management
manage independently choices and consequences of life
Compliance
degree to which a plan is followed (passive)
Adherence
agreement to follow a plan of action (active)
pedagogy
literally means the "art and science of teaching children
andrgogy
intentional and professionally guided activity the aims at a change in adults
Nurse-managed centers
nurse-managed centers provide a safety net for the poor and undeserved in rural and urban areas; run by advanced practice nurses, and may be associated with universities or may be independent
parish nursing
licensed, registered nurses practicing holistic care in faith communities
correctional health nursing
nurses working with populations in jails, prisons, detention centers, holding facilities
occupational health nursing
nurses working with populations within their work environment; provide workplace clinics, conduct safety education and improving working conditions to prevent injury; balance the company's need for productivity with knowledge of occupational health and wo
OSHA
sets health and safety work standards, employers are legally required to protect workers from hazards; employees have right to know what hazards they are exposed to
HIPPA
protects the privacy of identifiable, private health information
EPA
reduce environmental risk and protect the public, maintain safe air and water, establish pollution regulations, solid waste and toxic substance disposal, regulate pesticides, oversee radiation hazards, and noise abatement
HHS (US Dept. of Health and Human Services)
principle government agency that protects the health of our country; under its umbrella are: CMS, CDC, NIH, FDA, SAMHSA
CMS
Center for Medicare and Medicaid Services
CDC
monitors and tracts diseases, research injury, infectious disease, environmental health, genomics, global health, chronic disease prevention, birth defects and developmental disorders; publishes the morbidity and mortality weekly report
NIH
mission is to seek fundamental scientific truth about the natures and behavior of the living systems and the application of science to improve health, lengthen life and reduce the heavy load of illness and disability
SAMHSA
Substance Abuse and Mental Health Administration; coordinates and funds sustainable substance abuse and mental health programs in communities or community health agencies
stakeholders
those who stand to gain or lose from the success or failure of an initiative
documentation standards
an agency's standards for how care is recorded/documented on an individual or program level; provides a legal record, and should be performed in a timely manner to ensure accuracy
risk management protocol
identification of areas where mistakes of omission or commission can be made
performance standards
defined standards/expectations for how business is to be conducted and how performance will be measured
mentoring
expert who establishes a long-term relationship with a mentee to help them meet professional goals or learn the role
preceptor
guidance and role modeling are ways to nurture colleagues or students
professional credibility
clearly demonstrates expertise in an area
expert
perform as an expert maintain standards of behavior and accountability