Using spatial video geonarratives to improve nursing care for people who use drugs and experience homelessness: A methodology for nurses.

BACKGROUND: People who are insecurely housed and use drugs are disproportionately affected by drug poisonings. Nurses are uniquely positioned to utilize harm reduction strategies to address the needs of the whole person. Needle debris encompasses drug paraphernalia discarded in public spaces. Studying needle debris provides a strategic opportunity to identify where drugs are being used and target public health strategies accordingly. AIM: Our aim in this article is to illustrate how spatial video geonarratives (SVG) combined GPS technology interviews, and videos of locations with needle debris, can elicit valuable data for nursing research. METHODS: Using SVG required knowledge of how to collect data wearing cameras and practice sessions were necessary. A Miufly camera worn at waist height on a belt provided the stability to walk while interviewing stakeholders. We wore the cameras and conducted go-along interviews with outreach workers, while filming the built environment. Upon completion of data collection, both the interview and GPS information were analysed using Wordmapper software. CONCLUSIONS: This methodology resulted in data presented uniquely in both a visual map and narrative. These data were richer than if a single modality had been used. These data highlighted specific contextual factors that were related to the location of needle debris, which created opportunities for nursing interventions to support people experiencing vulnerability.

Nurses' mental workload and public health emergency response capacity in COVID-19 pandemic: A cross-sectional study.

AIMS: The aim of this study was to assess the level of mental workload of Chinese nurses through a latent profile analysis and to explore its relationship with public health emergency response capacity. DESIGN: A cross-sectional design with a convenience sample. METHODS: A convenience sample of nurses from five tertiary hospitals in Chengdu between May and December 2022. Demographic, work-related information, Nurse's version of NASA's Task Load Index Scale and Nurse's Public Health Emergency Response Capacity Scale were used in this study. RESULTS: The mean scores for mental workload and emergency response capacity for nurses were (57.19 ± 15.67) and (3.58 ± 0.77) respectively. We found that the mental workload of nurses fell into three potential categories. In addition, there were differences in psychological training and supply of epidemic prevention materials in the department among nurses with different mental workload subtypes. There was a moderate negative correlation between nurses' mental workload and public health emergency response capacity. CONCLUSION: Our results show that there is still a strong mental workload on a proportion of nurses, and enhanced psychological training and material supply support are beneficial in relieving nurses' mental workload. The better the nurses' capacity to cope with public health emergencies, the lower their mental workload. IMPACT: Nursing managers should pay ongoing attention to the mental workload status of nurses in the latter stages of a pandemic and individual differences in nurses' mental workload. In addition, nursing managers should be aware of the impact of public health emergency response capacity on nurses' mental workload. They can intervene in nurses mental workload from a new perspective. PATIENT OR PUBLIC CONTRIBUTION: 560 registered nurses participated in this study.

Factors affecting nurses' emergency competencies in public health emergency: A cross-sectional study based on the stress-coping adaptation model.

OBJECTIVES: To investigate the factors associated with stress, resilience, coping styles, and emergency competencies when nurses are faced with a public health emergency. DESIGN: This study used a cross-sectional design. SAMPLE: Study data came from a survey of 646 nurses who were from a tertiary hospital in Southern China in March-June 2022. METHODS: Participants responded to self-report questionnaires through a web-based survey. Stress, resilience, emergency competencies, and response to public emergencies were assessed using the Perceived Stress Scale, Connor-Davidson Resilience Scale, the core competencies of nurses in public health emergencies, and a simplified coping style questionnaire. RESULTS: A total of 646 nurses participated in this study. Slightly over half of the participants were ≤30 years old, and almost all were female. Resilience, positive coping, and negative coping were positively correlated with emergency competencies. Multiple linear regression analysis demonstrated that resilience, working years, and participation in the treatment of infectious diseases were significant predictors of emergency competencies. CONCLUSION: The findings suggest that nurses require additional training in emergency management and clinical practice to enhance their emergency competencies. More interventions and social support should be provided to improve nurses' resilience and positive coping strategies when they encounter public health emergencies.

Partnering to prepare: An academic/workforce collaboration to develop disaster shelter training for nurses.

In California, more frequent, intense, and destructive wildfires have prompted public health departments to enhance disaster response plans as evacuations and shelter needs increase. In addition, individuals utilizing shelters have increasingly complex medical and behavioral health needs and are accessing shelters for longer periods of time. Public health nurses (PHNs) are often called to staff disaster shelters but may have less recent experience in, or comfort with, direct patient care. Many health departments are experiencing challenges developing sustainable training infrastructure that prepares PHNs to deliver direct patient care in disaster shelters. Partnering with academic institutions can address this challenge. This article describes a partnership between a regional collaborative of health jurisdictions and a public university to train public health nurses to work in disaster shelters. The training demonstrates a sustainable way to instruct public health nurses while also highlighting the potential of partnerships between academic institutions and local health departments to address disaster preparedness and response needs in a community. Public health nurses are essential to public health preparedness and providing additional training can augment their ability to respond to disasters.

A crosswalk of foundational BSN population health documents and the AACN essentials.

To guide the development of entry-level nursing education, the American Association of Colleges of Nursing (AACN) published the Essentials document in 2021 with a broadened scope of competencies. Community, population, and public health (CPPH) nurse educators use a number of foundational documents to crosswalk for gaps in the AACN principles, highlighting the need of including these contemporary documents within the baccalaureate CPPH nursing curriculum. In this crosswalk, the authors highlight important capabilities and knowledge exclusive to these fundamental documents and tools, as well as the relevance of these competencies and knowledge to CPPH baccalaureate nursing education.

Overcoming barriers and improving public health nursing practice.

Public health nurses (PHN) are critical to ensuring the health of communities. Absent the most basic information on the PHN workforce in our state, we conducted interviews with 21 PHN and school health nurse (SHN) leaders and an online survey of PHNs and SHNs practicing in Maryland (N = 491). Our study identified an older, very experienced, and well-educated workforce. Both the interviews and survey identified similar barriers: low salaries, recruitment and hiring challenges, limited funding for public health programs, and no opportunities for education or career advancement. Survey participants also identified barriers of inadequate leadership, recognition, and communication including PHNs not being represented at decision-making tables or at the state leadership level. Strategies to promote public health nursing from leaders and survey participants were similar: increasing awareness about what public health and PHNs do and their value; improving advocacy and stakeholder engagement; improving access and availability of services; improving PHN leadership representation at the state level; a improving PHN salaries and benefits including tuition reimbursement. Although results were similar to national studies, comprehensive, granular workforce data is critical to ensure the public health workforce can meet current and emerging public health needs and that public health infrastructure and services are appropriately funded.

Public health nursing education in Ireland and Norway: A comparative analysis.

BACKGROUND: Public health, primary health care, and nursing are founding principles of public health nursing. Thus, the underpinning curriculum needs to reflect these core principles. Public health nursing educators sought to delve deeper into curricula and training of public health nurse (PHNs) in Ireland and Norway OBJECTIVE: To compare PHNs' educational training in Ireland and Norway through a collaborative process DESIGN: This study used a descriptive comparative design SAMPLE: A panel of expert educators (the authors) compared national Public health nursing education strategies, guidelines, and curricula used to train PHN students RESULTS: Four core categories emerged from the analysis: general characteristics, theoretical and empirical knowledge base for PHNs practice, applying theory to clinical practice, and professional/ethical dimensions for practice. Results revealed more similarities than differences in both countries' educational models. The central difference related to the specialist role in Norway versus the generalist role in Ireland CONCLUSIONS: Workforce requirements drive the delivery of Public Health Nursing programs and educational curricula. However, it is imperative that educators evaluate their curricula in terms of fitness and practice, not just purpose.

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.

Hypothetical model for on-the-job training through case conferences of public health nurses.

Public health nurses (PHNs) face difficulties supporting vulnerable individuals and families. On-the-job training (OJT) is essential for improving nurses' competencies. However, PHN managers lack the knowledge to systematically implement OJT. The aim of this study was to develop a hypothetical model to systematically promote OJT for PHNs through case conferences (CC). Literature review, based on an integrative approach, has three stages: (1) theoretical framework development, (2) literature review, and (3) modeling. Literature review from five databases (MEDLINE, CINAHL, PsycInfo, Cochrane Central Register of Controlled Trials, Japan Medical Abstract Society) was conducted to identify the OJT process, its outcomes, and the conditions associated with OJT according to the theoretical framework. Based on 18 articles, this model progressed from "OJT process through CC," comprising the CC design, implementation, and evaluation to OJT produced "outcomes through CC." Outcomes included staff perception and behavior changes, improvements in client's condition, and staff turnover reductions. The OJT model involved "conditions for implementing CC as OJT" and "individual and organizational conditions." Future research should incorporate the social, political, and historical contexts of specific practice situations into the hypothetical model to help refine the model to be used in practice.

Twenty years with the public health intervention wheel: Evidence for practice.

The Public Health Intervention Wheel (PHI Wheel) is a population-based practice model for public health nursing practice that encompasses three levels of practice (community, systems, individual/family) and 17 public health interventions. This article shares the story of how the PHI Wheel was created, disseminated, implemented by public health nurses (PHNs) and educators across the globe, and updated with new evidence published in the second edition of Public Health Interventions: Applications for Public Health Nursing in 2019. Evidence on the relevance of PHI Wheel interventions for public health practice in cultural and international settings supports the model's value in explaining PHN practice. This article highlights the experiences of various countries with the PHI Wheel including Canada, Ireland, New Zealand, Norway, Sweden, the United Kingdom, and the United States. The evidence update confirms the relevance of the model to PHN education and practice and reinforces the conviction that development of new evidence is essential for promoting population health.

The nurse as peacebuilder: Intersections of health and peace.

The purpose of this review is to examine peacebuilding as a concept relevant to nursing practice. A historical view of Lilian Wald's contribution to public health nursing sets the stage for nursing's commitment to the ethics of social justice and responsibility to address the social determinants of health as root causes to health inequities. The interweaving of health and peace are highlighted through exploration of works from leading organizations in health and nursing, nationally and globally. Finally examples of current peacebuilding in public health nursing are highlighted.

Public health nurses in Canadian schools: An opportunity to build capacity and nursing scholarship.

Public health nurses (PHNs) in Canada have the potential to significantly benefit the health and academic outcomes of school age children with its impact lasting into adulthood. Unfortunately, cuts in government funding over the years have diminished the presence of PHNs in schools and their ability to practice to their full scope. In the midst of a pandemic, having a strong nursing presence in schools may facilitate public health efforts and reduce the burden on teachers and administration. This discussion paper will explore the current role of nurses in Canadian schools in relation to school nurses in other parts of the world. An overview of the literature looking at the impact of the school nurse on school health (i.e., student health and academic outcomes) will be presented to provide evidence in support of rebuilding nursing capacity in Canadian schools. Finally, the Framework for 21st Century School Nursing Practice will be introduced as a viable nursing theory to facilitate rebuilding PHN capacity in schools.

Public health nurses' workforce factors and population health outcomes in the United States.

OBJECTIVES: (a) To examine associations between public health nurse (PHN) workforce factors (PHNs' highest education and PHNs' mean years of employment) and health-risk behaviors (smoking and physical inactivity rates), and (b) to investigate the associations between PHN workforce factors and premature mortality rates across all counties of the United States. DESIGN: Secondary analysis. SAMPLE: A total of 5,705 PHNs from the 2015 National Nursing Workforce Survey and 2,977 U.S. counties from the 2016 County Health Rankings & Roadmaps data were included. METHODS: Multilevel linear regression was used. RESULTS: Bachelor's, and master's or doctorate-prepared PHNs accounted for 41.5% and 17.0%, respectively. The mean year of employment among PHNs was 17.3. The percentages of PHNs with bachelor's, master's, and doctoral degrees were significantly associated with decreased physical inactivity rates. The PHNs' mean year of employment was significantly associated with decreased physical inactivity rates and reduced premature age-adjusted mortality rates. CONCLUSIONS: The findings indicated that PHNs with higher levels of education and more years of employment were important in improving health outcomes (health-risk behavior and premature mortality). Policymakers need to consider strategies to encourage more PHNs to obtain advanced degrees and to retain PHNs longer in the public health field.

Opening the doors for school health-An exploration of public health nurses' capacities to engage in comprehensive school health programs.

OBJECTIVES: Public health nurses (PHNs) have a significant role in engaging the voice and actions of school communities in promoting the health of children and youth. School nursing was one of the early 20th century public health nursing foci and specialties in Canada, however over several decades, there has been a gap in actualizing PHNs' full potential in schools. At the same time, intersectoral and interdisciplinary comprehensive school health (CSH) models have emerged as exemplars of partnerships between schools and communities to advance health promotion and ultimately chronic disease prevention with school populations (Pan-Canadian Joint Consortium for School Health, ; World Health Organization, ). DESIGN AND MEASUREMENT: Using a participatory action research methodology we explored the role of PHNs in CSH, drawing on the concept of engagement in intersectoral healthy school teams. RESULTS AND CONCLUSIONS: The three themes that emerged from the data analysis were: facilitators of public health nursing engagement, barriers to public health nursing engagement, and the influences of community context on engagement. Overall, findings indicate that the PHN role in CSH must be developed and supported so that PHNs remain a vital link between school health communities, programs, and policies in the promotion of health.

Effectiveness of an educational program for mid-level Japanese public health nurses to improve program planning competencies: A preliminary randomized control trial.

OBJECTIVE: To evaluate the effectiveness of an education program for mid-level Japanese public health nurses (PHNs) to improve their competencies in program planning, which will fulfill community health needs. DESIGN: Randomized control trial. SAMPLE: During 2017, 103 PHNs with 5-20 years of PHN work experience in Japan were enrolled and randomly allocated to the intervention (n = 51) or control group (n = 52). MEASUREMENTS: The primary outcome measured competency in program planning based on Competency Measurement of Creativity for PHNs (CMC), knowledge, and skills regarding program planning. INTERVENTION: Six web-based learning modules followed by two face-to-face group sessions. RESULTS: The PHN participants averaged about 12 years of experience. In the intervention group, 25 PHNs completed all modules (49.0%). Post intervention, there were no statistically significant differences among any between-group CMC scores. However, the intervention group's CMC 3 score was significantly higher than that of the control group of ≥12 years of experience. Total knowledge and skill scores also improved significantly in the intervention group compared with the control group. CONCLUSIONS: The results suggest that PHNs with ≥12 years of experience are a suitable target of this educational program, and should play a key role in program planning.

Weathering the rural reality: delivery of the Nurse-Family Partnership home visitation program in rural British Columbia, Canada.

BACKGROUND: Pregnant girls/young women and new mothers living in situations of social and economic disadvantage are at increased risk for poor health. Rural living may compound marginalization and create additional challenges for young mothers. Public health nurses (PHNs) delivering the Nurse-Family Partnership (NFP) to mothers living in rural communities may help to improve maternal and child health outcomes. The purpose of this analysis, grounded in data collected as part of a broader process evaluation, was to explore and understand the influence of rural geography on the delivery of NFP in British Columbia, Canada. METHODS: For the analysis of this qualitative data, principles of inductive reasoning based on the methodology of interpretive description were applied. A total of 10 PHNs and 11 supervisors providing the NFP program in rural communities were interviewed. RESULTS: The results of this analysis reflect the factors and challenges of providing the NFP program in rural communities. PHNs noted the importance of NFP in the lives of their rural clients, especially in the face of extreme financial and social disparity. Remaining flexible in their approach to rural nursing and protecting time to complete NFP work supported nurses practicing in rural environments. Rural PHNs were often the sole NFP nurse in their office and struggled to remain connected to their supervisors and other NFP colleagues. Challenges were compounded by the realities of rural geography, such as poor weather, reduced accessibility, and long travel distances; however, these were considered normal occurrences of rural practice by nurses. CONCLUSIONS: PHNs and NFP supervisors are well-positioned to identify the modifications that are required to support the delivery of NFP in rural geography. NFP nurses need to articulate what classifies as rural in order to effectively determine how to best provide services to these populations. Environmental conditions must be considered when offering NFP in rural communities, particularly if they impact the time required to deliver the program and additional services offered to young mothers. Regular NFP meetings and education opportunities address common problems associated with rural nursing but could be enhanced by better use of technology.

Implementation of the Family Nurse Partnership programme in England: experiences of key health professionals explored through trial parallel process evaluation.

BACKGROUND: The Family Nurse Partnership (FNP) programme was introduced to support young first-time mothers. A randomised trial found FNP added little short-term benefit compared to usual care. The study included a comprehensive parallel process evaluation, including focus groups, conducted to aid understanding of the introduction of the programme into a new service and social context. The aim of the focus groups was to investigate views of key health professionals towards the integration and delivery of FNP programme in England. METHODS: Focus groups were conducted separately with Family Nurses, Health Visitors and Midwives at trial sites during 2011-2012. Transcripts from audio-recordings were analysed thematically. RESULTS: A total of 122 professionals participated in one of 19 focus groups. Family Nurses were confident in the effectiveness of FNP, although they experienced practical difficulties meeting programme fidelity targets and considered that programme goals did not sufficiently reflect client or community priorities. Health Visitors and Midwives regarded FNP as well-resourced and beneficial to clients, describing their own services as undervalued and struggling. They wished to work closely with Family Nurses, but felt excluded from doing so by practical barriers and programme protection. CONCLUSION: FNP was described as well-resourced and delivered by highly motivated and well supported Family Nurses. FNP eligibility, content and outcomes conflicted with individual client and community priorities. These factors may have restricted the potential effectiveness of a programme developed and previously tested in a different social milieu. Building Blocks ISRCTN23019866 Registered 20/04/2009.

A falls case summary: Application of the public health nursing intervention wheel.

BACKGROUND: The Public Health Intervention Wheel (PHIW) is a population-based practice model that encompasses three levels of practice (community, systems, and individual/family) and 17 public health interventions. Each intervention and practice level contributes to improving population health. Public health nurses (PHNs) provide care at the three levels of practice. Prevention of falls is a public health issue and the majority of falls happen at home. Therefore, prevention and management of falls in the community could benefit from a public health systems approach by PHNs underpinned by the PHIW. CASE PRESENTATION: A hypothetical case is presented of a 78-year-old gentleman who had a fall which resulted in a fractured right acetabulum and surgery before being discharged home. METHODS: The aim of this paper was to use a case summary to illustrate PHN practice in the context of the PHIW as applied to falls management and prevention. This paper focuses on fall incidence and PHN response in Ireland and Norway. The PHIW is described and relevant interventions from the PHIW are applied to PHN practice in managing the case. CONCLUSIONS: The PHIW model provides insight into the potential scope of public health nursing in falls, articulating PHN practice in the community.

Educational program for middle-level public health nurses to develop new health services regarding community health needs: protocol for a randomized controlled trial.

BACKGROUND: Developing health services is a key strategy for improving the community health provided by public health nurses. However, an effective educational program for improving their skills in planning such services has not been developed. To describe our program and its evaluation protocol for the education of middle-level public health nurses to improve their skills in developing new health services to fulfil community health needs in Japan. METHODS: In this randomized control trial, eligible participants in Japan will be randomly allocated to an intervention group and a control wait-list group. We will provide 8 modules of web-based learning for public health nurses from July to October 2018. To ensure fairness of educational opportunity, the wait-list group will participate in the same program as the intervention group after collection of follow-up data of the intervention group. The primary outcomes will be evaluated using the scale of competency measurement of creativity for public health nurses at baseline, immediately after the intervention. Secondary outcomes will be knowledge and performance regarding program development of public health nurses. DISCUSSION: This study will enable the analysis of the effects of the educational program on public health nurses for improving their competency to develop new health services for fulfilling community health needs and enriching health care systems. TRIAL REGISTRATION: We registered our study protocol to the University hospital Medical Information Network- Clinical Trials Registry approved by International Committee of Medical Journal Editors (No. UMIN000032176, April, 2018).