The Strategic Prevention Framework: A Systematic ti Public Health Model that t Enhances the Results of the Nursing Process in Population Level Care

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1 The Strategic Prevention Framework: A Systematic ti Public Health Model that t Enhances the Results of the Nursing Process in Population Level Care Presented by: Tin Barton-Caplin and Abby Young, BSN, RN The Strategic Prevention Framework: A Systematic Public Health Model that Enhances the Results of the Nursing Process in Population Level Care 1

2 Objectives We hope that you will gain a greater understanding of the application of: Public Health Nursing The Nursing Process The Strategic Prevention Framework A Systematic Public Health Model Ultimate Goal We will achieve greater health promotion for our patients and in our communities by using both the Nursing Process and the Strategic Prevention Framework simultaneously. 2

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4 What does a public health nurse do? Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations (ANA). The common thread uniting different types of nurses who work in varied areas is the nursing processthe essential core of practice for the registered nurse to deliver holistic, patient-focused care (ANA). Comparing the Nursing Process to the S i P i F k Strategic Prevention Framework 4

Implementation Evaluation The Strategic Prevention Framework

5 Comparing the Nursing Process to the Strategic Prevention Framework The Nursing Process Assessment Nursing Diagnosis Planning Implementation Evaluation The Strategic Prevention Framework Assessment Capacity Building Planning Implementation Monitoring & Evaluation Assessment 5

6 Assessment The Nursing Process: Assessment Physical: head to toe assessment. What is my baseline and what is abnormal? Psychological: How is the person mentally responding to the situation? Social: Who/what does the person have for supports? Life Style: What about this persons life might effect health promotion? The Strategic Prevention Framework: Assessment Physical: What do the natural and built environments look like? Data: What do health statistics tell us about our population? What is my baseline and what is abnormal? Community Resources: What community supports exist for people living in this community? Community Readiness: Does the community understand the problem? Are they ready to address it? The Nursing Process: Assessment Assessment The Strategic Prevention Framework: Assessment HR:120 Population: 6, square miles BP:115/75 Glucose: 70 Weight: 135 kg Hx: depression and diabetes Subjective: Found in his home unresponsive to painful stimuli and hypoglycemic with a suicide note in close proximity. EMS administered dextrose and supportive care and transported the patient to the hospital. 9.5 people per square mile Household Income: $37,679 18% of adults are obese 24% of high school students are obese (compared to 10% statewide) 26% of adults smoke Subjective: Jon is from a very rural area lacking a number of resources including public transportation, grocery stores, pharmacies, etc. Residents worry about a number of things including lack of access to healthy foods and the number of people struggling with weight issues. 6

conditions The Strategic Prevention Framework: Capacity Building Increasing the availability of and

7 Nursing Diagnosis & Capacity Building Nursing Diagnosis & Capacity Building The Nursing Process: Nursing Diagnosis The nurse s clinical judgment about the client s response to actual or potential health conditions The Strategic Prevention Framework: Capacity Building Increasing the availability of and addressing gaps in community resources Increase awareness Encourage collaboration Identify and engage stakeholders 7

ineffective awareness tissue perfusion Focus group with county Risk for activity residents to identify barrier to intolerance Risk

8 Nursing Diagnosis and Capacity Building Nursing Process: Nursing Diagnosis The Strategic Prevention Framework: Capacity Building Risk for falls Share data about obesity Risk for suicide rates Risk for shock Mass media campaign focused on obesity Risk for ineffective awareness tissue perfusion Focus group with county Risk for activity residents to identify barrier to intolerance Risk for infection Fluid volume excess achieving healthy weight. Hold community forum to engage community residents in generating solutions. Planning 8

9 Planning The Nursing Process: Planning Short and long term goals are met to achieve health promotion. The Strategic Prevention Framework: Planning Prioritizing risk and protective factors Data driven and evidence based Development of a logic model The Nursing Process: Planning Maintain glucose level within acceptable parameters. Ensure adequate cardiac output. Maintain skin integrity. Ensure client safety. Ensure adequate fluid balance Planning The Strategic Prevention Framework: Planning Educate select board members to the importance of increasing the number of sidewalks Advocate and fundraise for a new rail-to-trail bike path Increase availability of diabetes education in local health center Increase ability of local health center to deliver treatment aimed at weight management Create a walking group Offering the virtual farmers market 9

10 Logic Model 10

11 Implementation Implementation The Nursing Process: Implementation A deliberate action performed to achieve a goal. The Strategic Prevention Framework: Implementation Simply do it! Maintaining fidelity when appropriate. 11

healthy community design Local health center receives provider training on strategies for treating overweight patients Local health

12 The Nursing Process: Implementation Implementation The Strategic Prevention Framework: Implementation FS q15min Presented to 3 town select BP checks/orthostatics frequent skin checks/repositioning Suicide Precautions Bed Alarm boards about importance of sidewalks & healthy community design Local health center receives provider training on strategies for treating overweight patients Local health center secures a grant to hire part time diabetes educator Local convenience store starts managing the virtual farmers market Monitoring & Evaluation 12

13 Monitoring & Evaluation The Nursing Process The Strategic Prevention Framework The judgment of effectiveness of an intervention or progress. Have short term goals been met? Has capacity for implementation changed? Did we maintain fidelity (appropriate for evidencebased strategies)? Can include qualitative and/or quantitative data. Monitoring & Evaluation The Nursing Process The Strategic Prevention Framework Blood Glucose Trends 3 towns received health community design training Blood Pressure Trends Intake and Output Trends Behavior changes 1 town constructed additional sidewalks Virtual farmers market implemented, however, after 1 year it was not financially viable Local health center increased its percentage of overweight patients who receive education and treatment t t Local health center increased its percentage of patients at risk for diabetes who received diabetes education 13

14 Summarizing our Case Study about Jon Making Change in Southern Essex County Vermont St. Johnsbury Office of Local Health is utilizing the Strategic Prevention Framework to improve health in Southern Essex County Vermont. 14

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16 Assessment Comprehensive analysis of existing statistics 29% of adults smoke (almost double the state average) 23% of adults eat the daily recommended servings of vegetables 28% of adults over 20 are obese Assessment Key Informant Interviews Focus Groups 16

17 Capacity Building Strengthening partnerships Gilman Senior Center Concord Health Center Northeastern Vermont Regional Hospital Northeastern Vermont Area Agency on Aging Community Forums Future: Planning, Implementation, Evaluation Summarize and share all the assessment data Convene additional stakeholders Identify community-supported strategies Construct community health improvement plan Implement with partners Evaluate if our process made a difference 17

18 Suturing it all together Combining Our Worlds Patients will benefit from nurses being aware of community resources Ensure that gaps are addressed Keep the possible causal pathways in mind Together we can provide the most holistic care 18

19 References American Nurses Association. (n.d.). The nursing process. Retrieved from US State of Vermont Map [Web Graphic]. Retrieved from Leidenfrost, W. (Photographer). (2012, September 25). [Web Photo]. Retrieved from bike lanes police/ CT River Rapids at Pittsburg, NH [Web Graphic]. Retrieved from Museum/ _PJBQxw/ _Qf4974c Strategic prevention framework. (n.d.). Retrieved from framework Laguartilla, R. (Author). (2012, August 27). nursing care plan renal failure [Print Photo]. Retrieved from American Nurses Association. (n.d.). What is nursing?. Retrieved from American Nurses Association. (n.d.). The nursing process. Retrieved from (2013, July 3). Unemployment rates [Web Graphic]. Retrieved from (2013, July 21). weightless space [Web Graphic]. Retrieved from Insulin [Web Graphic]. Retrieved from (2012, February 9). Winter road [Web Photo]. Retrieved from pills [Web Photo]. Retrieved from / / i h d 0 Social isolation [Web Photo]. Retrieved from (2012, October 1). Depression [Web Photo]. Retrieved from Vermont map [Web Graphic]. Retrieved from Modern town borders in Essex County, Vermont [Web Graphic]. Retrieved from Barnie s Market [Web Graphic]. Retrieved from (2011, January 7). Suture [Web Graphic]. Retrieved from

Chapter 01: Professional Nursing Practice Lewis: Medical-Surgical Nursing, 10th Edition

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