Learning Objectives. Public Health Nurse Orientation. Public Health Nurse Orientation. Overview of Module. Public Health Nurse Orientation.

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1 Public Health Nurse Orientation Module 3 Services to Prevent Chronic Diseases and Injuries Public Health Nurse Orientation Services to Prevent Chronic Diseases and Injuries Written and narrated by: Jody Moesch Ebeling, BSN, RN Northeast Region Public Health Nursing Consultant and Deborah L. Pasha, BSN, RN Southeast Region Public Health Nursing Consultant Wisconsin Division of Public Health Learning Objectives After completing the module, public health nurses should be able to: Describe the role of the public health nurse in the prevention of chronic diseases and injuries Recognize features of the community health improvement plan as nursing process applied to the community-as-client Identify resources available to support disease and injury prevention Overview of Module Definitions, statutory references, and theoretical models describing PHN role Conceptual framework of the community- as-client Resources, including credible references and funding Application examples Public Health Nurse Orientation Services to Prevent Chronic Diseases and Injuries Section I Definitions, statutory references, and theoretical models describing PHN role State Administrative Rule Requirements (HFS ) All local health departments shall assume leadership for developing and maintaining the public health system for their area of jurisdiction and shall provide or arrange for the provision of at least the following services: Provide a generalized public health nursing program Prevent and control communicable disease Prevent other diseases Promote health Abate and remove human health hazards 1

2 Examples of other diseases What is Other Disease Prevention? Arthritis Asthma Cancer Cardiovascular illnesses Diabetes Mental illnesses Substance abuse and addictions Violence-related injuries Prevention Terms and Definitions Chronic disease Injury, including unintentional and intentional Community Health Improvement Plan Epidemiology Risk assessment Source: Wisconsin Statutes Chapter (1), Wisconsin Administrative Rule HFS Statutory Requirements for Services to Prevent Other Diseases #1 Inform the public about the occurrence and underlying causes of priority problems and emerging conditions, illnesses, injuries, and events affecting the health of the population. #2 Disseminate prevention guidance related to diseases and injuries. Implement programs and environmental changes for population groups. #3 Arrange screening, referral, and follow-up intervention services for population groups. #4 Implement measures or programs to prevent or delay the onset of chronic disease and injuries. Required Services # 1 Public Health Intervention Wheel Inform the Public 2

3 Public Health Nursing Role for Service #1 Epidemiology Overview Collaboration Disease & Health Event Investigation Required Services #2 Public Health Nursing Role for Service #2 Community Organizing Outreach Disseminate prevention guidance Implement programs and environmental changes Required Services #3 Public Health Nursing Role for Service #3 Referral & Follow-up Case Management Case Finding Outreach Screening Arrange screening, referral, and follow-up Delegated Functions 3

4 Required Services #4 Public Health Nursing Role for Service #4 Implement measures known to prevent or delay the onset of chronic disease and injuries Coalition Building Social Marketing Advocacy Policy Development & Enforcement Public Health Nurse Orientation Services to Prevent Other Diseases Community as Client Section II Conceptual framework of the community-as-client The client or unit of care is the population. While the public health nurse may engage in activities with individuals, dua families, or groups, the dominant responsibility is the population as a whole. Source: Public Health Nursing: Scope & Standards of Practice (ANA, 2007) 4

5 Go in Search of your people. Love them. Learn from them. Play with them. Serve them. Begin with what they have. Build on what they know. But of the best leader, when the task is accomplished, the work is done, the people will remark We have done it ourselves. - Old Chinese Proverb Social Environment Physical Environment Genetic Endowment Social Psychosocial Individual Response Behavior Biology Health & Function Well Being Chemical Physical Biological Built Environment Disease Prosperity Health Care Adapted from Evans, R. G., & Stoddart, G. L. (1990). Producing health, consuming health care. Social Science and Medicine, 31, The public health system seeks to extend the benefits of current knowledge in ways that will have maximum impact on the health status of the entire population. It is a collective effort to identify and address the unacceptable realities that result in preventable and avoidable health outcomes. (Turnock, 2001) A System of Partners Business Advocacy & Labor Organizations Faith Community Media Healthcare Professional Providers Organizations Healthcare Consumers Community Health Centers Civic Organizations State & Local Public Health Departments Foundations Educators Hospitals Managed & Clinics Care Community Healthcare Colleges, Universities, Residents Purchasers & Technical Schools Public health nurses are a flexible entity in an otherwise concrete enterprise. (Marla E. Salmon, ScD, RN) Law Enforcement State and Local Elected Officials Agriculture, Natural Resources, Public Instruction, and other governmental agencies Visiting Nurse Service of New York 5

6 A local board of health shall assure that measures are taken to provide an environment in which individuals can be healthy (7) Community Health Improvement Plan (CHIP) Healthiest Wisconsin 2010: A Partnership Plan to Improve the Health of the Public Public Health Nurse Orientation Services to Prevent Chronic Diseases and Injuries Section III Resources, including credible references and funding Partners as Resource Manpower Goals Funds Marketing Policy development Department of Health and Family Services Division of Public Health Bureau of Community Health Promotion 6

7 Funding to prevent disease and injuries Lead MCH Prevention Tobacco WWWP Grants and Contracts (GAC) //apps4.dhfs.state.wi.us/gacsystem/ 7

8 Public Health Nurse Orientation Services to Prevent Chronic Diseases and Injuries Practical Applications Section IV Application examples Levels of Prevention Primary Secondary Tertiary Health Promotion Disease Prevention Early Diagnosis and Prompt Treatment Disability Limitation (Leavell & Clark, 1953) Rehabilitation Tobacco Prevention A public health nurse partners with the local tobacco prevention coordinator to present the health effects of tobacco at the local chamber of commerce meeting. Following the presentation, member agencies have requested assistance to develop smoke-free work policies and implement tobacco cessation benefits for the employees. Diabetes Prevention The Regional Public Health Nurse Consultant informs local health departments that new evidence based diabetes care guidelines have been released. A workshop has been scheduled for local health department nurses to assist in implementation of guidelines with community partners. A local PHN sees the opportunity for partnership with other care providers in promoting optimum diabetes treatment to prevent or delay complications. Diabetes Prevention Community Level Interventions Educate the community leaders by holding a community educational session Partner with other providers to hold a community town hall meeting Media advocacy Meet with community groups to promote good health Assist diabetes educators to implement care guidelines 8

9 What level of public health intervention would address the determinants for all of these other diseases? Success Story: Issue Asthma Cancer Cardiovascular illnesses Diabetes Mental illnesses Substance abuse Violence-related injuries Success Story: Intervention Success Story: Impact More steps Pledge drive encouraging residents to commit replacing one trip per week with active transportation Issue paper informing an asthma coalition s stakeholders regarding g the impact of alternative transportation on air quality and emergency department visits for asthma Letter to a bicycle pedestrian advocacy organization linking the health priorities to the need for bike racks on buses (cited at a public hearing, resulting in a unanimous vote of approval!) I Impact and Value: Telling Your Program s Story Success stories can be used: In response to public inquiries about the program. To educate decision makers. To demonstrate that funds are well spent. To make the target population aware of your program. To show movement in program progress when planned outcomes will not be realized until the distant future. To help mobilize resources. To help your program get needed resources. ss_story_workbook.pdf 9

10 Acknowledgments This program was developed through a partnership between the Wisconsin Department of Health Services and the University of Wisconsin-Madison School of Nursing through the Linking Education and Practice for Excellence in Public Health Nursing Project funded by DHHS/HRSA/#D11HP This module would not have been possible without the input of the many public health nurses in academia and practice across the State of Wisconsin who contributed to this program. We would like to give special thanks to the those who provided content review of this module. Acknowledgments (cont d) Expert Consultation was provided by: Linda Hale, BSN, RN, Chief Family Health Section Cynthia A. Musial, CHES, Training and Technical Assistance Coordinator, Tobacco Prevention & Control Program Ann Altman Stueck, MSN, RN, Infant and Child Health Nurse Consultant Wisconsin Division of Public Health Bureau of Community of Health Promotion Jeanne B. Hewitt, PhD, RN Associate Professor, UWM College of Nursing Associate Director, UWM Institute of Environmental Health Director, Community Outreach and Education Programs, National Institute of Environmental Health Sciences Marine & Freshwater Biomedical Sciences Center at UW-Milwaukee 10