Community Nursing – Questions

Review the attached PowerPoint presentations. Once done please answer the following questions:

1. Define epidemiology and discuss how the epidemiology triad can be applied to health issues we see in the hospital?

2. Epidemiology is not just useful for community health nurses; it is useful for all healthcare professionals. Brainstorm some ways in which epidemiology could be used in an acute care setting. What types of problems arise in acute care that might need to be measured? How could nurses use epidemiology to assess those problems and attempt to intervene? How can this data be further used in a community setting in terms of follow-up or continuation of intervention?

3. What are some of the causes of increases in healthcare costs in recent years, as outlined in the chapter? Brainstorm some examples that you have witnessed in the clinical setting. Can any of these factors be modified? What could nurses do to help cut down on costs related to the different factors?

4. Why is it important for nurses to know about global health issues or concerns if they are not planning to work in other countries? How can this information be used in the workplace here in the US?

– Present your assignment in an APA format, word document, Arial 12 font.

– A minimum of 2 evidence-based references (besides the class textbook) are required.

– A minimum of 500 words (excluding the first and references page) are required.
Chapter 7 Global Health

Global Health

Population expansion

Aging population in some areas

Decrease in life expectancy in others (HIV)

High birth rates and poverty

Role of International Agencies

United Nations

Nongovernmental organizations (NGOs)

Carter Center

Bill & Melinda Gates Foundation

United Nations Children’s Fund

World Health Organization

World Bank

Global Health Issues

Disease burden

Infectious diseases

New pathogens

Human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS)

Tuberculosis (TB)

Lower respiratory infections

Chronic diseases

Obesity

Cardiovascular diseases

Cancers

Diabetes

Chronic respiratory diseases

Violence and War

Levels of violence

Armed conflict and war

Poverty

Women’s rights

Global Initiatives

Declaration of Alma Ata

Millennium developmental goals

Nursing shortages

International Council of Nurses

Nursing and human rights
Chapter 4
Epidemiology of
Health and Illness
Epidemiology

The study of the distribution and the determinants of states of health and illness in human populations
Epidemiological model or triangle
Host
Agent
Environment
Scope of Epidemiology

Demographic changes
Patterns of disease
Methods of control and prevention of health problems
Wellness focus
The Basis for the
Epidemiological Process

Identifying health problems and needs

Collecting and analyzing data to identify risk factors

Planning, implementing, and evaluating methods for prevention and control

The Epidemiological, Research, and Nursing Processes

Similarities include:
Defining the problem
Gathering data
Analyzing the data
Evaluating the data
Natural History of Disease

Prepathogenesis period
Pathogenesis period
Levels of prevention
Primary prevention
Secondary prevention
Tertiary prevention
Descriptive Epidemiology

Focuses on the frequency and distribution of states of health within a population:
– Person

– Place

– Time

Use of Rates

Incidence rates
Mortality
Prevalence rates
Morbidity
Crude rates
Specific rates
Adjusted rates
Sources of Data

Census data
Vital statistics
Centers for Disease Control and Prevention (CDC)
Morbidity and Mortality Weekly Report (MMWR)
National Center for Health Statistics
Person, Place, and Time

Who develops the health problem
Where the rates of the health problem are the highest and lowest can be determined by examining the characteristics of place
When health problems occur
Short-term
Seasonal or cyclical
Long-term
Analytic Epidemiology

Cross-sectional studies
Retrospective (case-control) studies
Prospective studies
Intervention (experimental) studies
Chapter 5 Transforming the Public’s Healthcare Systems

Evolving U.S. Healthcare Delivery System

Healthcare delivery system

Transforms resources into essential services to meet the healthcare needs of certain populations

Settings

Hospitals

Physicians’ offices

Shelters

Specially equipped vans or shopping malls

Evolving U.S. Healthcare Delivery System (cont.)

Reimbursement

Private insurance companies

Managed care organizations

Government agencies

Foundations

Patient

Affordable Care Act (ACA) of 2010

Types of healthcare systems

Private

Public

Military

Private Healthcare Delivery

Fee-for-service

Hill-Burton Act

Tax Equity and Fiscal Responsibility Act of 1982

1983 Amendments to the Social Security Act

Diagnosis-related groups (DRGs)

Prospective payment system (PPS)

Third-party payers

Insurance companies

Health maintenance organizations (HMOs)

Preferred provider organizations (PPOs)

Managed care organizations (MCOs)

Public Health Care

Defined as the health outcomes of a group of individuals

Shattuck

1850 Report of the Sanitary Commission of Massachusetts

1872 Public Health Association formed

Social Security Act of 1935

Local health departments

Centers for Disease Control and Prevention (CDC)

Military Health Care

National Defense Authorization Act (2005)

Care provided:

Ambulatory care

Military base and regional clinics

Hospital service

Base dispensaries or sick bays

Simple hospitals services

Regional hospitals

Advanced care

Types of programs

TriCare

Veterans Administration

Healthcare Reform

Legislative initiatives were proposed seven times during the 20th century

Based on the need to control healthcare costs while providing access to quality healthcare services

Nursing and healthcare reform

ACA

Current U.S. Healthcare Delivery System

Interrelated systems

Horizontal and vertical integration of services

Levels of care

Preventive care

Primary care

Secondary care

Tertiary care

Restorative care

Healthcare Providers

Physicians

Nurses

Physician assistants

Specialized care providers

Technicians/therapists

Other providers

Pharmacists

Social workers

Healthcare Settings

Acute care facilities

Short-term specialized care facilities

Long-term care facilities

Ambulatory care sites

Daycare centers

Hospices

Retirement communities

Complementary/alternative health care

Issues Affecting the Delivery of Healthcare Services

Deregulation

Emphasis on secondary and tertiary healthcare services

Increasing consumerism

Technological advances

Increasing longevity of Americans

Defensive health care and government regulation

Managed Care

MCOs

Capitation

HMOs

PPOs

Point-of-service plans (POSs)

Integrated healthcare systems

Patient Care Outcomes

Defined as the consequences of care that the patient receives or does not receive

Outcome studies

Look for trends over time in patient status and adverse events

Data obtained used as a basis for decisions

Development of policies and procedures

Community-Based Healthcare Settings

Shelters in the community

Role of nurse

Abuse shelters

Homeless shelters

Disaster shelters

Ambulatory care centers

Ambulatory emergency/trauma

Primary care centers

Ambulatory surgery centers

Health Politics and Policy

Government policy

Healthy People

Healthy People 2020

ACA

Public opinion and special interest groups

Nursing and healthcare policy

American Nurses Association (ANA)

New Nursing Opportunities

Advanced practice registered nurses (APRNs)

Entrepreneurs

Data management and evaluation

Research

Community focused and community based

Prevention and risk reduction focus for all BSN nurses