Barriers and Facilitators to the Incorporation of Environmental Health into Public Health Nursing Practice

ABSTRACT Objectives: To describe the environmental health (EH) demands placed on public health nurses (PHNs) as well as the barriers and facilitators to incorporating EH into PHN practice. Design and Sample: A cross‐sectional multimode (Web and pencil/paper) survey was used to collect data from PHNs in 1 rural western state. Research participants included 141 PHNs from a total of 228 survey invitations (61% response). Measures: A 39‐item questionnaire was developed to measure the frequency of EH demands experienced by PHNs as well as the barriers and facilitators to the incorporation of EH into PHN practice and standard demographics. Results: Significant numbers of PHNs reported less than baccalaureate preparation (29%), suggesting that EH competencies cannot be assumed. PHNs are often asked for basic EH information and cite lack of time and lack of interest on the part of the populations being cared for as barriers to incorporating EH into their practice. Facilitators included free or inexpensive continuing education programs offered via the Internet and additional Internet resources or staff resource people. Conclusion: PHNs represent a significant portion of the public health workforce and have implied and explicit mandates to address EH issues in their practice. Resources should be directed toward helping PHNs become better prepared to address the current and future EH needs of populations.     

Community/Public Health Nursing Practice Leaders' Views of the Doctorate of Nursing Practice

ABSTRACT Objectives: This paper presents thoughts of practice leaders in the community/public health nursing (C/PHN) specialty on advanced nursing practice (ANP) and the necessary educational preparation for such practice.
Design and Sample: Practice leaders were engaged in conversations specifically focused on the Doctor of Nursing Practice (DNP) as preparation for ANP in their specialties, and asked to consider the benefits of, and challenges to, this educational program.
Measures and Results: The resulting remarks were then assessed for themes by the interviewers and these are presented along with thoughts on the future of education for ANP.
Conclusion: Overall, there was much agreement among the practice leaders interviewed about the importance of a broad skill set for ANP in the specialty. However, the practice leaders interviewed here also identified the practical challenges involved in educating nurses at the DNP level in the C/PHN specialty, as well as some concerns about the definitions of ANP for the future.     

Essentials of Baccalaureate Nursing Education for Entry‐Level Community/Public Health Nursing

ABSTRACT Community/public health nursing (C/PHN) educators and practitioners need a framework from which to plan, implement, and evaluate curriculum and community‐based practice. The Association of Community Health Nursing Educators (ACHNE) periodically updates the Essentials of Baccalaureate Nursing Education for Entry Level Community/Public Health Nursing to reflect changes in core knowledge, basic competencies, and practice. This update reflects relevance to 21st‐century health care and to national trends influencing nursing education. The 2009 revision is based on critical analysis of key C/PHN literature and input from public health nursing educators and practitioners. A key assumption is that a baccalaureate nursing degree is the minimum requirement for professional C/PHN. Fifteen essential concepts for baccalaureate nursing education are delineated along with related competencies. Newly defined essentials include communication, social justice, and emergency preparedness, response, and recovery. Issues related to didactic and clinical experiences are addressed. The ACHNE Essentials is an important guide for baccalaureate education curriculum planning and evaluation. The Essentials may be useful as a baseline from which to develop competencies of graduate nursing programs. The document is also useful for guiding practice setting orientation and professional development.     

The Dialogue Continues: The Future of Public Health Nursing

This editorial reflects upon the current discussion among nursing academics and educators about the division between individual level care and population health and its implications for the subdiscipline of public health nursing, from the perspective of a current practitioner in the field.     

Research Priorities for Public Health Nursing

ABSTRACT The Association of Community Health Nursing Educators (ACHNE) Research Committee initiated a revision of the ACHNE Research Priorities for public health nursing practice in 2006, following those developed in 1992 and in 2000. The committee (a) reviewed public health nursing research abstracts (n=485) from 7 selected nursing journals to evaluate progress in addressing the 2000 Priorities; (b) identified research methods used, health issues and health behaviors addressed, and demographics of study populations in the abstracts; and (c) reviewed research priorities from key federal funding agencies and journal editors. Overall, progress toward meeting previous priorities was modest, with a limited range of methods, topics, and samples described. The 2009 ACHNE Research Priorities for public health nursing include: (1) Population‐Focused Outcomes, and (2) Public Health Nursing Workforce. Multisite studies, clinical trials, community‐based participatory research, development and/or analysis of existing large data sets, and development of valid and reliable methods are needed to address these priorities. Collaboration among educators, researchers, and practitioners is crucial to develop the scientific evidence base for population‐based nursing practice.     

Special Features: Clinical Concepts: Reinvigorating Performance Evaluation: First Steps in a Local Health Department

ABSTRACT The ability of a local health department to assess and improve employee performance through an effective evaluation process is critical to overall organizational success. A constructive performance evaluation process not only provides meaningful feedback on work performance but also provides opportunities to reinforce work behaviors that support the organization's mission, to recognize exceptional work, and to guide future growth and learning. The Los Angeles County Department of Public Health is creating a new approach to performance evaluation that recognizes 3 distinct components of work performance: standard business practices, competencies, and standards of practice. This multidimensional perspective acknowledges that the expectations of workers are complex and that evaluations of performance are not easily captured with single‐dimension assessment tools. This report describes the conceptual relationships of these 3 components and how they integrate to form a single performance evaluation process. Key elements within this structure include a base document of competencies for all workers, expanded competency sets for professional staff, role‐specific duty statements for workers who perform similar work, and standards of competent practice related to the mission of units to which individuals are assigned. Key first steps are to define the terminology of performance evaluation and to create role‐specific duty statements.     

Updating the Definition and Role of Public Health Nursing to Advance and Guide the Specialty

National changes in the context for public health services are influencing the nature of public health nursing practice. Despite this, the document that defines public health nursing as a specialty—The Definition and Role of Public Health Nursing—has remained in wide use since its publication in 1996 without a review or update. With support from the American Public Health Association (APHA) Public Health Nursing Section, a national Task Force, was formed in November 2012 to update the definition of public health nursing, using processes that reflected deliberative democratic principles. A yearlong process was employed that included a modified Delphi technique and various modes of engagement such as online discussion boards, questionnaires, and public comment to review. The resulting 2013 document consisted of a reaffirmation of the one‐sentence 1996 definition, while updating supporting documentation to align with the current social, economic, political, and health care context. The 2013 document was strongly endorsed by vote of the APHA Public Health Nursing Section elected leadership. The 2013 definition and document affirm the relevance of a population‐focused definition of public health nursing to complex systems addressed in current practice and articulate critical roles of public health nurses (PHN) in these settings.     

Academic Faculty Qualifications for Community/Public Health Nursing: An Association of Community Health Nursing Educators Position Paper

ABSTRACT The Association of Community Health Nursing Educators (ACHNE) has developed a number of documents designed to delineate the scope and function of community/public health nursing (C/PHN) educators, researchers, and practitioners. Consistent with the mission of ACHNE, this position paper entitled Academic Faculty Qualifications for Community/Public Health Nursing has been developed by the Faculty Qualifications Task Force. The shortage of qualified nursing faculty has been well documented. In particular, this shortage has increased the difficulty in having sufficient numbers of faculty who are educationally and experientially qualified to teach in the C/PHN specialty. ACHNE is addressing this concern by setting forth preferred qualifications for faculty to teach C/PHN at both the graduate and undergraduate level. While we recognize that the current faculty shortage may require schools to use faculty to teach in areas in which they do not have appropriate formal preparation, the paper outlines best practices for teaching C/PHN, a goal we urge all schools of nursing to work toward. Task Force members developed an earlier draft of the document in fall 2008, and input was solicited and received from ACHNE members and considered in the final document, which was approved by the ACHNE Executive Board in July 2009.     

Effectiveness of Community Health Worker/Nursing Student Teams as a Strategy for Public Health Nursing Education

ABSTRACT A unique program that partners community health workers with nursing students was developed in response to community‐based participatory research data and integrated into a public health practicum at a baccalaureate nursing program in West Michigan. The goal of the program is to promote the health of 3 underserved urban neighborhoods while educating nursing students in population health and public health nursing. The purpose of this paper is to describe program conception and implementation and discuss evaluation of educational outcomes as a public health learning experience.     

Establishing the Essential Nursing Competencies for Genetics and Genomics

PURPOSE: To describe the development and process of consensus used to establish essential genetic and genomic nursing competencies relevant to the entire nursing profession in the United States (US) regardless of academic preparation, role, practice setting, or clinical specialty. ORGANIZING CONSTRUCT: Rogers' diffusion of innovation theory applied to the adoption of genetics and genomics as the central science for health care. METHODS: Multiphased national nursing initiative to develop, refine, and establish with consensus essential competencies in genetics and genomics for all nurses. FINDINGS: Genetics and genomics have emerged as the central science for health care in the 21st century, transforming recommendations for nursing education, practice, regulation and quality control. CONCLUSION: The Essential Nursing Competencies and Curricula Guidelines for Genetics and Genomics indicate the minimal criteria for competency in genetics and genomics for the entire nursing profession in the US.