INDUSTRIAL NURSING

By V. HAMAL

CONTENTS PUBLIC HEALTH NURSING INTERVENTIONS 1 SURVEILLANCE 13 DISEASE HEALTH EVENT INVESTIGATIO 30 OUTREACH 43 CASE FINDING 58 SCREENING 67 REFERRAL FOLLOW UP 84 CASE MANAGEMENT 99 DELEGATED FUNCTIONS 120 HEALTH TEACHING 129 COUNSELING 160 CONSULTATION 175 COLLABORATION 188 COALITION BUILDING 223 COMMUNITY ORGANIZING 248 ADVOCACY 277 SOCIAL MARKETING 300 POLICY DEVELOPMENT ENFORCEMENT 329 PUBLIC HEALTH NURSING INTERVENTIONS PUBLIC HEALTH NURSES PHNS WORK IN SCHOOLS HOMES CLINICS JAILS SHELTERS OUT OF MOBILE VANS AND DOG SLEDS THEY WORK WITH COMMUNITIES THE INDIVIDUALS AND FAMILIES THAT COMPOSE COMMUNITIES AND THE SYSTEMS THAT IMPACT THE HEALTH OF THOSE COMMUNITIES REGARDLESS OF WHERE PHNS WORK OR WHOM THEY WORK WITH ALL PUBLIC HEALTH NURSES USE A CORE SET OF INTERVENTIONS TO ACCOMPLISH THEIR GOALS INTERVENTIONS ARE ACTIONS THAT PHNS TAKE ON BEHALF OF INDIVIDUALS FAMILIES SYSTEMS AND COMMUNITIES TO IMPROVE OR PROTECT HEALTH STATUS THIS FRAMEWORK KNOWN AS THE INTERVENTION MODEL DEFINES THE SCOPE OF PUBLIC HEALTH NURSING PRACTICE BY TYPE OF INTERVENTION AND LEVEL OF PRACTICE SYSTEMS COMMUNITY INDIVIDUAL FAMILY RATHER THAN BY THE MORE TRADITIONAL SITE OF SERVICE THAT IS HOME VISITING NURSE SCHOOL NURSE OCCUPATIONAL HEALTH NURSE CLINIC NURSE ETC THE INTERVENTION MODEL DESCRIBES THE SCOPE OF PRACTICE BY WHAT IS SIMILAR ACROSS SETTINGS AND DESCRIBES THE WORK OF PUBLIC HEALTH NURSING AT THE COMMUNITY AND SYSTEMS PRACTICE LEVELS AS WELL AS THE CONVENTIONAL INDIVIDUAL FAMILY LEVEL THESE INTERVENTIONS ARE NOT EXCLUSIVE TO PUBLIC HEALTH NURSING AS THEY ARE ALSO USED BY OTHER PUBLIC HEALTH DISCIPLINES THE PUBLIC HEALTH INTERVENTION MODEL DOES REPRESENT PUBLIC HEALTH NURSING AS A SPECIALTY PRACTICE OF NURSING SEE THE CORNERSTONES OF PUBLIC HEALTH NURSING APPENDIX A AN ENLARGED BLACK AND WHITE COPY OF THE WHEEL CAN BE FOUND IN APPENDIX B 1 1WILLIAMS C A HIGHRITER M E 1978 COMMUNITY HEALTH NURSING POPULATION AND PRACTICE PUBLIC HEALTH REVIEWS 7 4 201 THE INTERVENTION WHEEL THE MODEL OR THE INTERVENTION WHEEL AS IT HAS COME TO BE KNOWN INTEGRATES THREE DISTINCT AND EQUALLY IMPORTANT COMPONENTS 1 THE POPULATION BASIS OF ALL PUBLIC HEALTH INTERVENTIONS 2 THE THREE LEVELS OF PUBLIC HEALTH PRACTICE COMMUNITY SYSTEMS INDIVIDUAL FAMILY 3 THE 17 PUBLIC HEALTH INTERVENTIONS SURVEILLANCE DISEASE AND HEALTH THREAT INVESTIGATION OUTREACH SCREENING CASE FINDING REFERRAL AND FOLLOW UP CASE MANAGEMENT DELEGATED FUNCTIONS HEALTH TEACHING COUNSELING CONSULTATION COLLABORATION COALITION BUILDING COMMUNITY ORGANIZING ADVOCACY SOCIAL MARKETING POLICY DEVELOPMENT AND ENFORCEMENT THE MODEL ITSELF CONSISTS OF A DARKENED OUTSIDE RING THREE INNER RINGS AND SEVENTEEN SLICES EACH OF THE INNER RINGS OF THE MODEL ARE LABELED POPULATION BASED INDICATING THAT ALL PUBLIC HEALTH INTERVENTIONS ARE POPULATION BASED A POPULATION IS A COLLECTION OF INDIVIDUALS WHO HAVE ONE OR MORE PERSONAL OR ENVIRONMENTAL CHARACTERISTICS IN COMMON 1 A POPULATION OF INTEREST IS A POPULATION THAT IS ESSENTIALLY HEALTHY BUT WHO COULD IMPROVE FACTORS THAT PROMOTE OR PROTECT HEALTH A POPULATION AT RISK IS A POPULATION WITH A COMMON IDENTIFIED RISK FACTOR OR RISK EXPOSURE THAT POSES A THREAT TO HEALTH 1 PUBLIC HEALTH INTERVENTIONS ARE POPULATION BASED IF THEY FOCUS ON ENTIRE POPULATIONS POSSESSING SIMILAR HEALTH CONCERNS OR CHARACTERISTICS THIS MEANS FOCUSING ON EVERYONE ACTUALLY OR POTENTIALLY IMPACTED BY THE CONDITION OR WHO SHARE A SIMILAR CHARACTERISTIC POPULATION BASED INTERVENTIONS ARE NOT LIMITED TO ONLY THOSE WHO SEEK SERVICE OR WHO ARE POOR OR OTHERWISE VULNERABLE POPULATION BASED PLANNING ALWAYS BEGINS BY IDENTIFYING 2 INDUSTRIAL NURSING 2 POPULATION BASED PRACTICE ASSESSMENT PLANNING AND EVALUATION MODEL 1999 CHS PLANNING GUIDELINES MINNESOTA DEPARTMENT OF HEALTH ATTACHED AS AN APPENDIX 3 INSTITUTE OF MEDICINE 1988 THE FUTURE OF PUBLIC HEALTH WASHINGTON DC NATIONAL ACADEMY PRESS 4SEE FOR INSTANCE EVANS R G STODDARD G L 1990 PRODUCING HEALTH CONSUMING HEALTH CARE SOCIAL SCIENCE AND MEDICINE 31 1347 1363 OR WILKINSON R MARMOT M 1998 SOCIAL DETERMINANTS OF HEALTH THE SOLID FACTS WORLD HEALTH ORGANIZATION AVAILABLE HTTP WWW WHO UK DOCUMENT E59555 PDF 5TURNOCK B 1997 PUBLIC HEALTH WHAT IT IS AND HOW IT WORKS GAITHERSBURG MD ASPEN PUBLISHERS EVERYONE WHO IS IN THE POPULATION OF INTEREST OR THE POPULATION AT RISK FOR EXAMPLE IT IS A CORE PUBLIC HEALTH FUNCTION TO ASSURE THAT ALL CHILDREN ARE IMMUNIZED AGAINST VACCINE PREVENTABLE DISEASE EVEN THOUGH LIMITED RESOURCES MAY COMPEL PUBLIC HEALTH DEPARTMENTS TO TARGET PROGRAMS TOWARD THOSE CHILDREN KNOWN TO BE AT PARTICULAR RISK FOR BEING UNDER OR UNIMMUNIZED THE PUBLIC HEALTH SYSTEM REMAINS ACCOUNTABLE FOR THE IMMUNIZATION STATUS OF THE TOTAL POPULATION OF CHILDREN 2 PUBLIC HEALTH INTERVENTIONS ARE POPULATION BASED IF THEY ARE GUIDED BY AN ASSESSMENT OF POPULATION HEALTH STATUS THAT IS DETERMINED THROUGH A COMMUNITY HEALTH ASSESSMENT PROCESS A POPULATION BASED MODEL OF PRACTICE ANALYZES HEALTH STATUS RISK FACTORS PROBLEMS PROTECTIVE FACTORS ASSETS WITHIN POPULATIONS ESTABLISHES PRIORITIES AND PLANS IMPLEMENTS AND EVALUATES PUBLIC HEALTH PROGRAMS AND STRATEGIES 2 THE IMPORTANCE OF COMMUNITY ASSESSMENT CANNOT BE EMPHASIZED ENOUGH ALL PUBLIC HEALTH PROGRAMS ARE BASED ON THE NEEDS OF THE COMMUNITY AS COMMUNITIES CHANGE SO DO COMMUNITY NEEDS THIS IS WHY THE CORE FUNCTION OF ASSESSMENT IS SO IMPORTANT 3 PUBLIC HEALTH AGENCIES NEED TO ASSESS THE HEALTH STATUS OF POPULATIONS ON AN ONGOING BASIS SO THAT PUBLIC HEALTH PROGRAMS RESPOND APPROPRIATELY TO NEW AND EMERGING PROBLEMS CONCERNS AND OPPORTUNITIES 3 PUBLIC HEALTH INTERVENTIONS ARE POPULATION BASED IF THEY CONSIDER THE BROAD DETERMINANTS OF HEALTH A POPULATION BASED APPROACH EXAMINES ALL FACTORS THAT PROMOTE OR PREVENT HEALTH IT FOCUSES ON THE ENTIRE RANGE OF FACTORS THAT DETERMINE HEALTH RATHER THAN JUST PERSONAL HEALTH RISKS OR DISEASE EXAMPLES OF HEALTH DETERMINANTS INCLUDE INCOME AND SOCIAL STATUS HOUSING NUTRITION EMPLOYMENT AND WORKING CONDITIONS SOCIAL SUPPORT NETWORKS EDUCATION NEIGHBORHOOD SAFETY AND VIOLENCE ISSUES PHYSICAL ENVIRONMENT PERSONAL HEALTH PRACTICES AND COPING SKILLS CULTURAL CUSTOMS AND VALUES AND COMMUNITY CAPACITY TO SUPPORT FAMILY AND ECONOMIC GROWTH 4 4 PUBLIC HEALTH INTERVENTIONS ARE POPULATION BASED IF THEY CONSIDER ALL LEVELS OF PREVENTION WITH A PREFERENCE FOR PRIMARY PREVENTION PREVENTION IS ANTICIPATORY ACTION TAKEN TO PREVENT THE OCCURRENCE OF AN EVENT OR TO MINIMIZE ITS EFFECT AFTER IT HAS OCCURRED 5 A POPULATION APPROACH IS DIFFERENT FROM THE MEDICAL MODEL IN WHICH PERSONS SEEK TREATMENT WHEN THEY ARE ILL OR INJURED NOT EVERY EVENT IS PREVENTABLE BUT EVERY EVENT DOES HAVE A PREVENTABLE COMPONENT THUS A POPULATION BASED APPROACH PRESUMES THAT PREVENTION MAY OCCUR AT ANY POINT BEFORE A PROBLEM OCCURS WHEN A PROBLEM HAS BEGUN BUT BEFORE SIGNS AND SYMPTOMS APPEAR OR EVEN AFTER A PROBLEM HAS OCCURRED 3 INDUSTRIAL NURSING