pvn 2014 presented by rebecca maier, bsn concorde career college

PVN 2014

Presented by Rebecca Maier, BSN

Concorde Career College

COMMUNITY HEALTH NURSING

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What is it?

COMMUNITY HEALTH

THE HEALTH IN COMMUNITY HEALTH

Where did it come from?

2600 BC The Egyptian Imhotep describes the diagnosis and

treatment of 200 diseases

COMMUNITY HEALTH

James Lind publishes his Treatise of the Scurvy stating that citrus fruits

prevent scurvy

1747

Edward Jenner develops the process of vaccination for

smallpox

1796

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THE MOTHER OF NURSING

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1882-1883

The 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

http://apha.org/

http://apha.org/

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1. Divide into your clinical groups - choose a secretary

2. Brainstorm what factors contribute to a thriving community.

3. Make a listYou have 10 minutes

WHAT'S YOUR TOWN'S PROGNOSIS?

Group secretary write your group list on the board

Group discussion – What does the community NEED to be healthy and live well?

GROUP SECRETARY

How does our community compare to your lists?

WHAT'S YOUR TOWN'S PROGNOSIS?

HEALTHY COMMUNITY DESIGN CASE STUDIES

http://www.youtube.com/watch?v=DOUYPl6Phrw

http://www.youtube.com/watch?v=DOUYPl6Phrw

1. Divide into your clinical groups

2. Brainstorm what public/ community health is.


WHAT'S COMMUNITY /PUBLIC HEALTH?


Group discussion – What is Public Health?

WHAT IS PUBLIC HEALTH?

1. Divide into your clinical groups

2. Brainstorm what a public/ community health nurse does.


WHAT'S COMMUNITY /PUBLIC HEALTH?


WHAT IS PUBLIC HEALTH?

PUBLIC HEALTH NURSING – WHAT IS IT?

WHAT IS IT?

What has it accomplished?COMMUNITY HEALTH

"Concepts of Community Health:

Promotion, Protection and Prevention";

COMMUNITY HEALTH

ABOUT COMMUNITY HEALTH NURSING

"How can nurses make a difference in

health in today's changing society?“

COMMUNITY HEALTH NURSING

Discussion

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 homeb. Quality assurancec. Method of paymentd. Number of children in the home

BIt is necessary for a nursing supervisor for home health care to always be concerned with patient care and quality assurance

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

CThere is an increase in the number of older patients with chronic illness

REF: ATI Mental Health Nursing Chapter 10 Unit 3 Page 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 questionsb. Provide reassurancec. Discuss the clients past

achievementsd. Offer advice about how to

reduce anxietye. 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.

REF: FON Page 1192

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

4. C Balanced Budget Act

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 vomitingb. Call an ambulancec. Call poison controld. Bring the child to the emergency department

QUESTION 5

Ref: dewit 1081. 2009 NCLEX pg 151 (96)

CIf 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.

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 gownb. Gloves and gogglesc. Gloves, gown, and gogglesd. Gloves, gown and shoe protectors

CGoggles 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.

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. DStay 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.

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 booksb. Telemonitoringc. Wellness checksd. IV pumps

8. B

9. Which services does a home health agency usually provide? (Select all that apply)a. Skilled nursing b. Nutritional supportc. Home Health Aided. Recreational therapy

9. A, B, C

REF: FO N Page 1187

10. Define Medicarea. Is a federal program that requires general rules regarding staffing, patients, and visitors be followedb. Is a federal program that recommends types of treatments and facilities for patientsc. Is a federal program that requires agencies to be certified that they meet the federal conditions of participationd. 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

REF: FON Page 1187

11. Define Medicaid (select all that apply)a. Is a state program that pays for home care servicesb. 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 homed. 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 homePays for High technology equipment

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

REF: FON Page 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 rehabilitationc. Provides basic support services that sometimes enable the elderly to stay at home- personal care, physical assistance, household choresd. Provide assistance with a patient’s emotional, financial, and household problems

A

Expanding the disease management approach into a lifestyle management approach

REF: FON Page 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 setb. Assisted livingc. Telemonitoringd. Radiographic examinations

14.C

Telemonitoring

REF: FON Page 1179

15. . Who can provide home care services?a. Only state certified health care providersb. Only companies accredited by both state and federal accreditationc. Only governmentally certified organizationsd. Any individual, service group, organization, or agency

DAny individual, service group, organization, or agency

REF: FON Page 1181

16. What kinds of Home health Agencies are there?a. Involuntary, unofficial, for profit, institutionalb. Institutional, Private, Collegialc. 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

CVoluntary public and private, official public and nonprofit, hospital, proprietary(for profit), and Private not for profit

REF: FON Page 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

environmentd. Accept differences in ethnic culturese. 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.

REF: FON Page 1183

18. An RN has to supervise an LPN in home health

a. Trueb. False

18. . A True

REF: FON Page 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 unitb. Remove the straps 2-3 x / day to wash, dry, and stimulate the skinc. Observe the tops of the ears for skin impairment from pressure pointsd. 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.

REF: ATI PN Mental Health Nursing Chapter 10 unit 3 Page 83

20. An appropriate nursing intervention for a client having a panic attack is to:a. Suggest relaxation techniques for the clientb. Show the client how to change her behavior c. Distract the client with a television showd. Stay with the client and speak quietly

20. DDuring 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.

I WILL WRITE IT (AND TRY TO WRITE THE FINAL)

THIS WEEKEND

MID TERM WILL BE TAKE HOME

WHAT IS IT?

Long Term Care

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”

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

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

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.

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

http://www.youtube.com/watch?v=WKMItUOvJv0

DEFINING HEALTH



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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• Provide access to health care • Patients include: • poor and

• uninsured populations

• from culturally and economically diverse backgrounds.

JOB OF THE PUBLIC HEALTH NURSE

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.

Educate patients through community-based intervention

programs

THE GOAL OF A PUBLIC HEALTH NURSING

http://www.youtube.com/watch?v=Lg3g76QFlzg

COMMUNITY NURSING




Promote prevention over treatment

A PUBLIC HEALTH NURSE DOES:

Several different working environments:

• Patient's home• Community center• The Work Place

WHERE DOES COMMUNITY HEALTH WORK HAPPEN?

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

HOME HEALTH - WHAT KINDS OF HOMES MIGHT

YOU GO TO?

Apartments

Assisted Living

Private Homes – multi-generaltional

Private homes – elder lives alone

http://www.youtube.com/watch?v=TkHrvWaCgrQ

HOME HEALTH CARE



WHAT MIGHT YOU DO?

Wellness checks, decrease social isolation

Medication administration

Mental health assessments

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

COMMUNITY CENTER NURSING

http://www.youtube.com/watch?v=hnA6b7BPI_0



WHAT HAPPENS HERE?

Respite care for families with medically fragile elders

Community Education

OCCUPATIONAL HEALTH

PPE fit testing

Health screenings

Occupational Health

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How it all works

THE BIG PICTURE BROKEN DOWN

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

General Principles of Infectious Diseases in the Community

WHAT DO YOU NEED TO KNOW TO BE EFFECTIVE IN COMMUNITY HEALTH?

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