Challenges and demands in the population-based work of public health nurses

Norwegian public health nurses' competence areas

OBJECTIVE

To explore the competence areas of public health nurses in Norway.

DESIGN

A qualitative and comparative design was employed.

SAMPLE

A purposive sample of 41 public health nurses participated.

MEASUREMENTS

Data were gathered from focus groups and individual interviews. The interviews centered around an open question about public health nurses' knowledge. They also discussed 10 proposed competence areas for public health nursing, developed from the literature. A qualitative content analysis was conducted on the interview transcripts, followed by a synthesis of the data from the interviews and earlier developed competencies. The 10 competence areas for Norwegian public health nursing were then refined. Finally, we compared the affirmed competence areas with earlier developed cornerstones and the new educational guidelines.

RESULTS

The interviews revealed 10 competence areas. These 10 competence areas were synthesized with the 10 proposed competencies from literature. Ten affirmed competence areas, which mostly corresponded with the competences from literature, were developed. The affirmed competencies were supported by the previously developed cornerstones and new educational guidelines.

CONCLUSIONS

The affirmed competencies will help promote and explain the content and focus of PHNs' work in Norway and may have implications for education and international research.

An analysis of Norwegian public health nursing curricula: Where is the nursing literature?

BACKGROUND

Norwegian public health nurses prevent diseases and promote health in children and young people aged 0-20 and their families. Public health nursing programs prepare students for their practical role and provide relevant theoretical knowledge.

OBJECTIVES

To gain knowledge of the literature in the Norwegian public health nursing curricula, and to examine further the nursing base in these curricula.

DESIGN

An explorative and descriptive design was chosen.

SAMPLE

Reading lists based on syllabus documents from the 10 higher educational institutions in Norway offering programs in public health nursing.

MEASUREMENTS

A summative content analysis and a categorization of content from reading lists were performed.

RESULTS

Numerical information on the content and categorization of reading lists shows that social science and humanities literature dominates, followed by psychology and medicine. Nursing texts, theories and philosophy comprise only a minor part of the curricula.

CONCLUSION

The paper provides valuable data on the theoretical focus in Norwegian public health nursing and raises important questions about the paucity of nursing texts in the curriculum. The imbalance in reading lists in Norway should be studied further and similar studies conducted in other countries to encourage reflection on the theoretical content of public health nursing education globally.

Impact of blended learning on learning outcomes in the public healthcare education course: a review of flipped classroom with team-based learning

BACKGROUND

A flipped classroom with team-based learning is a blended educational strategy that guides active learning inside and outside the classroom. This study aimed to verify the effects of this innovative blended educational strategy on knowledge, problem-solving ability, and learning satisfaction of undergraduate nursing students undergoing public healthcare education.

METHODS

The subjects were undergraduate nursing students enrolled in H University in South Korea. The experiment was conducted over a period of 8 weeks in the public healthcare course. Two groups, blended learning (A flipped classroom with team-based learning) which was the experimental group and traditional lecture-based classroom group, the control group, were assessed. In the blended learning group, the students had pre-class, in-class (including team-based learning elements), and post-class learning elements. The two groups were compared on the following learning outcomes: knowledge, problem-solving ability, and learning satisfaction.

RESULTS

Results showed that the blended learning instructional methods, in comparison with traditional lectures, enhanced the students' knowledge, problem-solving ability, and learning satisfaction in the public healthcare course.

CONCLUSIONS

This study supports the feasibility of the flipped classroom with team-based learning as a blended learning strategy, able to produce improvements in nursing students' learning outcomes. Blended learning approaches may be an effective alternative to conventional approaches in nursing education.

Being a real nurse: A secondary qualitative analysis of how public health nurses rework their work identities

Many Western nations are emphasizing the importance of population health across health care delivery organizations and education systems. Despite significant momentum to integrate population health into nursing practice, a parallel effort to examine how these efforts impact practicing nurses' views of their professional role and work identity has not occurred. This secondary qualitative analysis, employing an abductive approach, explored processes public health nurses use in creating and maintaining their work identity through three organizing themes: narrative self-identity, mandated identity, and identity as struggle. The analysis was based on interview data collected from 30 US public health nurses residing in 17 states. 'Being a real nurse' describes public health nurses' efforts to balance a contradictory work identity where at times they are expected to focus on populations and at other times, on individuals. The identity work revealed through this study should be further explicated and specific strategies developed for stabilizing a work identity for public health nurses, as well as for any nurse charged with a population health role.

Public health nurse perceptions of evolving work and how work is managed: A qualitative study

AIM

To explore public health nurse (PHN) perspectives of their evolving work and how public health nurse work is managed in a Canadian health region.

BACKGROUND

Professional and public health organisations describe public health nurse practice roles as population-focused work. Health care management directs public health nurse work to achieve specific goals.

METHODS

In this qualitative study, data were collected during focus groups with 42 public health nurse participants in one health region. Focus group data were analysed for meanings and themes.

RESULTS

Public health nurses perceived increasing immunizations and limited resources for public health nurse work meant that population-focused care for the public was rationed or missing. Participants perceived the health care organisation directed, managed and assigned public health nurse specialist work; however, public health nurses managed their client-focused practice with knowledge, reasoning and support from colleagues.

CONCLUSIONS

Evolving visible public health nurse work was managed by health organisational management directives to increase immunizations and disease control. Public health nurses managed their evolving visible and invisible work supported by their knowledge, practice values and public health nurse colleagues.

IMPLICATIONS FOR NURSING MANAGEMENT

Nursing management must lead and communicate the vision supporting better health, better population-focused care and health outcomes to public health nurse and stakeholders, while reviewing resources needed to optimize public health nursing and improve population health.

Models and frameworks that enable nurses to develop their public health practice-A scoping study

AIMS AND OBJECTIVES

This scoping review commissioned by the Public Health England, WHO collaborating Centre, aimed to explore the models and frameworks which enable nurses to develop their public health practice and deliver public health interventions to individuals, families and communities.

BACKGROUND

There is a plethora of literature regarding the role, activities and scope of practice undertaken by public health nurses across the world. However, only two reviews have explored the models and frameworks used for public health nursing practice.

DESIGN

The study drew upon an established framework with a narrative review drawing upon five methodological steps.

METHODS

A search of databases, Medline, PsycINFO, Embase, CINHAL and British Nursing Index, was undertaken. The search took place between April 2018 and June 2018 retrieving 9,513 peer-reviewed articles published from 2008.

RESULTS

Ninety-five studies were retrieved and analysed thematically. From an initial review of literature, two themes were identified: public health models used in practice and models used in public health education. Within the first theme, three subthemes were emerged: Characteristics of the interventions; Characteristics of the public health nurse; and Lack of measurable health benefits. Within the second theme, three subthemes were identified: Faculty and Students Working Together; The Experiential Academic Approach, and What works in Educating Nurses for Public Health.

CONCLUSION

The review identified that many models and frameworks are used in practice. However, within public health practice there is a limited evidence base and it fails to demonstrate that the frameworks and models developed for practice result in measurable health benefits on an individual or population level. However, within education innovative models were apparent with collaborative partnerships enabling preregistration nursing students to develop public health nursing competencies.

RELEVANCE TO CLINICAL PRACTICE

Innovative approaches to education of preregistration nursing students could point the way forward for the delivery of public health nursing practice.