ublic Health Epidemiology Week 5 DQ

See the Quad Council Competencies for Public Health Nurses document. Imagine you are the nurse consultant at the state department of health. This presentation has been sent by an advocacy group to the Governor for him to make the program funding requests and recommendations. As the nursing director, you have been assigned to the “Fact Check” which includes checking for accuracy of all the information. Based upon your research, select two core competencies and summarize for the Governor the need for the services and how this may positively impact public health.

Your initial posting should be 250 to 350 words in length and utilize at least one scholarly source other than the textbook.

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The Quad Council of Public Health Nursing Organizations is comprised of the Association of Community Health Nurse Educators (ACHNE), the Association of State and Territorial Directors of Nursing y ( ), g (ASTDN), the American Public Health Association Public Health Nursing Section (APHA) and the American Nurses Association’s Congress on Nursing Practice and Economics (ANA). The Quad Council of Public Health Nursing Organizations was founded in the early 1980’s to address priorities for public health nursing education, practice, leadership, and research, and as the voice for public health nursing.

Methods In 2010, Quad Council undertook revision of the “Core Competencies for Public Health Nursing” (YR), in part because the Council on Linkages between Academia and Public Health Practice (CoL) revised its “Core Competencies for Public Health Professionals.”

We have kept this Core Competencies for Public Health Nursing (CCPHN) document consistent with the “Definition of Public Health Nursing” adopted by the APHA’s Public Health Nursing Section in 1996 and the Scope and Standards of Public Health Nursing (Quad Council, 1999). Therefore this CCPHN may be used at all levels and in a variety of practice settings. We planned competencies that could be useful for agencies/organizations employing PHNs and educational institutions and other agencies engaged in educatingagencies/organizations employing PHNs, and educational institutions and other agencies engaged in educating PHNs. For example, this CCPHN could be used for initial PHN educational experience, orientation to a new agency, or meeting PHN continuing education needs.

In undertaking the revision process, Quad Council adopted the Council on Linkages (CoL) structure for competencies: eight recognized domains spanned by three tiers of practice As we developed the CCPHN wecompetencies: eight recognized domains spanned by three tiers of practice. As we developed the CCPHN, we assumed that PHNs practice at the intersection of population‐focused nursing care and public health practice. Proceeding from this assumption, we used the CoL document to determine how PHNs should demonstrate core competencies for public health professionals at all three levels: the basic or generalist level (Tier 1); the specialist or mid‐level (Tier 2); and at the executive and/or multi‐systems level (Tier 3).

Further, we maintained each of the eight domains in the CoL document. Of course, some redundancy is inevitable, given the encompassing nature of public health and PHN practice. Competencies in some domains, such as Community Dimensions of Practice, reappear in virtually all domains.

Throughout the composition of this CCPHN, we solicited public feedback and carefully considered it. Feedback came from a broad array of PHNs in practice and academia, primarily members of the Quad Council member organizations What resulted was a useful organized list of knowledge attitudes behaviors and skills thatorganizations. What resulted was a useful, organized list of knowledge, attitudes, behaviors, and skills that provide the floor for PHN practice at the three levels of service. The Quad Council gratefully acknowledges all those PHNs who invested their time in reviewing our drafts and commenting thoughtfully.

Levels of Practice PHNs practice in diverse settings and environments. Thus these competencies represent the continuum of evolving PHN practice roles, responsibilities, and functions for which PHNs may have to account. Public Health Epidemiology Week 5 DQ

The baccalaureate degree in nursing (BSN) is the established educational preparation for entry level PHN practice (ACHNE, 2009; ANA, 2007; Quad Council, 2004). The BSN provides an essential framework of liberalpractice (ACHNE, 2009; ANA, 2007; Quad Council, 2004). The BSN provides an essential framework of liberal arts and sciences education that serves as a foundation for PHN practice. From this framework, PHNs understand how social and ecological determinants affect the health of individuals, communities, and populations. BSN education prepares PHNs both didactically and clinically. As in the previous iteration of these competencies, the Quad Council reaffirmed that a PHN generalist has entry‐level preparation at the b l t l l fl t d b Ti 1 t i T i f th US k i blibaccalaureate level, reflected by Tier 1 competencies. True, in many areas of the US, nurses work in public health without the BSN. However, the Quad Council believes that those nurses may require a job description that reflects a differentiated level of practice and/or may require extensive orientation and education to successfully achieve generalist competencies in Tier 1.

Tier 1 Core Competencies apply to generalist public health nurses who carry out day‐to‐day functions in state and local public health organizations, including clinical, home visiting and population‐based services, and who are not in management positions. Responsibilities of the PHN may include working directly with at risk populations carrying out health promotion programs at allResponsibilities of the PHN may include working directly with at‐risk populations, carrying out health promotion programs at all levels of prevention, basic data collection and analysis, field work, program planning, outreach activities, programmatic support, and other organizational tasks. Although the CoL competencies and the Quad Council competencies are primarily focused at the population level, public health nurses must often apply these skills and competencies in the care of individuals, families, or groups. Therefore, Tier 1 competencies reflect this practice.

Tier 2 Core Competencies apply to PHNs with an array of program implementation management and/or supervisoryTier 2 Core Competencies apply to PHNs with an array of program implementation, management and/or supervisory responsibilities, including responsibility for clinical services, home visiting, community‐based and population‐focused programs. For example, responsibilities may include: implementation and oversight of personal, clinical, family focused, and population‐ based health services; program and budget development; establishing and managing community relations; establishing timelines and work plans, and presenting recommendations on policy issues.

Tier 3 Core Competencies apply to PHNs at an executive/senior management level and leadership levels in public healthTier 3 Core Competencies apply to PHNs at an executive/senior management level and leadership levels in public health organizations. In general, these competencies apply to PHNs who are responsible for oversight and administration of programs or operation of an organization, including setting the vision and strategy for an organization and its key structural units, e.g., a public health nursing division. Tier 3 professionals generally are placed at a higher level of positional authority within the agency/organization, and they bring similar or higher level knowledge, advanced education, and experience than their Tier 2 counterparts.

The following assumptions guided the Quad Council’s work: While the CoL Competencies document was the basis for reformatting the competencies for Public Health Nursing, this document is designed to reflect the unique practice of PHNs, at the intersection of both public health and nursing practice. The Quad Council adopted the CoL definition of core competency: “The individual skills desirable for the delivery of Essential Public Health Services. “ Public Health Nursing is defined as the practice of promoting and protecting the health of populations, using knowledge from nursing, social, and public health sciences. PHNs engage in population‐focused practice, but can and do often apply the CoL concepts at the individual and family level. PHNs must first possess basic generalist nursing competencies common to all baccalaureate graduates. PHNs also accomplish all CoL competencies, but from the unique perspective of public health nursing.

Competencies are written to be demonstrable and measurable. Tier 1 reflects PHN practice primarily directed at individuals, families, and groups in the community/public health setting; Tier 2 reflects PHN practice primarily with communities or populations; Tier 3 reflects organizational and systems level PHN leadershipcommunities or populations; Tier 3 reflects organizational and systems level PHN leadership.

The tiers are defined on a continuum, so PHN practice in each tier assumes mastery of the competencies of the previous tier.

This CCPHN supports the scope and standards of practice for public health nursing. We used the Public Health Nursing: Scope and Standards of Practice (ANA, 2007) document as a reference to ensure continuity and consistency with those standardsstandards.

Competencies are not intended to limit PHN practice. They reflect minimum competencies at each of the three tiers of practice within each domain.

Conversely, the basic competencies do not necessarily reflect the practice of exceptional nurses in each tier. Job descriptions for PHNs may reflect components from each level, depending on agency size, needs, structure, leadership, and services. Public Health Epidemiology Week 5 DQ

As noted in the CoL document, for workers within each competency, intended levels of mastery (and therefore learning objectives) will differ depending upon the workers’ backgrounds, job duties, and years of experience.

Application to Practice These competencies have relevance to all PHNs and the agencies that employ them. PHNs will benefit from using these competencies as a foundation for accountable PHN practice. Agencies will benefit from these competencies in designing job descriptions, orientation plans, and professional staff development options. Educators will find the competencies useful for designing curricula that reflect current practice needs, ensuring that their graduates have the knowledge and skills to perform the core functions and essential services of public health, and enabling thoseknowledge and skills to perform the core functions and essential services of public health, and enabling those graduates to thrive in the public health workforce. Most importantly, the CCPHN provides the basis for public health nursing’s efforts to meet the needs of the populations we serve, and to protect and promote the health of communities locally and globally.

Assumptions ‐ The following assumptions supported the Quad Council work:

Public Health Nursing is defined as the practice of promoting and protecting the health of populations, using knowledge g p p g p g p p , g g from nursing, social and public health sciences. PHNs engage in population‐focused practice, but can and do often apply the Council on Linkages concepts at the individual and family level.

While the Council on Linkages Competencies document was the basis for reformatting the competencies for Public Health Nursing, this document is designed to reflect the unique practice of PHNs, the intersection of both public health and nursing. g

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