Introduction to the health care industry and health care services Nadeeka Jayasinghe (Week 2)

What is health?

Definition of Health “A state of complete physical, mental and social wellbeing” (WHO, 1947)

Health concepts cont. Health is a state of being that people define in relation to their own values, personality and lifestyle. Each person has a concept of health. “Actualization of inherent and acquired human potential through goal-directed behaviour,competent self care, and satisfying relationships with others, while adjustment are made as needed to maintain structural integrity and harmony with the environment” – (Pender, Murdaugh and Parsons, 2002)

“All people free of disease are not equally health” –(Pender, Murdaugh and Parsons, 2002). Heath and illness must be defined in terms of the individual. Nurses’ attitude towards health and illness must be defined in terms of the total person, as well as the environment in which the person lives, to individualize nursing care and enhance meaningfulness of the client’s future health status.

LEVELS OF CARE PREVENTATIVE CARE: Education, Prevention PRIMARY CARE: Early detection and Routine care SECONDARY CARE (acute care): Emergency treatment, Critical Care (intense and elaborate diagnosis and treatment)

LEVELS OF CARE CONT… TERTIARY CARE (special care): Special care (highly technical services for clients in a large geographical area) RESTORATIVE CARE: Intermediate follow up care (surgical post-operative routine care, routine medical care), rehabilitation, homecare CONTINUING CARE: Long term care, chronic care, personal care, hospice care

LEVELS OF CARE CONT.. Each level of creates different requirements and opportunities for the nurse. A lot of importance is now placed on primary care and preventative care. High resource allocation for: immunization programs, school health, breast screening etc. WHY?

ACTIVITY: 5 GROUPS LIST EXAMPLES FOR : Health Promotion (Preventative Care) Illness Prevention (Primary Care) Secondary & Tertiary Care Restorative Care Continuing Care

ISSUES IN HEALTH CARE DELIVERY What are the main issues that nurses struggle with whilst attempting to deliver quality health care?? Cost Acquiring knowledge and skills (Competency) Designing new approaches for client centered delivery (evidence based)

COMPETENCY Policies, procedures and protocols are designed by hospitals to keep up with accrediting standards. Ensures quality care. Nurses must obtain necessary education and certification when choosing to practice in certain areas. Keep up with current literature, research etc to strengthen practice

EVIDENCE BASED PRACTICE Client Centered Scientifically based Population outcome based Re fined through quality improvement and benchmarking Individualized to each client Compatible with system policies and resources

SECONDARY AND TERTIARY CARE HOSPITALS Emergency departments, critical care units, inpatient medical and surgical units Nurses work very closely with all members of the health care team Constantly monitors, evaluates care and considers how it can be improved Must respond to client needs and expectations to form effective care partnerships Customer service centered

Community-Based Health Care What is community-based nursing? “Involves the acute and chronic care of individuals and families that enhances their capacity for self care and promotes autonomy in decision making” -(Ayers, Bruno and Langford 1999)

Community Health Nursing A community health nurse considers the needs of the population and is prepared to provide direct care services to sub-populations within a community. (sub-population examples: stroke patients, patients requiring immunizations etc)

Community Health Nurse cont. Case Manager Collaborator Educator Counselor Client Advocate Change Agent Briefly describe how a community health nurse must fulfill the above roles.

ACTIVITY Discuss the major health problems listed below in older adults and describe the community health nursing roles and interventions that you would provide. Hypertension Cancer Dental problems Drug and alcohol abuse

HEALTH CARE PERSONEL Dietician Physiotherapist Speech therapist Social Worker Case Manager