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Population-Promotion-Prevention-And Disease Manage (NUR 4150) Public Health

John Marsh
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Nova Southeastern University

Population Health: Promotion, Prevention, And Disease Manage (NUR 4150)

Final Exam Review – Chapter summaries – Public Health Nursing: Population-Centered Health Care in the Community

Community Final Exam Review
Chapter 1
Public health is what members of a society do collectively to ensure that conditions exist in
which people can be healthy.
• Assessment, policy development, and assurance are the core public health functions at all
levels of government.
• Assessment refers to systematically collecting data on the population, monitoring of the
population’s health status, and making information available on the health of the community.
• Policy development refers to the need to provide leadership in developing policies that support
the health of the population, including the use of the scientific knowledge base in decision
making about policy.
• Assurance refers to the way public health practice makes sure that essential community-wide
health services are available. This may include providing essential personal health services for
those who would otherwise not receive them. Assurance also includes making sure that a
competent public health and personal health care workforce is available.
• The setting is frequently viewed as the feature that distinguishes PHN from other specialties. A
more useful approach is to use characteristics such as the following: a focus on populations of
individuals who live in the community, an emphasis on prevention, concern for the interface
between the health status of the population and the environment (e.g., physical, biological,
sociocultural), and the use of political processes to influence public policy to achieve goals.
• Specialization in PHN is seen as a subset of community-oriented nursing practice.
• Population-focused practice is the focus of specialization in PHN. The focus on populations in
the community and the emphasis on health protection, health promotion, and disease prevention
are the fundamental factors that distinguish PHN from other nursing specialties.
• Population is defined as a collection of individuals who share one or more personal or
environmental characteristics. The term population may be used interchangeably with the term
Chapter 2
• A historical approach can be used to increase the understanding of public and community
health nursing in the past and its contemporary dilemmas and future challenges.
• Public health and community health nursing are products of various social, economic, and
political forces and incorporate public health science in addition to nursing science and practice.
• Federal responsibility for health care was limited until the 1930s, when the economic
challenges of the Depression highlighted the need for and led to the expansion of federal
assistance for health care.
• Florence Nightingale designed and implemented the first program of trained nursing, and her
contemporary, William Rathbone, founded the first district nursing association in England.
• Urbanization, industrialization, and immigration in the United States increased the need for
trained nurses, especially in public and community health nursing.
• The increasing acceptance of public roles for women permitted public and community health
nursing employment for nurses and public leadership roles for their wealthy supporters.
• Frances Root was the first trained nurse in the United States who was salaried as a visiting
nurse. She was hired in 1887 by the Women’s Board of the New York City Mission to provide
care to sick persons at home.
• The first visiting nurse associations were founded in 1885 and 1886 in Buffalo, Philadelphia,
and Boston.
• Lillian Wald established the Henry Street Settlement, which became the Visiting Nurse
Service of New York City, in 1893. She played a key role in innovations that shaped public and
community health nursing in its first decades, including school nursing, insurance payment for
nursing, national organizations for public health nurses, and the US Children’s Bureau.
• Founded in 1902, with the vision and support of Lillian Wald, school nursing tried to keep
children in school so that they could learn.
• The Metropolitan Life Insurance Company established the first insurance-based program in
1909 to support community health nursing services.
• The National Organization for Public Health Nursing (founded in 1912) provided essential
leadership and coordination of diverse public and community health nursing efforts; the
organization merged into the new National League for Nursing in 1952.
• Official health agencies slowly grew in numbers between 1900 and 1940, accompanied by a
steady increase in public health nursing positions.
• The innovative Sheppard-Towner Act of 1921 expanded community health nursing roles for
maternal and child health during the 1920s.
• Mary Breckinridge established the Frontier Nursing Service in 1925 to provide rural health
• The tension between the nursing roles of caring for the sick and of providing preventive care
and the related tension between intervening for individuals and for groups have characterized the
specialty since at least the 1910s.
• The challenges of World War II sometimes resulted in extension of community health nursing
care and sometimes in retrenchment and decreased public health nursing services.
• By the mid-20th century, the reduced incidence of communicable diseases and the increased
prevalence of chronic illness, accompanied by large increases in the population older than 65
years of age, led to a reexamination of the goals and organization of community health nursing



Population-Promotion-Prevention-And Disease Manage (NUR 4150) Public Health

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