Community-Based Practice NUR101 FALL 2008 LECTURE# 20 K. BURGER, MSEd, MSN, RN, CNE PPP By Sharon Niggemeier RN MSN

Community-Based Nursing Focused on individual and family health needs Moving from traditional settings to community/neighborhood locations Integrated system of health care including institutions, providers, agencies, policies, payment plans, families and of course patients

Community-Based Nursing Provides health services where people spend their time Traditionally such as: home (home care nursing), work (occupational nursing), school (school nurse)

Community-Based Services Evolved to include various settings Senior centers Day care centers Storefront clinics Homeless shelters Mental health centers Drug rehab programs Ambulatory care centers Outreach centers Institution-based centers Parish nursing Hospitals

Vulnerable Populations Immigrants Poor/Homeless persons Abused clients Substance abusers Severely mentally ill persons Older adults

Common Health Problems in the Community HTN Ca Arthritis Visual Impairment Hearing Impairment Confusional states Alzheimer’s Disease Dental problems Medication use/abuse Substance abuse Nutrition issues

US Department of Health and Human Services: Public Health Services Public- anyone can receive services… funded through federal, state or local taxes, although eligibility criteria must be met Visiting Nurse Services (VNS) Veterans Administration Suffolk County Department of Health Hospitals

Private Healthcare Services Private- requirements such as private pay or insurance Doctors offices Ambulatory care centers Treatment centers

Healthcare Team Nurse Doctor Physician’s Assistant (PA) Physical Therapist (PT) Respiratory Therapist (RT) Speech Therapist (ST) Occupational Therapist (OT) Dietician Pharmacist Social Worker Unlicensed Assistive Personnel (UAP)

Types of Services Preventive Primary: health promotion Secondary: early detection and prompt interventions and health maintenance Tertiary: rehabilitate and restore to maximum functioning

Healthcare Finance Private insurance Managed care- HMO, PPO Medicare Medicaid

Healthcare Reform Is health care access a right or a privilege? Changes needed to the system to provide health care to individuals Challenges to health care reform include: greed, waste, ethical issues How can Nurses be involved?????

Summary Community-based nursing incorporates various settings and populations Continuity of care from hospital to home incorporates community based care Reform is a nursing issue, being involved politically allows for changes