Module 1: Introduction to Community / Public Health. Presented to. M. Kay Sandor. In Partial Fulfillment. Of the Requirements for the Course

Transcription

1 Running Head: PUBLIC HEALTH 1 Module 1: Introduction to Community / Public Health Presented to M. Kay Sandor In Partial Fulfillment Of the Requirements for the Course GNRS 5337 Innovations in Community Health Practice September 14, 2012 By Group 6-Sandor Johnny Gilmore Karina Gonzalez Jouvonna Gray Abby Griffith Erin Gurski Beatrice Gyebi THE UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON SCHOOL OF NURSING

2 PUBLIC HEALTH 2 Module 1: Introduction to Community / Public Health The focus of community/public health nursing has evolved throughout history with contributions from multiple disciplines. During the Industrial Revolution, improving the health of the public was based on basic concepts such as hygiene and nutrition to prevent spread of disease (Radzyminski, 2007, p.37). Presently, the government provides resources within the public health arena for health promotion and disease prevention for citizens, taking into account safety and environmental factors as well. With an aging population of individuals who are living longer as a result of advances in technology and standards of health care, it is perceptible that there is an inherent need for the field of community/public health nursing. Therefore, the need for a proactive approach to educate the population and attempt to prevent health disparities before they arise is essential. Definition of Community/Public Health Nursing The group defines community/public health nursing as a multifaceted approach to promoting and protecting the wellbeing and health of a population, based on the physical, social, cultural, environmental, and economic needs of that defined group of individuals. Initially, the current status and subsequent needs of the population within the community must be assessed and a plan of action developed for health promotion. The community should have an active role in the plan development so that goals are mutually decided upon, improving the chance of success. Additionally, populations in need of cost-effective health care and health promotion must be identified and all individuals should have equal access to the same standard of care and resources.

3 PUBLIC HEALTH 3 Although there are several terms currently in use to describe community/public health nursing, they all have a similar focus health promotion to achieve a general state of wellbeing for a defined group of individuals. Radzyminski (2007) identifies the overlap of the objectives of population health, public health, and community health as incorporating health promotion, disease prevention, environmental influences, and culture to groups of people (p. 41). These objectives are enforced with the knowledge that environment and culture influence an individual s health and approach to health care. In order to achieve these objectives, the focus of health care must shift from individualized care received in the hospital or clinic setting, to population-based care, planning, and evaluation (Radzyminski, 2007). Community/public health interventions are aimed at changing surrounding influences to promote population health which ultimately impacts individual health. Furthermore, regardless of the title given to populationfocused health care, the most advantageous plan would be one that is all encompassing and pulls the key elements of each public health care approach. Core Public Health Functions Identified in Examples of Essential Public Health Services In 1994, the Core Public Health Functions Steering Committee developed ten essential public health services to align with the three previously established core functions of public health (assessment, policy development, and assurance). The essential public health services define public health and provide a foundation of responsibilities for local public health systems to execute (Centers for Disease Control and Prevention [CDC], 2010). The first essential public health service encourages local public health systems to monitor the population's health status in order to identify and solve community health problems (CDC, 2010). On a daily basis, Abby, Erin, and Karina routinely screen vulnerable populations by

4 PUBLIC HEALTH 4 asking patients if they have received influenza or pneumococcal vaccines, when their last colonoscopy or mammogram was performed, if they use tobacco products, or if they have had the potential for tuberculosis (TB) exposure. Additionally, Johnny assesses patients upon admission in the areas of mental health for suicide risk and depression, physical health through calculation of body mass index, and Jouvonna assesses for any environmental risks within the patient s home through her home health visits. Furthermore, Beatrice volunteers at community health fair events through her church where blood pressure screenings are performed to identify individuals with hypertension. Referrals for resources or further evaluation, vaccinations, and TB skin tests are then given to any identified patients at risk. These examples represent the first core function of assessment because an understanding of the determinants of health and of the nature and extent of community needs is a fundamental prerequisite to sound decision-making about health (Institute of Medicine [IOM], 1988, p.141). Assessment of the status of individuals provides data on the population as a whole, which can then be utilized to formulate and implement solutions. Informing, educating, and empowering people about health issues are the objectives of the third essential public health service, which corresponds with the second core function of policy development (CDC, 2011). One of the goals of the Healthy People 2020 initiative, created by the Department of Health and Human Services, is to increase the quality, availability, and effectiveness of educational and community-based programs designed to prevent disease and injury, improve health, and enhance quality of life (HealthyPeople.gov, 2012). Beatrice, Johnny, Erin, and Karina abide by hospital policies by providing each patient with discharge instructions and education about their illness, as well as ways to improve health, prior to the patient leaving the hospital. Through her home health visits, Jouvanna educates patients and their families about

5 PUBLIC HEALTH 5 disease processes and preventive measures that can be utilized in an effort to prevent readmission to the hospital. Likewise, Abby provides chemotherapy and cancer-related education to patients within the outpatient adult oncology setting. These examples reinforce the importance of policy development because it is the responsibility of community and public health providers to serve the public interest in the development of comprehensive public health policies by promoting use of the scientific knowledge base in decision-making about public health and by leading in developing public health policy (IOM, 1988, p. 141). Connecting individuals to needed personal health services and assuring the provisions of health services when otherwise unavailable, or when the individual is unaware of such services, is the focus of the seventh essential public health service (CDC, 2010). Unfortunately, many people do not have the resources necessary to achieve health or a state of well-being and are in need of assistance. Abby and Karina routinely assist their patients in obtaining services such as Meals on Wheels, Medicaid and Medicare referrals, Medicare Transportation Assistance, and Free Gas USA, Inc. Additionally, Johnny advocates for his patients by ensuring culturally and linguistically diverse populations receive the appropriate care and translational services during patient education. Furthermore, through her faith community, Beatrice identifies underserved populations and provides assistance in gaining access to needed health and social services. These examples portray the third core function of assurance because access to fundamental services that benefit the well-being of the population should be universally available and their assurance guaranteed (IOM, 1988).

6 PUBLIC HEALTH 6 Conclusion Community /public health nursing involves a multitude of interventions. The continuous cycle of core functions and utilization of the essential services of public health are imperative for the success of community/public health nursing. Nurses within this field, no matter where they practice, identify individuals with unmet health and social needs and ensure access to necessary services. They promote health by teaching and empowering individuals and their community to achieve their potentials, perform health screenings to detect early risk factors so that appropriate treatment or intervention is given, and provide and coordinate direct care. Above all, public health nurses collaborate with other professionals and community members to influence community decisions and policymaking (Smith, 2009).

7 PUBLIC HEALTH 7 References Centers for Disease Control and Prevention. (2010). 10 essential public health services. Retrieved from Centers for Disease Control and Prevention. (2011). Core functions of public health and how they relate to the 10 essential services. Retrieved from HealthyPeople.gov. (2012) topics & objectives: Educational and community-based programs. Retrieved from Institute of Medicine. (1988). The future of public health. Washington, D.C.: National Academies Press. Radzyminski, S. (2007). The concept of population health within the nursing profession. Journal of Professional Nursing, 23(1), Smith, C.M. (2009). Responsibilities for care in community/public health nursing. In F. A. Maurer & C. M. Smith (Eds.), Community/public health nursing practice: Health for families and populations (pp. 2-30). St. Louis, Missouri: Elsevier.

8 PUBLIC HEALTH 8