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Smith DL, Klein K, Smith M. The use of Community/Public Health Nursing Competencies during the COVID-19 pandemic. Public Health Nurs 2024; 41:356-366. [PMID: 38296813 DOI: 10.1111/phn.13284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 11/03/2023] [Accepted: 01/11/2024] [Indexed: 02/02/2024]
Abstract
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.
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Affiliation(s)
- Diane L Smith
- Assistant Professor of Nursing, Missouri State University, Springfield, Missouri, USA
| | - Kayla Klein
- Community Outreach Specialist, Taney County Health Department, Forsyth, Missouri, USA
| | - Martha Smith
- Public Health Nursing Manager/Missouri Maternal Child Health Director, Missouri Department of Health and Senior Services, Jefferson City, Missouri, USA
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Tetui M, Tennant R, Adil M, Bala A, Burns C, Waite N, Grindrod K. "Flying a plane and building it at the same time": Lessons learned from the dynamic implementation of mass vaccination clinics in the Region of Waterloo, Ontario, Canada. Health Res Policy Syst 2023; 21:102. [PMID: 37784061 PMCID: PMC10546698 DOI: 10.1186/s12961-023-01036-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 08/12/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Vaccination plays a critical role during pandemics, and mass vaccination clinics are often an imperative public health measure. These clinics usually consist of multi-disciplinary teams, which can pose significant coordination challenges, yet also present an opportunity for collectively contributing towards mitigating the impact of infection within communities. This study explores the coordination dynamics of the Region of Waterloo's coronavirus disease of 2019 (COVID-19) mass vaccination clinics in Ontario, Canada, between July 2021 and April 2022. METHODS This qualitative study included 16 purposively selected participants working in mass vaccination clinics. Participants were individually interviewed for 40-60 min. An inductive and iterative thematic analysis was undertaken, including open coding, grouping, labelling, regrouping and making sense of the themes. RESULTS Three interrelated themes were created: (1) unpredictable work environment, which was comprised of changing clinic processes and the impact of clinic adjustments to the running of the clinics; (2) clinic cohesion challenges, which included staff role disparities, limited job preparation and clinic system silos; and (3) adaptable and supportive work environment, which was comprised of staff adaptability, dispositional flexibility and a supportive work environment. While the first two themes created a precarious situation in the clinics, the third countered it, leading to a largely successful clinic implementation. CONCLUSIONS The rapid evolution and high transmissibility of COVID-19 in communities required a public health response that felt like flying and building a plane simultaneously - a seemingly impossible yet necessary task. However, an adaptable and supportive work environment was critical for establishing an atmosphere that can overcome challenges from a constantly changing pandemic and the guidance of public health officials. Such lessons gained from understanding the dynamic experiences in mass vaccination clinics are essential for improving the development and operation of future immunization campaigns.
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Affiliation(s)
- Moses Tetui
- School of Pharmacy, University of Waterloo, Kitchener, Ontario, Canada.
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden.
| | - Ryan Tennant
- Systems Design Engineering, Faculty of Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Maisha Adil
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Arthi Bala
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Catherine Burns
- Systems Design Engineering, Faculty of Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Nancy Waite
- School of Pharmacy, University of Waterloo, Kitchener, Ontario, Canada
| | - Kelly Grindrod
- School of Pharmacy, University of Waterloo, Kitchener, Ontario, Canada
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Tennant R, Tetui M, Grindrod K, Burns CM. Multi-Disciplinary Design and Implementation of a Mass Vaccination Clinic Mobile Application to Support Decision-Making. IEEE J Transl Eng Health Med 2022; 11:60-69. [PMID: 36654771 PMCID: PMC9842226 DOI: 10.1109/jtehm.2022.3224740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 10/26/2022] [Accepted: 11/18/2022] [Indexed: 11/25/2022]
Abstract
Mass vaccination clinics are complex systems that combine professionals who do not typically work together. Coordinating vaccine preparation and patient intake is critically important to maintain patient flow equilibrium, requiring continuous communication and shared decision-making to reduce vaccine waste. OBJECTIVES (1) To develop a mobile application (app) that can address the information needs of vaccination clinic stakeholders for end-of-day doses decision-making in mass immunization settings; and (2) to understand usability and clinical implementation among multi-disciplinary users. METHODS Contextual inquiry guided 71.5 hours of observations to inform design characteristics. Rapid iterative testing and evaluation were performed to validate and improve the design. Usability and integration were evaluated through observations, interviews, and the system usability scale. RESULTS Designing the app required consolidating contextual factors to support information and workload needs. Twenty-four participants used the app at four clinics who reported its effectiveness in reducing stress and improving communication efficiency and satisfaction. They also discussed positive workflow changes and design recommendations to improve its usefulness. The average system usability score was 87 (n = 22). DISCUSSION There is significant potential for mobile apps to improve workflow efficiencies for information sharing and decision-making in vaccination clinics when designed for established cultures and usability, thereby providing frontline workers with greater time to focus on patient care and immunization needs. However, designing and implementing digital systems for dynamic settings is challenging when healthcare teams constantly adapt to evolving complexities. System-level barriers to adoption require further investigation. Future research should explore the implementation of the app within global contexts.
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Affiliation(s)
- Ryan Tennant
- Department of Systems Design EngineeringUniversity of Waterloo Waterloo ON N2L 3G1 Canada
| | - Moses Tetui
- Department of Epidemiology and Global HealthUmeå University 901 87 Umeå Sweden
- School of PharmacyUniversity of Waterloo Waterloo ON N2G 1C5 Canada
| | - Kelly Grindrod
- School of PharmacyUniversity of Waterloo Waterloo ON N2G 1C5 Canada
| | - Catherine M Burns
- Department of Systems Design EngineeringUniversity of Waterloo Waterloo ON N2L 3G1 Canada
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Belita E, Jack SM, Lokko H, Dobbins M. Exploring the context, role and impact of public health nursing during COVID-19: A multiple case study protocol. J Adv Nurs 2022; 78:2646-2655. [PMID: 35621356 PMCID: PMC9348384 DOI: 10.1111/jan.15304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 05/07/2022] [Indexed: 11/30/2022]
Abstract
AIM The purpose of this study is to: (a) describe public health nursing roles over the course of the COVID-19 pandemic in Ontario, Canada; (b) describe the contextual factors that influence public health nursing role implementation; and (c) describe nurses' perceived impact of their roles on client outcomes and professional/personal nursing practice. DESIGN Descriptive multiple case study. METHODS Recruitment of public health nurses (PHNs), working in direct service or administrative leadership positions, in an Ontario public health unit will be conducted through purposive and snowball sampling. Nursing roles will be compared and contrasted across three cases differentiated by geographic setting: urban, urban-rural, northern. In each geographic case, a priori estimates of sample size will include 10 PHNs providing direct care and at least five nurses in an administrative leadership role; with an overall estimated study sample size of 45 individuals. Demographic data will be collected using an online anonymous survey. Individual semi-structured interviews with PHNs, and focus groups with nursing administrators will be conducted via telephone and audio-recorded. Individual interviews and focus groups will be transcribed verbatim. Reflexive thematic analysis will be used to generate emergent themes in each case and cross-case synthesis will be used to compare and contrast patterns across geographic cases. DISCUSSION Expected findings will provide an in-depth analysis of the rapidly evolving roles and functions of PHNs throughout the COVID-19 pandemic and their impact on individuals, families and communities. As well, findings will provide a new understanding about the contextual barriers and facilitators of PHN role implementation in their working environments. IMPACT Study findings can support decision-making in relation to funding, resource allocation and supportive work structures and processes at a public health system and/or individual public health organization level.
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Affiliation(s)
- Emily Belita
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Susan M Jack
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Heather Lokko
- Middlesex-London Health Unit, London, Ontario, Canada
| | - Maureen Dobbins
- School of Nursing, McMaster University, Hamilton, Ontario, Canada.,National Collaborating Centre for Methods and Tools, Hamilton, Canada
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Shakory S, Eissa A, Kiran T, Pinto AD. Best Practices for COVID-19 Mass Vaccination Clinics. Ann Fam Med 2022; 20:149-156. [PMID: 35346931 PMCID: PMC8959732 DOI: 10.1370/afm.2773] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 08/13/2021] [Accepted: 09/08/2021] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented global public health crisis. Mass vaccination is the safest and fastest pandemic exit strategy. Mass vaccination clinics are a particularly important tool in quickly achieving herd immunity. Primary care physicians have played a crucial role in organizing and running vaccination clinics. In this special report, we synthesize existing guidelines and peer-reviewed studies to provide physicians with practical guidance on planning and implementing COVID-19 mass vaccination clinics. METHODS PubMed, Ovid MEDLINE and Embase were used to search for relevant literature using search terms that included COVID-19, mass vaccination, and best practice. We also identified and analyzed national and international guidelines. RESULTS Forty-six relevant articles, reports, and guidelines were identified and synthesized. Articles included mass vaccination clinic guidelines and studies before and during the COVID-19 pandemic. Key considerations for COVID-19 mass vaccination clinics include leadership and role designation, site selection, clinic layout and workflow, day-to-day operations, infection prevention, and communication strategies. CONCLUSIONS Planning and implementing a successful COVID-19 mass vaccination clinic requires several key considerations. Primary care plays an important role in organizing clinics and ensuring populations made vulnerable by social and economic policies are being reached. Ongoing data collection is required to evaluate and continuously improve COVID-19 mass vaccination efforts. As the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine rollout occurs in various countries, research will be required to identify the main factors for success to inform future pandemic responses.VISUAL ABSTRACT.
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Affiliation(s)
- Shima Shakory
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada
| | - Azza Eissa
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Family and Community Medicine, St Michael's Hospital, Toronto, Ontario, Canada
| | - Tara Kiran
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Family and Community Medicine, St Michael's Hospital, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada.,Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada
| | - Andrew D Pinto
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada .,Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada.,Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada.,Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada
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Abstract
BACKGROUND The COVID-19 pandemic has overwhelmed health care systems globally. To understand how health care systems can best support frontline health care providers caring for patients in similar situations, it is necessary to gain insights into their experience. PURPOSE This quality improvement study explored the lived experience of Canadian frontline medicine nurses caring for COVID-19 patients during the first wave of the pandemic. METHOD A qualitative interpretive phenomenological approach was conducted. Forty-three eligible nurses participated in semistructured interviews and online surveys. Full transcription and thematic content analysis were performed. RESULTS Three overarching themes were deduced: (1) a traumatic experience, (2) living through the experience, and (3) achieving transcendence. CONCLUSION Several recommendations were identified. These recommendations aim to aid health care systems in emergency preparation planning and future pandemic responses while supporting frontline health care providers' resilience and well-being.
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Schaer JM, Campbell LA, Thomas LJ. The first line of prevention: A public health nursing advocacy video. Public Health Nurs 2021; 39:677-682. [PMID: 34856640 DOI: 10.1111/phn.13013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 10/29/2021] [Accepted: 11/03/2021] [Indexed: 11/29/2022]
Abstract
Public health nurses (PHNs) serve as the first line of prevention in public health and safety threats such as the COVID-19 pandemic. Although PHNs provide vital services to protect communities and populations' health, a pervasive lack of knowledge exists regarding the PHN role among policymakers and the general public. Advocacy for investment in the public health nursing workforce remains a priority as staffing and financial constraints have created sizeable barriers for PHNs during the COVID-19 response. Creating an advocacy video with personal stories from PHNs emerges as a powerful and cost-effective strategy to increase the visibility of PHNs. For this project, interviews with PHNs from COVID-19 hot spots were used to create a 3-min advocacy video. PHNs featured in this video discussed the implications of rerouting resources to combat COVID-19 for the populations they serve. The authors disseminated the video through popular social media venues, public health and nursing organizations and nurse influencers to reach nursing students, faculty, and the public. Over an 8-week period, the video received 2732 views on social media with an average view duration of 2 min. This article includes strategies to maximize the impact of an advocacy video when shared with relevant stakeholders.
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Affiliation(s)
- Janita M Schaer
- Department of Nursing, Lone Star College-Tomball, Tomball, Texas, USA.,Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Lisa A Campbell
- School of Nursing, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Laura J Thomas
- School of Nursing, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
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Pan Y, Du L, Gan Q, Ma W, Wang M, Lu Z, Luo Y. Meta-analysis of whether influenza vaccination attenuates symptom severity in vaccinated influenza patients. Public Health Nurs 2021; 39:509-516. [PMID: 34614241 DOI: 10.1111/phn.12985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 09/15/2021] [Accepted: 09/17/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Influenza vaccination has been associated with decreased risk of influenza-related infections. However, associations between influenza vaccination and the severity of influenza cases have not been systematically summarized. We conducted a meta-analysis to evaluate whether influenza vaccination could attenuate symptom severity in vaccinated influenza patients. METHODS A systematic literature search was performed using the PubMed, Web of Science, EMBASE, and Scopus databases. A quantitative synthesis of the data was conducted using a fixed/random effects model in the meta-analysis. RESULTS A total of seven studies, involving 6342 vaccinated and 7036 non-vaccinated patients were included. Compared with non-vaccinated, vaccinated patients were significantly less likely to develop a fever (OR = 0.66, 95% CI: 0.43-0.89), be admitted to the ICU (OR = 0.79, 95% CI: 0.64-0.97), suffer mortality (OR = 0.55, 95% CI: 0.34-0.89), stay in the ICU (WMD = -1.37, 95% CI: -2.15 to -0.60) or stay in the hospital (WMD = -0.32, 95% CI: -0.61 to -0.04). CONCLUSION Those benefits that could be highlighted in the communication material to enhance the uptake of influenza vaccination among both the public health nurses and the community as a whole.
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Affiliation(s)
- Ye Pan
- Department of Infectious Disease, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, 362000, PR China
| | - Lijiang Du
- Department of Infection, Kunming Children's Hospital, Kun Ming, Yunnan, 224200, PR China
| | - Quan Gan
- Department of Infection, Kunming Children's Hospital, Kun Ming, Yunnan, 224200, PR China
| | - Wei Ma
- Department of Infection, Kunming Children's Hospital, Kun Ming, Yunnan, 224200, PR China
| | - Meifen Wang
- Department of Infection, Kunming Children's Hospital, Kun Ming, Yunnan, 224200, PR China
| | - Zhiying Lu
- Department of Infection, Kunming Children's Hospital, Kun Ming, Yunnan, 224200, PR China
| | - Yunjiao Luo
- Department of Infection, Kunming Children's Hospital, Kun Ming, Yunnan, 224200, PR China
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