Advanced physical assessment skills: implementation of a module

This article aims to explore and examine advanced physical assessment skills and the role of the district nurse. It will particularly highlight district nurses' perceptions of how they may implement skills learnt on a new module introduced into the Community Health Care Nursing degree at a university in London. Physical assessment skills have traditionally been viewed as part of a doctor's role; however, with the advancement of nursing roles, it is argued that it has become a key nursing skill. As Government policy continues to expect health professionals to keep patients in the community who have complex health and social care needs, the role of the district nurse presents as 'best placed' to take on this challenge (Department of Health (DH), 2005a; 2005b). Evaluation of the district nurses' perceptions of their practice is shared here, highlighting some of the challenges that they face. The article will address the complexity of developing a curriculum in response to the DH initiatives and the importance of listening to students on courses.     

《社区护理学》考核方法改革探讨

目的探讨《社区护理学》考核方法及其效果。方法在对64名护理专科生《社区护理学》课程教学中，进行小组书面作业、建立家庭健康档案、进行社区健康教育、操作考试和理论测验等多种形式的考核。结果考核方法受到了学生的欢迎，学生认为理论知识、思维能力、应变能力、操作能力、表达能力均得到了提高。结论考核方法的改革是有益的尝试，对社区护理人才的培养具有重要意义。     

Health promotion and partnerships: collaboration of a community health management center,county health bureau,and university nursing program

Effective partnerships were established between a community health management center, a county health bureau and a university nursing program. A health fair was undertaken to heighten public health awareness through the collaboration of these various agencies. In this research, formative, process, and summative evaluations were conducted to determine the benefits of partnerships. Elements evaluated included the planning process, health fair relevancy, integration of community resources, participants satisfaction and knowledge acquisition, and partnership satisfaction. The samples of this study included (1) 529 adult participants who completed the on-site evaluation questionnaires; (2) 1,090 child participants who returned gift-reward cards; (3) 114 partners who gave written feedback on their satisfaction; and (4) 57 third-year and 16 fourth-year undergraduate nursing student participants. Data was collected from the evidence report of the Department of Health, the project proposal, activity protocols, meeting records, the project final report, students term papers, and questionnaires. The chief administrator of the County Health Bureau was very impressed with the creative exhibits in the fair and, therefore, invited a coalition to continue further workshops. Seventeen educational exhibits, two dance programs and two drama programs related to health issues were demonstrated in the fair. Resources from community organizations were successfully integrated and allocated. Community participants expressed satisfaction with the fair and anticipated similar activities in the future. Participants revealed more than 80% accuracy in health knowledge quizzes. The senior nursing students highlighted their interaction with the community, community health nurses, and health volunteers. Community-based health promotion and nursing education can be successfully connected when various disciplines and sectors form effective partnerships.     

Preparation of community health nursing leaders for social action

Indiana University School of Nursing graduate Department of Community Health Nursing has been preparing community health nurses for primary health care practice, as defined by the World Health Organization since 1978. The faculty are committed to preparing community health nursing leaders for social action aimed at improving the health of the community in both the Department's major in the master's programme and its new major in the doctoral programme. The core curricula for these majors in both programmes are presented. The master's curricula is based on integrating public health principles with those of community development. The doctoral major builds on this base of primary health care practice with a curriculum focused on the contribution of community health nursing to public and health policy. The graduates of the master's programme are prepared to work with community groups as a social force in promoting the health of the community. The graduates of the new doctoral major entitled "Health Policy and the Health of the Community" are being prepared as community health nursing leaders with expertise in health care policy and the legislative process with a focus on issues related to nursing and community health. These graduates will be able to function within the broader community, including national and international settings. Based on experiences in graduate education in community health nursing recommendations are made for the response graduate nursing education must make in order to prepare appropriate leaders who can work toward the goal of improving the community's health.     

Needs assessment as a marketing strategy: an experience for baccalaureate nursing students.

A marketing needs assessment was undertaken as a community health project for baccalaureate nursing students. The objective of the project were: (1) to conduct a needs assessment utilizing the concepts of marketing in health planning, and (2) to identify health needs of a community based on active participation by members of the community. Through a collaborative effort with a community health agency, students were able to integrate the principles of marketing and participative decision-making into a learning experience. The results of the needs assessment provided the agency with valuable information for strategic planning.     

University Sponsored Home Care Agency as A Clinical Site

This paper describes the use of a certified home health care agency to provide clinical experience for baccalaureate nursing students. It discusses the development of the Creighton Home Health Care Agency as a cooperative venture of the Creighton University School of Nursing, Community Health Division, and the Creighton School of Medicine, Family Practice Division. The Home Health Care Agency provides opportunities for students in community health nursing to provide care to families from a variety of socioeconomic and racial backgrounds under the supervision of the nursing faculty.     

社区护理服务需求研究

目的：拓展社区护理服务的内容,寻找社区护理服务潜在需求,为研究社区护理未来的发展方向,制定相关政策和计划提供参考依据。方法：采用问卷调查方法对护理人员和社区居民进行社区卫生服务需求等相关内容的调查。结果：①社区居民对健康教育、疾病康复、慢性病随访、家庭卫生服务（居家护理）、连续治疗等存在比较大的需求;②护理人员对未来社区护理服务的潜在需求,倾向于慢性病护理、老年护理和居家护理。结论：社区健康教育的内容应以健康咨询、健康指导、用药指导为重点内容,社区护理服务应该加大对慢性病病人的随访和连续治疗的护理服务和家庭康复的护理服务。同时,应加强我国社区老年护理的模式的研究,适应我国人口老龄化的需要。     

Knowledge, skills and experiences for community health nursing practice: the perceptions of community nurses, administrators and educators

Nursing in Canada is committed to preparing all new graduates at the baccalaureate level for entry to nursing practice by the year 2000 This goal has major implications for community health nursing education and practice Health care reform is also expected to move care out of the hospital and into the community It was against this backdrop that the researchers mounted a study on the educational preparation needed for graduates to begin to practice community health nursing In this paper, the knowledge, professional and personal skills, and experiences that graduates need to begin community practice are reported The study was carried out within an action-research framework All major groups of stakeholders involved in community health nursing throughout the study province were involved in the project This included nurses and administrators from two public health agencies (provincial and municipal), home care nurses, home health nurses (l e non-governmental visiting nurses), community health centres, provincial health care and nursing consultants, and faculty from two universities In addition to the generation of relevant research findings for use by the educational institutions, the study was initiated to set the stage for future and ongoing interactions between the researchers and community experts to implement the findings from the project Data were collected from 118 participants by means of 27 focus groups of community nurses, administrators and educators Interviews were tape-recorded transcribed and analysed using latent content analysis and constant comparison techniques Findings indicated that qualified nurses from university programmes need a wide range of knowledge, skills and experiences to begin to practice community health nursing Detailed accounts of these requirements are outlined and the implications for practice and education put forward     

Primary health care theory to practice: experience of first-year nursing students in Hong Kong

In the past, nursing education in Hong Kong has focused on acute illness care, and institutions providing nursing education have been slow to modify the illness-focused curriculum to a health-based curriculum. The nursing curriculum at the University of Hong Kong is unique in that it focuses on primary health care, and these concepts are introduced in both theory and practice in the first year of the baccalaureate program. In the second semester of the first year, students are required to develop and implement a primary health care project in a community setting. This article outlines the process and outcomes of the experience of 8 first-year nursing students who developed and implemented a primary health care project with older adults in a Hong Kong community. The Generalized Model for Program Development (McKenzie & Smeltzer) was used to guide the students in their practicum activities. The students demonstrated a high degree of competency in relation to health assessment skills; analysis of individual and community needs; development of appropriate health promotion sessions in relation to coronary artery disease, diabetes mellitus, and arthritis; and evaluation strategies to demonstrate effectiveness of the intervention. This experience early in the program provided a strong foundation for the students in primary heath care and grounded their nursing practice in scientific-based evidence.     

不同教育层次护生对社区护理认知及就业意愿的调查

目的了解不同教育层次护士学生（以下简称护生）对社区护理的认知及就业意愿,为促进高校社区护理教育改革,发展社区护理提供依据。方法采用自行设计的调查问卷对821名不同教育层次护生进行调查。结果不同教育层次护生对社区护理工作的主观认识及社区护理的就业意愿比较,差异具有统计学意义（均P〈0.01）。影响护生选择社区护理作为就业意向的因素有个人因素、专业因素和社会因素。已学习《社区护理学》课程的护生较未学习的护生对社区护理知识的认知得分高。结论在校护生对社区护理知识整体认知不足,就业于社区的意愿不高。学校应加强指导,改善社区护理实践环境,并适当开展职业指导以培养护生正确的择业观。     

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.     

Teaching patient-centered holistic care

Nursing education aims to help students understand concepts and gain competencies in holistic care. The purpose of this paper was to present a nursing curriculum that adapted and introduced holistic care into an adult nursing curriculum taught at a university of science and technology. The course framework included both holistic and nursing domains. The holistic aspect addressed client physical psychological-spiritual needs and related factors, health related factors, and the status of Maslow's hierarchy of needs and related factors. The nursing aspect addressed the way in which nursing was applied to identify client problems and provide individualized, integrated and continuous care in hospital, family or community based settings employing primary, secondary, or tertiary prevention. Scenario with problem based learning and concept mapping were used in class to guide students to consider in depth the concepts that underpin holistic care.     

Community as client: appropriate baccalaureate- and graduate-level preparation

This article focuses on the theoretical concept of community as client and its application in community health nursing education and practice. Although the concept of community as client has been widely accepted, it was observed that care to individuals and families within community settings constitutes the bulk of current community health nursing practice. The argument is made that undergraduate nursing students should be prepared as generalists to provide care within community settings. Undergraduate nursing students should be introduced to the concept of community as client, with an emphasis on understanding the relationship between individual or family needs and community needs. It is also argued that graduate nursing students should be prepared at the specialist level, focusing primarily on providing care to the community as client. An example of undergraduate and graduate levels of preparation in one university nursing program is described.     

Care of homeless men in the community

The author describes health care provided to homeless men by community health nursing students who conduct a service learning project at an inner city mission. Service learning is an educational method that combines the academic learning objectives of community nursing students and the health care educational and service needs of a vulnerable population of homeless men. Holistic and interdisciplinary nursing skills are practiced. Clients learn healthier life-style choices and to determine more appropriately the need and source for professional health care when problems are identified.     

Public health nursing in Greece

Nursing is considered, as the main profession that covers the need for primary health care services, in cooperation with physicians and other health and social care professions. In Greece, public or community health nursing as a concept exists since the beginning of professional nursing in the seconf half og the 19 century. There are three professions in Greece that are mainly involved in the provision of community nursing services. These are general nurses, health visitors, and midwives. General nurses are educated at degree level in the university or polytechnics. Health visitors and midwives are separate professions, also educated at degree level in polytechnics. Although all general nurses are prepared to work at any level of health care provision, they are not considered adequately educated to perform their full role in the community, with just their existing knowledge and experience. It is therefore essencial that further education or specialization is needed, in order that they could practice independently or as members of the primary health care teams effectively, and be able to respond to public health needs of the population     

Academic microsystems: adapting Clinical Microsystems as an evaluation framework for community-based nursing education

When an academic nursing program and clinical agency form a partnership to both educate students and effect changes in the health care of the community, evaluation presents a challenge for measuring structure, processes, and outcomes at three levels: student educational processes and outcomes; student-sensitive outcomes for the community; and the effectiveness of the partnership itself. This article describes how we adapted the Clinical Microsystems model as an Academic Microsystems model to evaluate the complementary processes and outcomes for the community and for the nursing program in a senior Community Capstone course. The Capstone is a community-based initiative in which students assess community needs, intervene appropriately, evaluate their intervention, and pass the initiative on to the next year's class. Although outcomes for students and the community were positive, the model revealed that developing the frontline microsystem of student/faculty/community nurse mentor was the key to success.     

Integration of theory and practice in learning mental health nursing

This article describes an action research project that aimed at a better integration of theory and practice in the education of mental health nursing students. Two partners, an institute of nursing and health care and a university hospital, collaborated to develop a new educational programme for mental health nursing. The blocks of theoretical studies were implemented simultaneously with practical training, and the theory content was taught by nursing teachers as well as by nurse practitioners who worked on the teaching wards. In addition, the students had their own personal nurse-preceptors on the wards. The nurse managers were responsible for the educational level of the teaching wards and the director of nursing planned the teaching arrangements together with the nursing teachers. In all, the project involved over 50 different actors and several researchers. The results are encouraging: all the participants - students, preceptors, nurse managers and nursing teachers - found the project rewarding and they want to continue to develop and improve the level of teaching and learning in mental health nursing education. All the participants grew and developed professionally during the project.     

Impact of a service-learning project on nursing students

This article describes the incorporation of a service-learning project in a maternal-infant health course in a baccalaureate nursing program. Partnership goals between university faculty and project Early Head Start were to develop and implement a clinical education experience that not only enhanced services to teenage mothers, but also taught students key elements in the delivery of community services to this vulnerable population. This article examines the impact of the service-learning experience on students' understanding of diversity, perceptions of social responsibility in community service, and health care issues. Implications for faculty investment of time and resources are also explored.     

Community assessment: an RN-BSN partnership with community.

Conducting a community assessment can be a vital aspect of a community health course for a baccalaureate nursing student. This experience can enable the student to use the nursing process in a basic community assessment as well as provide community decision makers with significant data and analysis about community health related needs and potential solutions. This paper describes use of the Community-as-Partner model by Anderson and McFarlane to do a class project to assess a local community.