Learning Outcomes of Flipped Classroom on Community Health Nursing Course.

PURPOSE: To improve the quality of community health nursing practice, the learning outcomes of nursing students in community health nursing courses must be enhanced. Although the flipped classroom is considered an effective innovative teaching strategy, evidence of its application in community health nursing courses is limited. Therefore, this study aimed to examine the effects of a flipped classroom approach on community nursing competence, academic performance, course engagement, and learning satisfaction for a community health nursing course. DESIGN: A quasi-experimental study design was adopted between September 2021 and January 2022. METHODS: Two classes of nursing students (n = 92) from a 2-year nursing program at a university in Taiwan were recruited. The classes were randomly assigned to the intervention group (n = 50) that attended a flipped classroom and the control group (n = 42) that received traditional lecture-based instruction. FINDINGS: Compared with the control group, the intervention group demonstrated significantly greater improvements in community nursing competence (p = .012) and significantly higher academic performance (p = .005). In addition, the course engagement and learning satisfaction of the two groups were high, but not significantly different. CONCLUSIONS: A flipped classroom can be an important strategy to enhance community nursing competence and academic performance. CLINICAL EVIDENCE: The flipped classroom strategy can enhance community nursing competence of nursing students, which may improve the quality of population-based healthcare.

'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.

Career Intention of Baccalaureate Student Nurses: Understanding the Barriers, Enablers, and Predictors Toward Public/Community Health Nursing.

AIM: This study had two aims: to determine initial career intention of nursing students and to assess whether nursing education variables predict career intentions toward public health/community health nursing. BACKGROUND: Nursing graduates are expected to be prepared to work in community settings. However, there is uncertainty in whether students are attracted to these settings and whether nursing education is impactful in shaping career intention. METHOD: A cross-sectional survey targeted baccalaureate and accelerated students across Oregon. Analyses utilized descriptive statistics and multiple regression. RESULTS: Students reported most interest in acute care. Didactic and clinical learning were not related to intention to pursue a public health/community health career. The strongest predictor was career intention when starting nursing school. CONCLUSION: Students enter nursing school with largely fixed intentions. Educators need to develop greater prenursing outreach and understanding of the drivers toward public and community health to build curricula and passion for this area of nursing.

A Sisyphean task: Developing and revising public health nursing competencies.

BACKGROUND: Competencies are intended to enhance the public health workforce's skills. Competencies used to evaluate public health nursing (PHN) practice and education have been promoted by several nursing organizations. Having multiple sets of competencies raises questions about redundancies and their usefulness in evaluating PHN, as well as the central question about the value of the competencies themselves. METHODS: A literature review of psychometric evaluation research of the competencies was performed. Qualitative content analyses were conducted of seven documents: Association of Community Health Nursing Educators', 2000 and 2010 essentials; Quad Council Coalition's 2004, 2011, and 2018 competencies; and the American Nurses Association's, 2013 and the 2021 draft of PHN scope and standards of practice with respect to competency definition, conceptual basis, and use of an established taxonomy. RESULTS: No psychometric evaluations of the competency sets were found. Textual content analysis revealed inconsistent and or missing competency definitions and theoretical frameworks with competencies proliferating over time. Taxonomy analysis identified minimal competencies at higher complexity levels according to Bloom's revised taxonomy. CONCLUSIONS: Analyzed competencies lack reliability and validity testing, making assessment difficult for PHN educators and practitioners. Multiple and competing competencies further erode PHN's visibility, even among public health nurses. With unending revisions of PHN competencies and lack of supporting evidence regarding their effect and their integration into education or practice, recommendations for future efforts are offered.

Adapting a community health nursing course to an online format.

As COVID-19 spread through the United States in March 2020, universities were forced to move to online learning to minimize COVID-19 transmission. Students in nursing programs represent several generational cohorts with varying learning styles and comfort with technology. This move to an online format required faculty and students to use digital tools from video conferencing, remote testing, online classes, and an unfolding case study. Community Health Nursing is an important capstone course in the Baccalaureate of Science in Nursing curriculum. Community health nursing focuses on the care of populations. Communication skills, analysis of data from various sources, collaboration with peers, and planning and evaluation of interventions are essential competencies of community health nursing. This article describes strategies to teach the core competencies online and how two group activities were formatted for online delivery: development of a public service announcement and a debate. The faculty employed an approach to online teaching that preserved the activities and fostered student engagement through the use of various online strategies.

COVID-19 updates: Real-time epidemiology for BSN community/public health nursing course.

Teaching nursing students about epidemiology is often a daunting task, with many lacking the knowledge and application of and interest in epidemiological elements. Baccalaureate science nursing (BSN) essentials state that BSN nursing students need educational applications for health promotion and disease prevention for effective population-based communities. The COVID-19 pandemic data have allowed for real-time analysis and synthesis of live application of data which meets the specific requirements on current and future epidemiological problems. Nursing students can monitor weekly trends through disease surveillance and application to the surrounding community, providing for effective critical thinking and clinical judgment. Comparing weekly changes in data assists in developing interest on applying this information for practice. Discussion about background evidence, valid national, regional, and local websites, specific implementation steps, and overall student reflection feedback will be discussed.

Identity and the learning experience of non-traditional students undertaking the specialist practitioner qualification.

This small qualitative study is an exploration of the concept of identity and its relationship to the learning experience of non-traditional students undertaking the Specialist Practitioner Qualification in District Nursing. Using a narrative inquiry approach, three participants were asked to recall their experiences 1 year after completing the SPQDN programme. Individual narratives were analysed, and central themes were extracted using NVivo coding. The findings indicated that feelings of academic self-doubt, the impact of past learning experiences and the connotations of being labelled as a student all had an influence on the participants' learning experience.

Personal protective equipment training team: a community nursing initiative.

COVID-19 provided significant challenges for community services and care homes. Residential and nursing care patients are considered highly vulnerable to the coronavirus due to their physical needs and environmental factors. Significant concern was raised with personal protective equipment (PPE) availability and appropriate training and support in local care homes. Members of the district nursing team and community services formed a team to deliver face to face training and support to care home workers to improve PPE adherence and reduce risks of transmission. Visits were offered to all 46 care homes in the locality and over 55 visits for teaching were performed in the first month. Challenges were faced with managing and prioritising frontline clinical duties. Feedback was overwhelmingly positive and care staff benefited from face-to-face delivery of education to support best practice.

Association of Community Health Nursing Educators', 2020 evidence-based project priorities: A national blueprint for unifying research and evidence-based practice priorities.

The Association of Community Health Nursing Educators (ACHNE) Research Committee Subcommittee on Evidence-Based Practice (EBP) presents a paper on the state of translation of science into public health nursing education practice. The paper builds from the integrative research review completed by the ACHNE Research Priorities Subcommittee (McElroy et al., Public Health Nursing, 2020) offering updated research priorities and a Research in Action model. Four EBP Project Priorities were established using the Johns Hopkins EBP Model guided by Dang and Dearholt's (Johns Hopkins nursing evidence-based practice: Model and guidelines, 2018) 19-step process. The EBP Project Priorities emphasize the need for EBP projects to align ACHNE strategic plans and research priorities. The authors recommend that the Research in Action model guide deliberate unification of both the Research and EBP Project Priorities. Standards and criteria for essential effort unifying collaborative effort between PhD and Doctorate in Nursing Practice scholars, coordination of research efforts, and innovative practice partnerships is provided.

Association of Community Health Nursing Educators 2020 Research Priorities and Research in Action Model.

OBJECTIVE: The Association of Community/Public Health Nurse Educators (ACHNE) Research Priorities Subcommittee presents a report on the state of the science of public health nursing education. DESIGN: Whittemore and Knafl's (Journal of Advanced Nursing, 2005, 52, 546) five-step integrative review was used. SAMPLE: Fifty-two articles were reviewed. MEASUREMENTS: Braun et al's. (Handbook of research methods in health social sciences, 2019, 843) thematic analysis methods were used. RESULTS: Four themes emerged: (a) Community/Public Health Nursing Education and teaching strategies/modalities; (b) Clinical teaching and learning partnerships; (c) Environmental health and emergency response; and, (d) Cultural competence and awareness. CONCLUSIONS: Themes informed the following research priorities: (a) a need for rigorous scientific studies highlighting the impact and effectiveness of Community/Public Health Nursing Education; (b) a need for evidence on faculty development, support and training related to community/public health activities; (c) a need for evidence on impact of Community/Public Health Nursing teaching on communities and students, and (d) a need for evidence on impact of C/PHNE strategies on long-term student knowledge, attitudes or behavior (competencies). Finally, a Research in Action Model is proposed as a means for continued forward movement of the discipline, connecting the three fundamental driving mechanisms.

High-Impact Community Clinical Experiences to Promote Health and Enhance Well-Being of Older Adults.

Given the complex needs of the aging population, nurse educators must prepare future registered nurses to help older adults remain safe and healthy in their homes. This article describes partnerships between a school of nursing and low-income senior housing providers to develop new, high-impact community-based learning experiences. Baccalaureate nursing students conducted home visits in low-income senior housing communities and engaged in a research study to quantify activities conducted by students and the impact the home visits had on client personal health goal attainment.

Quad Council Coalition community/public health nursing competencies: Building consensus through collaboration.

BACKGROUND: The changing professional environment for community/public health nursing practice necessitates competencies grounded in current evidence-based practice. The Quad Council Coalition (QCC) appointed a Task Force to revise the 2011 QCC Competencies for Public Health Nursing. The goal of the competencies is to guide professional nursing practice, curricula, research, and policy development. This paper describes the process used to develop the revised 2018 Competencies. METHODS: A biphasic Delphi technique was used to conduct a detailed examination and build consensus. Four individuals representing community/public health practice and education collaborated to identify and implement a systematic process for revising the QCC Competencies. The process included multiple iterations of review and feedback using consistent methods and tools to analyze and synthesize themes. RESULTS: The primary result of this project is the 2018 QCC Competencies document that has strong consensus and provides a coherent voice from professionals on the practice of community/public health nursing. DISCUSSION: Use of current QCC Competencies will strengthen the community/public health nursing capacity to positively impact the health and well-being of populations.

Implementation and evaluation of SBIRT training in a Community Health nursing course.

OBJECTIVE: The purpose of this paper is to report on the implementation and evaluation of a Screening, Brief Intervention and Referral to Treatment (SBIRT) educational program into an undergraduate nursing curriculum and to recommend modifications for future trainings. DESIGN AND SAMPLE: A one-group pre-test/post-test design was used. The sample consisted of senior level undergraduate nursing students. MEASURES: Core knowledge, perceived competency, and program satisfaction were measured. Process evaluation activities were performed to gather feedback on the training and solicit ideas and recommendations for improvement. RESULTS: Of the 354 nursing students enrolled in the training, 249 (70%) participated in the research portion, with 240 (96%) completed the pre- and post-training evaluations. All four core knowledge components and 13 perceived competency indicators were statistically significant (p ≤ .001) when comparing pre- and post-t test values. Process evaluation data collected through 25 telephone interviews found that the training improved the students' confidence and ability to screen for substance misuse with patients. CONCLUSION: Findings support the implementation of SBIRT training into an undergraduate nursing curriculum. Modifications for future training and research are proposed.

Integrating naloxone education into an undergraduate nursing course: Developing partnerships with a local department of health.

BACKGROUND: Substance misuse continues to be a significant concern in the United States, with over 700,000 lives lost from a drug overdose between 1999 and 2017. However, nursing curricula have failed to keep pace with the epidemic. METHODS: The current study used a pre-post study design and involved a convenience sample of undergraduate nursing students (n = 37) enrolled in a community health nursing course. Students completed an 11-item online survey examining naloxone stigma, naloxone self-efficacy, and naloxone knowledge. A paired sample t test was conducted to evaluate the impact of the in-person training and education event. RESULTS: There was a statistically significant increase in post-intervention naloxone knowledge scores from the pre-survey (M = 3.57, SD = 0.959) to the post-survey (M = 4.70, SD = 0.520). Stigma toward naloxone demonstrated a statistically significant increase in the post-intervention stigma survey (M = 9.00, SD = 1.312) compared with the pre-intervention stigma survey (M = 7.78, SD = 2.228). Naloxone self-efficacy also demonstrated a statistically significant increase in the post-intervention naloxone efficacy survey (M = 10.08, SD = 1.064) compared with the pre-intervention naloxone efficacy scores (M = 7.38, SD = 2.22). CONCLUSIONS: The students' scores demonstrated a significant increase in naloxone knowledge, self-efficacy, and stigma. Future research is needed to explore the impact of integrating naloxone education in the undergraduate nursing curriculum.

Malnutrition in community-dwelling older people: lessons learnt using a new procedure.

This article reports the implementation of a new procedure for screening and treatment of malnutrition in a community NHS trust in England. The barriers and facilitators to implementation were assessed with staff from Integrated Community and Older People's Mental Health teams. Data from interviews and surveys were collected at baseline, 2 months after initial training and 16 months after initial training as well as following deployment of a nutrition lead to embed new developments for nutritional care. The adoption of the procedure made screening and treatment of malnutrition simpler and more likely to be actioned. The benefit of a nutrition lead and local nutrition champions to support and empower staff (avoiding reliance on training alone) was shown to drive change for nutritional care across the community. Prioritisation and commitment of leadership at the organisational level are needed to embed and sustain malnutrition screening and treatment in routine practice.

Challenges and opportunities: the role of the district nurse in influencing practice education.

The responsibility of the district nurse (DN), alongside complex case management and leadership, is to ensure Specialist Practitioner Qualification District Nurse (SPQDN) education continues to create practitioners delivering quality evidence-based care. DN leadership and its importance have come to the fore during the COVID-19 crisis, where hospital discharges have increased rapidly to make way for highly complex admissions (HM Government, 2020). This paper examines the importance of the SPQDN qualification, exploring the role of the DN within practice education. Continuation of the vital DN qualification will ensure that the numbers of qualified DNs increase, ultimately protecting community capacity. With a move towards an apprenticeship model to achieve the SPQDN, DNs must engage with and influence curriculum development to confirm courses deliver requirements of the workplace, commissioners and the 2019 NHS Long Term Plan. Expectations of the DN role within practice education have changed, moving away from the practice teacher standards to the new Nursing and Midwifery Council Standards for Student Support and Assessment. This poses new challenges in DN education in practice. The implications of this transition threaten to de-value the quality of the assessment process by removing the high standards of preparation previously demanded; ultimately, this is a risk to the provision of the quality practice education that previously existed.

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.

Gett'n on the bus: evaluation of Sentinel City®3.0 virtual simulation in community/population health clinical placement.

Objectives The purpose of this project was to implement and evaluate the integration of a computer-based virtual simulation program into a community clinical course as an alternative or complement to conventional clinical with agencies or neighbourhoods. Securing quality community health clinical opportunities for undergraduate nursing students remains challenging. In addition, evidence of a theory-practice gap in community clinical education, particularly in non-traditional settings, suggests that nurse educators need to adopt different pedagogies to ensure that students will gain competencies necessary to practice community/population health nursing. In response, we piloted the use of Sentinel City®3.0, a virtual reality simulation program. Method A 5-point Likert-style questionnaire was administered to students randomly assigned to different clinical placements. Results Results indicated that there were no learning outcomes in which students in Sentinel City®3.0 reported percentages lower than students in agencies or geographical neighbourhoods. When there were statistically significant differences, students engaged in Sentinel City®3.0 performed better than students in other experiences. Conclusion We recommend further exploration of multi-contextual pedagogies for community clinical.

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.

Community health nursing clinical teaching models practiced in undergraduate nursing programme at a private university in Pakistan.

OBJECTIVE: To explore the perceptions and experiences of students and faculty about the modified community clinical model. METHODS: The descriptive qualitative study was conducted at a nationally-accredited Baccalaureate School of Nursing and Midwifery in Pakistan in November 2016, and comprised final year students enrolled in Advanced Concepts in Community Health Nursing course, and experienced community health nursing faculty members. Individual interviews were conducted with students while faculty members were requested to write out their reflections. On the basis of this data, codes and categories were identified which led to two broader themes; window of opportunities, and challenges in practice. RESULTS: Of the 17 subjects, 12 (70.6%) were students and 5(29.4%) were faculty members. All subjects were females. The window of opportunities theme had three categories: perceived comfort and safety; stakeholder's involvement and support; and open door for personal recognition and self-image. The challenges in practice theme had two categories: time consuming, and home visits. Faculty reflections highlighted the need for sustaining student-related activities within the communities. CONCLUSIONS: The findings are suggestive of a wide range of application of the modified clinical model at undergraduate nursing education level.