Matching a graduate curriculum in public/community health nursing to practice competencies: the Rush University experience

An evidence-based approach to Public/Community Health Nursing (P/CHN) requires that P/CHN educators prepare practitioners with the relevant skills, attitudes, and knowledge. Such education should be competency-based and have measurable outcomes to demonstrate student preparation. In 2003, the Quad Council competencies were developed to be applied at two levels of public health nursing practice: the staff nurse/generalist role and the manager/specialist/consultant role. This paper describes a process for evaluation and revision of a graduate curriculum to prepare Advanced Practice Clinical Nurse Specialists (CNS) in P/CHN, to ensure that the educational program addresses and develops knowledge and proficiency in all relevant competencies. This paper documents the process of integrating the competencies throughout the P/CHN graduate curriculum at varying levels, guiding students to achieve proficiency in each competency by the end of the program. Measurement of achievement in these competencies will be discussed, and examples provided. Advanced Practice Public Health Nurses educated via this competency-based approach will be prepared to sit for national certification as a CNS in Public/Community Health, and to assume leadership roles in public health nursing.     

Use of health fairs to develop public health nursing competencies

This paper describes a community-campus partnership for health education established through the effort of faculty, students, and the community. Health fairs designed to address issues of concern to a community agency were originally conducted with nursing students. This partnership between nursing and a community was expanded to include social work, physical therapy, and medical students. A shared learning experience was structured through the presentation of health fairs in collaboration with agencies in Burlington, Vermont. One goal of nursing education is to produce professionals who have the beginning competencies of public health nursing. Reflection on the process, relationships, and outcomes of the health fairs revealed that students attained these beginning competencies in all eight public health nursing competency domains. Combining community-campus partnerships and an interdisciplinary focus enabled nursing students to become more responsive to community needs and to learn to work collaboratively toward creating healthier communities, thus building skills required for public health nursing.     

公共卫生护士胜任力特征的质性研究

目的 探讨我国公共卫生护士所具备的胜任力特征,为我国未来进行公共卫生护士的培养提供参考。方法 采用目的抽样法,对北京市10所社区卫生服务中心的17名社区护士和15名公共卫生医生进行访谈,运用内容分析法对访谈资料进行分析。结果 提炼出知识、技能、能力及职业素养4个主题及25个亚主题。结论 公共卫生护士需要具备的胜任力涵盖知识、技能、能力及职业素养4个方面,可为未来我国公共卫生护士的培养提供参考。     

Public health nursing competencies 1953-1966: effective and efficient

The Quad Council of Public Health Nursing Organizations developed public health nursing competencies in 2003. They are guides for determining skills at two levels, and they identify public health nurses as providing care to individuals and families or to populations and systems with the nurse having proficiency, awareness, or knowledge. The primary purpose of this paper is to discuss historical nursing roles and qualifications as judged by the 2003 competencies, including educational preparation and experience for the administrative and staff nurse. The historical exemplar for the nursing roles is a combination public/private nursing association, referred to as the partnership, that took place in 1953-1966. Primary sources include archived material from the Instructive Visiting Nurse Association, Richmond, VA. Administrative responsibilities were divided between the chief nurse and the nursing supervisors. Staff nurse responsibilities included clinic activities, home visitation, and referral coordination between health care organizations. The delineation of nursing roles demonstrates nurses' meeting the 2003 competencies. Based on the Quad Council's 2003 public health nursing competencies, the partnership nurses were competent.     

Development of public health nursing competencies: an oral history

This paper identifies the external and internal forces that led to the initiation and completion of a set of Public Health Nursing (PHN) competencies by nursing representatives from the Quad Council (QC) organizations: the Association of Community Health Nursing Educators, the American Public Health Association/Public Health Nursing Section, the Association of State and Territorial Directors of Nursing, and the American Nurses Association Congress on Nursing Practice and Economics. Discussion on the need for competencies began in 1988 with the Institute of Medicine report, The Future of Public Health, which cited a widening gap between the education and practice of public health (PH). PH leaders promptly responded by initiating many interactions to improve academic programs and enhance workforce development, including the development of competencies for PH professionals. PHN responded through the Quad Council of Public Health Nursing Organizations, which completed development of a set of national PHN competencies in 2003. The unfolding of that process is reported from the content-specific oral histories of five PHN leaders who served on the QC and participated in developing the PHN competencies.     

A case study of a distance-based public health nursing/community health nursing practicum

Facilitating a distance-based public health/community health nursing practicum for RN to BSN students posed challenges and opportunities. Challenges included time involved in arranging the practicum, relationship building with agencies and staff, communicating with students, and the need for flexible practicum scheduling. Exposure to practice models from across the nation allowed students to compare and contrast these public health nursing models. Programs planning to offer this type of course should consider faculty workload particularly during the semester prior to teaching the practicum.     

Continuing nursing education policy in China and its impact on health equity

XIAO LD. Nursing Inquiry 2010; 17 : 208–220
Continuing nursing education policy in China and its impact on health equity The aim of this study was to evaluate the mandatory continuing nursing education (MCNE) policy in China and to examine whether or not the policy addresses health equity. MCNE was instituted in 1996 in China to support healthcare reform was to include producing greater equity in health‐care. However, the literature increasingly reports inequity in participation in MCNE, which is likely to have had a detrimental effect on the pre‐existing discrepancies of education in the nursing workforce, and thereby failing to really address health equity. Despite a growing appeal for change, there is lack of critical reflection on the issues of MCNE policy. Critical ethnography underpinned by Habermas’ Communicative Action Theory and Giddens’ Structuration Theory were used to guide this study. Findings are presented in four themes: (i) inaccessibility of learning programs for nurses; (ii) undervaluation of workplace‐based learning; (iii) inequality of the allocation of resources; and (iv) demands for additional support in MCNE from non‐tertiary hospitals. The findings strongly suggest the need for an MCNE policy review based on rational consensus with stakeholders while reflecting the principles of health equity.     

Factors associated with the professional competencies of public health nurses employed by local government agencies in Japan

OBJECTIVE: This paper aims to clarify some of the factors associated with the professional competencies of public health nurses (PHNs) employed by local government agencies in Japan. DESIGN: A cross-sectional study. SAMPLE: PHNs (N=1,614) working in local government agencies in Japan. MEASUREMENTS: Based on self-reported questionnaires, the nurses were grouped according to experience. Statistical differences between the groups were analyzed using analysis of variance. Multiple regression analyses were used to determine associated factors. RESULTS: Variables contributing to high self-evaluation of interpersonal health support competencies were length of experience as a PHN, an awareness of the role expectations of community health support and administration, marital status, and participation in off-the-job training programs. The same variables contributed to high self-evaluation of community health support and administration competencies. In addition, experience of job transfer or rotation was found to be a variable. CONCLUSIONS: These results show the importance of off-the-job training programs designed to foster exposure to a wide variety of personal and professional experiences. They also illustrate the importance of planned on-the-job training programs that promote an understanding of the nature of the field, as well as developing planning and administrative competency in career development.     

Achieving clarity in evaluation of community/public health nurse generalist competencies through development of a clinical performance evaluation tool

Community/public health nursing practice is complex and based on interventions targeted at individuals, families, populations, and communities. Evaluating clinical practice involves a comparison of predetermined standards, such as those developed by American Nurses Association (ANA), against competencies associated with the practice of the specialty. In this study, 301 performance evaluation records from a locally developed clinical performance evaluation tool were examined for construct validity and reliability based on the ANA Standards for Community and Public Health Nursing.     

Evaluating health promotion: a model for nursing practice

AIMS: To investigate the place and validity of effective process in evaluating health promotion practice in nursing and, in doing so, develop a specific model for this purpose. BACKGROUND/RATIONALE: The failure of many nurses to provide successful health promotional programmes is underpinned by a distinct lack of evaluation research activity. Without this type of activity, health-related nursing practice remains limited in its scope and nature. This article seeks to redress this situation by proposing a specific evaluation model that assists the nurse in their attempts to include evaluative research activity in future health promotion practice. METHOD: This article draws on existing literature to develop an evolving theoretical perspective for health promotion practice in nursing. The proposed model was developed from this perspective. CONCLUSION: Evaluation is an essential activity for any health promotion programme. Failure to include it in practice ensures that attempts to conduct health promotion are usually rendered ineffective and unsuccessful. Evaluation models are valuable tools that nurses can incorporate routinely into existing frameworks of practice, alongside other models of health education/health promotion, such as planning models. The development of this model is intended to enable nurses to review their current practice and offer a further framework for those who wish to extend their current health promotion repertoire.     

Enhancing a public health nursing shelter program

The Shelter Nurse Program offers important nursing care and resources that help meet the health needs of the homeless population and improve the health of homeless individuals and families. However, formalized program goals and objectives, along with an evaluation plan that demonstrates population outcomes, had never been developed even as the program has evolved over time. Thus, the agency sought our assistance as public health nursing consultants to enhance the overall program to improve the health of the homeless population. To accomplish this, we worked with the agency and the shelter nurses throughout each step of the process to assess the needs of the program, develop appropriate goals and objectives, and develop an effective outcome evaluation plan for the existing Shelter Nurse Program. Lessons learned included the value and applicability of the selected program development model, the importance of agency ownership and active participation by front‐line workers, and the value of educating the workers and introducing resources throughout the process.