course materials

1. Community Nursing Discussion Question
Community Nursing Discussion Question ON Community Nursing Discussion
QuestionOccupational HealthPlease read chapters 29 and 30 of the class textbooks and
review the attached PowerPoint presentations. Once done answer the following
questions;1. Discuss how Healthy People 2020 can be used to shape the care given in a
school health setting. Give at least one example.2. Identify and discuss the eight components
of a comprehensive school health program.3. Identify and discuss the skills and
competencies germane to occupational health nursing.4. Describe and discuss a
multidisciplinary approach for the resolution of occupational health
issuesINSTRUCTIONS:As stated in the syllabus present your assignment in an APA format
attached to the forum in the discussion tab of the blackboard titled “Week 15 discussion
questions” and the SafeAssign exercise in the assignment tab of the blackboard (which is
mandatory). A minimum of 3 evidence-based references besides the class textbook no older
than 5 years must be used and quoted according to APA guidelines. A minimum of 800
words are required. Please make sure to follow the instructions as given and use either
spell-check or Grammarly before you post your assignment. I will also pay close attention to
spelling and/or grammar. You must present the assignment according to how it is posted,
answering the questions by number and essay-style assignments will not be accepted
unless otherwise specified.Community Nursing Discussion
Questionattachment_1attachment_2Unformatted Attachment PreviewChapter 30
Occupational Health Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an
imprint of Elsevier Inc. Occupational Health Nursing The specialty practice that focuses on
the promotion, prevention, and restoration of health within the context of a safe and healthy
environment … – American Association of Occupational Health Nurses (2012) Copyright ©
2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 2 Occupational
Health Nursing … … includes the prevention of adverse health effects from occupational and
environmental hazards. … provides for and delivers occupational and environmental health
and safety programs and services to clients. … is an autonomous specialty, and nurses make
independent nursing judgments in providing health care services. – American Association of
Occupational Health Nurses (2004) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by
Saunders, an imprint of Elsevier Inc. 3 Occupational Health Nursing … (Cont.) … has a
multidisciplinary base: ? Nursing science ? Medical science ? Occupational health sciences ?
Epidemiology ? Business and economic theories, concepts, and principles ? Social and
behavioral sciences ? Environmental health ? Legal and ethical issues Copyright © 2015,

2. 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 4 Occupational
Health Nursing Knowledge Domains Figure 30-1 From Rogers B: Occupational health
nursing expertise, AAOHN J 46:477-483, 1998. Copyright © Bonnie Rogers, 1998. Copyright
© 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 5 Evolution
of Occupational Health Nursing: Part 1 ? ? ? ? ? 1888: Betty Moulder hired by a group of coal
mining companies 1895: Ada Mayo Stewart was “first industrial nurse” 1897: Anna B.
Duncan visited sick employees at home 1899: Nursing service established for employees at
worksite 1912: Workers’ compensation legislation passed; cost-effectiveness of providing
health care to employees was achieving increased recognition Copyright © 2015, 2011,
2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 6 Evolution of Occupational
Health Nursing: Part 2 ? ? ? ? ? 1913: A registry of industrial nurses initiated 1915: Basis for
Industrial Nurses Organization formed 1916: Factory Nurses Conference organized 1917:
First educational course for industrial nurses offered at Boston University’s College of
Business Administration Great Depression: Nurses lost jobs because industrial nursing was
considered nonessential Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an
imprint of Elsevier Inc. 7 Evolution of Occupational Health Nursing: Part 3 ? ? ? ? ?
Community Nursing Discussion QuestionWorld War I: Government demanded health
services for workers at factories and shipyards holding defense contracts World War II:
Increased number of women in workforce 1942: Health conservation of the “industrial
army” was the most urgent civilian need during the war 1938-1943: Number of
occupational health nurses increased by 10,000 1942: American Association of Industrial
Nurses formed Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of
Elsevier Inc. 8 Evolution of Occupational Health Nursing: Part 4 ? ? ? ? ? ? 1951: AAIN voted
to remain an independent, autonomous association, not merge with NLN 1953: Industrial
Nurses Journal formed (now AAOHN Journal) 1977: AAIN became American Association of
Occupational Health Nurses (AAOHN) 1989: AAOHN developed first research agenda 1993:
Office of Occupational Health Nursing established by OSHA 1999: AAOHN Foundation
established and competencies in the specialty were delineated. Copyright © 2015, 2011,
2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 9 Evolution of Occupational
Health Nursing: Part 5 ? ? ? 2003: Annual joint conference, the American Occupational
Health Conference was abolished even though it was 60 years old 2005: AAOHN held its
first separate occupational health nursing conference 21st Century: AAOHN continues to
expand specialty borders, emphasizing the importance of occupational health concepts and
population-based practice. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders,
an imprint of Elsevier Inc. 10 Demographic Trends and Access Related to Occupational
Health Care ? Industrial transformations in the 21st century: ? ? ? ? ? ? ? Changing workforce
demographics Rising health care costs Diversity of health care systems with the integration
of managed care Influence of the world economy Shift in production from goods to services
Proliferation of advanced technologies Industry moving away from large facilities to
smaller, service-based businesses Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by
Saunders, an imprint of Elsevier Inc. 11 Occupational Health Nursing Practice and
Professionalism ? ? ? ? ? ? Often the only on-site health care professional. Collaborates with
workers, employers, and other professionals. Roles are diverse and complex. Coordinates

3. comprehensive, holistic services. Practice guided by AAOHN’s Standards of Occupational
and Environmental Health Nursing Practice and Code of Ethics (2012). Empowered, well-
trained, usually educated at the baccalaureate level. Copyright © 2015, 2011, 2007, 2001,
1997, 1993 by Saunders, an imprint of Elsevier Inc. 12 The Occupational Health Nurse ? ? ? ?
? Practice guided by an ethical framework. Encourages and enables individuals to make
informed decisions about health care concerns. Is a worker advocate; upholds professional
standards and codes. Responsible to and compensated by management; must practice
within a framework of company policies and guidelines. Fosters equitable and high-quality
health care services and safe, healthy work environments. Copyright © 2015, 2011, 2007,
2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 13 Occupational Health and
Prevention Strategies ? Prevention of exposure to potential hazards ? ? ? ? ? Biological-
infectious hazards Chemical hazards Enviromechanical hazards Physical hazards
Psychosocial hazards Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an
imprint of Elsevier Inc. 14 Primary Prevention Strategies ? Health promotion ? Facilitates
lifestyle changes • Community Nursing Discussion QuestionEnhances awareness • Increases
motivation • Builds skills • Creates environments that s positive health practices ? One-on-
one interaction is an important strategy for evaluating risk reduction behavior for
individuals Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of
Elsevier Inc. 15 Primary Prevention Strategies (Cont.) ? Disease prevention ? ? ? ? Recognize
health risks, diseases, or environmental hazards “Seize the moment” with every employee
encounter Use aggregate-focused intervention strategies “Walk-throughs” on a regular basis
• Recognize potential and existing hazards • Maintain communications with safety and
industrial hygiene resources to prevent illness and injury from occurring Copyright © 2015,
2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 16 Primary
Prevention Strategies (Cont.) ? Overall health promotion ? ? Health fairs, on-site fitness
center, etc. Nonoccupational programs ? ? Cardiovascular health, cancer awareness,
personal safety, immunization, prenatal and postpartum health, accident prevention,
retirement health, stress management, and relaxation techniques Emergency response, CPR,
first aid and CPR, right-to-know training, immunization programs for international business
travelers, back injury prevention with proper lifting and ergonomics Copyright © 2015,
2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 17 Primary
Prevention Strategies (Cont.) ? Women’s health and safety issues ? ? Maternal-child health,
reproductive health, breast cancer early detection, stress management, workhome balance,
etc. Racial and ethnic minority groups ? Basic health concerns for this population and the
illnesses traditionally associated with these groups or workers ? Programs must be
culturally and linguistically appropriate ? Veterans special health needs Copyright © 2015,
2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 18 Secondary
Prevention Strategies ? ? Aimed at early diagnosis, early treatment interventions, and
attempts to limit disability. Focus is on identification of health needs, health problems, and
employees at risk. ? ? ? Conduct assessments and provide treatment and referrals Health
screenings at worksite with relative ease, minimal cost Pre-placement evaluations for
baseline medical and occupational health history, and a targeted physical assessment and
medical tests (ADA compliance) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by

4. Saunders, an imprint of Elsevier Inc. 19 Secondary Prevention Strategies (Cont.) ?
Community Nursing Discussion QuestionFocus (Cont.) ? Periodic assessments to document
any health changes • Annual and biannual • Specific protocols for exposure to substances or
irritants (e.g., lead, asbestos, noise, chemicals) ? Job transfer evaluations • Document any
changes in health while working in a specific area or with a specific process • Comply with
OSHA regulations or NIOSH recommendations ? Assessment of commonly occurring health
conditions Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of
Elsevier Inc. 20 Tertiary Prevention Strategies ? Rehabilitation and restoration of the
worker to an optimal level of functioning ? ? ? ? Avoiding disability syndrome Case
management for the disabled employee’s successful return to work Negotiation of
workplace accommodations appropriate to the employee’s health limitations Counseling
and for workers returning to work Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by
Saunders, an imprint of Elsevier Inc. 21 Skills and Competences of Nurses ? Competent ? ?
Proficient ? ? Confident, has mastery of skills, ability to cope with specific situations,
stresses consistency of practice rather than individual differences Increased ability to
perceive situations as a whole based on past experiences, predict the events to expect, able
to alter protocols when needed Expert ? Extensive experience, broad knowledge base, able
to grasp situation quickly and initiate appropriate action; a sense of salience grounded in
practice guiding actions and priorities – Benner (1984) Copyright © 2015, 2011, 2007,
2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 22 Skills and Competencies of the
Occupational Health Nurse ? Skills and competencies ? Clinical and primary care ? Case
management ? Workforce, workplace, and environmental issues ? Legal and ethical
responsibilities ? Management and administration ? Health promotion and disease
prevention ? Occupational and environmental health and safety education ? Research ?
Professionalism ? Nursing Code of Ethics Copyright © 2015, 2011, 2007, 2001, 1997, 1993
by Saunders, an imprint of Elsevier Inc. 23 Federal Legislation and Occupational Health ?
Occupational Safety and Health Act—OSHA (1970) ? ? Workers’ Compensation Acts (state
based) ? ? Employers must “furnish a place of employment free from recognized hazards
that are causing or likely to cause death or serious physical harm to employees.” Provide
income replacement and health care for employees who sustain a work-related injury or
death. Americans with Disabilities Act—ADA (1990) ? Employers must make “reasonable
accommodations” to enhance opportunities for individuals with disabilities; prohibits
discrimination on the basis of disability. Copyright © 2015, 2011, 2007, 2001, 1997, 1993
by Saunders, an imprint of Elsevier Inc. 24 Legal Issues in Occupational Health ? ? The
occupational health nurse is professionally primarily accountable to workers and worker
populations and to the employer, the profession, and self. (AAOHN, 2012) Liability and legal
issues relate to… ? ? ? The employee-nurse relationship The employment capacity of the
occupational health nurse Any acts of negligence Copyright © 2015, 2011, 2007, 2001,
1997, 1993 by Saunders, an imprint of Elsevier Inc. 25 Multidisciplinary Teamwork Figure
30-2 Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier
Inc. 26 Chapter 29 School Health Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by
Saunders, an imprint of Elsevier Inc. School Health The healthy development of children and
adolescents is influenced by many societal institutions. After the family, the school is the

5. primary institution responsible for the development of young people in the United States. –
Centers for Disease Control and Prevention (CDC, 2011) Copyright © 2015, 2011, 2007,
2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 2 Academic Success ? ? ? ? It is
impossible to achieve success in school without maximizing the health of the students. Poor
academic performance is strongly correlated with uninsured status of youth; acquisition of
health insurance leads to an increase in school performance. Health problems lead to
increase in absenteeism. Community Nursing Discussion QuestionThe school nurse has a
unique opportunity to make a positive impact on the nation’s youth. Copyright © 2015,
2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 3 History of School
Health ? ? 1840: First mandatory education 1850: Shattuck Report ? ? ? ? Proposed that
health education was a vital component in the prevention of disease. 1860s: Prevention
program for smallpox 1870: Smallpox vaccination required 1902: NYC hired the first school
nurses ? Lillian Wald was able to show that the presence of school nurses could reduce
absenteeism by 50%. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an
imprint of Elsevier Inc. 4 History of School Health (Cont.) ? ? ? ? Early 20th century: Health
education and “gymnastics” introduced 1918: NEA and AMA published Minimum Health
Requirements for Rural Schools 1921: Schools required physical and health education; fire
drills required 1946: National School Lunch Program ? Included School Breakfast Program
in 1976 Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of
Elsevier Inc. 5 History of School Health (Cont.) ? ? ? ? ? ? 1960s: First NP programs with
inclusion of primary care services in schools 1975: Education for the Handicapped Act
1976: First National School Conference 1986: Drug-Free Schools and Community Act 1994:
Above act expanded to include violence prevention measures 1990s: CDC Division of
Adolescent and School Health formed Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by
Saunders, an imprint of Elsevier Inc. 6 History of School Health (Cont.) ? ? 1990s: School-
based health centers 2001: No Child Left Behind Act ? ? Safe and Drug Free Schools and
Communities focused on prevention of school violence and illegal use of alcohol, tobacco,
and drugs 2010: Patient Protection and Affordable Care Act (ACA) ? Awarded funds to 278
school-based health centers to create new sites and expand services ? Expansion of services
in medically underserved areas Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by
Saunders, an imprint of Elsevier Inc. 7 Components of School Health Programs ? ? ? ? ?
Health education Physical education Health services Nutrition services Counseling,
psychological, and social services ? ? ? Healthy school environment Health promotion for
staff Family and community involvement Copyright © 2015, 2011, 2007, 2001, 1997, 1993
by Saunders, an imprint of Elsevier Inc. 8 Components of School Health Programs (Cont.)
Figure 29-1 Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of
Elsevier Inc. 9 Health Education ? CDC guidelines and priority areas: ? Alcohol and drug use
? Injury and violence (including suicide) ? Tobacco use ? Poor nutrition ? Lack of physical
activity ? Sexual behavior that results in STDs or unwanted pregnancies Copyright © 2015,
2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 10 National Health
Education Standards ? ? ? Established to promote positive health behaviors for students in
all grades. Gives students, families, and communities a framework for development of
health education programs in schools. The students will… 1.…comprehend concepts related

6. to health promotion and disease prevention to enhance health. 2.…analyze the influence of
family, Community Nursing Discussion Questionpeers, culture, media, technology, and other
factors on health behaviors. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders,
an imprint of Elsevier Inc. 11 National Health Education Standards (Cont.) ? The student will
demonstrate the ability to… 3.…access valid information, products, and services to enhance
health. 4.…use interpersonal communication skills to enhance health and avoid or reduce
health risks. 5.…use decision-making skills to enhance health. 6.…use goal-setting skills to
enhance health. 7.…practice health-enhancing behaviors and avoid or reduce health risks.
8.…advocate for personal, family, and community health. – CDC (2011) Copyright © 2015,
2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 12 Youth Risk
Behavior Survey ? Conducted by the CDC every 2 years among selected high school students
in the U.S. ? ? http://www.cdc.gov/HealthyYouth/yrbs/index.htm Reports provide valuable
information that can help improve health education programs in schools. Copyright © 2015,
2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 13 Youth Risk
Behavior Survey (Cont.) ? Purposes of YRBS (CDC, 2007): ? ? ? ? ? ? Determine the
prevalence and age of initiation of health risk behaviors. Asses whether health risk
behaviors increase, decrease, or remain the same over time. Examine the co-occurrence of
health risk behaviors. Provide comparable data among subpopulations of youth. Provide
comparable national, state, territorial, tribal, and local data. Monitor progress toward
achieving the Healthy People 2020 objectives and other program indicators. Copyright ©
2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 14 Injury
Prevention ? Should be taught early and be age appropriate ? ? ? ? ? ? Bicycle safety and
helmets Proper use of backpacks Schoolyard and playground safety Motor vehicle safety for
adolescents Sports safety • Equipment • Hydration and frequent rest periods • Stretching,
warm-up, and cool-down activities • Pool safety Related school policies, recommendations,
data collection on injuries, and staff training Copyright © 2015, 2011, 2007, 2001, 1997,
1993 by Saunders, an imprint of Elsevier Inc. 15 Tobacco Use ? Tobacco ? Smoking is the
single leading preventable cause of death in the United States. ? An estimated 80% of adults
who use tobacco began before the age of 18 years. ? Adolescents who use smokeless tobacco
are more likely to become cigarette smokers. ? Adolescents targeted by tobacco advertising.
? Teach adolescents the negative consequences associated with tobacco. Copyright © 2015,
2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 16 Substance Abuse ?
Alcohol ? Use of alcohol and other drugs is associated with problems in school, injuries,
violence, and motor vehicle deaths. ? The most commonly used and abused drug among
children and …Community Nursing Discussion Question