The document provides information on health care environment and related topics. It begins with definitions of health and environmental health. It then discusses Florence Nightingale's environmental theory of nursing, including the components of physical, psychological, and social environments according to her theory. The document also covers environmental health hazards in four categories, environmental influences on health, emerging environmental issues like global warming and acid rain, and the Environmental Protection Agency. It concludes with sections on economics concepts and indicators in health care as well as the planning process.

1. Health care Environment,
Mr.Veeresh Demashetti
MSc 1st Year
Govt. CON– KIMS, Hubli
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2. Content
• Definition
• Florence Nightingale’s Theory
• Environmental health Hazard
• Environmental Influences on Health
• The Environmental Protection Agency (EPA)
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3. Health care Environment
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4. Definition of Health:
According to W.H.O., Health is a state of
complete physical, mental, social and Spiritual well
being and not merely the absence of disease or
infirmity.
Environmental Health
It refers to the state of all substances, forces and
conditions in an individual's surroundings that may
exert an influence on health and well being. When
environmental conditions are favorable, health
status is enhanced.
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5. Florence Nightingale's
Environmental Theory of Nursing
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6. Introduction of Nightingales Theory
The foundation of Nightingale
theory is the environmental external conditions and forces
that influences life and development of an organism.
according to her, external influences and conditions can
prevent supress or contribute to disease or death.
her main goal was to help the patient to retained his or own
validity by meeting basic needs through control of
environment.

7. Types of Environment
Physical
Environment
Psychological
Environment
Social
Environment

8. Components Of Environment According To
Nightingale
 ComponentsOf Physical Environment
 Ventilation
 Air
 Cleanliness
 Light
 Noise
 Water
 Bedding
 Drainage
 Diet Etc

9. Components of Psychological Environment
Psychological environment can be affected
by physical environment which then causes stress. Stress
again may affect patient body or health status by means of
delayed recovery or in the form psychosomatic disorder.
The components of psychological environment include the
following
 Stress
 Communication
 Advices
 Hope etc

10. Components of Social Environment
social environment includes the social
components which influences on patient
health.
Ex: family , community etc

11. Environmental Health Hazards
4 general categories
oBiological.
oPhysical.
oChemical.
oPsychosocial.
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12. Environmental Health Hazards
▫ Biological
• Disease producing infectious agents in the
environment that are capable of entering the
human body such as viruses , bacteria or other
micro organisms are environmental hazards of
biological nature .
▫ Chemical
• These include toxic agents such as asbestos , lead
and pesticides such as insecticides ( DDT ,
hydrocarbons ) , industrial waste, emissions from
motor vehicles.
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13. 13
Environmental Health Hazards
▫ Physical
• Natural disasters such as earthquakes, volcanoes
and accidents, noise, heat, vibration, radiations,
insects, rodents and certain type of equipment fall
into the category of physical hazards.
▫ Psychosocial
• Many of the stressors violence, stress, substance
abuse and dependence are known threat to health
of individuals, families and communities.
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14. Environmental Influences on Health
1. Toxic Agents:
* Asbestos
It has been linked to diseases such as lung and GI cancer
*Lead
Biologically interferes with blood formation often resulting in anemia. It
can also cause kidney damage, birth defects, and injury to the CNS, poor
memory, hair loss, hypertension, mental retardation, convulsions, coma
and death.
*Pesticides
Pesticide residues are contact poisons and tend to accumulate in fatty
tissues in living organisms and remain in the body indefinitely.
2. Air Pollution
The effects of air pollution on the health of individuals depend on
the chemical properties of the pollutant and size of particle, which in
turn affects the site of deposition in the respiratory tract, adverse health
effects from air pollution may range from mild to severe.
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15. Environmental Influences on Health
3. Water Pollution
The most pressing health problems related to water quality involve
contamination of waterways with the microbial pathogens found in human
body wastes, a problem directly related to lack of or faulty sewage disposal
facilities.
4. Noise Pollution
It can be defined as any unwanted or undesirable sound in the
environment. Its effects can range from mildly annoying to psychologically
and physically debilitating.
5. Accidents
Unintentional injuries like falls, drowning and fires kill more than
100,000 people each year and incapacitate millions of others with many
lifelong disabilities. Of these approximately 46,000 deaths are motor vehicle
related injuries.
6. Social and Hazardous Wastes
Wastes are being generated at an alarming rate. The amount of solid
waste continues to soar, partly as a result of today's throw away ' attitude
where many products are used once and then discarded. In addition to solid
wastes, the disposal of hazardous waste is a critical issue.
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16. Emerging Environmental Issues
Major Issues
1.Population
2.Food Production
3.Natural Resources
4.Water
5.Forests
6.Wild Life
7. Pollution
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17. Emerging Environmental Issues
Global Warming
▫ As a result of increased burning of fossil fuels, deforestation and the
production of certain synthetic chemicals, there is dramatic increase
in heat trapping gases in the atmosphere. Carbon dioxide is the major
offender, allowing energy from the sun to pass through, while
absorbing radiation from the earth and creating a planetary hot
house. NASA (National Aeronautics and Space Administration) has
reported that the atmospheric ozone layer, which protects life from
harmful ultraviolet radiations, has begun to shrink globally. As ozone
layer diminishes in the upper atmosphere, the earth receives more
ultra violet radiations, which promotes skin cancers and cataracts and
depresses the human immune system.
Acid Rain
▫ Acid rain is caused by emission of sulphur dioxide and nitrogen
oxides. Nitrogen oxides, formed when fuel is burnt at high
temperature, come principally from motor vehicle exhaust, electric
utilities and industrial boilers that burn coal or oil. Once released into
the atmosphere, these compounds can be carried long distances by
prevailing winds until they return to the earth as acidic rain, snow, fog
or dust. Fish and wildlife suffer harm, lakes are contaminated,
buildings and statues deteriorate and people experience health
problems such as respiratory impairment.
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18. The Environmental Protection Agency (EPA)
• Legislation establishing regulations and policy
occurs at national level.
• The EPA is an independent agency formed to
coordinate environmental programs related to air
and water pollution, solid and hazardous waste
management, noise, public water supplies,
pesticides and radiation.
• The agency also administers the municipal sewage
treatment construction grant program authorized
by congress in the 1972 Clean Water Act.
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19. Save Earth
to
Save Life.
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20. ECONOMICS
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21. Economic Indicators of Health Care
1. Consumer Price Index (CPI): CPI measures the
average changes in prices of all types of consumer
goods and services purchased by urban wage earners
and clerical workers. This index is computed monthly
by the Federal Government.
2. Hospital Status : Admissions, Cost per inpatient
day, Length of stay, Outpatient visits, Occupation
rates and Staffed beds indicate consumption and cost
of consumption for hospital care.
3. National Health Expenditure : It includes both
public and private expenditures for personal health
care, medical research, the construction of medical
facilities, program administration, insurance costs
and Government sponsored public health
programmers.
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22. Economic Indicators of Health Care
4. Personal Consumption Expenditure ( PCE ) :
PCE represents private payments for medical care.
5. Personal Health Care Expenditure ( PHCE ) :
• It indicates expenditures for consumers whether
insured or not. Included are expenses for no prescribed
drugs and medicines, household supplies and other
items not covered by insurance.
6. Professional Status :
• Office Visits indicate the number of office calls
consumers make to a physician.
• Physician Fee reflects charges for office and other
physician visits.
• Surgical Charges indicate the fee for common surgical
procedures and emergency medical procedures.
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23. Economic Concepts in Health Care
• The three basic concepts of SUPPLY, DEMAND & COST
are intricately related in economics.
• The SUPPLY of health care refers to the amount of
resources currently available for delivering health services.
Resources include health care facilities, manpower and
financing.
• The DEMAND for health care refers to the amount and
type of health care the consumer requires and is willing to
purchase.
• The COST of health care refers to the amount a provider
pays to produce health related goods and services, as well
as the amount a consumer pays to purchase these goods
and services.
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24. PLANNING PROCESS
Planning is a process of analyzing and
understanding a system, formulating its goals
and objectives, assessing its capabilities,
designing alternative courses of action or plans
for the purposes of achieving these goals and
objectives, evaluating the effectiveness of these
plans, choosing the preferred plan, initiating the
necessary action for its implementation and
monitoring the system to ensure the
implementation of the plan and its desired effect
on the system.
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25. Health Planning
It is an orderly process of defining community
health problems, identifying correct needs and
surveying the resources to meet them,
establishing priority goals that are realistic and
feasible and projecting administrative action to
accomplish the purpose of the proposed
programme.
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26. Characteristics of Planning:
1. Planning is essential for the entire job.
2. Good planning should focus on the purpose i.e. every
programme including health programme has their own
purpose or objectives e.g. RCH programme.
3. Planning is a continuous process, there should be a
provision for flexibility to some extent according to
changes due to event or situation.
4. Planning should not be based on high ideals and be
blind to social and political conditions in the
environment.
5. Planning of health programmers must be precise in its
objectives, scope and the nature.
6. Planning should be documented because it serves as a
blue - print for implementation.
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27. Steps of Planning Process
• Analysis of the health situation.
• Establishment of objectives and goals.
• Assessment of resources.
• Fixing priorities.
• Write up the formulated plan.
• Programming and implementation. .
• Evaluation.
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28. Planning Cycle
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Assessing Planning
environment
Data collection &
Data analysis
Strategy
formulation &
Target setting
Participatory plan
formulation
Plan authentication
Task Adaptation &
plan
Implementation
Mid term
appraisal &
correction
Evaluation &
replanning

29. POLICIES
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30. Introduction
A policy is an established course of action
determined to achieve a desired outcome.
Government and institutions create policies
to achieve their missions.
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31. Definition
• Policy is defined as principles that govern actions
directed towards given ends; policy statements set
forth a plan, direction or goal for action.
Policies may be laws, regulations or guidelines
that govern behavior in the public arena, such as in
Government or in the private arena such as in
workplaces, schools, organizations and
communities.
• Policies are formalized procedures that are followed
by persons responsible for delivering Governmental
or institutional services.
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32. Health Policy:
It refers to the public or private rules,
regulations, laws or guidelines that relate to the
pursuit of health and the delivery of health
services.
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33. Implied and Expressed Policies
Implied Polices :
Implied policies are neither written nor
expressed verbally, have usually developed over
time and follow a precedent.
• For example a hospital may have an implied
policy that employees should be encouraged and
supported in their activity in community,
regional and health care organizations.
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34. • Expressed Polices:
Expressed policies are donated verbally or in
writing. Most organizations have many written
policies that are readily available to all people
and promote consistency of action.
It may include a formal dress code, policy for
sick leave or vacation time and disciplinary
procedures.
Before any action is taken, an issue should be
put on the public agenda.
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35. Policy Decisions :
According to Mason, Leavitt and Chaffee
Policy decisions reflect the values and beliefs of
those making the decisions.
As the values and beliefs change, so do policy
decisions.
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36. Types of Policies
1. Distributive Policies: Distributive policies extend goods
and services to members of an organization, as well as
distributing the costs of goods or services amongst the
members of organization.
2. Regulatory Policies : These policies are generally thought
to be best applied in situations where good behavior can
be easily defined and bad behavior can be easily
regulated and punished through fines.
3. Constituent Policies : These create executive power
entities or deal with laws.
4. Miscellaneous Policies : Policies are dynamic; they are
not just static list of goals or laws. Policy blueprints have
to be implemented, often with unexpected results.
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37. Other Types of Policy
• Domestic Policy:
• Economic Policy
• Education Policy
• Environmental Policy
• Health Policy Analysis
• Foreign Policy
• Human Resource Policy
• Public Policy
• Social Policy
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38. Impact of Policy on Nursing
• Public policy has significant impact on the practice
of nursing. The ability of the individual nurse to
provide is affected by public policy decisions.
• State licensure of a registered nurse (RN) derives
from legislation that defines the scope of nursing
practice. The defined scope determines what a nurse
legally can and cannot do.
• Regulations that are developed to implement
legislation also affect practicing nurses and their
work environments.
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39. Spheres of Nursing Influence
• The nurse has an opportunity to make an impact
on policies in four aspects of influence as
identified by Talbot and Mason (1988).
These spheres are:
• Government.
• Work place.
• Organizations.
• Community.
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40. 1. Government:
• Laws, with their accompanying rules and regulations, control
nursing practice and health care.
• Nurses have been more involved in federal and state
Governments, although local Governments provide many
health care services.
• Local Governments control school health programs, local
public hospitals and home and community health care.
• In general, the nurse first must be a registered voter.
• Nurses can join collective actions by working with PACs
(Political Action Committees). These committees support
deserving candidates who support nursing and health care
issues.
• Most states have state nurses association PACS for state and
local candidates.
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41. 2. Workplace :
• Over 66 % of nurses work in hospitals and
should be influential in setting hospital policies,
especially regarding patient care. Nurses can
influence how quality care is delivered with
controlled costs. Most hospitals currently
require that many non nursing tasks be done by
nurses. Through collective action, nurses serving
on committees in the institution can help
eliminate these tasks.
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42. 3.Organizations :
• Important influences include professional
organizations such as ANA and many specialty
organizations.
• The organizations work in coalitions with other
health groups to support or oppose issues.
• By joining and being active in a professional
organization, an individual nurse has access to a
wider range of tools and information to use in
order to influence health care policies.
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43. 4. Community :
• Political involvement with community often
arises out of one's own interest in living and
working in community that is supportive of the
health and well being of it citizens .
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44. POLITICAL PROCESS IN NURSING
PROFESSION
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45. Politics
• Merriam Webster's Collegiate Dictionary (1994)
defines politics as “the art or science concerned
with guiding or influencing guiding policy and,
the art or science of winning and holding control
over a government”.
• Policies are the decisions; Politics is the
influence of those decisions.
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46. Politics and Nursing
Broader issues affecting the nursing
profession are political in nature. Issues of pay
equity or equal pay for the work of comparable
value are of concern to nurses, because they have
historically been underpaid for their services.
One of the earliest case demonstrating the
inequality of nursing salaries involved public
health nurses in Colorado. They were paid
considerably less than city tree trimmers and
garbage collectors.
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47. • Times have changed. Through the efforts of
American Nurses Association (ANA) , other
professional organizations , constituent member
associations , political action committees
(PACS), nurses are now participating much
more effectively in both Governmental and
Electoral politics .
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48. Levels of Politics in Nursing
Nurse Citizens
Nurse Activists
Nurse Politicians
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49. Current Political Issues Affecting the
Practice of Professional Nursing and
Health Care
• The patient safety act of 1997
• The Genetic Information Non - discrimination in
Health Insurance Act of 1997
• The HIV Prevention Act of 1997
• Victims of Abuse Protection Act of 1997
• The Tele health Bill of 1997
• Working Families and Flexibility Act
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50. Causes of Political Apathy in Nursing
• Lack of political knowledge:
• Powerlessness in nursing:
• Perceived ethical conflict between professional
values and political involvement:
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51. CONCLUSION
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52. Thank You
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