1 / 50

COMMUNITY HEALTH

COMMUNITY HEALTH . ROXANNE RIEDY MSN MARILEE ELIAS MSN, CNE. Community. “the gift or fellowship of common relations and feelings ”( Hiemstra , 2000) It’s a group: of like-minded people that works together who share a common language, rituals, and customs. Population.

waseem
Download Presentation

COMMUNITY HEALTH

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. COMMUNITY HEALTH ROXANNE RIEDY MSN MARILEE ELIAS MSN, CNE

  2. Community • “the gift or fellowship of common relations and feelings”(Hiemstra, 2000) • It’s a group: • of like-minded people • that works together • who share a common language, rituals, and customs

  3. Population • All the individuals inhabiting a specific area • Leesburg, FL 22,286 (2009) • Clermont, FL 13,252 (2009) (www.census.gov )

  4. Aggregate • A group of individuals with at least one shared characteristic (personal or environmental) • We each belong many aggregates. What are some of yours?

  5. Community Components • Structure • Status • Process

  6. Community Components Structure: general characteristics of a community, includes: • Demographic data • Data about healthcare services

  7. Community Components Status: describes the outcome components of the community • Biological Outcome Components • Emotional Outcome Components • Social Outcome Components

  8. Community Components • Process: the overall effectiveness of the community • Perceptions of group membership • Extent of intergroup interactions • Community forum for conflict resolution

  9. What makes a Community Healthy?

  10. Healthy People Initiatives • We’re in the 4th decade of this national health framework for public health preventions priorities and actions. • The overarching goals and focus topic areas are refocused every 10 years using the input from public health and prevention experts, government officials and the public.

  11. Healthy People 2020 • “The launch of Healthy People comes at a critical time. Our challenge and opportunity is to avoid preventable diseases from occurring in the first place.” HHS Secretary Katherine Sebelius • Use of IT to make Healthy People come alive through a “challenge” to develop ‘myHealthyPeople’ apps. (www.healthypeople.gov )  • Revision of Healthy People 2010

  12. Healthy People 2020 • 13 New Topic Areas • Main (or broad) goals of this plan: • increase healthy life expectancy • reduce health care disparities • create social and physical environments that promote good health for all • Promote quality of life, healthy development, and healthy behaviors across all life stages

  13. New Topic Areas 2020 • Adolescent Health Genomics • Blood Disorders & Blood Safety Global Health • Early and Middle Childhood Preparedness • Dementias, including Alzheimer’s Disease • Healthcare-Associated Infections • Health-Related Quality of Life and Well-Being • Lesbian, Gay, Bisexual, and Transgender Health • Sleep Health • Social Determinants of Health

  14. What’s in Healthy People 2020?(www.healthypeople.gov)

  15. Each Community also has Vulnerable Populations • Aggregate with increase risks for: • Developing illness • Adverse health outcomes

  16. Vulnerable Populations Vulnerability Factors: • Limited economic resources • Limited social resources • Age • Chronic disease • History of abuse or trauma

  17. Federal Poverty Levels • Issued each January • Range of 25% to 300% of Poverty Level • Based on Family Size • Pregnant woman= family of 2 • Low-income assistance programs base benefits on these official income levels

  18. Community Nursing • A Community is: • A site for Healthcare Delivery • A recipient of Healthcare Services

  19. Community Based Care • Focuses on the community • Focuses on lowering the cost of care • Healthcare Services are provided in many types of Facilities • Acute care • Rehabilitative services

  20. Community Based Care Three approaches • Community health nursing • Public health nursing • Community oriented nursing

  21. Community Based Care Community Health Nurse • Focus: how the Individual’s Health affects the health of the community • Goal: maintain health of the population • Deliver personal health services

  22. Community Based Care Public Health Nursing • Focus: effect of Community’s Health on individual • Goal: prevention of disease; promote health • Protect health of the community • Large-scale programs

  23. Community Based Care Community-Oriented Nursing • Combines community and public health • More comprehensive approach • Uses information from individuals to change health on the community level

  24. Pioneers of Community Nursing • Florence Nightingale • Lillian Wald • Clara Barton • Margaret Sanger

  25. Community Nursing • Empowering the Individual and the Community: • Access and Use Available Resources • Achieve/Maintain Desired Level of Health • Achieve Autonomy • Maintain Positive Self-esteem

  26. Roles of Community Health Nurse • Client advocate • Educator • Collaborator • Counselor • Case Manager

  27. Community Nursing Intervention Classification • Primary (first-level) • Secondary (second-level) • Tertiary (third-level)

  28. Community Based Careers • School nurse • Occupational health • Parish nursing • Correctional nursing • Public health • Disaster services • International

  29. Geopolitical Community Assessment • Windshield survey • Databases • Client perceptions

  30. Nursing Diagnosis • Analyze the information, develop a list of the communities strengths and limitations • Prioritize the information • Create a community based diagnosis

  31. Nursing in Home Care

  32. Home Health • Established in 1800’s • Growth R/T Medicare Payments (1965) • Over 132,000 RNs delivering care • Over 1,000,000 Work in Home Care • Over 12 million patients • 2009 projected costs over $72 billion ( www.nahc.org, 2012)

  33. Home Health Care Recipients • Individuals with skilled-care needs • Recuperating from illness or surgery • Terminal ill • On going care for individuals with chronic illnesses in an attempt to prevent hospitalization

  34. How do our clients get referred to home healthcare? • Hospital-based Referrals • Other Community Sources of Referrals • Reimbursement Evaluation

  35. Goal of Home Health care • Promoting self-care by: • Fostering client independence • Completing client/family teaching • Demonstrating skill techniques • Explaining all aspects of care

  36. Home Health Care • Advantages • Disadvantages

  37. Home Health Agencies • Direct care agencies • Indirect service agencies • Types of agencies Public Voluntary Proprietary Hospital-based

  38. Home Health Team • RN is coordinator of health services • Multidisciplinary Team based on patients needs

  39. Roles of Home Health Nurse • Direct care provider • Client /family educator • Client advocate • Care Coordinator

  40. Hospice Nurse • Focus is caring for pt’s who are dying or condition is not expected to improve • Care can be provided in the hospital, home, nursing home or Hospice house • Promote comfort & quality of life

  41. Reimbursement • Medicare • Medicaid • Private insurance company • Patient Self-Pay

  42. Medicare • Individuals over 65 or • Disabled or • Diagnosis of ESRD • Largest payer- over $15 billion (2007) • Employer- over 90,000 RNs • Criteria-based Reimbursements

  43. Medicaid • Individuals with limited financial resources • Sponsored by federal government and each state • Payer for Home and Hospice Care

  44. Private Insurance • Sources: • Employer • Retirement Plan Benefit • AARP and other available plans • Criteria-based Reimbursements (again) • Documentation is Vital for Payment

  45. Future of Home Health Care • Expect Increased Use • Increased home Hospice care • Technological advances = safe and affordable complex care in the home • Expanded research

  46. Home Visit Three phases • Preparation prior to the visit • Nursing care provided during the visit • Evaluation after the visit is completed

  47. Home Visit Before the visit: • Review Chart/Referral Form • Gather necessary Supplies/Materials • Assess need for additional information • Schedule Home Appointment • Assess Safety Issues

  48. Home Visit During the visit: • Make introductions • Initial Visit is vital to building trust/rapport • Be respectful of client’s home, beliefs, practices, cultural differences • Develop a trusting relationship • Verify/complete data • Identify barriers to goals • Begin Documentation

  49. The Home Visit Review • We’re Nurses so we: • Assess • Client • Home Safety Issues • Infection Control Issues • Generate Nursing Diagnoses • Risk for Caregiver Role Strain • Caregiver Role Strain • Plan Outcomes/Evaluations • Plan Interventions/Implementation

  50. Home Visit After the visit: • Safety (again) • Proceed to safe area PRN & then • Complete necessary documentation

More Related