CHN MIDTERMS

• Determinants of Health

  • Education Access and quality
  • Health care and quality
  • Neighborhood and built environment
  • Social and community context
  • Economic stability
• Community Health Nursing

  Global or umbrella term, broader and more general specialty area that encompasses subspecialties that include public health nursing, school nursing, occupational health nursing and other developing fields of practice home health, hospice care and independent nursing practice
• Definition Highlights of Community Health Nursing

  • Goal of professional practice is the promotion and preservation of the health populations
  • The nature of practice is comprehensive, general, continual and not episodic
  • Knowledge base comes from nursing and public health
  • The different levels of clientele - individual, families and groups
  • The practitioner's recognition of the primacy of the population as a whole
• Public Health

  Organized, legislated and tax-supported efforts that serve all people through health departments or related government agencies
• Community Health Nursing Concepts applied from the Science of Public Health

  • Emphasis on the "greatest good for the greatest number"
  • Assessing health needs, planning, implementing and evaluating the impact of health services on population groups (ADPIE)
  • Priority of health-promotive and disease-preventive strategies over curative interventions
  • Tools for measuring and analyzing community health problems
  • Application of principles of management and organization in the delivery of health services in the community
• Actual Duties and Responsibilities of Public Health Nurses (PHNs)

  • Management Function
  • Research Function
  • Training Function
  • Health Education and Education Function
  • Collaborating and Coordinating Function
  • Nursing Care Function
  • Supervisory Function
• Functions of Company Nurses / Occupational Health Nurses (OHNs)

  • Curative/palliative
  • Preventive
  • Educative
  • Administrative
• Major areas of concern for Company Nurses / Occupational Health Nurses (OHNs)

  • Emergency and palliative care
  • Family planning
  • Counseling
  • Immunization
  • Environmental sanitation
  • Work safety
  • Disaster prevention and control
  • Orientation of new employees
  • Health education
• Activities of School Nurses

  • Health promotion
  • Disease prevention
  • Early detection of disease
  • Emergency care
  • Referral to higher level health facilities
  • Health assessment
  • Screening
  • Case-finding
  • Health education
  • Nursing procedures
  • Manage the school clinic (for in-house school nurses)
• Primary Health Care


  The essential care made universally accessible to individuals and families in the community through their full preparation
• Key Elements of Primary Health Care

  • Reducing exclusion and social disparities in health (universal coverage)
  • Organizing health services around people's needs and expectations (health service reforms)
  • Integrating health into all sectors (public policy reforms)
  • Pursuing collaborative models of policy dialogue (leadership reforms)
  • Increasing stakeholder participation
• 8 Essential Health Services

  • Education for health
  • Locally endemic disease control
  • Expanded program for immunization
  • Maternal and child health including responsible parenthood
  • Essential drugs
  • Nutrition
  • Treatment of communicable and noncommunicable diseases
  • Safe water and sanitation
• 4 Principles of Primary Health Care

  • Equity/ Equitable Distribution
  • Community Participation
  • Intersectoral Coordination
  • Appropriate Technology
• 4 A's in Primary Health Care

  • Accessibility
  • Affordability
  • Acceptability
  • Availability
• Universal Health Care is a key component of the Philippine Healthcare Delivery / Referral System
• Demography


  The science which deals with the study of human population's size, composition, and distribution in space
• Vital statistics

  Other term "health indicators", "vital statistical indicators", quantitative measures usually expressed as rates, ratio, or proportions that describe and summarize various aspects of the health status of the population
• Tools needed in identifying community health needs

  • Demography
  • Vital statistics
  • Epidemiology
• Statistical measures in public health / epidemiology

  • To describe risk
  • To make comparisons among communities and smaller subgroups
  • To identify high-risk groups
  • To develop hypotheses about the causes of disease

  
• Differences in risk among different populations can provide clues for investigation of what caused one group to have a higher risk. If causes can be identified, then prevention and control measures can also be identified
• Types of frequency measures

  • Counts
  • Ratios
  • Proportions
  • Rates
• Ratios


  Obtained from dividing one number by another, indicates how many times larger one quantity is compared to the other, the numerator is usually not part of the denominator
• Ratios

  • Fetal death ratio: fetal deaths / live births
  • Sex ratio: male/female
  • Annual Report 2011 Government Worker: Doctors 37,596, Dentists 50,101, Public Health Nurses 18,095, Midwives 5,470
• Proportions

  A type of ratio that relates a part to a whole, the numerator (x) is part of the denominator (y), often expressed as a percentage (%)
• Rates


  Measure the occurrence of an event in a population over time, always specific to a particular population, reflect groupings of people based on time, place and person
• Incidence


  Refers to the occurrence of new cases of disease or injury in a population over a specified period of time
• Prevalence


  The proportion of persons in a population who have a particular disease or attribute at a specified point in time or over a specified period of time, includes all cases, both new and pre-existing, in the population at the specified time
• Incidence differs from prevalence in that prevalence includes all cases, both new and pre-existing, in the population at the specified time, whereas incidence is limited to new cases only

  
• Crude death rate (CDR)

  The mortality rate from all causes of death for a population, factors affecting CDR include age, sex composition of the population, the adverse environmental and occupational conditions
• Nurses should participate in investigative efforts to determine what is precipitating the increase or decrease in rates and work to remedy the identified threats or risks
• Types of health indicators and examples


  • Health status indicator (morbidity): Prevalence, Incidence
  • Health status indicator (mortality): Crude and specific death rates, maternal mortality, infant mortality, neonatal mortality, postnatal mortality, child mortality
  • Population indicators: Age-sex structure of the population, population density, migration, population growth (crude birth rate, fertility rate)
  • Indicators for the provision of health care: Access to health programs and facilities, availability of health resources (facilities, health manpower, finances)
  • Risk reduction indicators: Causes consulting health provider, infants exclusively breast-fed for the first 6 months
  • Social and economic indicators: Quantity of suspended particulate matter, hydrocarbons, oxidants, Portability of drinking water
  • Disability indicators: Disability adjusted life years (DALYs), indicators of restricted activity, indicators of long-term disability
• e vs Prevalence

  Figure represents 10 new cases of illness over about 15 months in a population of 20 persons
• Each horizontal line represents one person
• Down arrow


  Indicates the date of onset of illness

  
• Solid line


  Represents the duration of illness
• Up arrow


  Represents the date of recovery
• Cross


  Represents the date of death
• Calculating point prevalence on April 1, 2005

  1. Numerator: 7 (On April 1, seven persons - 1, 4, 5, 7, 9, and 10, were ill)

  2. Denominator: 18 (2 deaths occurred before April 1)

  3. Factor = 100
• Mortality indicators

  A measure of the frequency of occurrence of death in a defined population during a specified interval
• Crude death rate (CDR)

  The mortality rate from all causes of death for a population