Community Exam 1

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srramos
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87195
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Community Exam 1
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2011-05-22 16:27:31
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NURS Community
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Exam 1
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  1. Core functions of public health
    • assessment
    • policy devt
    • assurance
  2. Assurance
    • public health role of making sure that essential community-oriented health services are available.
    • it's not a guarantee.
  3. Health promotion
    keeping healthy people healthy
  4. Health prevention
    use of vaccines and disaster preparedness
  5. Health protection
    regulations we have to keep the people from harm; ie: OSHA, FDA, EPA, TSA
  6. Public Health Nrsg
    synthesis of nursing and science of public health; looking at the big picture; nursing measures that promotes health and prevent disease in the community
  7. Community health nrsg
    looking at a group of people/aggregate; emphasis is on health promotion and prevention
  8. Comm based nrsg
    primary focus is TREATMENT; basically a clinic located in the community
  9. What happened during the Colonial period?
    • -a health system was developed
    • -Elizabethan poor law was used
    • -Boards of Health was established
    • -Charitable orgs
    • -Shattuck report
  10. Elizabethan poor law
    • -established the care for the sick, poor, mentally ill, disabled, or dependent
    • -based on Protestant ethic: everybody puts in the effort
    • -became the basis for medicaid
  11. Shattuck report
    • -published in 1850 by Massachusetts sanitary commission
    • -1st proposal for modern approach to pub health
    • -laid the groundwork for the Sheppard-Towner act
    • Report included:
    • -est of state health depts & local health boards
    • -sanitary surveys & collection of vital statistics
    • -environmental sanitation
    • -food, drug, & comm disease control
    • -well child care & health educ
    • -smoke & alcohol control
    • -town planning
    • -teaching preventive medicine in med schools
    • (not implemented til 1995)
  12. Sheppard-Towner Act
    • -est in 1921
    • -aka Maternity & Infancy Act
    • -ended in 1929
    • -established state programs: WIC, EPSDT
  13. Florence Nightingale
    • -volunteered to help the sick during Crimean war
    • -organized hospital nrsg practice & educ
    • -replaced untrained nurses w/ Nightingale nurses
  14. William Rathbone
    • -est the first District nursing
    • -assessed the needs of a particular area
  15. Francis Root
    -she was hired by the US to begin the visiting nurses
  16. Lillian Wald
    • -1st publich health nurse
    • -est the Henry St Settlement House
    • -Met Life Insurance Co
    • -American Red Cross: est rural health nrsg
    • -Children's Buereau: prelude to WIC & Medicaid
  17. Mary Adelaide Nutting
    -proposed that there should be advanced education in public health nursing
  18. Mary Breckenridge
    • -est the FNS (Frontier Nursing Services) in rural Kentucky
    • -introduced the 1st nurse midwives
  19. 1st nursing schools based on F. Nightingale opened in?
    1870s
  20. Lina Rogers
    1st school nurse
  21. Social Security Act of 1935
    • enacted to protect the health of people and included funds for education and employment of public health nurses
    • -this was one of the impacts of Depression
  22. Medicare & Medicaid was est:
    1966
  23. Declaration of Alma Mata
    • -1977
    • -became the basis for HFA (Health for All) and later the Healthy People 200
  24. Esther Lucile Brown
    -recommended that basic nrsg be done in colleges and universities
  25. Health Care Delivery trends
    • 1800-1900
    • -epidemics
    • -inadequate & unsafe hospitals
    • -minimal technology
    • -experienced-based training
    • -avoids hospitals

    • 1900-1945
    • -focus on acute infectious disease/trauma
    • -shorter life span
    • -shift to science-based training
    • -improved tech

    • 1945-1984
    • -focus on chronic diseases
    • -increase # of facilities
    • -better technology
    • -increase in med specialties
    • -health insurance

    • 1984-present
    • -focus on new & old infectious diseases
    • -cost containment issues
    • -super drugs
  26. Health care system concerns:
    • Cost
    • Access
    • Quality
  27. 2 prim goals of Healthy People 2010
    • -increase years of healthy life
    • -eliminate disparities among diff populations
  28. Capitation
    • -prospective standardized fee for services
    • -pay up front
    • -ie. HMO
  29. DRG
    • Dx Related Groups
    • -used by insurance to tell us how long we receive care and how much money
    • -made hospitals & nurses more accountable
  30. Manged care
    • -not the same as Care management
    • -this is basically the insurance, handling the amount of time and money the pt's receive
  31. Macro & Micro economics
    • -Macro: overall spending for health care
    • -Micro: consumption & spending of individuals
  32. Payment types in health care
    • -Prospective: capitation; ie HMO; preset amount
    • -Retrospective: after service is rendered
    • -Fee for service: based on usual, customary or traditional charges
  33. Types of 3rd party payers:
    • Medicare
    • -for >65 y/o
    • -anyone w/ ESRD
    • -disabled
    • -A: hospitalization up to 60 days
    • -B:Dr/outpt (premium & deductible)
    • -C:ABD
    • -D:prescriptions

    • Medicaid
    • -for pregnant women, children <5, indigent
    • -women & children still quality even if 1 1/2 times above pov line

    • Managed Care
    • -HMO: capitation
    • -PPO: predetermined rates for services
  34. Medical Savings Account v Flex Accounts
    Med savings: account for med expenses that carries over yr to yr

    Flex: use it or lose it
  35. Primary Care v Primary Health care
    • Prim Care:
    • -individual focused
    • -"comm based nrsg"
    • -professional dominance
    • -emphasis on cure/tx

    • Prim health care:
    • -comm focused
    • -"comm health nrsg"
    • -self reliance
    • -emphasis on promotion/prevention
  36. 3 levels of care & prevention
    • Care:
    • 1: when a person first enters the health system (got sick, go to Dr)
    • 2: diagnostics & testing
    • 3: rehab

    • Prevention:
    • 1: healthy person receving educ
    • 2: person @ risk receiving educ or early screenings/diagnostics
    • 3: already have disease
  37. Dimensions of cultural competence
    • Perseveration: allowing pt's to hold on to their values
    • Accomodation: making adaptations or taking into consideration the cx of another
    • Repatterning: thinking about things differently
    • Brokering: negotiating w/ pt
  38. Descriptive v Analytic epidemiology
    • D: deals w/ what, who, when, where
    • A: deals w/ why, how
  39. Point epidemic
    -everybody in a particular pt/source
  40. Cyclical time patterns
    -expect certain diseases to occur @ a certain time
  41. Event related
    -something triggered a response
  42. Types of analytic epid
    • Ecological
    • -holistic approach; looking at other factors

    • Cross-sectional
    • -snap shot; looking @ what is present

    • Case-control
    • -studying those that have the disease(case) and those that dont (control)

    • Cohort
    • -prospective: looking forward
    • -retrospective: reviewing back

    • Clinical trials
    • -involve some type of intervention

    • Community trials
    • -health promotion & prevention
  43. John Snow
    • -father of epidemiology
    • -connected that cholera was linked to a faulty water pump
  44. Lister
    -developed antisepsis
  45. Robert Koch
    -able to grow cultures of tb, anthrax, cholera
  46. Attack rate
    -how many people developed the disease over the people who were exposed
  47. Bioterroristic potential agents
    • anthrax
    • botulism
    • smallpox
    • hemorrhagic viruses
    • tularemia
    • plague
    • ebola

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