Community/public health nursing faculty's knowledge, skills and attitudes of the Quad Council Competencies for Public Health Nurses

The use of Community/Public Health Nursing Competencies during the COVID-19 pandemic

OBJECTIVES

(1) Ascertain the use of the Quad Council Competencies for Community/Public Health Nursing (QCC-C/PHN) Competencies by community/public health nurses (C/PHNs) during the COVID-19 pandemic; (2) Inform from a systems-level the need to sustain the C/PHN workforce; (3) Assess the C/PHN infrastructure for response capacity.

DESIGN

Cross-sectional. Statewide email distribution lists were used for dissemination.

SAMPLE

Convenience sample (n = 169) obtained using emailed Qualtrics link with the eligibility criteria of self-identification as a C/PHN who works in the state of Missouri.

MEASUREMENTS

Demographic questions included employment sector, nursing education level, years of nursing, and C/PHN experience. Two Likert-type questions and one optional open-text question were created for the eight domains.

RESULTS

One hundred sixty-nine participants' data were analyzed. One hundred fifty-four were employed in a local public health agency. Total 63.2% held a bachelor's degree in nursing or higher. The average number of years of nurse experience was 20.84, and C/PHN experience was 9.84. The domain of Communication Skills scored highest and Cultural Competency was the lowest. Three themes emerged from the open-ended questions including vulnerabilities of the public health system.

CONCLUSION

Understanding the experiences of C/PHNs in Missouri related to the utilization of QCC-C/PHN competencies informs efforts to strengthen public health infrastructure and target resources to equip Missouri's C/PHNs.

Developing a Virtual Reality Simulation Program for Improving Nursing Students' Clinical Reasoning Skills in Home Settings: A Protocol Paper

Most nursing simulation programs focus on persons' healthcare needs in hospital settings, and little is known about how to identify them in home settings. This study aims to develop and validate a virtual reality (VR) simulation program for nursing students to improve their clinical reasoning skills and confidence in assessing persons' healthcare needs in home settings. We developed a VR simulation program based on a literature review and expert discussion. In Phase 1, home visit nurses or public health nurses will validate the program through their interviews in 2022. In Phase 2, we will conduct a pilot and main single-blinded randomized trial for nursing students to confirm the effectiveness from 2022 and 2023. Participants will be randomly allocated into an intervention group using VR simulations and a control group receiving videos regarding three kinds of community residents' lives [1:1]. After obtaining informed consent, the students will submit their anonymous data to the researchers to prevent associating their grade evaluation. The primary outcome will be their clinical reasoning skills. The second outcome will include their satisfaction and self-confidence. This study will examine the effectiveness of improving their clinical reasoning skills and confidence in assessing persons' healthcare needs in home settings.

A Sisyphean task: Developing and revising public health nursing competencies

BACKGROUND

Competencies are intended to enhance the public health workforce's skills. Competencies used to evaluate public health nursing (PHN) practice and education have been promoted by several nursing organizations. Having multiple sets of competencies raises questions about redundancies and their usefulness in evaluating PHN, as well as the central question about the value of the competencies themselves.

METHODS

A literature review of psychometric evaluation research of the competencies was performed. Qualitative content analyses were conducted of seven documents: Association of Community Health Nursing Educators', 2000 and 2010 essentials; Quad Council Coalition's 2004, 2011, and 2018 competencies; and the American Nurses Association's, 2013 and the 2021 draft of PHN scope and standards of practice with respect to competency definition, conceptual basis, and use of an established taxonomy.

RESULTS

No psychometric evaluations of the competency sets were found. Textual content analysis revealed inconsistent and or missing competency definitions and theoretical frameworks with competencies proliferating over time. Taxonomy analysis identified minimal competencies at higher complexity levels according to Bloom's revised taxonomy.

CONCLUSIONS

Analyzed competencies lack reliability and validity testing, making assessment difficult for PHN educators and practitioners. Multiple and competing competencies further erode PHN's visibility, even among public health nurses. With unending revisions of PHN competencies and lack of supporting evidence regarding their effect and their integration into education or practice, recommendations for future efforts are offered.

Assessing Undergraduate Student Nurses' Performance in Various Public Health Roles Using Simulation

Purpose: To expose students to various public health roles and complement clinical experience using simulated encounters.Design: This exploratory study assessed students' performance of basic nursing tasks for three public health nurse roles.Methods: 15-guided questions were used to evaluate a convenience sample of 137 students' expected performance compared to their actual performance of basic nursing skills.Findings: Students' performed well in all nurse roles with some significant differences in completing a few critical tasks in the case manager and school nurse roles.Conclusion: Simulation can address gaps in nursing programs and expose student nurses to various public health roles using real-life scenarios.Clinical Evidence: Lack of clinical sites in public health limits students' experience to a myriad of nurse functions within communities.

Effectiveness of Health Guidance Simulation in Community Settings for Public Health Nursing Students: A Preliminary Study

Introduction

Simulation-based learning is a relatively new concept in public health nursing education, and little is known about the efficacy of this approach for teaching of health guidance. Objective: The aim of this study was to evaluate the effectiveness of health guidance simulation in community settings for public health nursing students.

Methods

Using a pre/post-test design, 29 public health nursing students in their third year participated in a high-fidelity simulation program with standardized patients. We developed six scenarios on health guidance for three themes (mother and child, tuberculosis, and adult occupational health) and practice guidelines for the standardized patients to act and assist in understanding of the purpose of the course. Data were collected at baseline and after the simulation sessions through evaluation sheets that the students placed in a designated box on campus. Changes in the level of self-confidence of the students were evaluated based on the “practical skills required for public health nurses and achievement level at graduation” of the Ministry of Health, Labor and Welfare, and the skills in the minimum requirements for public health nurse education defined by the Japan Association of Public Health Nurse Educational Institutions.

Results

The total score for self-confidence and the mean self-confidence scores for health guidance skills for mother and child, tuberculosis, and adult occupational health nursing were significantly higher post-test compared to pre-test (p < 0.001).

Conclusion

These results indicate that high-fidelity simulation focused on health guidance in community settings can bridge the gap between theoretical knowledge and practice of students.

Association of Community Health Nursing Educators 2020 Research Priorities and Research in Action Model

OBJECTIVE

The Association of Community/Public Health Nurse Educators (ACHNE) Research Priorities Subcommittee presents a report on the state of the science of public health nursing education.

DESIGN

Whittemore and Knafl's (Journal of Advanced Nursing, 2005, 52, 546) five-step integrative review was used.

SAMPLE

Fifty-two articles were reviewed.

MEASUREMENTS

Braun et al's. (Handbook of research methods in health social sciences, 2019, 843) thematic analysis methods were used.

RESULTS

Four themes emerged: (a) Community/Public Health Nursing Education and teaching strategies/modalities; (b) Clinical teaching and learning partnerships; (c) Environmental health and emergency response; and, (d) Cultural competence and awareness.

CONCLUSIONS

Themes informed the following research priorities: (a) a need for rigorous scientific studies highlighting the impact and effectiveness of Community/Public Health Nursing Education; (b) a need for evidence on faculty development, support and training related to community/public health activities; (c) a need for evidence on impact of Community/Public Health Nursing teaching on communities and students, and (d) a need for evidence on impact of C/PHNE strategies on long-term student knowledge, attitudes or behavior (competencies). Finally, a Research in Action Model is proposed as a means for continued forward movement of the discipline, connecting the three fundamental driving mechanisms.

Quad Council Coalition community/public health nursing competencies: Building consensus through collaboration

BACKGROUND

The changing professional environment for community/public health nursing practice necessitates competencies grounded in current evidence-based practice. The Quad Council Coalition (QCC) appointed a Task Force to revise the 2011 QCC Competencies for Public Health Nursing. The goal of the competencies is to guide professional nursing practice, curricula, research, and policy development. This paper describes the process used to develop the revised 2018 Competencies.

METHODS

A biphasic Delphi technique was used to conduct a detailed examination and build consensus. Four individuals representing community/public health practice and education collaborated to identify and implement a systematic process for revising the QCC Competencies. The process included multiple iterations of review and feedback using consistent methods and tools to analyze and synthesize themes.

RESULTS

The primary result of this project is the 2018 QCC Competencies document that has strong consensus and provides a coherent voice from professionals on the practice of community/public health nursing.

DISCUSSION

Use of current QCC Competencies will strengthen the community/public health nursing capacity to positively impact the health and well-being of populations.

Leveling the core competencies of public health nursing to evaluate senior baccalaureate nursing students

OBJECTIVES

This study assessed a revised instrument based on the tier one Core Competencies for Public Health Nurses. Following instrument revision, the self-reported competence of prelicensure baccalaureate nursing students was examined.

DESIGN AND SAMPLE

In this descriptive study, 102 senior, prelicensure baccalaureate nursing students completed a revised Core Competencies instrument prior to and immediately following completion of public health nursing courses. Parametric statistics were used to determine if there were significant differences in pre- and postcourse domain scores and the impact of selected demographic variables on postcourse domain scores.

RESULTS

Pilot testing confirmed the reliability and validity of the revised instrument. A paired t test determined postcourse domain scores were significantly higher than precourse domain scores. Overall, students rated themselves as competent in all domains, with the lowest ratings of competence in policy development/program planning. Likelihood of choosing a future career in public health was significantly higher for students in traditional public health clinical settings.

CONCLUSION

The revised tier one Core Competency instrument provided information related to students' self-reported competence in public health nursing competencies. These findings provide valuable insight for development and revision of public health nursing courses ensuring a nursing workforce competent in the provision of population health.

Systems Thinking for Transitions of Care: Reliability Testing for a Standardized Rubric

PURPOSE

The purpose of this study was to develop a standardized rubric for systems thinking across transitions of care for clinical nurse specialists.

DESIGN

The design was a mixed-methods study using the Systems Awareness Model as a framework for bridging theory to practice.

METHODS

Content validity was determined using a content validity index. Reliability was established using statistical analysis with Cronbach's α and intraclass correlation coefficient. Usability of the rubric was established using content analysis from focus group discussions about their experiences in using the rubric.

RESULTS

Content validity was established with a content validity ratio of 1.0. Statistical analysis showed a high interrater reliability (α = 0.99), and sections of the rubric showed a strong degree of reliability with α's ranging from 0.88 to 1.00. Content analysis revealed several overall themes for usability of the rubric: clarity, objectivity, and detail. The area for improvement included adding more detail in the scholarly writing section.

CONCLUSION

The research team recommends using the rubric to reflect application of systems thinking across transitions of care.

A crosswalk between the Omaha System and guiding undergraduate public health nursing education documents

The Omaha System is the hallmark evidence-based clinical information management system used in nursing education, research, and practice. Multiple education documents guide public health workforce preparation. This qualitative study identified similarities and gaps between the Omaha System and seven guiding documents commonly used by nurse educators. A crosswalk design was employed. The setting was virtually based using online technology. Recommendations are for public health nurse educators to update their teaching practices using evidence-based approaches.