1. The Health Care Delivery System

2. Health Care Delivery System? Mechanism for providing services that meet the health-related needs of individuals. Nursing is a major component of the U.S. health care delivery system.

4. Types of Health Care Services Primary: Health promotion and illness prevention Secondary: Diagnosis and treatment Tertiary: Rehabilitation

6. Three Levels of Prevention

9. Adults age 65 and over who ever received pneumococcal vaccination, 1999-2006 Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey, 1999-2006.

12. Rehabilitation

14. Health Care Settings Public Sector Federal Level U.S. Department of Health and Human Services (DHHS) State Level Department of Health

17. Health Care Settings Public Sector Local Level Health Units Communicable disease control Health records maintenance Individual health services Environmental health and safety Public health education

18. Public Health Sector of Health Care Delivery Communicable Disease Control Health Records Maintenance (Vital Statistics) Individual Health Services (e.g. Maternal-Child Health Programs) Environmental Health and Safety Public Health Education Federal Level U.S. Department of Health and Human Services (DHHS) State Level Department of Health Local Level Health Units

19. Health Care Settings Private Sector Hospitals Extended care facilities Home health agencies Hospices Outpatient settings

21. Hospices

22. Health Care Settings Private Sector Schools Industrial clinics Managed care organizations Community nursing centers Rural primary care hospitals

23. Health Care Team Nurse (RN) Physician (MD) Physician Assistant (PA) Pharmacist (RPh) Dentist (DDS) Dietitian (RD) Social Worker (SW)

25. Health Care Team Respiratory Therapist (RT) Physical therapist (PT) Occupational Therapist (OT) Chaplain Unlicensed Assistive Personnel (UAP) Dental Hygienist

26. Roles of the Nurse Caregiver Teacher Advocate Manager Expert Case Manager Team Member

28. Challenges Within the Health Care System Nursing shortage Loss of control over health care decisions Decreased use of hospitals Changing practice settings Ethical issues Vulnerable populations

29. Home Health Nursing The percentage of home health nurses is increasing in numbers, as health care reform places more nurses (as this home health nurse) outside the acute care setting.

30. Challenges Within the Health Care System Vulnerable Populations Children The elderly People with AIDS The homeless Others living in poverty

33. Nursing’s Response to Health Care Challenges Standards of care Advanced practice Public versus private programs Public health Community health School nursing Long-term care