Definition
The coordinated efforts specific to promoting and preserving the health of individuals, families, and groups in the community setting.
Florence Nightingale's curriculum
Hospital based, but also provided eduation in SELF care and health of communities.
* Caring is the essence of nursing
District nurses
Nightingale's term for 'nurse visitors' that care for and educate the sick inside their homes.
VNA
Visiting nurses association. Established in England 1900, came later to the US (sponsored by rich women to help poorer women and children)
WW1 and home health care
Shifted from 90% being in community to more hospital setting. Continued to 1980.
Red Cross
Assisted in developing public health nursing in many states.
Now, each state has their own health department.
Frontier nursing service
Serves areas in the Appalacian Mountains - now drive jeeps instead of ride horses (dummies)
National League of Nursings involvement
From 1980-2000, there was a 155% increase in nurses being employed. They said that all levels of nursing need to be educated in community nursing.
Home care nurses' focus
Illness care in the home.
A key component of health promotion is that people in a community are able to:
Recognize their health needs and help develop strategies to improve their own health care.
Community based nursing care: Focus
Cost containment, reduces disease, empowers ppl towards self care and wellness.
Centers on individual and family health care needs.
Mutual respect by caregiver and receiver.
Provides direct services to individual.
Community based nursing care: Settings
Where people work, play, live, worship, or attend school (IE: Support groups, free standing clinics, mobile van, home care, prisons).
Community based nursing care: Role of RN
Nurse must know composition and characteristics of the clients.
Culturally competent.
Must educate, coordinate, and advocate.
Community based nursing practice
Care within the contex of the client's family and community with a prevention focus
Community health nursing
forcus is the health of the community with priority of health promotion and illness prevention.
Skilled nursing
provision of nursing services for individuals requiring ongoing care.
Home health care
Services provided to individuals and families in their residence to promote and restore health.
A community
A small neighborhood in a major city or a large area of rural residents.
Population focused care
Focuses on needs of a community or population group.
Includes research (data), assessment, program planning, evaluation of program goals.
Population focused care: Settings
public health department
center for disease control
policy development
Population focused care: Roles of RN
-Health promotion
-Protect the public from environmental hazards
-Plan for primary, secondary, and tertiary care
-Assure resources and services are available and accessible to populaton
** The greatest good for the greatest # of people
Purposes of community based health care
1. Cost containment
2. Healthy people 2020 (see below)
3. Empowering people towards SELF care (primary prevention as opposed to treating disease)
4. To reduce the spread of disease in communities.
Healthy people 2020
Healthy People 2020 follows a variety of health indicators such as: physical activity and obesity; drug, alcohol and tobacco use; mental health; incidence of violence and injury; environmental issues; and access to health care; responsible sexual behavior
Components of Community based care
1. Self care actions of members of community
2. Health promotion and prevention (primary, secondary, tertiary measures)
3. Care within people, location, and social system.
4. Collaboration of care to prevent fragmentation of care due to mulitiple provider
Which definition best describes wellness?
Actively practicing healthy behaviors. Daily lifestyle choices
The nurse is teaching a group of clients at a senior center about ways to reduce their blood pressure through exercise and recreation. What type of care is this nurse providing?
Community based care focuses on individual and family healthcare needs. Care is provided directly to empower individuals to promote self-care. Nursing is provided for clients wherever they are
Community health
in general is provided to population based groups.
Skilled nursing
is the provision of care focused on restorative or curative care
Ambulatory care is
outpatient care
Downstream thinking
A pt has a problem, goes to doctor for a solution with short-term, crisis oriented focus.
Doctor is busy addressing issue, doesn't look 'upstream' to focus on the cause.
Upstream Model for Wellness
Focuses action our efforts from tertiary and secondary to primary prevention
CDC shift of focus
Health protection focus (inform and guide health system actors, prevention focus, integrating health-information systems).
WHO (World Health Organization)
25-33% of disease is due to environmental exposure, and related to 25% of preventable illness in the world.
Primary prevention
Used before person gets disease. IE: applying sunblock to protect skin from UV rays, immunizations.
Secondary prevention
These interventions happen after an illness or serious risk factors have already been diagnosed. The goal is to halt or slow the progress of disease (if possible) in its earliest stages.
IE: taking low-dose aspiring to avoid stroke, screenings
Tertiary prevention
This focuses on helping people manage complicated, long-term health problems such as diabetes, heart disease, cancer and chronic musculoskeletal pain.
Obesity sequalae
Corononary heart disease, type 2 diabetes, cancers (endometrial, breast, colon), HTN, dyslipidemia, stroke, liver and gullbladder disease, sleep apnea and respiriatory problems, osteoarthritis, gynocological problems (abnormal menses, infertility)
Teaching : Acute
Focuses on DC instructions
Time restrictions
Shortened hospital stays
Phone call f/u
Teaching: Community setting
Maintains health
Threats to health
Lifestyle choices
Informed decision making
Clients learn self-care
15 minute family interview article summary
1. Manners - introduce yourself to pt and family
2. Therapeutic conversations (with purpose)
3. Family genome and ecomaps
4. Therapeutic questions
5. Offer commedations
Family caregivers article summary
Early d/c put stress on caregivers
More ppl are keeping the elderly at home because of care, cost, few women stay home.
A lot of treatments can be given at home now.