Learning Outcomes 1 Differentiate health care services based

Learning Outcomes 1. Differentiate health care services based on primary, secondary, and tertiary disease prevention categories. 2. Describe the functions and purposes of the health care agencies outlined in this chapter. 3. Identify the roles of various health care professionals.

Learning Outcomes (cont'd) 4. Describe the factors that affect health care delivery. 5. Describe frameworks for the delivery of nursing care. 6. Compare various systems of payment for health care services. Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Audrey Berman • Shirlee Snyder Copyright © 2012 by Pearson Education, Inc. All rights reserved.

Types of Health Care Services • Primary prevention – Health promotion – Illness prevention • Secondary prevention – Diagnosis – Treatment Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Audrey Berman • Shirlee Snyder Copyright © 2012 by Pearson Education, Inc. All rights reserved.

Primary prevention q Health promotion programs addresses areas such as: § adequate and proper nutrition § weight control, exercise and stress reduction q Health promotion activities: role of clients role in maintaining their own health and encourage them to maintain the highest level of wellness they can achieve Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Audrey Berman • Shirlee Snyder Copyright © 2012 by Pearson Education, Inc. All rights reserved.

• Primary prevention • illnesses prevention programs may be directed at the client or the community and involve such practice as: ü providing immunization ü identifying risk factor for illnesses ü early detection of disease : routine screening. e. g. mammograms screening, education to Brest cancer Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Audrey Berman • Shirlee Snyder Copyright © 2012 by Pearson Education, Inc. All rights reserved.

Types of Health Care Services • Tertiary prevention – Rehabilitation: – Health restoration – Palliative care: Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Audrey Berman • Shirlee Snyder Copyright © 2012 by Pearson Education, Inc. All rights reserved.

Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Audrey Berman • Shirlee Snyder Copyright © 2012 by Pearson Education, Inc. All rights reserved.

Primary Prevention • Healthy People 2010 – Increase quality and years of healthy life – Achieve health equity and eliminate health disparities – Create healthy environment for everyone – Promote health and quality life across the life span Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Audrey Berman • Shirlee Snyder Copyright © 2012 by Pearson Education, Inc. All rights reserved.

Primary Prevention (cont'd) • Address adequate and proper nutrition, weight control and exercise, and stress reduction • Emphasize the important role clients play in maintaining their own health and encourage to maintain the highest level of wellness clients can achieve Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Audrey Berman • Shirlee Snyder Copyright © 2012 by Pearson Education, Inc. All rights reserved.

Secondary Prevention • Hospitals – Emergency care – Intensive care – Around-the-clock care • Health promotion services – Early detection – Routine screening Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Audrey Berman • Shirlee Snyder Copyright © 2012 by Pearson Education, Inc. All rights reserved.

Tertiary Prevention • Help people move to their previous level of health • Highest level they are capable of given their current health status • Rehabilitation to function adequately in the physical, mental, social, economic, and vocational areas of their lives • Outreach programs for mental health illness Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Audrey Berman • Shirlee Snyder Copyright © 2012 by Pearson Education, Inc. All rights reserved.

Tertiary Prevention (cont'd) • Palliative care – Providing comfort and treatment – End-of-life care may be conducted in many settings including the home Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Audrey Berman • Shirlee Snyder Copyright © 2012 by Pearson Education, Inc. All rights reserved.

Health Care Agencies • Government agencies – Public health services – Local health departments develop programs to meet the health needs of the people, providing necessary nursing and staff to carry out these programs, continue evaluating the effectiveness of the program, and monitoring changing needs Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Audrey Berman • Shirlee Snyder Copyright © 2012 by Pearson Education, Inc. All rights reserved.

Health Care Agencies (cont'd) • Government agencies – State health organizations are responsible for assisting local health departments • Physicians’ offices – Routine health screening – Diagnosis and treatment Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Audrey Berman • Shirlee Snyder Copyright © 2012 by Pearson Education, Inc. All rights reserved.

Health Care Agencies (cont'd) • Ambulatory care centers – Diagnostic treatment facilities – Minor surgery • Occupational health clinics – Run by companies for employees – Health promotion activities Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Audrey Berman • Shirlee Snyder Copyright © 2012 by Pearson Education, Inc. All rights reserved.

Health Care Agencies (cont'd) • Hospitals – Acute inpatient services – Outpatient and ambulatory care – Emergency department – Hospice care • Subacute care – Variation of inpatient care – Technically complex treatments Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Audrey Berman • Shirlee Snyder Copyright © 2012 by Pearson Education, Inc. All rights reserved.

Health Care Agencies (cont'd) • Extended care facilities (formerly called nursing homes) – Independent living – Assisted, skilled, extended care facilities – Rehabilitation Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Audrey Berman • Shirlee Snyder Copyright © 2012 by Pearson Education, Inc. All rights reserved.

Health Care Agencies (cont'd) • Retirement and assisted-living centers – For clients unable to stay at home, but do not require hospital or nursing home Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Audrey Berman • Shirlee Snyder Copyright © 2012 by Pearson Education, Inc. All rights reserved.

Health Care Agencies (cont'd) • Rehabilitation centers – Restore or recuperate health – Drug and alcohol • Home health care agencies – Education to clients and families – Care to acute, chronic, or terminally ill Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Audrey Berman • Shirlee Snyder Copyright © 2012 by Pearson Education, Inc. All rights reserved.

Health Care Agencies (cont'd) • Rural care hospitals – Federal funding – Services for rural residents Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Audrey Berman • Shirlee Snyder Copyright © 2012 by Pearson Education, Inc. All rights reserved.

Health Care Agencies (cont’d) • Day-care centers – Infants or children – Adults that cannot be left at home • Hospice services – Care for dying in home or facility – Improve or maintain quality of life until death Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Audrey Berman • Shirlee Snyder Copyright © 2012 by Pearson Education, Inc. All rights reserved.

Health Care Agencies (cont'd) • Crisis centers – Emergency services for life crises – Counseling and support • Mutual support or self-help groups – Health problems – Life crises Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Audrey Berman • Shirlee Snyder Copyright © 2012 by Pearson Education, Inc. All rights reserved.

Health Care Professionals • Nurses • Alternative (complementary) care providers • Case manager • Dentists • Dietitians • Nutritionists Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Audrey Berman • Shirlee Snyder Copyright © 2012 by Pearson Education, Inc. All rights reserved.

Figure 6 -6 Although all members of the health care team individualize care for the client based on the expertise of their own discipline, there areas of overlap facilitated through teamwork. Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Audrey Berman • Shirlee Snyder Copyright © 2012 by Pearson Education, Inc. All rights reserved.

Health Care Professionals (cont'd) • Alternative (complementary care providers) • Dentists • Nurses • Nutritionists • Occupational therapists • Paramedics/EMTs • Pharmacists Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Audrey Berman • Shirlee Snyder Copyright © 2012 by Pearson Education, Inc. All rights reserved.

Health Care Professionals (cont'd) • • Physical therapists Physician assistants Podiatrists Respiratory therapists Social workers Spiritual support personnel Unlicensed assistive personnel (UAPs) Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Audrey Berman • Shirlee Snyder Copyright © 2012 by Pearson Education, Inc. All rights reserved.

Factors that Affect Health Care Delivery • • • Increasing number of elderly Advances in technology Economics Women’s health issues Uneven distribution of services Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Audrey Berman • Shirlee Snyder Copyright © 2012 by Pearson Education, Inc. All rights reserved.

Factors that Affect Health Care Delivery (cont'd) • Access to health insurance • Homeless and the poor • Demographic changes Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Audrey Berman • Shirlee Snyder Copyright © 2012 by Pearson Education, Inc. All rights reserved.