Factors in Health Care and Population-Centered Nursing

P R A C T I C E A P P L I C A T I O N Population-focused nursing practice is different from clinical nursingcaredeliveredinthecommunity.Ifoneacceptsthatthe specialist in public health nursing is population-focused and has a unique body of knowledge, it is useful to debate where and how public health nursing specialists practice. How does theirpracticecomparewiththatofthenursespecialistincom- munityorcommunity-basednursing?
A. In your public health class, debate with classmates which nurses in the following categories practice population- focusednursing: 1. Schoolnurse 2. Staffnurseinhomecare 3. Directorofnursingforahomecareagency 4. Nursepractitionerinahealthmaintenanceorganization
20 PART 1 Influencing Factors in Health Care and Population-Centered Nursing
K E Y P O I N T S Publichealthiswhatwe,asasociety,docollectivelytoensure
theconditionsinwhichpeoplecanbehealthy. Assessment,policydevelopment,andassurancearethecore
publichealthfunctions;theyareimplementedatalllevelsof government.
Assessment refers to systematically collecting data on the population, monitoring of the populations health status, and making available information about the health of the community.
Policy development refers to the need to provide leadership indevelopingpoliciesthatsupportthehealthofthepopula- tion; it involves using scientific knowledge in making deci- sionsaboutpolicy.
Assurance refers to the role of public health in making sure that essential community-wide health services are available, which may include providing essential personal health services for those who would otherwise not receive them. Assurance also refers to ensuring that a compe- tent public health and personal health care workforce is available.
The setting is frequently viewed as the feature that distin- guishespublichealthnursingfromotherspecialties.Amore
useful approach is to use the following characteristics: a focusonpopulationsthatarefree-livinginthecommunity, an emphasis on prevention, a concern for the interface between the health status of the population and the living environment (physical, biological, sociocultural), and the use of political processes to affect public policy as a major interventionstrategyforachievinggoals.
Accordingtothe1985ConsensusConferencesponsoredby the Nursing Division of the U.S. Department of Health and Human Services, specialists in are defined as those who are prepared at the graduate level, eithermastersordoctoral,withafocusinthepublichealth sciences(USDHHS,1985).Thisisstilltruetoday.
Population-focused practice is the focus of specialists in public health nursing. This focus on populations and the emphasis on health protection, health promotion, and disease prevention are the fundamental factors that distin- guishpublichealthnursingfromothernursingspecialties.
A population is defined as a collection of individuals who shareoneormorepersonalorenvironmentalcharacteristics. The term population may be used interchangeably with the termaggregate.
REFERENCES American Association of Colleges of
Nursing (AACN): AACN Position Statement on the Practice Doctorate in Nursing. Washington, DC, 2004, AACN.
American Association of Colleges of Nursing (AACN): The Essentials of Doctoral Education for Advanced Nursing Practice. Washington, DC, 2006, AACN.
American Association of Colleges of Nursing (AACN): Public Health: Recommended Baccalaureate Competencies and Curricular Guidelines for Public Health Nursing: A Supplement to The Essentials of Baccalaureate education for Professional Nursing Practice? See URL: http:// www.aacn.nche.edu/education
-resources/BSN-Curriculum -Guide.pdf.
American Nurses Association (ANA): Public Health Nursing: Scope and Standards of Practice. Washington, DC, 2013, ANA.
American Public Health Association (APHA): The Definition and Role of Public Health Nursing in the Delivery of Health Care: A
Statement of the Public Health Nursing Section. Washington, DC, 1981, APHA.
American Public Health Association (APHA): The Definition and Role of Public Health Nursing: A Statement of the APHA Public Health Nursing Section, [March 1996 update]. Washington, DC, 1996, APHA.
P R A C T I C E A P P L I C A T I O N contd 5. Vicepresidentofnursinginahospital 6. Staffnurseinapublichealthclinicorcommunityhealth
center 7. Directorofnursinginahealthdepartment Providereasonsforyourchoices.
B. Choosethreecategoriesintheprecedinglist,andinterview at least one nurse in each of the categories. Determine the scope of practice for each nurse. Are these nurses carrying outpopulation-focusedpractice?Couldthey?How? Answers can be found on the Evolve site.
C L I N I C A L D E C I S I O N – M A K I N G A C T I V I T I E S 1. Define the following for your personal understanding, and
suggestwaystocheckwhetheryourunderstandingiscorrect: A. Essentialfunctionsofpublichealth B. Specialistinpublichealthnursing C.Nursespecialistinthecommunity
2. Stateyouropinionaboutthesimilaritiesand/ordifferences between a clinical nursing role and the population-focused role of the public health nursing specialist. What are some ofthecomplexissuesindistinguishingbetweentheseroles?
3. Review the model of public health nursing practice of the APHAasdescribedinthischapter.Canyouelaborateonthe differencesbetweenthestaffnurseandthespecialistnurse?
4. Withthreeorfourclassmates,identifysomenursesinyour community who are in an administrative role and discuss withthemthefollowing: A. Thewaytheydefinethepopulationstheyareserving B. Strategies they use to monitor the populations health
status C.Strategies they use to ensure that the populations are
receivingneededservices D.Initiativestheyaretakingtoaddressproblems
5. Doadditionalquestionsneedtobeaskedtodeterminetheir views on population-focused practice and the responsibili- tiesofthestaffnurse?Elaborate.

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