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Interventions/Nursing Actions

The nursing process is a familiar framework within which to craft interventions or nursing actions in environmental health. The following is based on the nursing practice recommendations in the IOM's report on Nursing, Health and Environment. Case studies are included to further illustrate the possibilities for nursing intervention.

Assessment Elements

• The Exposure History of the Individual, Family or Community - Click for Assessment for specific tools and checklists
• The visual inspection, site visit or "Walk-Through" - The visual inspection should be attempted whenever possible to increase the assessment data. Click here for more information on Homes, Schools, Workplaces, and Community Assessments.
• Risk Assessment - Review the existing health effects information about the Hazards which are identified. Included specific exposure measurements if available. Click on the Hazards A-Z or Resources sections for more in-depth information
• Identifying Patterns of co-morbidity among family/community members suggesting environmental etiologies. (Consider reviewing Environmental Epidemiology in Basic Concepts).
• Be alert for sentinel events.
• Continuous input from individuals, families, communities

Diagnosis

• North American Nursing Diagnosis Association (NANDA) Nursing Diagnosis for individuals, families and communities;Nurse practitioners may use medical terminology.

Planning/Outcomes

• Establish health optimal outcomes for individuals, families and communities

Interventions  Not every situation will require every interventions listed below, however, this is a framework for planning nursing interventions.

• Education - Providing information about hazards and ways to protect from hazards
  • Access to information: Utilizing Right to Know laws
  • Must have knowledge of local resources
  • Ability to access resources
  • Risk Communication
  • Community Education
  • Internet Consumer Resources
• Advocacy
  • Enforcement of existing regulations
  • New protections or regulations
  • Providing testimony
  • Invoking Precautionary Principle
• Referrals
  • Occupational/Environmental medicine experts for verification of medical diagnosis
  • Nursing Colleagues: Occupational Health Nurses
  • Environmental engineers/industrial hygiene
  • Public Health agencies
  • Legal Organizations
  • Social Services
• Case Management
  • Coordinating activities to reduce/eliminate exposure

Evaluation

• Consider health outcomes
• Evaluate Hazard Abatement - Has hazard been removed?
• Effectiveness of Interventions
• Preventive Measures in place to prevent future occurrences
• Patient/Community satisfaction