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Community Based Nursing


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Community Based Nursing
The acute and chronic nursing care of individuals and families that enhances their capacity for self care and promotes autonomy in decision making
Focus of community based nursing
the individual with an acute or chronic illness
community health nursing aka
public health nursing
public health
the art of the science and art of preventing disease, prolonging life and promoting health and efficienty through organinzed community efforts
groups within a community that have similar characteristics or problems
Ambulatory care
health care provided on an outpatient basis- Dr's office, private clinic, Gov. run public health clinic,
palliative care
care designed to provide effective
preventative care
designed to prevent or minimize disease or injury.
Jointly sponsored state and federal program that pays for health care services for the aged, poor, disabled, and families with dependent children
Federally funded health insurance program for individuals who are 65 yo and older, the disabled and those with ESRD. Administered by HCFA
skilled interventions
interventions that require the administration or supervision of a licensed health care professional
role of case manager
planning, organizing, delegating, evaluating and coordinating care
ensure's the client health care rights and supports self-determination in health care decisions
change agent
facilitates change in client or agency behavior to more readily achieve care goals
critical thinking
the disciplined intellectual process of actively and skillfully conceptualizing, applying and analyzing, synthesizing and evaluating information
nuclear dyad
two adults (married or unmarried, same or opposite sex)
nuclear family
two adults (married/unmarried, same/opposite sex) with children (biologic, step, adopted, foster)
competencies in community based nursing
critical thinking, communication and collaboration
Richard Paul on critical thinking
"the art of thinking about your thinking while you are thinking to make your thinking better"
Assessment of client's learning needs
developmental level: knowlede base, abilities, and motivation; family structure and dynamics; and relevant cultural and economic factors
Three dimensions of the case manager
Clinical, managerial and financial
health maintenance
behaviors directed toward keeping a current state of health
health promotion
positive health-related actions aimed at enhancing health and wellness
health protection
regulatory and environmental measures used to protect specified populations from illness and injury
primary prevention
health promotion and protection against specific health problems
risk profile
a profile of various factors known to cause or be assoc. with a particular disease
secondary prevention
early identification of health problems and prompt intervention to alleviate health problems
tertiary prevention
restoration and rehabilitation to an optimal level of functioning
a dynamic process used to attain, maintain and enhance health
health according to WHO
Health is a state of complete physical, mental and social well-being, not merely the absence of disease and infirmity
illness prevention/health maintenance
behaviors focused on reducing or eliminating the threat of disease and its complications
health promotion according to WHO
The process of enabling people to increase control over and improve their health
Three levels of healh care prevention
primary, secondary and tertiary
failure to adhere to one's legal duty.
common law
law that is developed through actual court cases
any information written/spoken that is untrue
ethical principles
abstract concepts, grounded in a moral foundation, which serve as guidelines for practice
Ethical principles in CBN
responsibilities include caring, confidentiality, accountability, advocacy and honesty
standard of care
written statement describing the rules, actions or condtions that direct client care.
Deviation from standard of care
failure to identify appropriate diagnoses that guide health promotion, reduce illness and promote rehabilitation of the client would be a deviation from the standard of care
Under the Safe Medical Devices Act of 1990
requires that such information be reported to the Food and drug administration with in 10 days of occurrence. Failure to comply with the Act's reporting requirements can resul tin civil fines starting at $15,000.00
Client Self Determination Act of 1991
Requires community health care agencies to provide info. & education & advance directives to clients and the community. Requirement extends to documentation of whether or not the client has an advance directive and requires the nurse to comply with the client's advance directive to the extent req. by state law
study of population characteristics
demographic characteristics
age, gender, race/ethnicity socioeconomic status, and education.
science of population health applied to the detection of morbidity and mortality in population
Two types of morbidity rates
incidence and prevalence
measures existing events in a population during a period
Primary preventions
focus on health promotion and prevention of disease or injury
a secondary prevention activity
Alma Alta declaration
emphasized health or well-being as a fundamental right and a worldwide social goal. Attempted to address inequality in health status of persons in all countries and to target government responsibility for policies that would promote economic, social and health development.
primary health care
Primary care
provision of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health services, developing a sustained partnership with patients, and practicing in the context of family and community
Focus of Primary Care
Address personal health services and not population-based public health issues
competencies for collaboration
effective communication skills, mutual respect, trust and a decision-making process
ontinuity of care
coordination of health care servicies by health care providers for clients moving from one health care setting to another & between & among health care professionals
discharge planning
the process of preparing a client to leave one level of care for another within or outside the current health care agency.
health promotion approach
categorized as an approach behavior
primary prevention approach
considered an avoidance behavior
precontemplation stage-change
person does not think about changing behavior- nor is interested in info about behavior
contemplative stage-change
person seriously considers changing a specific behavior- actively gathers info
preparation stage-change
person undertakes cognitive and behavioral activites that prepare the person for change
action stage-change
person actively implements behavioral and cognitive strategies to interrupt previous behavior patterns and adopt new ones
maintenance stage-change
person integrates newly adopted behavior patterns into his or her lifestyle
step test
individual steps up and down an a 17-inch step for 3 minutes at a prescribed rate 22-24 steps per minute. /p the test the client sits in a chair while the nurse measures the apical or carotid pulse rate from 5-20 seconds into recovery
health risk appraisal
asssessment and educational tool that indicates a client's risk for disease or injury over the next 10 years
risk factor
a phenomeno eg age or lifestyle behavior that increases a person's chance of acquiring a specific disease such as cancer
Locus of control
is a measureable concept that can be used to predict which people are most likely to change their behavior.
ANA's definition of nursing
the diagnosis and treatment of human responses to health and illness
primary concept of community -based nursing care
self-care and preventive care within the context of culture and community
eligibility for homecare service
acutely ill, homebound and in need of skilled nursing services
1. changeable: liable to change
2. undergoing frequent change: readily or frequently undergoing chemical or physical change
leading problems of elementary school children
injuries, infections (including influenza and pheumonia), malnutrition, dental disease and cancer
Leading health problems of high school children
alcohol and drug abuse, injuries, homicide, pregnancy, sexually transmitted disease, sports injuries, dental disease and mental and emotional problems

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