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Chapter 01 Population-Focused Practice: The Foundation of Specialization in Public Health Nursing. Objectives. State the mission and core functions of public health and the essential public health services.
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Chapter 01Population-Focused Practice: The Foundation of Specialization in Public Health Nursing
Objectives State the mission and core functions of public health and the essential public health services. Describe specialization in public health nursing and community health nursing and the practice goals of each. Contrast clinical community health nursing practice with population-focused practice. Describe what population-focused practice means.
Objectives, Cont’d Name barriers to acceptance of population-focused practice. State key opportunities for population-focused practice. Recognize quality performance standards programs in public health.
Introduction Shift to protect and improve health of Americans Patient Protection and Affordable Care Act National Prevention, Health Promotion, and Public Health Council Prevention and Public Health Fund Managed care
Benefits of Public Health Practice Dramatic increase in life expectancy since 1900s Improved sanitation and control of infectious diseases Population-based prevention programs Potential to prevent 70% of early deaths in United States Enormous impact despite limited funding
Public Health in America(Figure 1-1) Vision: Healthy people in healthy communities Mission: Promote physical and mental health Prevent disease, injury, and disability Essential PH services: Assessment Policy development Assurance
Definitions in Public Health Public health Public health core functions Assessment Policy development Assurance
Core Competencies of Public Health Professionals Analytic/assessment Policy development/program planning Communication Cultural competency Community dimensions of practice Basic public health sciences Financial planning and management Leadership and systems thinking
Curriculum Content Areas for Public Health Workers Informatics Genomics Cultural competence Community-based participatory research Policy Law Global health Ethics
National Public Health Performance Standard Program Set the bar for the level of performance necessary to deliver essential public health services Four principles that guided the development Developed around the 10 essential public health services Focus on the overall public health system rather than on single organizations Describe an optimal level of performance Support a process of quality improvement
Definitions of Public Health Nursing (PHN) Scope and Standards of Public Health Nursing Practice (Quad Council, 1999) Defined as the practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences It is population-focused practice that emphasizes the promotion of health, the prevention of disease and disability, and the creation of conditions in which all people can be healthy.
PHN Specialty Characteristics: Population-focused Community-oriented Health and preventive focus Interventions are made at the community or population level There is concern for the health of all members of the population/community, particularly vulnerable subpopulations
Essential Areas for the Preparationof PHN Specialist (Box 1-4) Epidemiology Biostatistics Nursing theory Management theory Change theory Economics Politics History of public health Issues in public health Public health administration Community assessment Program planning and evaluation Interventions at the aggregate level Research
Education for PHN Current BSN graduate has basic preparation to function as a staff PHN Master’s degree required for specialization in PHN Then eligible to sit for certification exam Future BSN graduate has basic preparation to function as a staff PHN Doctor of Nursing Practice (DNP) will likely be required for specialization in PHN Then eligible to sit for certification exam
Definitions of Population-Focused Practice Population or Aggregate A collection of individuals who have one or more personal or environmental characteristics in common Members can be defined in terms of: Geography (e.g., a county, a group of counties, or a state) Special interest or circumstance (e.g., children attending a particular school) Subpopulation Group within the larger population
Population-Focused Practice Versus Individual-Focused Practice Population-Focused Practice: Diagnoses, interventions, and treatments are carried out for population or subpopulation Levels of prevention (primary, secondary, tertiary) Population-level decision making is different Concerned with more than one subpopulation Individual-Focused Practice: Diagnoses, interventions, and treatments are carried out at individual client level
PHN Specialists and Core PH Functions: Assessment Participate in and provide leadership for: Assessing community needs, health status of populations within the community, and environmental and behavioral risks Look at trends in the health determinants Identify priority health needs Determine the adequacy of existing resources within the community Engage in policy-development efforts
PHN Specialists and Core PH Functions: Policy Development Core function AND core intervention strategy Seeks to build constituencies that can help bring about change in public policy Examples: Development of Healthy People 2020 state objectives National effort to control acquired immunodeficiency syndrome (AIDS) Anti-smoking ordinances
PHN Specialists and Core PH Functions: Assurance Focuses on the responsibility of public health agencies to make certain that activities have been appropriately carried out to meet public health goals and plans Includes the development of partnerships between public and private agencies
PHN and Community Health Nursing Versus Community-Based Nursing PHN Community-oriented, population-focused strategies Community-based combination of population-focused, community-oriented strategies and direct-care clinical strategies Community health nurse Applies to all nurses practicing in the community
Community-based nursing: provision of personal care to individuals and families in the community Community-oriented care Community-based care Three role functions of nursing practice Master’s prepared clinical specialist PHN and Community Health Nursing Versus Community-Based Nursing, Cont’d
Roles in PHN Public health nursing administrators Staff nurses Curriculum plan to prepare staff nurse or generalist Identification of skills and necessary knowledge
Challenges for the Future Barriers to specializing in PHN Changing mindset that nursing is only at bedside Work structure and role socialization Few nurses receive graduate-level preparation in PHN concepts and strategies Developing population-focused nurse leaders Shifting public policy