1. PVN 2014 Presented by Rebecca Maier, BSN Concorde Career College

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4. What is it? COMMUNITY HEALTH

5. THE HEALTH IN COMMUNITY HEALTH

6. Where did it come from? 2600 BC The Egyptian Imhotep describes the diagnosis and treatment of 200 diseases COMMUNITY HEALTH

7. James Lind publishes his Treatise of the Scurvy stating that citrus fruits prevent scurvy 1747

8. Edward Jenner develops the process of vaccination for smallpox 1796

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10. 1798

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12. 1816

13. 1818

14. 1850

15. THE MOTHER OF NURSING

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17. 1857

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20. 1895

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22. 1882-1883

23. The American Public Health AssociationThe American Public Health Association In 1872, the American Public Health Association was founded. APHA is now the oldest and largest organization of public health professionals in the world. 1872

24. 1878

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26. 1.Divide into your clinical groups - choose a secretary 2.Brainstorm what factors contribute to a thriving community. 3.Make a list You have 10 minutes WHAT'S YOUR TOWN'S PROGNOSIS?

27. Group secretary write your group list on the board Group discussion – What does the community NEED to be healthy and live well? GROUP SECRETARY

28. How does our community compare to your lists? WHAT'S YOUR TOWN'S PROGNOSIS?

29. HEALTHY COMMUNITY DESIGN CASE STUDIES

30. 1.Divide into your clinical groups 2.Brainstorm what public/ community health is. 3.Make a list You have 10 minutes WHAT'S COMMUNITY /PUBLIC HEALTH?

31. Group secretary write your group list on the board Group discussion – What is Public Health? WHAT IS PUBLIC HEALTH?

32. 1.Divide into your clinical groups 2.Brainstorm what a public/ community health nurse does. 3.Make a list You have 5 minutes WHAT'S COMMUNITY /PUBLIC HEALTH?

33. Group secretary write your group list on the board WHAT IS PUBLIC HEALTH?

34. PUBLIC HEALTH NURSING – WHAT IS IT?

35. WHAT IS IT?

36. What has it accomplished? COMMUNITY HEALTH

37. "Concepts of Community Health: Promotion, Protection and Prevention"; COMMUNITY HEALTH

38. ABOUT COMMUNITY HEALTH NURSING

39. "How can nurses make a difference in health in today's changing society?“ COMMUNITY HEALTH NURSING

40. Discussion

41. Quiz 1 1.It is necessary for a nursing supervisor for home health care to always be concerned with patient care and : a.Location of the home b.Quality assurance c.Method of payment d.Number of children in the home B It is necessary for a nursing supervisor for home health care to always be concerned with patient care and quality assurance

42. REF: FON Page 1179, 1191 2. A student nurse asks her instructor why there is an increase in demand for home health care. The most accurate response by the instructor would be: a. More family members want to care for their ill loved ones at home b. There is a shortage of nurse who want to work in acute hospital settings c. There is an increase in the number of older patients with chronic illnesses d. There is increased technology in hospitals, which provokes anxiety in many patients C There is an increase in the number of older patients with chronic illness

43. REF: ATI Mental Health Nursing Chapter 10 Unit 3Page 82 3. When collecting data from a client who states that she has been dealing with constant anxiety for the past 4 weeks, the nurse should use which of the following communication techniques (select all that apply) a. Ask open ended questions b. Provide reassurance c. Discuss the clients past achievements d. Offer advice about how to reduce anxiety e. Invite the client to participate in decision making A, C, E Open ended questions allow the client to tell the nurse about her anxiety. Talking about past achievements and encouraging input into the care plan helps enhance the client’s self-esteem. Providing reassurance and offering advice are examples of nontherapeutic communication that dismisses the client’s concerns.

44. REF: FONPage 1192 4. In 1997 Congress imposed new limits on home health payments through a provision of the : a.Social Security Administration b.National Institute of Health (NIH) c.Balanced Budget Act (BBA) d.Human and Health Services (HHS) 4.C Balanced Budget Act

45. 5. A mother calls the neighborhood nurse and tells her that her 3 year old child has ingested liquid furniture polish. The nurse would direct the mother to immediately: a.Induce vomiting b.Call an ambulance c.Call poison control d.Bring the child to the emergency department QUESTION 5

46. Ref: dewit 1081. 2009 NCLEX pg 151 (96) C If a poisoning occurs the poison control center should be contacted immediately. Vomiting should not be induced without instructions to do so. Some cleaners contain chemicals that will damage the airway and esophagus if not neutralized, if the patient is unconscious or the substance is a strong petroleum product or a strong corrosive, first. Bringing the child to the emergency department or calling an ambulance is not the first thing to do because this would delay treatment. The poison control center may advise the mother to bring the child to the ER, if this is the case the mother should call an ambulance.

47. 6.A home health nurse is caring for a client who was discharged recently from the hospital with MRSA. In preparing to change his colostomy bag what precautions should she observe? a.Gloves and a gown b.Gloves and goggles c.Gloves, gown, and goggles d.Gloves, gown and shoe protectors C Goggles are worn to protect the membranes of the eye during an intervention that may result in splashes of blood, other body fluids, secretions, or excretions. In addition, contact precautions require the use of gloves and a gown if direct contact with a patient is expected. Shoe protectors are not necessary.

48. 7. An appropriate nursing intervention for a client having a panic attack is to: a. Suggest relaxation techniques for the client b. Show the client how to change her behavior c. Distract the client with a television show d. Stay with the client and speak quietly 7.D Stay with the client and speak quietly. During a panic attack the client is unable to think about anything except her symptoms. The nurse should stay with her, as the client will not be distractible and cannot concentrate on learning new material. The nurse should postpone other interventions until after the attack. This can cause a backup in a nurse’s home visit schedule.

49. Over the past several years technology advances have helped increase the adoption of _______ to monitor the patients vital signs, oxygen saturation, and weight in the home. For the home health agency, a. Log books b. Telemonitoring c. Wellness checks d. IV pumps 8.B

50. 9.Which services does a home health agency usually provide? (Select all that apply) a.Skilled nursing b.Nutritional support c.Home Health Aide d.Recreational therapy 9. A, B, C

51. REF: FO NPage 1187 10.Define Medicare a.Is a federal program that requires general rules regarding staffing, patients, and visitors be followed b.Is a federal program that recommends types of treatments and facilities for patients c.Is a federal program that requires agencies to be certified that they meet the federal conditions of participation d.Is run by the state 10. C Is a federal program that requires agencies to be certified that they meet the federal conditions of participation

52. REF: FONPage 1187 11.Define Medicaid (select all that apply) a.Is a state program that pays for home care services b.Is a federal program that pays for home care services to indigent and low income people of all ages. c.Enables institutionalized children to come home d.Pays for High technology equipment 11.A, B, C, D Is a state program that pays for home care services Is a federal program that pays for home care services to indigent and low income people of all ages.. Enables institutionalized children to come home Pays for High technology equipment

53. REF: FON ; ATI Fundamentals of Nursing Page 1184; 10 12. The home health nurse will refer the patient who requires promotion of independence with the use of a self-help device to the: a.Social worker b.Physical therapist c.Home health aide d.Occupational therapist 12. B (or D) Physical therapist The book says B “ The physical therapist completes a detailed assessment of the patient and then determines treatment, education, and assistive devices needed for rehabilitation” pg. 1184 paragraph 3 But I will accept D

54. REF: FONPage 1184 13.An occupational Therapist a.Expands the disease management approach into a lifestyle management approach. b.Completes a detailed assessment of the patient and then determines the treatment, education, and assistive devices needed for rehabilitation c.Provides basic support services that sometimes enable the elderly to stay at home- personal care, physical assistance, household chores d.Provide assistance with a patient’s emotional, financial, and household problems A Expanding the disease management approach into a lifestyle management approach

55. REF: FONPage 1180, 1192 14. Over the past several years, technology advances have helped increase the adoption of _________________ to monitor the patient’s vital signs, oxygenation, and weight in the home for the home health agency. a.Minimum data set b.Assisted living c.Telemonitoring d.Radiographic examinations 14. C Telemonitoring

56. REF: FON Page 1179 15.. Who can provide home care services? a.Only state certified health care providers b.Only companies accredited by both state and federal accreditation c.Only governmentally certified organizations d.Any individual, service group, organization, or agency D Any individual, service group, organization, or agency

57. REF: FONPage 1181 16. What kinds of Home health Agencies are there? a.Involuntary, unofficial, for profit, institutional b.Institutional, Private, Collegial c.Voluntary public and private, official public and nonprofit, hospital, proprietary(for profit), and Private not for profit d.Agencies associated with a hospital, educational, or research facility C Voluntary public and private, official public and nonprofit, hospital, proprietary(for profit), and Private not for profit

58. REF: FONPage 1183 17. Home health nursing requires nurses to: (select all that apply) a.Adapt to the patient b.Adapt to the family c.Adapt to the home environment d.Accept differences in ethnic cultures e.Only A, B, and C A, B, C, and D When working in the home of a patient you will not always have the necessary supplies and you will need to improvise. Home health nursing requires nurses adapt to the patient, family and home environment. You must be respectful and accepting of differences in ethic cultures.

59. REF: FONPage 1183 18. An RN has to supervise an LPN in home health a.True b.False 18.. A True

60. REF: FONPage 1183 safety alert box 19.. An LPN is working with a patient on oxygen / mask in their home. The nurse needs to remember to:(select all that apply) a.Keep the family together as a functioning unit b.Remove the straps 2-3 x / day to wash, dry, and stimulate the skin c.Observe the tops of the ears for skin impairment from pressure points d.Adjust the level of the oxygen to whatever makes the patient comfortable regardless of what the orders read 19..B, C When administering oxygen in the home setting it is important for the LPN to check the tops of the ears for skin impairment from pressure from the straps, and if using a mask the straps should be removed 3-4 x/day and the skin washed, dried and stimulated.

61. REF: ATI PN Mental Health Nursing Chapter 10 unit 3Page 83 20. An appropriate nursing intervention for a client having a panic attack is to: a.Suggest relaxation techniques for the client b.Show the client how to change her behavior c.Distract the client with a television show d.Stay with the client and speak quietly 20. D During a panic attack, the client is unable to think about anything except her symptoms. The nurse should stay with her, as the client will not be distractible and cannot concentrate on learning new material. The nurse should postpone other interventions until after the attack.

62. I WILL WRITE IT (AND TRY TO WRITE THE FINAL) THIS WEEKEND MID TERM WILL BE TAKE HOME

63. WHAT IS IT? Long Term Care

64. Long Term Care – pg 1193 FON “The provision of physical, psychological, spiritual, and economic services to people to attain, maintain, and regain their optimal level of functioning”

65. Definition of Public Health Nursing Public health nursing is the practice of promoting and protecting the health of populations using knowledge of nursing, social and public health sciences

66. Systematic Approach 1. Assess the health and health care needs of a population in order to identify sub-populations, families and individuals who would benefit from health promotion or who are at risk of illness, injury, disability or premature death 2.Develop a plan with the community to meet the identified needs taking into account available resources

67. Systematic Approach 3. Implement the plan at the community, family or individual level 4.Evaluate the impact of the intervention 5.Use the results of the evaluation to influence and direct current delivery of care, deployment of health resources and the development of local, state and national health policy and resources to promote health and prevent disease.

68. Role of the Public Health Nurse To: Provide input to interdisciplinary programs that monitor, anticipate and respond to health problems in population groups for all diseases or public health threats including bioterrorism To: Evaluate health trends and risk factors of population groups to help determine priorities forming targeted interventions

69. http://www.youtube.com/watch?v=WKMItUO vJv0 DEFINING HEALTH

70. Oregon health care workers: When disaster strikes Public Health http://public.health.oregon.gov/Preparedness/Prepare/HealthAlertNetwork/ Documents/esarvhp/index.html PROVIDE INPUT TO INTERDISCIPLINARY PROGRAMS

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72. Provide access to health care Patients include: poor and uninsured populations from culturally and economically diverse backgrounds. JOB OF THE PUBLIC HEALTH NURSE

73. PUBLIC HEALTH NURSES INTEGRATE COMMUNITY INVOLVEMENT AND KNOWLEDGE OF THE ENTIRE POPULATION WITH THE PERSONAL CLINICAL UNDERSTANDINGS OF HEALTH AND ILLNESS GLEANED FROM THE EXPERIENCES OF INDIVIDUALS AND FAMILIES WITHIN THE POPULATION.

74. Educate patients through community- based intervention programs THE GOAL OF A PUBLIC HEALTH NURSING

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76. Promote prevention over treatment A PUBLIC HEALTH NURSE DOES:

77. Several different working environments: Patient's home Community center The Work Place WHERE DOES COMMUNITY HEALTH WORK HAPPEN?

78. Services that enable individuals of all ages to remain in their homes while receiving health care. The nurse works primarily in the area of secondary or tertiary care, providing hands-on care and educating the patient and family on care and prevention of future episodes. home health nurse. HOME HEALTH DEFINED

79. HOME HEALTH - WHAT KINDS OF HOMES MIGHT YOU GO TO? Apartments Assisted Living Private Homes – multi- generaltional Private homes – elder lives alone

80. http://www.youtube.com/watch?v=TkHrvWaC grQ

81. WHAT MIGHT YOU DO? Wellness checks, decrease social isolation Medication administration Mental health assessments

82. ROLE OF THE LPN IN COMMUNITY HEALTH Promote the community’s positive attitude toward health care. Promote better health through: education, encouraging participation in community health projects, and other health oriented activities. FON pg 1245

83. COMMUNITY CENTER NURSING http://www.youtube.com/watch?v=hnA6b7BPI_0

84. WHAT HAPPENS HERE? Respite care for families with medically fragile elders Community Education

85. OCCUPATIONAL HEALTH PPE fit testing Health screenings

86. Occupational Health

87. How it all works THE BIG PICTURE BROKEN DOWN

88. What you need to know What home, community and public health are The role of the LPN as member of the interdisciplinary team in various healthcare settings How and why community and public health work

89. General Principles of Infectious Diseases in the Community WHAT DO YOU NEED TO KNOW TO BE EFFECTIVE IN COMMUNITY HEALTH?