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Community Health Nursing and Public Health Practices, Study Guides, Projects, Research of Community Health

An overview of community health nursing and public health practices. It covers key concepts, including promoting population health, identifying at-risk groups, and applying the nursing process. The document discusses prevention levels, frameworks, case management, primary care, chronic care, transitional care, and patient-centered medical homes. It also covers healthcare policies, systems, responsibilities, roles, disparities, and coverage.

Typology: Study Guides, Projects, Research

2024/2025

Available from 09/27/2024

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Community health Study Guide + Scenarios Exam 1

  1. What is community health nursing?: - The synthesis of nursing practice and public health practice applied to promoting and preserving the health of the popula- tion
  • Associated with the health and identifications of population at risk rather than with an episodic response to patient demand
  • Think COMMUNITY as primary client
  1. What is community based nursing?: - Application of the nursing process in caring for individuals, families, and groups where they live, work or go to school as they move through the healthcare system
  • Think SPECIFIC SETTING (home, school, work) and INDIVIDUAL/FAMILY as primary client
  1. Which level of prevention would getting immunizations, wearing a seat belt, and purifying water fall under?: Primary
  2. Which level of prevention would getting a mammography, blood pressure screening, COVI-19 testing and PSA fall under?: Secondary
  3. Which level of prevention would include teaching how to perform insulin

2 / 27 injection and disease management to a patient with diabetes, referral of pt with spinal injury for PT and leading a support group for grieving parents fall under?: Tertiary

  1. If there is a lead poisoning issue amongst children, and the nursing in- tervention focused primarily on the identification and treatment of child and family. What kind of conceptualization is that (micro or macro)?: Microscopic
  2. If there is a lead poisoning issue amongst children and the nursing interven- tion focused primarily on examining trends in the prevalence of lead poisoning over time, estimating the percentage of older homes in the neighborhood that may contain lead pipes or lead based paint surfaces and locating industrial sources of lead emissions. What kind of conceptualization is that (micro or macro)?: Macroscopic
  3. What is the basis of Health Belief Model?: - Based on the assumption that the major determinant of preventive health behavior is disease avoidance
  • Perceived susceptibility
  1. What are the 6concepts of avoidance that the Health Belief Model made up of?: - perceived seriousness of disease,

3 / 27

  • modifying factors,
  • cue to action
  • perceived benefits minus perceived barrier to preventative health actions,
  • perceived threat of disease
  • the likelihood of taking a recommended health action.
  1. What are modifiable and non-modifiable risk factors (application based questions)?: o Biology (NM) o Behaviors (M) o Social environment (M) o Physical environment (M) o Policies and intervention (NM and M)
  2. What is the most important take away for tobacco cessation?: - Number one issue to prevent deaths
  • Important step in achieving optimum health
  1. What are the phases of the health promotion model?: Individual Character- istics and Experiences
  • Prior related behavior -personal factors (biological, psychosocial and sociocultural)

4 / 27 Behavior specific cognitions and affect

  • Perceived benefits of action
  • perceived barrier to actions
  • perceived self-efficacy
  • activity related affect
  • interpersonal influences (family, peers)
  • Situational influences (options, demand characteristics, aesthetics)
  • Both lead to commitment to plan Behavioral outcomes
  • Immediate competing demands (low control) and preferences (high control)
  • Health promoting behavior
  1. What are the stages of transtheoretical model?: - Pre-contemplation -- The individual has no intention to take action toward behavior change in the next 6 months. May be in the is phase because of lack of information about the consequences of the behavior or failure on previous attempts to change
  • Contemplation

5 / 27 -- The individual has some intention to take action toward behavior change in the next 6 months. Weighing pros and cons to change

  • Preparation -- The individual intends to take action within the next month and has taken steps toward behavior change. Has a plant of action
  • Action -- The individual has changed overt behavior for less than 6 months. Has changed behavior sufficiently to reduce risk of disease
  • Maintenance -- The individual has changed over behavior for more than 6 months. Strives to prevent relapse. This phase may last months to years
  1. What is thinking upstream?: - THINK PROACTIVE
  • Focus on modifying economic, political and environmental factors that are the precursors of poor health throughout the world
  • Ex: working out to avoid obesity
  1. What is included in the peron-place-time model?: - Person: "Who" factors, such as demographic characteristics, health, and disease

6 / 27 status

  • Place: "Where" factors, such as geographic location, climate and environmental conditions, political and social environment
  • Time: "When" factors, such as times of day, week, or month and secular trends over months and year
  1. What are the elements of the epidemiological triangle?: - Agent -- Nutritive elements, chemical agents, physical agent, infectious agents
  • Host -- genetic, age, sex, ethnic group, physiological state, prior immunological experi- ence, intercurrent or pre-existing disease, human behavior
  • Environment -- physical, biological, socioeconomic
  1. What is descriptive epidemiology?: - Study of the amount and distribution of disease
  • Used by public health professionals
  • Identified patterns frequently indicate possible causes of disease
  1. What is analytic epidemiology?: - Examine complex relationships among the many determinants of disease

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  • Investigation of the causes of disease, or etiology
  1. What is the web of causation?: illustrates the complexity of relationships among casual variables for the heart
  2. Imagine you're a public health official monitoring the spread of a conta- gious disease in a region. You're particularly concerned about tracking the number of new cases to assess the effectiveness of preventive measures and to anticipate healthcare needs. What kind of rate is this prevalence or incidence?: Incidence rates
  3. A research scientist a studying all of the cases obesity within the time frame of February to March. What kind of rate is this prevalence or incidence?- : prevalence
  4. What is an observational study?: - Used for descriptive purposes, but also use them to discover the etiology of the disease
  • Do not allow the investigator to manipulate the specific exposure or experience or to control or limit the effect of other extraneous factors that may influence disease development
  • LITERALLY ONLY OBSERVING

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  1. What are cross sectional studies and differential factors?: - definition: Ex- amine relationships between potential causal factors and disease at a specific time
  • Think Relationship/Association and OCCURS ONCE
  1. What is retrospective studies and differential factors?: - Compare individu- als with a particular condition or disease and those who do not have the disease
  • Determine whether cases or diseased groups differ in their exposure to specific factor or characteristic relative to controls or non-disease groups
  • Think on BACK IN TIME
  1. What are prospective studies and differential factors?: - Monitor a group of disease free individual to determine whether and when disease occur
  • Think on FOLLOWING A COHORT
  1. What are experimental studies and differential factors?: - Randomly assigns subject at risk for a particular disease to an experimental or a control group
  • Observes both groups for the occurrence of disease over time,

9 / 27 but only the experimental group get intervention

  • Think RANDOMIZED CONTROL TRIALS
  1. What is the windshield survey?: - driving or walking through an area and making organized observations (MOST COMMON)
  2. What is shoe leather epidemio: o establish certain hunches or hypothesis about the community health, strengths, and potential health problems through its down to earth approach
  3. What is health planning model?: o Aims to improve aggregate health and applies the nursing process to the larger aggregate within a systems framework
  4. What are the components of Health Planning Model (HPM)?: Assessment:
  • Aggregate Characteristics
  • Identification and prioritization of health needs/problems Planning:
  • Mutual goals and objectives
  • Alternative levels of intervention (eg personal, group, and environment) Intervention:
  • At least one level (primary, secondary, tertiary)

10 / 27 Evaluation:

  • Based on objectives, plan and outcomes (ie process and product)
  1. What does PRECEDE stand for and do?: - predisposing, reinforcing, and enabling constructs in educational diagnosis and evaluation
  • It assess the diagnostic and planning process to assist in the development focused public health programs
  1. What does PROCEED stand for and do?: - policy, regulatory, and organiza- tional constructs in educational and environmental development
  • Guides the implementation and evaluation of the programs
  1. What are the examining factors of the PRECEDE-PROCEED framework: ยง Predisposing factors ยท Knowledge, attitudes, behavior, beliefs, and values before intervention that affect willingness to change ยง Enabling factors ยท The environment or community of an individual that facilitates or presents obstacles to change ยง Reinforcing factors ยท The positive or negative effect of adopting new behavior

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  1. What is the purpose and overview of case management?: o Case manage- ment is a term that describes a wide variety of patient care coordination programs in acute hospital and community setting o Focuses on care coordination, financial management, and utilization of resources for a patient centered plan of care
  • basically, collaborate to get best care possible
  1. What is included in primary care?: chronic and transitional
  2. What is chronic care management?: - Needs a referral by practitioner who has identified patient with two or more chronic conditions that put the patient at high risk of functional decline or death within next 12 months
  • Care coordinators work with patient and caregivers to improve self- management of disease, educate and coordinate care to empower patients to access care appropriately and efficiently
  1. What is transitional care?: - Referred by practitioners or hospital staff
  • Follow-up- face to face visits with outpatient practitioners and care coordination's services for 30 days post discharge
  1. What is patient centered medical home?: - Provides collaborative, quality-dri- ven, safe primary care

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  • Care coordination and case management processes:
  • Provide comprehensive, patient-centered, cost-effective, high-quality care
  1. What are the revisions and purposes of Patient Protection and Affordable Care Act of 2010?: o All US citizens and legal residents mandated to have a qualifying coverage o Changing eligibility requirements for Medicaid and expanded CHIPS o Subsidized premiums for lower and middle income families o Required coverage for dependent adult children up to 26 o Fostered heath insurances exchanges o Significant insurance reforms
  2. What is the Patient Protection and Affordable Care Act of 2010 funded by?: o Funded through new fees and taxes
  • Taxes on indoor tanning
  • Medicare taxes for higher income brackets
  • Fees for pharmaceutical companies and medical devices
  • Penalties for those who do not obtain health insurance o Cost cutting measures
  • Cut to medicare advantage programs

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  • Reductions in medicare spending
  • Reduced administrative cost, streamlined care, reduced fraud, and abuse
  1. What is the paradigm shift?: - Shift from cure to prevention
  • Policy is based on values and the first step in forming policy is identification of the issue
  • Therefore, it would seem rationale to define health as the starting point for any policy annexed to health care issues
  1. What is WHO definition for health?: - Considers health to be the state of complete physical, mental and social well-being not merely the absence of disease or infirmity
  2. What is included in private health care system: - Broken down into non- profit and profit
  • Services provided in clinics, physicians' offices, hospitals, hospital ambulatory cents, skilled care facilities and homes
  • Has voluntary agencies
  • Organized into 5 basic models: ยท Solo practice ยท Single specialty group model

14 / 27 ยท Multispecialty group practice ยท Integrated health maintenance model ยท Community health center

  1. What is public health system?: - Broken down into federal, state, local pro- grams
  • Concerned with the health of the population and a healthy environment
  1. What are the responsibilities of local health department?: - Community Services -- Control of communicable disease (surveillance and immunizations), maternal child health programs, nutrition services, and education
  • Environmental -- Food Hygiene (inspection of food producing) protection for hazardous substances, control of waste, air, noise and water pollution, occupational health
  • Personal
  • Mental: -- regional mental health and mental retardation facilities and programs
  1. What is a basic summary of federal level role in public health care?: -

15 / 27 Larger role in the protection of the population through regulation and funding such as medicare

  • Implemented and administered by the DHHS, which consists of 11 major agencies
  • Department divided into 10 regions and is directed by the secretary of health and human services
  1. What is a basic summary of state level role in public health care?: - establish health codes, regulates the insurance industry, and license healthcare facilities and personnel
  • Also helps fund services offered through medicare (care in mental hospitals, state medical schools)
  • Responsible for health of their citizens and are the central authorities in the public health care systems
  1. What is managed care?: o Involves capitated payments for care than for fee-for-service o Capitated payments for care o Health care providers integrated into the system such as health maintenance organizations o Solo practice fading

16 / 27 o More advanced nurse practitioners (ANPs) and o Physician assistants (PAs) assume primary practice roles in various settings. o Patient-centered homes have team approach to assist incoordination of care for positive outcomes

  1. What does the joint commission accreditate?: - Founded in 1951 to promote health care quality through setting and maintaining stands for hospitals
  2. What does National Committee of Quality Assurance accreditate?: ยง Over- sees accreditation programs for individual physicians, health plan, medical group to include MCOs (managed care organizations)
  3. By publishing materials to educate healthcare systems and professional to put research into practice and through generation of measures and data to be used by providers and policy makers, would fall under which organiza- tion?: Agency for Healthcare Research and Quality
  4. What is the Agency for Health Research and Quality entail?: o Main federal organization that works to improve the safety and quality of the health care system o Support efforts for clinicals and providers include clinical guidelines

17 / 27 and recom- mendations o Strategies and tools to enhance performance and patient safety Consumer assessment of healthcare providers and systems

  1. What does disparity in healthcare refer to?: o Refers to observable or quan- tifiable differences in the presences of disease, health outcomes, access to health care among different groups and populations o Factors ยง SES ยง Age ยง Mental Helath ยง Cognitive ยง Sensory ยง Physical disability ยง Sexual orientation or gender identity ยง Geographic location
  2. What are examples of disparity in healthcare?: - Ethnic minorities tend to have a higher prevalence of chronic conditions and higher rates of mortality and poorer health outcomes

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  • Blacks, american indian/alaskan natives have higher prevalence rates of asthma, diabetes, and cardiovascular disorders
  • Blacks experiencing over 8 to 10 higher rates of HIV and AIDS
  • Higher infant mortality rates for Blacks and american indian/alaskan natives
  1. Who is eligible for medicare/what is it ?: - Provided indemnity insurance to those over the age 65 years old or older, people who are disabled or have end-stage renal disease
  2. A 65 year old is currently in a hospice program. Prior to hospice, they were receiving inpatient care in a hospital. Which part of medicare cover this?: Part A
  3. What is covered in Part A of medicare?: o Basically hospital insurance o Includes inpatient care in hospitals/skilled nursing facilities, hospice care, some home health care o Must pay a deductible for health services o Does not pay for all health care costs of enrollees o Co-payments required after 60 days
  4. A 70 year old patient has been receiving physical therapy (outpatient procedure) for their post-op hip surgery. During their therapy, it was rec-

19 / 27 ommended to purchase a walker (durable medical equipment) to help with ambulating. What part of medicare would cover these services?: Part B

  1. What does Part B of medicare entail?: o Purchased by monthly fee o Helps pay for out-of-pocket costs for physician services, hospital outpatient care, durable medical equipment, and other services, including some home health care o Premiums prorated based on income o Enrollees must pay deductibles and coinsurance
  2. A 68 year old patient is in need of an eye check up and their annual teeth cleaning. Which part of medicare could cover this?: Part C
  3. What does Part C of medicare entail?: o Medicare Advantage Plans o Optional "gap" coverage o Provided by private insurance companies approved by, and under contract with, Medicare o May include HMOs and PPOs o May include vision, hearing, dental care, and other services not covered by Medicare Parts A, B, or D

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  1. A 75 year old is needed help with the cost of her prescriptions. Which part of medicare would help with this problem?: Part D
  2. What does Part D of medicare include?: o Initiated in 2006 to help defray costs of prescription drugs o Optional; must enroll in an approved prescription drug plan o Monthly premium, deductibles, and co-payments o Must pay 100% of costs when costs reach "coverage gap" or "donut hole"
  3. What is medicaid?: - A state administered health plan, provided a source for financing health care for some of the poor and disable
  • A title XIX of the social security actโ€”a public welfare assistance program
  • Title XIX of the Social Security Actโ€”a public welfare assistance program
  • Provides universal health care coverage for the indigent, children, women, the disabled, and impoverished elders and adults below poverty line in some states
  • A joint state and federal ventureยก Eligibility for this program depends on the sizeand income of the family
  1. Early blue cross blue shield was an example of which health insurance?-

21 / 27 : indemnity plan

  1. What does an indemnity plan entail?: ยง Paid all costs of covered services ยง Free choice of provider and service ยง Allowed persons to manage own health care ยง Became costly, no incentives for cost containment
  2. What does Health Maintenance Organization (HMO) include?: ยง More com- prehensive care ยง Lacked enrollees freedom of choice ยง Preventative care covered ยง Specialty care restricted ยง Encouraged to reduce costs by only providing most necessary services ยง GATEKEEPER/REFERRAL
  3. What does a preferred provider organization (PPO) entail?: o Negotiated with health care providers for services at reduced rate in exchange for guaranteed increase inconsumers o Negotiated reimbursement rate allows cost of plan to be somewhat controlled. o Enrollees offered incentives for choosing health care from within the

22 / 27 plan's net- work. o More flexible than HMOs

  1. What does a point of service insurance entail?: o Combine elements of HMO and PPO o If individual goes outside the network, he or she will be responsible for most costs unless referred by the PCP.
  2. What does high deductible health plans (HDHP) entail?: o Encourage em- ployees to select plans with lower premiums but more pronounced up-front cost sharing o Had health care consumer shop around for lower costs o Health savings account (HSAs)
  3. If someone wanted a plan that paid all cost of covered services, allowed free choice of provider/service, and allowed the person to manage their own health care, which insurance would you recommend?: Indemnity
  4. What insurance includes a more comprehensive care option, covers pre- ventative care; however, restricts specialty care, freedom of choice and need a referral?: HMO
  5. If someone wanted a plan that allowed negotiation with health care providers for services and reimbursement; however, needed to choose from

23 / 27 within plan's network (incentivized). Which insurance plan would you recom- mend?: PPO

  1. What is cultural competency?: o is respecting and understanding the values and beliefs of a certain cultural group so that one can function effectively in caring for members of that cultural group o Requires that the nurse understand life style, value system, health and illness behavior of diverse individuals, families, groups and communities
  2. What is person-nature orientation?: examines the ways in where person-na- ture is perceived
  3. What does destiny mean?: In which people are subjugated to nature in a fatalistic, inevitable manner
  4. What does harmony mean?: o In which people are intended to overcome natural forces and to put them to use for the benefit of humankind
  5. What does it mean to perceive time in the past?: - with traditions and ancestors playing an important role in clients life
  • Ex: Asians hold particular belief about ancestor and tend to value long standing traditions
  1. What does it mean to perceive time in the future?: - Change and

24 / 27 progress is highly valued

  • Ex: inquire about the latest treatment
  1. What does it mean to be have activity orientation?: - often directs the doing toward achievements of an externally applied standard
  • emphasis on productivity and being busy
  1. What is a collateral relationship?: - The focus is primarily on group goals, and family orientation is important
  • Ex: Asian clients describe family honor and the importance of working together toward an achievement
  1. What is an individual relationship?: - These refer to personal autonomy and independence. Individual goals dominate, and group goals become secondary
  2. What does a built environment entail?: - Building, spaces, and products that are created or modified by people: including home, schools, workplaces, park, greenway
  • Problem: -- drunk driving, secondhand smoke, noise exposure
  1. What is work-related area?: - Occupational exposure to environmental hazards that can cause illness

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  • Problems: -- agriculture accidents, radiation exposure from x-rays
  1. What is outdoor air quality?: - The protectiveness of the atmospheric layers, the risk of severe weathers, and the purity of the air for breathing purposes
  • Problems: greenhouse effect, destruction of ozone layer
  1. What is healthy homes referring to?: - The availability safety, structure strength, clines and location of shelter; including public facilities and family dwellings, this include indoor air
  • Problems: homelessness, rodent infestations, sick building syndrome
  1. What does water quality refer to?: - The availability of and accessibility to a clean water supply, the mineral content levels, pollution by toxic chemical and the presence of pathogenic microorganism
  • Problems: contamination, oil spills, pesticides
  1. What does food safety mean?: - The availability relative costs, variety, safety, and health of an animal and plant food source
  • Problems: malnutrition, bacterial food poisoning
  1. What does it mean by waste management?: - The management of