January 4, 2023

Analyze the roots of public health nursing. Explain its influence on pra

Nursing

Analyze the roots of public health nursing. Explain its influence on practice today.
APA style
3 paragraphs 3 sentences each
2 references

Chapter 3: Health Policy, Politics, and Reform

Chapter Highlights #1

Healthcare policy and the political process

Healthcare finance and cost–benefit in relation to health policy

Access to healthcare and insurance facts in the United States

Healthcare workforce diversity and its effects on the quality of healthcare

Nursing’s role in shaping healthcare policy

Chapter Highlights #2

Quality of care and evaluation

Information management facts

Equity in healthcare access

Ethical consideration in health policy

Political advocacy, how to be politically active and advocate

Chapter Highlights #3

Health advocacy and healthcare reform

Affordable Care Act (ACA) overview and updates

Community-based services and healthcare reform

Health services research application to healthcare policy

Healthcare Policy and Political Process

Policies: set of principles that govern an action to achieve a given outcome, or guidelines that direct individuals’ behavior toward a specific goal

Public health policy: decisions made in regard to the health of the individual and the community

Health policies: impact on the health of an individual, a family, and a population or community

Question #1

Is the following statement true or false?

Health policies impact on the health of an individual, a family, and a population or community.

Answer to Question #1

True

Rationale: Health policies impact on the health of an individual, a family, and a population or community.

Involving Politics

Process of influencing the allocation of resources needed to enable policy and involves the strategies needed to achieve the desired goals.

Policy-making takes a great deal of effort, time, and commitment.

Setting an agenda

Policy formulation

Policy adoption

Policy implementation

Policy assessment

Policy modification

Healthcare Finances and Cost-Benefit

Economics is the study of how individuals, groups, organizations, and society allocate and utilize resources.

When a policy is evaluated for its effectiveness, there is an interest in keeping the cost of a specific health program within reason, and it is critical to consider the overall costs and benefits of an existing program when a more efficient and effective service is identified and adopted.

Access to Care and Health Insurance

The U.S. healthcare system is a unique system of both independent and collaborative power and action by both federal and state governments.

Question #2

Is the following statement true or false?

The U.S. healthcare system is a unique system of both independent power and action by the federal government.

Answer to Question #2

False

Rationale: The U.S. healthcare system is a unique system of both independent and collaborative power and action by both federal and state governments.

Nursing’s Role in Shaping Healthcare Policy

Nursing has a rich history as a unique profession, with its own values, ethics, respect, integrity, and responsibility. Nurses’ contributions to the policies are unlimited; there is a need for greater coordination of action to ensure that nursing is actively supported and involved in influencing and shaping health and healthcare policies.

Historical Highlights on Nursing Political Involvement

Mid-‘70s and early ‘80s: Political involvement of nurses

1976: Important year of advocacy

1990s: Nurses included in healthcare policy formation

What Does It Mean to Be Politically Active?

Personal and professional political involvement of nurses

Nurses must be knowledgeable about issues, laws, and policy

Why is nurse-informed political involvement?

Direct caregivers

Awareness of patient safety and satisfaction, access to services, clinical outcomes, and health disparities

Positioned to see impact of policy on individuals

Nursing Advocacy and Policy Participation

Patient advocacy

Political advocacy

How to Be Politically Involved?

Evidence-based practice examples

Nurses’ milestones in policy development have contributed to:

Quality outcomes

Decreases in cost

Expanded access

Major differences to the health of the nation

Advocacy Activities of Professional Nursing Organizations

Role of professional nursing organizations

ANA

NLN

ICN

Current Situation of Nursing Involvement: Challenges and Barriers

Not enough time to get involved

Heavy workloads with understaffing

Perception of powerlessness

Gender issues

Political action breaching family time

Anxiety with public speaking

Lack of knowledge in legislative process

Fear of retaliation

Quality of Care

Safety

Effectiveness

Patient centeredness

Timeliness

Equality

Quality of care is defined by the Institute of Medicine (2001) as the degree to which health services for individuals and populations increase the likelihood of desired outcomes, and are consistent with current knowledge.

It is extremely difficult to evaluate the complexities of the quality of care for the U.S. population.

Information Management

U.S. policy-makers have made the adoption of health information technology a priority so that health records can be kept electronically, assisting patients, providers, and insurers.

Equity and Equality in Healthcare Access and Quality

Because of the vast disparities in healthcare access and quality, President Obama has made healthcare his top priority, promising affordable and adequate healthcare insurance for all Americans.

Question #3

Is the following statement true or false?

Equality is healthcare that does not vary in quality because of gender, race, ethnicity, geographic location, or socioeconomic status.

Answer to Question #3

True

Rationale: Equality is healthcare that does not vary in quality because of gender, race, ethnicity, geographic location, or socioeconomic status.

Community-Based Services Association with Healthcare Reform

Federally qualified health centers

Patient-centered medical home

Accountable care organizations

Meaningful use

Ethical Considerations

ANA Code of Ethics with Interpretive Statements

Code of Ethics for Nurses

Social Policy Statement

Scope and Standards of Practice in Nursing

Health Advocacy and Healthcare Reform

Advocacy is collaborating with colleagues and engaging in conversations with decision-makers

Healthcare systems are dynamic

Overview of the ACA Prior to the End of Obama Presidency

Patient Protection and Affordable Care Act

Health Care and Education Reconciliation Act

Health Services Research

Research continues to be an influencing power by documenting the need for accelerated reform in order to achieve quality care, proper information management, insurance for all, and equity of access.

Chapter 1: Public Health Nursing: Present, Past, and Future

Chapter Highlights

Healthcare changes in the 21st century

Characteristics of public health nursing

Public health nursing roots

Challenges for practice in the 21st century

Question #1

Is the following statement true or false?

Healthcare disparities are social conditions in which people live and work.

Answer to Question #1

False

Rationale: Social determinants of health are social conditions in which people live and work. Healthcare disparities are gaps in healthcare experienced by one population compared with another.

Major Changes in Healthcare in the 21st Century

Development of patient/client-centered care

Increased use of technology

Increased personal responsibility

Healthcare Changes in the 21st Century #1

Social determinants of health are social conditions in which people live, their income, their social status, their education, their literacy level, their home and work environment, their support networks, their gender, their culture, and the availability of health services

Healthcare Changes in the 21st Century #2

Healthcare disparities—differences in healthcare and health outcomes experienced by one population compared with another

Role of Government in Healthcare

Three core functions are as follows:

Assesses healthcare problems

Intervenes by developing relevant healthcare policy that provides access to services

Ensures that services are delivered and outcomes are achieved

Patient Protection and Affordable Care Act (PPACA)

Provide affordable health insurance coverage to most Americans

Lower costs

Improve access to primary care

Preventive care and prescription benefits

Cover pre-existing conditions

Extend young adults’ coverage

Question #2

What is one of the core functions of the role of government in healthcare?

Provide affordable health insurance coverage

Improve access to primary care

Lower costs

Assess healthcare problems

Answer to Question #2

D. Assess healthcare problems

Rationale: Three core functions are to assess healthcare problems, intervene by developing relevant healthcare policy that provides access to services, and ensure that services are delivered and outcomes are achieved. One of the goals of the Patient Protection and Affordable Care Act (PPACA) is to provide affordable health insurance coverage.

Patient/Client-Centered Care

Cultural traditions

Personal preferences

Values

Families

Lifestyles

Technology

Rapidly advancing forms of technology are dramatically improving lives.

Health Information Technology

Health information technology (HIT)—comprehensive management of health information and its exchange between consumers, providers, government, and insurers in a secure manner

Electronic health records

Telehealth

Use of electronic information and telecommunications technologies to support long-distance clinical healthcare, patient and professional health-related education, public health, and health administration

Personal Responsibility for Health

Active participation in one’s own health through education and lifestyle changes

Public Health Nursing

Public health nursing—population-based practice, defined as a synthesis of nursing and public health within the context of preventing disease and disability and promoting and protecting the health of the entire community

Principles of Public Health Nursing #1

Client or unit of care is the population.

Primary obligation is to achieve the greatest good for the greatest number of people or people as a whole.

Public health nurses collaborate with the client as an equal partner.

Principles of Public Health Nursing #2

Primary prevention is the priority in selecting appropriate activities.

Public health nursing focuses on strategies that create healthy environmental, social, and economic conditions in which populations may thrive.

Principles of Public Health Nursing #3

A public health nurse is obligated to actively identify and reach out to all who might benefit from a specific activity or service.

Optimal use of available resources and creation of new evidence-based strategies is necessary to assure the best overall improvement in the health of populations.

Principles of Public Health Nursing #4

Collaboration with other professions, populations, organizations, and stakeholder groups is the most effective way to promote and protect the health of people.

Scope and Standards of Practice

The American Nurses Association sets the scope and standards for all professional nursing practice.

The publication Public Health Nursing: Scope and Standards of Practice establishes the characteristics of competent public health nursing practice and is the legal standard of practice.

Competencies for Public Health Nursing Practice

Three tiers of practice

Competencies associated with that level of practice

Public Health Intervention Wheel

17 interventions

Actions taken on behalf of individuals, families, communities, and systems to protect or improve health status

Public Health Nursing Interventions

Population-based model

Applied to individuals, families, communities, or within systems

Focuses upon prevention

Education for Public Health Nursing Practice

Public health nursing practice

Baccalaureate degree in nursing (BS or BSN)

Generalist master’s degree as clinical nurse leader (CNL)

Public health nursing specialists in population health

MSN

MPH

MSN/MPH

Doctoral degrees: PhD, DNP, DrPH

Roots of Public Health Nursing

Early civilization

Middle Ages

English Poor Law

Variety of reforms in 1800s

Victorian times

District nursing

Public Health Initiatives in Early America

American social values strongly influenced by British traditions

Need for organized public health system

Lemuel Shattuck

Dorothea Dix

Clara Barton

Lillian Wald

Public Health Initiatives in the 20th Century

Mary Breckinridge

Early 20th-century federal healthcare initiatives

Public health in the second half of the century

The First Decade of the 21st Century

Department of Homeland Security: fosters an all-hazards, all-disciplines approach to emergency management

Must be flexible, be politically active, embrace change, and refresh their knowledge of public health issues on a continual basis

Engaging in Evidence-Based Practice

Evidence-based nursing is the integration of the best evidence available with clinical expertise and the values of the client to increase the quality of care.

Evidence-Based Public Health

Public health endeavor with judicious use of evidence derived from a broad variety of science and social science research

Epidemiology

Science of prevention

Knowledge of the natural history of diseases and the identified (risk) factors that increase a person’s susceptibility to illness

Challenges for Public Health Nursing in the 21st Century #1

Engaging in evidence-based practice

Helping eliminate health disparities in underserved populations

Demonstrating cultural competence

Planning for community change

Contributing to a safe and healthy environment

Challenges for Public Health Nursing in the 21st Century #2

Responding to emergencies, disasters, and terrorism

Responding to the global environment

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Analyze the roots of public health nursing. Explain its influence on pra

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