Use of a taxonomy to describe parish nurse practice with older adults

Parish nursing in a new model of health care delivery in which practitioners build partnerships to extend health care from institutions into the community. The study discussed in this article focused on the applicability of the North American Nurses Diagnosis Association taxonomy and the Nursing Intervention Classification to describe parish nurse practice with older adults. Findings from this study may help develop a framework for the practice.     

Parish nursing: holistic nursing care in faith communities

Modern-day parish nursing is a specialized practice in professional nursing that addresses the spiritual, physical, and emotional health needs of clients within a faith community. Parish nursing care has been described as holistic care; however, few studies have focused on the holistic nature of parish nursing care. A qualitative study was conducted with the clients of parish nurses. Seventeen clients utilizing the services of 3 parish nurses in Christian faith communities participated in the study. Following the institutional review board approval, the clients were recruited with the assistance of the parish nurses. The clients completed a 7-item demographic questionnaire, followed by a face-to-face interview with the author who used a semistructured interview tool. The interview questions encompassed 6 aspects of parish nursing: education, personal counseling, health screenings, spiritual support, referrals, and health advocacy. The interviews were transcribed and analyzed by the author. The results of the study indicated that the clients in all 3 churches received holistic care from their parish nurses. The care they received addressed their spiritual, physical, and emotional health needs. Recommendations for future research and implications for the clinical practice of parish nursing, using a holistic approach, are included. The findings of future research and the holistic interventions of parish nurses could influence the funding and positions for parish nurses in the future.     

Parish nursing assessment--what should you know?

The prospective payment system will require agencies to become more creative and network with community resources. This article describes a health needs assessment survey that provided the foundation for a parish nurse ministry. The survey revealed that parish nurses could complement home health nurses by filling some of the gaps in healthcare not provided by third-party payers.     

Community assessment: a church community and the parish nurse

In central Massachusetts a large urban parish asked the University of Massachusetts, Amherst School of Nursing to conduct a community assessment for the church and newly employed parish nurse. The aims of the assessment were: to determine the health status of parishioners, identify their perceived health needs and perceived barriers in meeting those needs, and to assist the church and parish nurse in developing a health program for their faith community. Findings of the assessment are based on questionnaire and focus group data. Four hundred and twenty-one questionnaires were completed, and six focus groups were held to validate the data. Results showed most parishioners felt they were in good health (93%), believed faith and spiritual beliefs were important in maintaining health and well-being (91%), and thought that the church should play a role in helping parishioners meet their health needs (70%). In addition, focus group discussions revealed a need for respite care for primary caretakers of the ill and elderly, and health education programs for their teen and elderly populations. In conclusion, parishioners were positive and articulated support of the parish nurse and activities designed to address the physical, emotional, and spiritual needs of their community.     

Education for differentiated role development for NP and CNS practice: one nursing program''s approach

Development of nurse care providers who best meet the public's health care needs is imperative. Some nurses believe the functions of nurse practitioners and clinical nurse specialists should be combined. However, the experience of the authors' nursing program argues otherwise. Two graduate nursing tracks, family nurse practitioner and rural health specialist, were developed to meet the health care needs of rural populations. Although the two tracks share expected competencies and areas of expertise to some extent, differences in practice are apparent in identified domains of practice and terminal competencies. Family nurse practitioner practice focuses on assessment, diagnosis, and management of health and illness conditions of individuals and families across the life span. Clinical nurse specialist practice incorporates traditional roles of client assessment, monitoring and coordination of care, outcome assessment, and client, family, and community education, with a new focus on case management strategies. These differences are important to care delivery in the managed care era.     

Illuminating the clinical nurse specialist role of advanced practice nursing: a qualitative study

As the advanced practice nursing initiative in Canada gains momentum, effort is being directed towards clarifying and defining advanced practice roles. A qualitative study was undertaken to increase understanding of the clinical nurse specialist role of advanced practice. Sixteen nurses who worked in advanced practice roles, organizing and providing healthcare for children with complex health needs and their families across the continuum of care, participated in in-depth conversations about the nature of their practice, the knowledge that informs it and the factors that influence it. Findings suggest that clinical nurse specialists have a unique role in the organization and delivery of healthcare for specialized populations with complex health needs in their dual focus on the system level of healthcare and on population health needs. Initiatives directed to children and families within the study participants' specialties included program development, consultation and educational outreach and the development of clinical guidelines and policies. Although the nurses described their practice as focusing both on individual children and families and on the population of children and families within their specialty, it is at the population level that they see their greatest potential for contributing to the delivery of high-quality, cost-effective healthcare.     

Expanding nurses' roles in telemedicine & genetics services

This article presents nursing roles in telemedicine and genetics services. Telemedicine offers a promising solution to delivering comprehensive genetics services to children and families when travel, distance, and shortage of genetics professionals interfere with access. Nurses are already using telemedicine to provide nursing and healthcare services but have become involved in the delivery of genetics services via telemedicine only recently. Involving nurses in the development of telemedicine systems for genetics services is essential as they serve as a vital link between the patient, the healthcare system, and the community. Some of the emerging nursing roles in telemedicine include genetic family-health risk assessment, evaluation and counseling at the advanced practice level and at the primary care level, referral, participation in genetic evaluation and counseling, and family- and community-based care coordination and management. The Genomics Nurse Case Coordinator role as described by is presented as a means of further expanding the maternal-child health nursing role in supporting women and families to manage their own genomic health. Telemedicine offers nurses an opportunity to assure and provide quality genetic healthcare tailored to the individual and family's specific needs within their own community.     

Faith community nurses: implementing Healthy People standards to promote the health of elderly clients

The face of aging in our society has changed dramatically over the past generation. Many seniors struggle to access needed services, which include health promotion and disease prevention activities. A “Parish Nurse Questionnaire” was developed by the authors using the Healthy People 2010 Critical Health Indicators, the International Parish Nurse Resource Center functions of the parish (faith community) nurse, and the ANA Scope and Standards for Faith Community Nurses to ascertain if, and how frequently, faith community nurses practice interventions that address strategies mandated by theses organizations. Data collected on 102 participants supported that the faith community nurse model of community-based practice guides the development of strategies addressing those established standards. Those who provide health promotion and disease prevention activities in faith communities serve as viable partners with community initiatives, which may help to provide more seamless and efficient services to the elder in the community.     

The emerging role of faith community nurses in prevention and management of chronic disease

Faith community nursing, formerly known as parish nursing, is one model of care that relies heavily on older registered nurses (RNs) to provide population-based and other nonclinical services in community settings. Faith community nursing provides services not commonly available in the traditional health care system (e.g., community case management, community advocacy, community health education). With appropriate support, this model of nursing could be expanded into other settings within the community and has the potential to draw on the skills of experienced RNs to provide communities with services that address unmet health care needs.     

Developing a CNS role to meet the mental health needs of the underserved

The purpose of this article is to describe a clinical nurse specialist program that prepares psychiatric-mental health nurses for positions in today's mental health care system. Recently, there has been a national increase in psychiatric-mental health nurse practitioner programs and a decrease in psychiatric-mental health-clinical nurse specialist programs. We faced the dilemma that many psychiatric-mental health nurse faculties face in this climate of mental health care delivery changes: how to best prepare psychiatric-mental health nurses for advanced practice. Because of our long history of preparing clinical nurse specialists, we believed the role was a viable one. The clinical nurse specialist role also fit with our university's mission and our beliefs regarding the importance of providing care for underserved populations. The role of the community mental health-clinical nurse specialist is described, and the economic, demographic, and mental health system changes that influenced the development of the community mental health-clinical nurse specialist role are explored. The curriculum and the impact of the program are described and evaluated. Finally, implications regarding the need and the viability of this new role in both psychiatric-mental health nursing and in other specialties as we care for clients in the community are presented.     

Differentiated practice: The evolution of professional nursing

Differentiated practice identifies and uses three distinct nursing roles to create a comprehensive nursing care delivery system that meets client needs across the health care continuum. Clearly defined associate degree in nursing, bachelor's of science in nursing, and master's science in nursing competencies present career opportunities for professional nurses at the bedside providing, integrating, or managing client care as well as options in management, education, and regulation. An evolutionary paradigm shift required of all nurses is the awareness that each nurse is not the whole of nursing, but rather each nurse contributes to the whole of nursing. A nursing community comprised of differentiated roles that are mutually valued and well integrated will position nursing as a powerful force in meeting the diversity and complexity of health care needs in contemporary society.     

Does Advanced Community/Public Health Nursing Practice Have a Future?

Societal trends and predicted needs of the health care system indicate that there will be increasing demands for health care professionals who can effectively manage the health needs of populations and communities. Nurses who have master's degrees in community/public health nursing have the educational background to provide this expertise. Although the Association of Community Health Nursing Educators and many nursing leaders maintain that these nurses are advanced practice nurses, most leading nursing organizations and state nurse practice acts do not include population and community health management skills in their definitions of advanced practice nursing. These exclusions have produced a serious status problem for master's programs in community/public health nursing. This article examines issues affecting the current and future status of master's-level community/public health nursing. Solutions are suggested for ensuring the viability of this specialty area.     

Development trends and future challenges in community nurse practitioner

Community health nursing is an innovative aspect of healthcare that has grown in response to changing environmental and social structure changes into a worldwide movement. Taiwan's fast growing elderly population, improving health technologies and rising healthcare costs impact significantly upon the development and definition of the scope of practice for community health nurse nurses. This paper explores the innovative community care model development experiences of several countries and reviews the scope of practice of community health nurse practitioners in each. We further explore the current situation of nurse practitioners in Taiwan and suggest a future path for Taiwan community health nurse practitioners development and policymaking.     

Parish nurses influencing determinants of health

How are the concepts health, health promotion, faith community, and health determinants connected? How can a nurse draw on the unique features of a faith community to promote health? In this article, we explore the relations among these concepts and consider the answers to these questions. Parish nurses provide a concrete example of the interactions among these concepts. They are often hired by faith communities to intentionally promote health within and beyond the faith community. Increasingly, faith communities are being used as settings for health promotion interventions. We describe examples of how a parish nurse can influence 2 determinants of health: social support and healthy child development.     

Clinical Competencies for Community Health Nursing

Cost-containment strategies initiated in the early 1980s caused a major shift in site of care delivery for persons needing nursing care. Where once the majority of clients were cared for in the acute-care setting until they were self-sufficient, now most are discharged to the home environment still requiring acute-care nursing interventions as well as community health nursing skills. This rapid shift in practice sites has placed severe strain on community health nursing agencies. Not only are more nurses required to fill the increased demand for services, but the demand comes at a time when we are experiencing a severe nursing shortage. This has forced many agencies to hire acute care nurses who have little or no community health nursing experience. These nurses come to community health nursing expecting to use the same set of skills and knowledge base used in their acute-care practice; however, the skill levels and concepts required for community health nursing are quite different from the acute care setting. Educational preparation has not kept pace with this shift in practice. Consequently, many nurses are not adequately prepared to enter community health nursing. Preparation must include theoretical and experiential components that focus on assessment skills (of the community and individual), decision making, case management, health systems management, teaching, and leadership. Collaborative efforts between community health organizations and educational institutions would seem to be one solution that would ensure adequately prepared nurses for community health nursing. The establishment and maintenance of strong staff-development programs within community health nursing agencies are also required.     

Neal Theory of Home Health Nursing Practice

The delivery of patient care is increasingly taking place in home settings requiring home healthcare nurses to provide skilled, efficient care within a short period to patients with complex and chronic illnesses (Aliotta & Andre, 1997). Today, the demands placed on the practice of home healthcare nurses by changes caused by altered reimbursement patterns, integrated networks of delivery, use of new technology, and use of new outcome and quality measurement systems significantly affect home healthcare nursing practice. However, none of the established theories of institutional care, home health, community health, or public health nursing provide an appropriate research-based model for home health nursing practice as it exists today or as it is predicted to occur in the future.     

Critical care concepts in baccalaureate nursing education

The high response rate of 65.1 percent to this survey suggests nurse educators across the country are interested and involved with the incorporation of critical care concepts in baccalaureate nursing education. Nurse educators are conscientiously working to provide an educational basis for graduate nurses to adequately address the complex healthcare needs of our society. Cooperative efforts between nurse educators and practicing critical care nurses can make a difference in the future delivery of healthcare.