'No health without mental health': where are we now?

Mental health services are under unprecedented pressure with overwhelming referrals and a current waiting list of 1.2 million people of all ages. The cross-government White Paper 'No health without mental health' was launched 12 years ago detailing the importance of wellbeing services in the creation of mentally healthy communities through health promotion and illness prevention. While primary care, community services and psychiatry are pivotal in the treatment of mental Illness/disorder, mental health care per se is on a continuum, and a great deal of work can be undertaken in communities by wellbeing services to prevent avoidable referrals. This paper proposes a broad framework of education and training for wellbeing/positive mental health services, primary and community care, and nurses working in Community Mental Health Treatment Teams and Home Treatment Teams to ensure all those working with potentially vulnerable adults and children are regulated and meet national standards for mandatory mental health education and training.

Evaluating Student Learning: Community-Based Nursing Education as Action to Address Inequities.

BACKGROUND: This study evaluated nursing students' learning at a nurse-led, faculty-organized, drop-in health care center that provided basic care to marginalized communities. Nursing students have engaged in practicum and coursework at this site for more than 30 years; thus, a review of learning outcomes was needed. METHOD: Using grounded theory as outlined by Strauss and Corbin, data were collected and then analyzed for patterns and themes to inform the research purpose. RESULTS: Four main themes were identified from the data analysis regarding what students learned during their practicum at the community health care center. The themes included: connecting on a human scale, using self-reflection, building relationships with marginalized individuals, and developing skills to make needed changes. CONCLUSION: The findings supported the continuation of this educational opportunity to provide learning experiences that addressed health inequities and social determinants of health for nursing students. [J Nurs Educ. 2022;61(9):525-527.].

Use of catheter maintenance solutions by community nursing staff: an assessment.

This article discusses catheter maintenance solutions, the way they are supposed to be used and the way they actually are being used in primary and community care in the UK. It discusses the knowledge that community nursing staff have regarding these solutions and the need for further education. Appropriate assessment from a suitably trained individual is recommended, resulting in both usage and cost being dramatically decreased, offering more appropriate management and the likelihood of decreasing the incidence of catheter-associated urinary tract infections (CAUTI). The literature surrounding catheter maintenance solutions is investigated, and the lack of available evidence is highlighted. Preliminary research exploring primary and community care nurses' knowledge of catheter maintenance solutions is also discussed.

An Academic-Fire Department Partnership to Address Social Determinants of Health.

BACKGROUND: As the link between social factors and health outcomes has been increasingly identified in nursing research, educators are called to provide clinical experiences that allow undergraduate nursing students to grapple with social complexity and barriers in the health care system. Future nurses need community-based experiences to develop care coordination and community partnering skills to lead in this area of health care transformation. METHOD: An innovative interdisciplinary partnership between a school of nursing and a city fire department was developed to provide students with opportunities to partner with clients to address social determinants of health, while limiting emergency medical services use for nonurgent problems. RESULTS: The program has multiple benefits to nursing students, faculty, clients, agencies, and community partners. Contextual factors leading to this educational partnership, partner benefits, and challenges are discussed. CONCLUSION: Innovative interdisciplinary partnerships are an effective education tool to provide nursing students with a broader view of health care through the lens of social determinants of health. [J Nurs Educ. 2020;59(1):34-37.].

A Slovenian Model of Comprehensive Care for Patients with Difficulties Accessing Healthcare: A Step Towards Health Equity.

Patients that cannot come to their family medicine practice (i.e. who have difficulties with access) do not receive the same preventive screening activities and management of their chronic diseases as those who can. Community nurses who provide healthcare to patients in their homes were trained in additional competencies, including screening for risk factors for selected diseases and the management of patients with selected chronic diseases. The presented model enables equal management of all registered patients, regardless of accessibility. It also fosters exchange of information within the team members and thus improves the quality of the team management of patients.

Benefits and challenges of a nursing service-learning partnership with a community of internally-displaced persons in Colombia.

Service-learning partnerships between nursing programs and health care settings in vulnerable communities may be challenging to initiate, but can offer multiple benefits for students, faculty, and the community served. The aim of this qualitative descriptive study was to explore the benefits and challenges of establishing a service-learning partnership between a university nursing program and an isolated community of internally-displaced persons in Medellin, Colombia. Semi-structured, in-depth interviews were conducted with 10 nursing professors and nine students who participated in the service-learning partnership. Interviews were audio-recorded, transcribed and analyzed using qualitative content analysis. Main benefits identified were: learning about the social determinants of health, development of compassion, appreciation for the community nursing role, professional growth and development, community engagement and increased access to care for community members. Challenges related to the service-learning experience included feelings of moral distress, lack of value for community nursing, and conflict with traditional biomedical approaches to care. Several threats to program sustainability were also identified. Professors and students offered several recommendations for program improvement, including interdisciplinary collaboration, documentation and dissemination of the service-learning experience, increased community autonomy and capacity for self-care, and curricular changes to enhance recognition of the importance of community nursing.

Experiential Community Health Assessment Through PechaKucha.

BACKGROUND: Nursing education is a robust vehicle for change for community health nursing (CHN) in undergraduate programs. Nurses with a broad range of CHN competencies will be needed to meet the demands of community-based care in the coming years. METHOD: To meet the changing curricular demands around CHN, an experiential learning opportunity presented itself with the use of PechaKucha to support students. This experiential approach to learning the Canadian Community Health Nursing Professional Practice Model & Standards of Practice using a windshield and walkabout survey resulted in the students presenting the findings through the PechaKucha method. RESULTS: Kolb's experiential learning theory served as the theoretical foundation. The experiential application of the Canadian Community Health Nursing Professional Practice Model & Standards of Practice helps to create interest in CHN and develop future competent and confident community nurses. CONCLUSION: By discovering CHN applications through experiential learning, students are in a better position to understand the scope and role of CHN practice. [J Nurs Educ. 2018;57(9):566-569.].

Improving Physical Assessment Observational Skills in the Community Setting: An Experiential Exercise.

To become skilled providers, nurse practitioner students are required to expand observational skills and develop acumen in differential diagnosis. Good observational skills are essential for developing differential diagnoses, which are narrowed through diagnostic reasoning to reach an accurate final diagnosis. Teaching observational skills and differential diagnosis methods to nurse practitioner students can be challenging for nurse educators. The goal of an experiential assessment exercise (EAE) was to breathe life into an online course and have fun while learning to gather data about the health status and risk factors of people in the community environment.

[Assessment of the pilot program for cervical cancer screening by health visitors]. / A védonoi méhnyakszurési pilot program értékelése.

INTRODUCTION: Within the tender (6.1.3.A-13/1-2013-0001) supported by the European Union, we wished to involve health visitors into the organized cervical cancer screening program. AIM: The aim of our survey was to assess the satisfaction of health visitors, instructors, and that of the teaching aids. Furthermore, we wished to assess whether the teaching materials met the expectations. METHOD: Satisfaction of the health visitors was assessed by a survey, in four groups of questions. These involved the assessment of the instructors, the teaching aids, evaluation of the further training day, and the compliance with the knowledge of training. Period for completion of the questionnaires lasted from October to December in 2014. We used descriptive statistics for data evaluation. RESULTS: Data of 2148 health visitors was evaluated. They rated the performance of gynecologist-obstetricians 4.65, that of health visitors 4.61, that of public health professionals 4.56, and that of IT specialists 4.52. 98% of the teaching aids were useful for them and the acquired knowledge was appropriate with their expectations. CONCLUSION: The health visitors were satisfied with the theoretical instruction within the pilot program. The professionally well prepared health visitors may contribute to the success of the cervical cancer screening program. Orv. Hetil, 2017, 158(12), 461-467.

"Nursing Students Assaulted": Considering Student Safety in Community-Focused Experiences.

Community nursing experiences for undergraduate students have progressed beyond community-based home visits to a wide array of community-focused experiences in neighborhood-based centers, clinics, shelters, and schools. Our Bachelor of Science in Nursing program chose to use sites situated within neighborhoods close to campus in order to promote student and faculty engagement in the local community. These neighborhood sites provide opportunities for students to deliver nursing services to underserved and vulnerable populations experiencing poverty and health disparities. Some of these neighborhoods are designated as high crime areas that may potentially increase the risk of harm to students and faculty. There is a need to acknowledge the risk to personal safety and to proactively create policies and guidelines to reduce potential harm to students engaged in community-focused experiences. When a group of baccalaureate nursing students was assaulted while walking to a neighborhood clinic, the faculty was challenged as how to respond given the lack of policies and guidelines. Through our experience, we share strategies to promote personal safety for students and recommend transparency by administrators regarding potential safety risks to students engaged in community-focused fieldwork activities.

Global Host Partner Perspectives: Utilizing a Conceptual Model to Strengthen Collaboration with Host Partners for International Nursing Student Placements.

OBJECTIVES: Collaboration in international nursing student placements requires equitable partnerships between global partners to address areas of shared importance, such as equity and justice in health promotion. This qualitative study was the first to use the Leffers and Mitchell Conceptual Model for Partnership and Sustainability in Global Health to elicit global host partners' perspectives regarding effective collaboration for Canadian community health nursing placements in the Dominican Republic. DESIGN AND SAMPLE: Focus group and semi-structured interview methodology was conducted with Dominican Republic (Dominican and Haitian) host partners (n = 23) about the engagement processes and host partner factors for effective partnership. RESULTS: Dominican (83%) and Haitian (17%) participants, comprised similar numbers of male and female adults aged 18-60 years (mean age = 36 years), represented the full range of the Dominican Republic host partners (e.g., teachers, health professionals). Interpretive analysis revealed themes that included (1) the unique role of the cultural broker; (2) relational collaboration in a collective society; (3) reciprocal approaches that honor local expertise; and (4) contextual socioeconomic and cultural factors that influence partnerships. CONCLUSIONS: Future research and implications at the individual, community, and policy levels are discussed.

Reviewing education challenges and solutions for health professionals in community care.

The biggest asset of the NHS is its staff. Health professionals working in the community are faced with a number of challenges to maintain and develop their knowledge and skills in their clinical practice. NHS England's Five Year Forward View describes the need for change, identifying the necessity to reshape care delivery, harnessing technology, and driving down variations in quality and safety of care. This article explores some of the challenges faced by community health-care providers and reviews possible solutions to meet community health-care needs for now as well as the future.

Factors explaining variability in health literacy outcomes of public health nursing clients.

OBJECTIVES: To evaluate variability in health literacy outcomes due to home visiting (HV) program components including PHN, Intervention, and Client. DESIGN AND SAMPLE: A comparative, correlational study evaluated PHN home visiting program data that included PHNs (N = 16); Interventions (N = 21,634); and Clients (N = 141). Client age ranged from 14 to 46 (median = 21, mean = 22.8, SD = 6.65). Clients were predominately White (75.9%), not married (84.4%), and female (99.3%). PHNS documented care using electronic health records (EHR) and the Omaha System. MEASURES: The outcome of interest was health literacy benchmark attainment (adequate knowledge) operationalized by Omaha System Problem Rating Scale for Outcomes Knowledge scores averaged across problems. INTERVENTION: Program of individually tailored, evidence-based HV interventions provided by PHNs. RESULTS: There were 233 different interventions for 22 problems. Knowledge benchmark was attained by 16.3% of clients. Four factors explained variance in reaching the knowledge benchmark: Client (51%), Problem (17%), Intervention (16%), and PHN (16%). CONCLUSIONS: The PHN and intervention tailoring are actionable components of HV programs that explain variability in health literacy outcomes. Further research should examine effects of training on PHN relationship skills and intervention tailoring to optimize outcomes of evidence-based PHN HV programs, and to evaluate whether improving health literacy may subsequently improve client problems.

The impact of the care equity project with community/public health nursing students.

OBJECTIVE: The purpose of this article is to report on the evaluation process of a multi-disciplinary interactive teaching-learning workshop implemented in a college of nursing baccalaureate program. DESIGN AND SAMPLE: A 6-hr workshop on cultural humility and care equity was implemented using educational theater to bring clinical situations involved in community/public health practice into the classroom. One hundred and forty-nine students participated in the workshop. Stages of Change (Prochaska and DiClemente [2005] Handbook of psychotherapy integration. New York: Oxford University Press) and the Learning Transfer Barriers Framework (Price, Miller, Rahm, Brace, & Larson [2010] Journal of Continuing Education in the Health Professions, 30, 237-245.) provided conceptual underpinnings for project evaluation. MEASURES: Nursing students completed a quiz, post-workshop online surveys at 2 and 8 weeks, and a clinical application report (CAR). Survey data provided information on barriers to the transfer of knowledge from theory class to the clinical setting. Qualitative methods were used to audit the CARs. Each CAR was independently reviewed to determine the Stage of Change reflected in the narrative. RESULTS: Workshop evaluation outcomes provide evidence that cultural humility skill building has created behavior change in clinical practice for new health care community/public health nursing providers.