Embracing a Competency‐Based Specialty Curriculum for Community‐Based Nursing Roles

The Quad Council competencies for public health nursing (PHN) provide guidance in developing curricula at both the generalist and specialist level. However, these competencies are based on nursing roles in traditional public health agencies and community/public health is defined more broadly than official agency practice. The question arises as to whether community‐based specialties require largely the same knowledge and skill set as PHN. The purpose of the competency cross‐mapping project reported here was to (a) assess the intersection of the Quad Council competencies with four community‐based specialties and (b) ensure the appropriateness of a Quad Council‐based curriculum to prepare graduates across these four specialties (home health, occupational health, environmental health, and school nursing). This article details the multistep cross‐mapping process, including validation with practice leaders. Results indicate strong alignment of community‐based specialty competencies with Quad Council competencies. Community‐based specialty‐specific content that did not align well is identified, along with examples of didactic and clinical strategies to address gaps. This work indicates that a Quad Council‐based curriculum is appropriate to prepare graduates in community‐based specialties when attention to the specialty‐specific competencies in the clinical setting is included. This work guides the development of a doctorate of nursing practice curriculum in PHN, encompassing the four additional community‐based specialties.     

Integrating environmental health into an undergraduate community health nursing course

Nurses are often the first members of the healthcare system to whom the public turns when environmental health hazards cause concern. Yet most nursing programs include scant formal environmental health content. This article describes a project that integrated significant environmental health content into an undergraduate community health nursing course. The revised course included additional environmental health classroom content and field experiences. Details are provided regarding changes to classroom content, revision of written assignments to include environmental health issues, planning and implementation of nursing student field experiences with environmental health professionals, and evaluations of the revised course. The article concludes with three recommendations to guide other schools of nursing, wishing to integrate environmental health into their curricula.     

The Quad Council Practice Competencies for Public Health Nursing

This article describes the most recent efforts by the Quad Council of Public Health Nursing organizations to review and revise the competencies for PHN practice, and highlights the implications of these competencies for practice, education, and research. The Quad Council is a coalition of four nursing organizations with a focus on public health nursing and includes the Association of Community Health Nursing Educators; the Association of Public Health Nursing (known prior to July 1, 2012 as the Association of State and Territorial Directors of Nursing); the Public Health Nursing section of the American Public Health Association; and the Council on Economics and Practice of the American Nurses' Association. The Quad Council competencies are based on the Council on Linkages competencies for public health professionals and were designed to ensure that public health nursing fits in the domain of public health science and practice.     

Identification of nurses' competencies in primary health care through a Delphi study in southern Brazil

ABSTRACT Objective: This investigation aimed to identify and analyze the general and specific competencies of nurses in the primary health care practice of Brazil.
Design: The Delphi Technique was used as the method of study.
Sample: 2 groups of participants were selected: One contained primary health care nurses ( n =52) and the other specialists ( n =57), including public health nurses and public or community health faculty.
Measurements: 3 questionnaires were developed for the study. The first asked participants to indicate general and specific competencies, which were compiled into a list for each group. A Likert scale of 1–5 was added to these 2 lists in the second and third questionnaires. A consensus criterion of 75% for score 4 or 5 was adopted.
Results: In the nurses' group, 17 general and 8 specific competencies reached the consensus criterion; 19 general and 9 specific competencies reached the criterion in the specialists' group. These competencies were classified into 10 domains: professional values, communication, teamwork, management, community-oriented, health promotion, problem solving, health care, and education and basic public health sciences.
Conclusions: These competencies reflect Brazilian health policy and constitute a reference for health professional practice and education.     

Hints for the Aspiring Public Health Nurse

ABSTRACT The original article from which these excerpts were taken, “Some Hints to the Nurse Who Seeks to Become a Successful Partner in the Community Health Program,” by Mary Margaret Muckley, was published the 1923 volume of the original Public Health Nursing journal. The paper listed practical pointers to nurses wanting to work in the area of public or community health nursing. The author's advice involved personal attributes, professional engagement, skills, effective organization, and community relations. Much of the original article contained sound advice for aspirants to nursing work in community settings, but some advice may be considered too idealistic even for this optimistic time period. While the particular references to organizations and agencies existing in Helena, Montana have been omitted, the nurse reading the paper in 1923 had a general guide to her key stakeholders. The excerpts from this paper may give contemporary readers an appreciation of the endurance of what Muckley terms the public health nurse's “Valuable Assets.”     

Overcoming barriers and improving public health nursing practice

Public health nurses (PHN) are critical to ensuring the health of communities. Absent the most basic information on the PHN workforce in our state, we conducted interviews with 21 PHN and school health nurse (SHN) leaders and an online survey of PHNs and SHNs practicing in Maryland (N = 491). Our study identified an older, very experienced, and well-educated workforce. Both the interviews and survey identified similar barriers: low salaries, recruitment and hiring challenges, limited funding for public health programs, and no opportunities for education or career advancement. Survey participants also identified barriers of inadequate leadership, recognition, and communication including PHNs not being represented at decision-making tables or at the state leadership level. Strategies to promote public health nursing from leaders and survey participants were similar: increasing awareness about what public health and PHNs do and their value; improving advocacy and stakeholder engagement; improving access and availability of services; improving PHN leadership representation at the state level; a improving PHN salaries and benefits including tuition reimbursement. Although results were similar to national studies, comprehensive, granular workforce data is critical to ensure the public health workforce can meet current and emerging public health needs and that public health infrastructure and services are appropriately funded.     

Development and testing of a practicum matching program for baccalaureate nursing education,a local public health unit

This article describes a novel approach to nursing education, designed to improve the experience of both students in public health nursing, and the local public health unit where they affiliate. Students, faculty, and public health department staff developed a method for matching programs and needs of the local public health unit to the skills and learning needs of nursing students. We describe our experience articulating student competencies, program-specific functions, and an approach to matching student interests and learning opportunities to agency needs. Students, faculty, and staff rated the program moderately to very high in feasibility, satisfaction, and acceptability. Data suggest the novel program served to improve the quality of the practicum affiliation, to the satisfaction of both the school and agency, while contributing to a robust public health learning experience for emerging professional nurses.     

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.     

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.     

Partnerships for learning population-based public health nursing: Web-delivered continuing education for public health nurse preceptors

Public health and other community health nurses frequently serve as preceptors to undergraduate student nurses learning population-based nursing in community/public health practicum courses. The extent of preparation and support for the preceptor role provided by schools of nursing is often limited. One strategy to address this problem is to provide targeted, Web-delivered continuing education (CE) to preceptors. A Web-delivered CE course entitled, "Partnerships for Learning Community Health Nursing," was created and pilot tested. Course content includes preceptor roles; assisting students in learning population-based public health nursing, critical thinking, and cultural competence; learning styles and teaching strategies; what to do in challenging situations; evaluation and feedback; and specific information about school policies, procedures, and course assignments. Precourse knowledge was assessed using a mailed survey. Postcourse knowledge and satisfaction were assessed using questions embedded in the course. Postsemester knowledge and satisfaction were evaluated through a postsemester survey. Knowledge gain was tested using repeated measures ANOVA and paired t tests. Thirteen preceptors participated in the pilot test. Repeated measures ANOVA indicated that knowledge gain occurred (multivariate F=55.603, df=2, error df=11, p<.0001). Participants increased knowledge from pretest to posttest (t=-10.25, p<.00001) and from pretest to end of the semester (t=-4.95, p<.0003). Knowledge decline from end of course to end of semester was not significant (t=1.94, p=.08). Participants reported satisfaction with the course. Web-delivered CE for community/public health nurse preceptors can support preceptor learning and is an acceptable method for receiving this type of education. Further research is needed on the impact of preceptor education on student learning.     

A crosswalk of foundational BSN population health documents and the AACN essentials

To guide the development of entry-level nursing education, the American Association of Colleges of Nursing (AACN) published the Essentials document in 2021 with a broadened scope of competencies. Community, population, and public health (CPPH) nurse educators use a number of foundational documents to crosswalk for gaps in the AACN principles, highlighting the need of including these contemporary documents within the baccalaureate CPPH nursing curriculum. In this crosswalk, the authors highlight important capabilities and knowledge exclusive to these fundamental documents and tools, as well as the relevance of these competencies and knowledge to CPPH baccalaureate nursing education.     

Enhancing students' perspectives of health through non-traditional community experiences

• ? The shift in emphasis to community-based health care necessitates that opportunities be provided for nursing students to acquire an understanding of the complex nature of health.
• ? A qualitative study was used to demonstrate the benefits accrued by junior baccalaureate nursing students in non-traditional community settings.
• ? Key themes that emerged from data analysis included definitions of health and illness as context specific, and environmental factors influencing health.
• ? The study demonstrated that learning experiences with diverse communities can broaden students' perspectives and understanding of health behaviours. Students gained an appreciation of the sociocultural variation in meanings of health and illness as well as of the social and political dimensions of health.

     

The Process of Structuring Community Health Needs by Public Health Nurses Through Daily Practice: A Modified Grounded Theory Study

PurposeIt is extremely difficult to apply the model learned in basic education for public health nurses (PHNs) to conduct community health assessments. The purpose of this study was to clarify the process by which community health needs can be structured through PHNs’ daily practice.MethodsSemistructured interviews were conducted in 29 PHNs, and continuous comparative analysis using a qualitative study was performed with a modified grounded theory approach.ResultsThe participants “used their five senses to understand the relationship between the health and life of people” and “considered those who do not attend” by “learning from stakeholders.” To verify such subjective feelings sourced from vague phenomena within the communities, subjective phenomena were converted into qualitative data.ConclusionThe application of the findings to organizational continuous education systems may not only help appropriately improve community health assessment methods but can also help improve the evaluation of daily practice and contribute to professional human-resource development.