1. Nursing Leadership & Management
Patricia Kelly-Heidenthal
Delmar Learning
Copyright © 2003 Delmar Learning, a Thomson Learning company

2. Population-Based Health Care Practice
Chapter 5:
Population-Based Health Care
Practice
Delmar Learning
Copyright © 2003 Delmar Learning, a Thomson Learning company

3. Copyright © 2003 Delmar Learning, a Thomson Learning company
Objectives
Upon completion of this chapter, the reader should be able to: 
Discuss the social mandate to provide population-based health care at the global, national, state, and local levels. 
Describe how population-based nursing is practiced within the community and the health care system.
Identify vulnerable and high-risk population groups for whom specific health promotion and disease prevention services are indicated.
Outline a multidisciplinary population-based planning and evaluation process that includes partnerships with the community and health care consumers.
Chapter 1
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4. Population-based Health Care Practice
Population-based health care practice is the development, provision, and evaluation of multidisciplinary health care services to population groups experiencing increased health care risks or disparities.
It involves partnership with health care consumers and the community in order to improve the health of the community and its population groups.
Chapter 1
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5. Population-based Health Care Practice
Vulnerable population groups are subgroups of a community that are powerless, marginalized, or disenfranchised and are experiencing health disparities.
Chapter 1
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6. Population-based Health Care Practice
Health risk factors are variables that increase or decrease the probability of illness or death.
Health determinants are variables that include biological, psychosocial, environmental (physical and social), and health systems factors or etiologies that may cause changes in the health status of individuals, families, groups, populations, and communities.
Chapter 1
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7. Population-based Health Care Practice
Health status is the level of health of an individual, family, group, population, or community.
Quality of life is the level of satisfaction one has with the actual conditions of one’s life.
Health-related quality of life refers to one’s level of satisfaction with those aspects of life that are influenced by one’s health status and health risk factors.
Chapter 1
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8. Population-based Health Care Practice
Functional health status is the ability to care for oneself and meet one’s human needs.
Activities of daily life are activities related to toileting, bathing, grooming, dressing, feeding, mobility, and verbal and written personal communication. 
Chapter 1
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9. Population-based Health Care Practice
Instrumental activities of daily living (IADLs) are activities related to food preparation and shopping; cleaning; laundry; home maintenance; verbal, written, and electronic community communication; financial management; and transportation, as well as activities to meet social and support needs, manage health care needs, access community services and resources, and meet spiritual needs.
Chapter 1
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10. Population-based Health Care Initiatives
Health for All by the Year 2000 (World Health Organization)
Cairo Action Plan for Women’s Health (United Nations)
Healthy People 2010 (United States)
Tobacco Education and Prevention Program (Arizona)
Community-oriented Primary Care Model (Arkansas)
New Hampshire Coalition Against Domestic and Sexual Violence (New Hampshire)
Roll Up Your Sleeves (New Mexico)
Tenncare (Tennessee)
Chapter 1
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11. Population-focused Nursing Practice
Assess health of community as a whole
Develop nursing diagnosis
Identify populations needing health care services
Identify types of services needed
Chapter 1
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12. Population-based Nursing Practice
Emphasis on improving health status of vulnerable or at-risk populations within a community
Emphasis on health promotion and disease prevention interventions
Chapter 1
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13. Population-based Nursing Practice Model
Population-based interventions encompass three levels: 
Community
Systems within the community
Individuals, families, and groups
Chapter 1
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14. Nontraditional Model of Population-based Nursing Practice
Vulnerable or at-risk populations are identified before community assessment.
Subsequent community assessment focuses on health determinants related to the at-risk groups.
Traditional model assesses overall community needs first, and at-risk population needs second.
Chapter 1
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15. Nursing Process Applied to Population-based Nursing Practice
Assessment
Diagnosis
Planning and implementation
Evaluation
Chapter 1
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16. Copyright © 2003 Delmar Learning, a Thomson Learning company
Assessment
Community level
Physical environment
Social environment
Policies and interventions
Health systems level
Access to quality health care
Behavioral
Data analysis
Chapter 1
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17. Copyright © 2003 Delmar Learning, a Thomson Learning company
Diagnosis
Identify North American Nursing Diagnosis Association (NANDA) category.
Identify etiology and list key evidence supporting diagnostic category.
Chapter 1
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18. Planning and Implementation
Select and employ population-based nursing intervention model. 
Examples of population-based nursing intervention models:
Minnesota Model
Virginia Model
Chapter 1
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Evaluation
Collect data.
Develop statistics.
Share results with multidisciplinary teams, health consumers, and community partnerships.
Identify unmet needs and further interventions.
Chapter 1
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20. Copyright © 2003 Delmar Learning, a Thomson Learning company
Program Evaluation
Integral part of population-based health care evaluation process
Provides justification of resources and budget
Factors to evaluate:
Access
Quality
Cost
Equity
Chapter 1
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