The Code of Ethics of the American Nurses Association (2001) promotes social reform by focusing on health policy and legislation to positively affect accessibility, quality, and cost of health care. Community health nurses must align themselves with public health programs that promote and preserve the health of populations by influencing sociocultural issues, such as human rights, homelessness, violence, and stigma of illness. Directing care toward socioeconomic issues, psychosocial issues, or developmental issues focuses on individuals, families, or groups, which in turn contributes to the health of the total population.
During the settled village stage of the Mesolithic period and Neolithic period, people became sedentary, formed villages, and domesticated herds of animals. They lived in close proximity to the animals and contracted diseases such as salmonella, anthrax, Q fever, and so forth because of cross-contamination of water and food supply. In the hunting and gathering stage, groups may have avoided many contagious diseases because the scattered aggregates were small, nomadic, and separated from other aggregates. In the preindustrial stage, large urban centers formed to support the expanding population. In the industrial cities stage, there was an increase in respiratory diseases such as tuberculosis, pneumonia, and bronchitis and in epidemics of infectious diseases such as diphtheria, smallpox, typhoid fever, typhus, measles, malaria, and yellow fever.
Community health nurses often perform a windshield surveys by driving or walking through an area and making organized observations to help gain an understanding of the environmental layout, including geographic features and the location of agencies, services, businesses, and industries and to locate possible areas of environmental concern through sight, sense, and sound. A needs assessment is completed by the community health nurse to gain understanding of the community's perspective on health status, the services used or required, and concerns. Census information is collected every 10 years by the U.S. Census Bureau to describe the population characteristics of the nation. To conduct an informant survey, the community health nurse may gather data by interviewing key informants in the community. Informants may be knowledgeable residents, elected officials, or health care providers.
A, B, C, D
Provisions from the Patient Protection and Affordable Care Act of 2010 include:
Creation of task forces on preventive services and community preventive services to develop, update, and disseminate evidence-based recommendations on health care delivery; establishment of the National Prevention, Health Promotion, and Public Health Council, an agency that will be charged with development of a national strategy to improve the nation's health; creation of an innovation center within the Centers for Medicare and Medicaid Services; and development of a national quality improvement strategy that will seek to improve delivery of health care services and population health.
Provision of billions of dollars for funding community health centers, school-based clinics, and the National Health Service Corps to improve access to care; establishment of an independent payment advisory board to make proposals to reduce the growth in Medicare spending; and establishment of a workforce advisory committee to develop a national workforce strategy and to suggest ways to enhance the workforce supply by supporting education of health professionals through scholarships and loans.
Regional Medical Programs were intended to establish regional cooperative arrangements among medical schools, research institutions, and hospitals to improve the health manpower and facilities available to the communities.
Cultural negotiation refers to the process in which messages, instructions, and belief systems are manipulated, linked, or processed between the professional and lay models of health problems and preferred treatment. In each act, the nurse gives attention to eliciting the client's views regarding a health-related experience (e.g., pregnancy, complications of pregnancy, or illness of an infant). Cultural diversity is a multifaceted and complex concept that refers to the differences among people, especially those related to values, attitudes, beliefs, norms, behaviors, customs, and ways of living. Cultural competence is respecting and understanding the values and beliefs of a certain cultural group so that one can function effectively in caring for members of that cultural group. Cultural imposition is a person's tendency to impose his or her own beliefs, values, and patterns of behavior on individuals from another culture.