Heath promotion as defined by the World Health Organization (WHO, 2013) is “the process of enabling people to increase control over, and to improve health. It moves beyond a focus on individual behavior towards a wide range of social and environmental interventions. ” It is the intention of this writer to present health promotion in nursing practice and relate this to methods implemented that encompass nursing. For the purpose of this paper the writer will use stroke to exemplify the issues. Influential forces effecting health can be political, social, physical, and economic.
Internal factors affecting health can be emotional, intellectual, spiritual and psychosocial. Ones own lifestyle guides the way for health promotion or health destruction. The American Nurses Association (ANA) guides the scope of practice by advocating safe quality care. Included is the necessity to provide interventions that include health promotion and prevention of sickness and disability. The patient today is more complex and the focus includes family and community. Three levels of nursing prevention primary, secondary, and tertiary should involve consumers (ANA, 2007).
The purpose of health promotion in nursing practice it to educate, influence and assist the patient to maintain an existing quality of life by preventing illness, slowing the progression of an illness or managing an illness. Public health promotion is an organized response to populations to prevent injury, disability, and address social conditions and problems . To have a well functioning society it is important to maintain a healthy community. Nursing Interventions assist the patient to make educated choices regarding lifestyle changes.
According to Edelman and Mandle (2010) these various levels of health promotion introduced by Leavall and Clark are primary, secondary, and tertiary. They are on a continuum but may overlap. Prevention at the primary level is to protect and promote health of the community or person from injury or disease (Edelman & Mandle, 2010). Community support is important at this level for the individual to incorporate and maintain healthy habits. Nursing plays an important role in education at this level in hopes of producing healthy behaviors.
According to Martinez and Kravitz (2010), education for cardiovascular health would include, healthy weight, smoking cessation, maintaining blood pressure, and a healthy diet. These health facts could educate the patient and guide in the prevention of stroke or myocardial infarction. Warning signs of stoke listed in this article are numbness/weakness, confusion/odd speech, visual problems, dizziness/ loss of coordination, and headache without a cause. Education implemented in the community regarding chronic disease is proactive. According to Alspac (2013) we still have a lapse in the use of calling 911when stroke symptoms are recognized.
They imply professionals need to provide better education on placing warning signs of a stroke as a “medical emergency by calling 911. ” Nursing can provide these implementations in a variety of settings. As we move forward to the secondary level of health promotion prevention as stated previously it can overlap with another level. This writer has experience in her work setting with a stroke alert team. Borrowed from the National Stoke Association is the acronym FAST (F=face, A= arm, S=speech, and T=time). At the secondary and primary level this could be recognized as a useful tool primarily for education and secondarily for assessment.
The secondary level is where interventions treat an early stage of a disease or provide screening. Screening gives one the ability to reduce disease progression by early detection. Nurses can influence by educating during screening (Edelman & Mandle, 2010). According to Bergman (2011) stroke is a major cause of long-term disability. By treating early one would hope not to progress to the tertiary level. Bergman (2011) states, ”Modern stroke care poses unique challenges to the nurse practitioner (NP) in diagnosis, care, risk prevention, patient education and, follow-up.
” (p. 659). The writer notes this must pertain to the type of stoke occurring. One needs to do a thorough evidence-based evaluation for appropriate interventions. Recommendations at the secondary level are for life style changes and treatment of any other existing diseases (Bergman, 2011). Screenings at the secondary level would include blood pressure checks, cholesterol level checks, assess physical activity level. Interventions may be to treat elevated blood pressure, lower cholesterol, treat diabetes appropriately, and start anticoagulants if warranted.
A patient encountering a stroke can have mild to profound disabilities. The tertiary level of health promotion is of great importance to a stroke patient and their family. Tertiary prevention is a process of minimizing effects of disability by preventing further decline. Tertiary promotions focus is rehabilitative measures and management of the disability by helping the patient achieve and maintain an ideal functioning level (Edelman & Mandle, 2010). Education is a continuum from the secondary level to the tertiary level with patient and family.
According to Cameron (2013) the family educational needs may differ from the patients needs including changes at home after discharge, altered roles, and stressors with available resources. At the tertiary level of stoke rehabilitation there is a great emphasis on multidisciplinary collaborative education (Cameron, 2013). This writer practiced rehabilitative nursing and the facility had a transition room. This room mimicked a home setting with bedroom and kitchen. The patient’s family would provide all care prior to discharge in preparation for home care.
It tremendously helped in planning further educational needs and discharge readiness. Jarmer and Fielding (2010) interventions include improving mobility and independence and assisting to cope with change. Treatment plans must be individualized to the type of disability. The biggest issue after discharge is safety. Nurses make up the majority of health care providers patients interact with. Nurses are a major resource for education and health promotion. The future of nursing is changing from an acute care based practice to a community based health promotion practice.
The role of the nurse in this new practice will be multifaceted. Public health nursing will be an expanding role. The shift in role to public health nurse will require analytic assessment skills, cultural competence, program planning skills and, community dimension skills (Kulbok, Thatcher, Park, & Meszaros, 2013). Cultural competencies assist the nurse to understand health promotion from the community’s viewpoint. This can includes values, beliefs, traditions and, attitudes. Program planning is used to optimize health through evidence-based programs made possible with analytic assessment skills (Kulbok et.
al. , 2013). Community dimensions skills refer to collaborative efforts among community leaders and stakeholders. The United States is a melting pot of cultural diversity nurses need to be prepared at all levels. There are many aspects of emerging roles of future nursing most notable is the ability to lead. References Alspach, J. (2013). Improving recognition and response to onset of stroke. Critical Care Nurse, 33, 9-13. doi:10. 4037 /ccn2013909 American Nurses Association (ANA). (2007). Health of the public. Retrieved from http://web. archive. org/web/20071027171411/http://www. nursingworld. org/
MainMenuCategories/HealthcarePolicyIssues/HoP. aspx Bergman, D. (2011). Preventing recurrent cerebrovascular events in patients with stroke or transient ischemic attack: The current data. Journal Of The American Academy Of Nurse Practitioners, 23, 659-666. doi:10. 1111/j. 1745-7599. 2011. 00650. x Cameron, V. (2013). Best practices for stroke patient and family education in acute care Setting: A literature review. MEDSURG Nursing, 22(1), 51-55. Edelman, C. , Mandle, C. (2010). Health promotion throughout the life span. Retrieved From http://pageburstls. elsevier. com/books/9780323056625/id//B97803230566
25000103_p1005 Jarmer, L. , & Fielding, R (2010). After the stroke. Rehab Management : The Interdisciplinary Journal Of Rehabilitation, 23(5), 18-21. Kulbok, P. A. , Thatcher, E. , Park, E. , Meszaros, P. S. (2012). Evolving public health nursing Roles: Focus on community participatory health promotion and prevention. The Online Journal Of Issues In Nursing, 17, doi: 10. 3912/OJIN. vol17No02Mn01 Martinez, A. , & kravitz, L. (2010). Cardiovascular health goals. IDEA Fitness Journal. 7(5), 14-17. World Health Organization (WHO). (2013). Health Promotion. Retrieved from http://www. Who. int/topics/health_promotion/en/
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