power point for lp11 12 spring 2012

7/29/2019 Power Point for LP11 12 Spring 2012

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Assessing the Community and

its Relationships Among

Individuals, Groups, and Health

Competency 11Nichole L. Hinkel, RN MSN

Overview of the Health Care Delivery

System

Structure of the Health Care Delivery

System

Public Sector

Divided into federal, state, and local levels

Typically concerned with the health of the

population and maintaining a healthy

environment

Private Sector

May be profit or nonprofit

Voluntary agencies

i.e. _______________________


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Health Care Provider Organizations

Ambulatory Health Care

Hospitals

Long-term Care Facilities

Health Care Financing

The high cost of healthcare

Public financing

Medicare

Medicaid

Health Care Financing

Private financing

Traditional health insurance

Health maintenance organizations

Preferred provider organizations

Caring for the uninsured


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Epidemiology

Models of Disease Causation

The epidemiological triangle

illustrates the interrelationships among the

three essential components with regard to

disease causation

A change in any of the three components can

result in the disease process

Group Work


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Models of Disease Causation (cont.)

Levels of Prevention

Primary Prevention

Preventing a problem before it occurs

Secondary Prevention

Early detection and early cure

Tertiary Prevention

Limiting disability and fostering rehab (where

the disease has occurred and resulted in a

degree of damage)

Myocardial Infarction

Primary:

Secondary:

Tertiary:


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Epidemiological Tools

Rates

Essential tools to identify actual and potential

problems in a given community.Allows a nurse to recognize when a health

threat or disease in normal or typical

In calculating a rate, the numerator is the

number of events occurring in a specified

period of time and the denominator consists of

those in the population at the specified time

period

Epidemiological Tools

Measures of Morbidity

Incidence rate

Prevalence rate

Measures of Mortality

Infant mortality rate

Crude death rate

Cause-specific death rate

Practice Time..

In the year 1910 there were 3925 cases of

measles in Utah. The population of Utah inthe 1910 census was 370,000 people. In the

year 2000 there were 30 cases of measles in

Utah and the population in 2000 was

2,230,000 people.

What was the incidence rate per 100,000

people of measles in 1910? Assume all of the

population was susceptible to measles.

What was the incidence rate per 100,000

people of measles in 2000? Assume all of the

population was susceptible to measles.


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Collection of Data

Windshield survey

People

Place Boundaries

Location of health services

Natural environment

Human-made environment

Housing

Social systems

Collection of Data

The census

Vital statistics

Health statistics

Descriptive vs. Analytical

Epidemiology

Descriptive Epidemiology

Person

Place

Time

Analytical Epidemiology

Focuses on the determinants of disease in a

given population


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Communicable Disease:

Prevention and Intervention

Chain of Infection

Communicable Disease Transmission


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Application

An elderly patient, hospitalized with a gastrointestinaldisorder, was on bed rest and required assistance foractivities of daily living. The patient had frequent

uncontrolled diarrhea stools and the nurse providedexcellent care to maintain cleanliness and comfort.Following one episode of cleaning the patient andchanging the bed linen, the nurse immediately wentto a second patient to provide care. The nurse'shands were not washed before assisting the secondpatient. The second patient receiving care had aFoley catheter

Infectious agent: E. Coli

Reportable Communicable Diseases

Reportable Diseases

Who Is Responsible for Reporting

What Information Is Required

How, When, and to Whom to Report

Steps Taken to Control Spread

Vaccine-Preventable Diseases

Immunity

Active

Passive

Immunization Schedule

Contraindications

Parental Education and Consent

Documentation

Reporting Adverse Vaccine Events

Adult Immunization
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Sexually Transmitted Diseases

Primary prevention of STDs

Secondary prevention and STDs

Trends in Incidence and Prevention of

Selected Communicable Disease

Acquired Immunodeficiency Syndrome and

Human Immunodeficiency Virus

Tuberculosis

Emerging Infections

International Travel

May increase exposure to a number of

communicable diseases Should seek medical advice in advance

Immunizations may be needed
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Biological Warfare

Category A agents

Can be easily disseminated or transmitted

from person-to-person Result in high mortality rate

Have potential for major public health impact

Require special action for public health

preparedness

Category A Agents

Anthrax

Types

Cutaneous

Inhalation

Gastrointestinal

Treatment

Antibiotics

Category A Agents

Botulism

Agent: clostridium botulinum

Types

Foodborne

Wound

Infant botulism

Inhalation

Treatment

Paralysis


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Category A Agents

Plague

Agent: bacteria (Yersinia pestis)

Types Pneumonic

Bubonic

Treatment: antibiotics

Smallpox

(to be reviewed for clinical SIM)

Category A Agents

Tularemia

Agent: Francisella Tularensis

Treatment: antibiotics

Viral hemorrhagic fevers

Viruses

Arenaviruses

Filoviruses

Bunyaviruses

Flaviviruses

Treatment: supportive therapy

The Role of Nursing and

Environmental Hazards andCommunity Crisis

Competency 12Nichole L. Hinkel, RN MSN


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Areas of Environmental Health

Living Patterns

Work Risks

Atmospheric quality Water quality

Housing

Food quality

Waste control Radiation risks

Housing and Living Patterns

Common concerns

overcrowding

Household chemical exposure

Potential for poisoning

Presence of firearms

Indoor Air Quality

Second hand smoke

Carbon monoxide

Indoor biological contaminants Lead Exposure

Nursing Interventions

Work Risks

Job hazards

Use of heavy equipment

Exposure to chemicals, biohazards, sunlight,

heat, cold, and noise

Potential for assault or violence

OSHA & NIOSH



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Atmospheric Quality

Effects of air pollution

Threaten the health of humans and animals

Harm crops and other vegetation

Contribute to the erosion and economic

devaluation of buildings and structures

Ozone Depletion


Water Quality

Microbial Contamination

Waterborne diseases

Chemical and Metal Contaminants

Community and Nursing Interventions

Food Quality

Microbiological Contamination

Intentional Food Additives Unintentional (Incidental) Food Additives

Seven commandments of food safety

Wash hands before handling food

Keep it safe-refrigerate

Do not thaw food on the kitchen counter

wash hands, utensils and surfaces after contact withraw meat and poultry

Never leave perishable food out over 2 hours

Thoroughly cook raw meet, poultry, and fish

Freeze or refrigerate leftovers promptly


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Waste Control

Two major concerns in the issue of waste control

Solid Waste Management

Landfills Incineration

recycling

Toxic and Hazardous Waste Control

Tips to reducing solid waste

Reduce

Reuse

Recycle

Respond

Radiation Risks

Radon Gas

Ultraviolet Radiation and Skin Cancer

Signs, Symptoms, and Detection of Skin

Cancer

Asymmetry

Border irregularity

Color

Diameter

Community Crisis

Disaster

Any event that causes destruction anddevastation that cannot be alleviated withoutassistance.

Result of natural occurrences

Result of human war, chemical & biologicalterrorism (intentional) and accidents

NA-TECH

Multiple vs. mass casualty


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Community Crisis

Emergencies

External

Occur in the community, outside of a definedbusiness, industrial complex, residence, or other

facility.

Internal

Initiate within a facility

Impact of a Disaster

Impact on Individuals

Impact on the Community

Impact on the Community:

Hurricane Katrina

Heroic Phase:

Honeymoon Phase:

Disillusionment Phase:

Reconstruction Phase:

Community Crisis

Disaster management

Governmental agencies _________________________________

American Red Cross

Role of the nurse during disasters

Triage

Emergency care

Shelter assistance


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Community Crisis

Nurse and disaster preparedness

Personal preparedness

Professional preparedness

Community preparedness

Emergency and Disaster management

Prevention/mitigation

Preparation and planning

Response

Recovery

Label that disaster (N, I, or A)

2005 Earthquake in Indonesia killed 300

2004 Florida hurricanes killed 124

2005 freight train collision-11500 gallons of

chlorine gas released

2004 Indian ocean-Tsunami 225,000 deaths

in eight countries

2001 world trade center attack kills 2726

Wildfires

A, B, C, or D

A community health nurse is a first responder

to a bombing incident and is assigned to thetriage area. Which of the following victims with

life-threatening injuries should be given the

highest priority?

A-The most seriously injured victims

B-Victims with the highest probability for

survival

C-Victims needing immediate transportation to

a trauma center

D-Victims at the highest risk for systemic

complications

power point for lp11 12 spring 2012

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