Environmental Health and Nursing Theory January 13, 2009

The Domains of Nursing Person, Environment, Health and Nursing: Concepts common to all theories and frameworks of nursing Comprehensive, holistic approach to the care of people and communities Theories and frameworks are a way to identify a body of unique body of knowledge to a given profession The purpose: Theories and frameworks in nursing guide practice, education and research as well as domains of expertise and areas of advocacy Person: the person or community receiving care Health: state of wellbeing Nursing: the art and science of providing care Environment: internal and external surroundings – despite this and our founder florence nightingale’s emphasis on environment, the physical environment is a forgotten piece of the nursing domain. It is however, as evidenced by all of you who have come here today, a critical component of health and needs to be put back into nursing education, and practice.

Nightingale’s EH Theory Environmental factors affecting health Adequate ventilation has also been regarded as a factor contributing to changes of the patient's process of illness recovery Defined in her environmental theory are the following factors present in the patient's environment: Pure or fresh air Pure water Sufficient food supplies Efficient drainage Cleanliness Light (especially direct sunlight) Any deficiency in one or more of these factors could lead to impaired functioning of life processes or diminished health status.

The Reality Although the domain of “environment” is in most major nursing theories and models, very few explicitly include the effects of environmental health hazards on human health. My PhD story Many nursing theorists have included the domain, but it usually refers to the psychosocial environment, or the “ climate” meaning therapeutic environment.

For students, at first not sure how to put this eh info into context

A model of the determinants of health. Reprinted from R.G. Evans and G.L. Stoddart, "Producing Health, Consuming Health Care," Social Science and Medicine," 31:1359

Integrative Model for Environmental Health (Dixon & Dixon, 2002)

Approaches to Teaching Environmental Health to Students Incorporation of environmental health assessment into comprehensive health assessment of individuals and communities Insertion of evidenced based environmental health content into disease prevention and management content Addition of environmental health principles such as reduction of toxins, body burden and less hazardous substitution into patient and community teaching, particularly for vulnerable populations

The Nursing Process and Environmental Health Hazards Identification and assessment of risks Prioritization of needs Interventions to minimize risk - Do the “doable” Implement plan and teach risk reduction Evaluate When we teach environmental health concepts, it is important to relate them and imbed them into the content you are trying to get across. On day one I always ask my students to tell me how they plan their care for a patient in the hospital. So we talk about the nursing process, and then I ask them to relate that to environmental health risks.

Questions