Use of telehealth simulation to teach the enhanced primary care RN role through community/public health-focused simulations.

America is facing a primary care provider shortage. Enhanced primary care RNs (EPC-RNs), registered nurses working at the top of their practice scope, can be an important part of community-based primary care provision. Typically, community health nursing education has not included primary care-based clinical experiences, and there is a clinical site shortage. Teaching students about EPC-RN roles can be an important domain of community/public health nursing education. Simulation is a creative pedagogical approach to learning about the EPC-RN role. The purpose of this manuscript is to 1) describe EPC-RN Telehealth Simulation development; and 2) describe student simulation feedback. Nursing faculty and simulation experts designed five simulations for community health students to teach about the EPC-RN role, incorporating recommendations from the Quad Council Coalition of Public Health Nursing Organizations community/public health nursing competencies and the National Competencies for Registered Nurses in Primary Care. Retrospective, descriptive quantitative, and qualitative student feedback data (n = 519) was collected through QuestionPro over multiple semesters. Student feedback data demonstrated support of the use of the simulations in community/public health nursing education. The EPC-RN Telehealth Simulations prepared pre-licensure nursing students to practice in community-based primary care settings. Innovative, sustainable experiences such as this can improve community/public health nursing education.

Perceived Competencies and Training Needs of Public Health Nurses in the Philippines: Basis for the Development of NurseLEAD: A Leadership Course on Advanced Practice Nursing in Public Health.

Background and Objective: Public health nurses (PHNs) perform more than the provision of direct care to clients. They are also expected to perform roles as leaders, managers, and collaborators in different settings, especially in areas where there are no physicians. Their continuous professional development must be facilitated to empower them to lead the delivery of health programs and services in pursuit of universal healthcare. This study aims to determine the perceived competencies of public health nurses and describe their training needs. Methods: A descriptive, cross-sectional study was utilized, where an online survey was administered to PHNs across the Philippines to determine their self-perceived competencies and training needs based on the eight domains of core competencies of public health professionals. Descriptive statistics was used to summarize the data. Results: A total of 330 PHNs answered the survey. The results showed that at baseline, PHNs perceived themselves to be competent (from most to least) in the following: communication, analytical/assessment, community dimensions of practice, policy development/ program planning, leadership and systems thinking, cultural competency skills, public health science, and financial planning and management. In terms of training needs, the enablers mentioned include a supportive work environment that can provide a work schedule that is inclusive of time for professional development and work-life balance; a learning environment where colleagues and supervisors support the need for training and innovation; strong internet connection; and enough equipment to participate and submit deliverables for courses taken. Conclusion: Filipino public health nurses perceived themselves to be competent in the areas of communication and community practice, but less competent in public health science, and financial planning and management. Future capacity-building programs must be designed to meet this demand. Furthermore, to make training programs truly responsive to the needs of nurses, steps must be taken to promote capacity-building enablers.

Harm reduction nursing and the path toward developing best practice: Lessons from caring for people with xylazine-associated wounds in Philadelphia, PA.

Xylazine-associated wounds are a distinct, novel clinical entity characterized by co-occurrence with substance use, progressive necrosis of skin, muscle, tendon, and bone, and slow healing. In Philadelphia, the specter of limb loss, stigma, and shame has hung over hospital-based care for xylazine-associated wounds among people who use drugs (PWUD) and kept many people away from engaging in care. Continued engagement in harm reduction wound care nursing, however, offers an opportunity for PWUD to address their wounds and their fears with members of the medical world. In the absence of established best practices, harm reduction's model of risk-reductive care offers a way forward for patients and practitioners alike. Here, "harm reduction" describes an ethic of practical, trauma-informed, patient-centered care. It is this integration of harm reduction into medicine and public health that effectively promotes the safety, survival, and recovery of PWUD across all spectrums of drug use habits and housing stability.

Building a strong public health nursing workforce in Canada: A continuing education solution.

Building a strong public health nursing (PHN) work-force capable of advancing population health and reducing inequities is critical. Though undergraduate nursing education is expected to provide introductory knowledge and practice of PHN in Canada, this is not always sufficient to adequately prepare nursing graduates for the complexity of PHN practice. To be practice ready for the full scope of PHN roles and interventions, new baccalaureate nurses and new registered nurses in public health are required to apply PHN competencies, theory, and knowledge of nursing and public health sciences, and to practice within the mandates of provincial and territorial public health legislation. To advance practice readiness a formal continuing education program is essential to foster these critical roles in PHN. This article describes the development of a postgraduate continuing education program for preparation to practice in PHN.

Web and theory-based motivational interviews in encouraging mothers for HPV vaccination of their daughters: A randomized controlled study.

BACKGROUND: Mothers' intentions regarding the Human Papillomavirus (HPV) vaccination of their daughters are crucial, especially in societies that prioritize cultural and religious values. OBJECTIVES: This study aimed to encourage mothers to vaccinate their daughters against HPV by enhancing their perceptions of the vaccine's benefits, susceptibility, severity, and knowledge levels, while reducing their barriers through web-based interventions and Health Belief Model-based motivational interviews. METHODS: The study was designed as a pre-mid-post test randomized controlled experimental study. The sample included 63 mothers of female high school students (31 in the experimental group, 32 in the control group). Data were collected using a "Demographical and Descriptive Characteristics Information Form", "Health Belief Model Scale for Human Papillomavirus and Its Vaccination" and "Human Papillomavirus Knowledge Scale". Mothers in the experimental group received three HBM-based motivational interviews, web support, and follow-up. CLINICALTRIALS: gov code is NCT04992741. RESULTS: Following the interventions, the experimental group exhibited higher levels of knowledge, benefit, susceptibility, and severity perception of HPV vaccination, and lower perceptions of barriers compared to the control group. At the end of the study, 24 mothers from the experimental group and 5 mothers from the control group decided to vaccinate their daughters against HPV. CONCLUSIONS: Motivational interviews, along with web support and monitoring, significantly enhanced mothers' knowledge and beliefs. IMPLICATIONS FOR PRACTICES: This study provides evidence for the applicability of theory-based motivational interviewing in the acceptance of HPV vaccine by mothers. It enables the dissemination of HPV vaccination and encourages community health nurses to use theory-based motivational interviewing to recommend HPV vaccination.

Establishing a community-academic nursing partnership to lead a healthcare response during a human trafficking extraction operation.

A community-academic nursing partnership formed to care for the urgent healthcare needs of individuals extracted from human trafficking during a multidisciplinary team operation. During past human trafficking extraction operations, law enforcement and the state sexual assault nurse examiner coordinator recognized the need to meet the patients' immediate physical and emotional needs while providing essential comfort to the newly extracted individuals. To meet the immediate holistic healthcare needs during the recovery operation, the nursing faculty partnered with a local nonprofit community clinic to provide onsite trauma-informed, patient-centered healthcare and comfort items. The healthcare team consisted of advanced practice nurses, mental health nurses who triaged the patient's immediate psychological needs, sexual assault nurses who collected forensic specimens, and nurses with expertise in substance use disorder who evaluated the patient's treatment needs. The patient's physical comfort was met by providing hygiene kits, blankets, socks, food, and drinks. Trauma-informed language was utilized to help the patient feel safe and to convey respect for the patient's autonomy in making decisions during the extraction process. The innovative community-academic nursing partnership laid the groundwork for providing healthcare to future human trafficking extraction operations with plans to incorporate nursing students and graduate nursing students to increase the number of patients served while providing a rich learning experience to the students.

Desiring support on a winding road with challenging intersections: Social and professional support for sexual minority forced migrant men.

AIM: To explore experiences of social and health professional support among sexual minority forced migrant men. DESIGN: Exploratory qualitative study. METHODS: Individual semi-structured interviews were conducted in 2023 with 15 participants recruited through convenience, purposive and snowball sampling. Interviews were audio recorded, transcribed and analysed with systematic text condensation in a collaborative process between researchers and experts by lived experience. RESULTS: The first category was 'desiring support along a road with challenging intersections'. Participants encountered a harsh reality and dangers in the host country. They sought social connections and communicated with others whilst in a social labyrinth within a new and reserved society. Although social support was desired and highly appreciated, the process involved a spectrum of both belonging and exclusion. The second category was 'navigating uncharted waters when seeking affirming health services'. A range of barriers to health services were encountered in a complex health system. Participants emphasized the importance of safe and affirming spaces that accommodate the vulnerability of disclosure. CONCLUSION: Ensuring respectful and affirming support for sexual minority forced migrants is essential. Barriers in accessing health services need to be addressed, including informing about rights and ensuring safety. IMPLICATION FOR THE PROFESSIONAL AND PATIENT CARE: Nurses and other health professionals can consider social support as a potentially valuable resource for health promotion. However, there is a need for more research investigating its mental health effects. IMPACT: The intersectional disadvantages and discrimination encountered by sexual minority forced migrants call attention to the need for further advancements in inclusion health and affirming care. REPORTING METHOD: This study adhered to the Consolidated Criteria for Reporting Qualitative Research. PATIENT OR PUBLIC CONTRIBUTION: Three sexual minority forced migrants were members of the research team. They were involved in the data collection, analysis and reporting in close collaboration with researchers.

The crucial importance of accurate enumeration to bringing public health nurses out from behind the "Other" category.

Public health nursing is a unique field of nursing with specialized skills, roles, and functions designed to address disease prevention and health promotion of populations and to respond to emerging health crisis such the COVID-19 pandemic. Despite the unique role and professional responsibilities of public health nurses, they are not identified as a distinct nursing specially by the U.S. Bureau of Labor Statistics workforce data. This is problematic as accurate enumeration of public health nursing can supply the necessary data to identify gaps of these essential professionals. To effectively address this gap and have the capacity to identify public health nursing workforce needs, a method to define, describe, and enumerate the public health nursing workforce nationally with a unique split Standard Occupational Classification is necessary. Further, the Centers for Disease Control and Prevention's Public Health and Data Authority must have the ability to coordinate data reporting on the public health workforce, support standardization, and streamline annual enumeration.

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.

Bridging the gap: Innovating undergraduate public health nursing education through a service-learning health fair project.

Amidst a critical shortage of registered nurses, nursing schools are aiming to expand enrollment while working with ongoing resource constraints. Service-learning clinical activities can enhance nursing education by improving clinical quality, addressing faculty and clinical site shortages, and meeting increasing enrollment demands. This paper describes a health fair experience that served as a service-learning clinical experience within an undergraduate public health nursing course. The experience bridged theoretical knowledge with real-world application, fostering competency-based learning and addressing community health needs, resulting in a positive impact on students, faculty, and the community.

The four stages of neighborhood trust: Classic grounded theory.

INTRODUCTION: Neighborhoods are often overlooked as a determinant of health. Among recent research, the focus on "place-based effects," due to prolonged residential environmental exposure, has been of particular interest. These studies' purpose is to identify and examine how a healthy neighborhood is intentionally created to describe a transferable process-driven theory. METHOD: A classic grounded theory approach was used in these studies. Data sources include individual in-depth interviews, historical documents, and a member-checking focus group, collected over 3-years. RESULTS: Analysis generated the Four Stages of Neighborhood Trust Model, which is nested within the context of perceived neighborhood safety. The theory outlines a social process of four stages of neighborhood trust: (a) rules-based agreements, (b) shared values, (c) cooperation, and (d) neighborhood belonging. CONCLUSIONS: We present the development of a process-driven theory that may be useful for public health nurses as they engage neighborhoods in health promotion activities. The stage of trust development will aid the nurse in identifying what is needed to move to the next stage in a healthy neighborhood process.

The development and challenges of public health nursing education in China from 1912 to 1949: A historical study.

OBJECTIVE: To examine the development and challenges of public health nursing education in China during the period of the Republic of China (1912-1949). METHODS: This study utilized a historical research design that combined a social framework and a policy framework to explore the early history of public health nursing education in China. Historical data were collected from periodicals, newspapers, archives, books and other sources. RESULTS: Public health was integrated into the nursing school curriculum for the first time during the period of the Republic of China, and health facilities and nursing schools conducted early explorations of public health nurse training. However, public health nursing education faced difficulties in terms of the curriculum, personnel training, and the localization of education. CONCLUSIONS: The achievements and difficulties associated with public health nursing education in China during the period of the Republic of China provide a historical reference for the integration of public health into current basic nursing education and the compatibility between the training of public health nurses and practical needs. Comparative studies of early public health nursing education across countries are expected to offer a better understanding of current public health nursing education.

Norwegian pre-service teacher students' and public health nursing students' views on health - a qualitative study of students' perceptions.

PURPOSE: In 2020, the Norwegian school curriculum was revised, introducing a new cross-curricular subject, Public Health, and Life Skills. The curriculum emphasizes collaboration between teachers and the school health service. Subsequently, a research project, Literacies for Health and Life Skills, was initiated at Oslo Metropolitan University. The aim was to develop a new approach to the subject. A part of the research was to explore perceptions about good and poor health among teacher students and public health nursing students. METHODS: This study has a qualitative design using auto-photography, group discussions and photo-elicitation interviews as methods to explore the students' views on health. RESULTS: A analysis revealed three themes about good health in both student groups: Relaxation and tranquillity, belonging and relations, and enjoyment as important to health. Three themes about poor health emerged in both student groups: The ideal body and self-perception, you are as healthy as you feel, and the best in life is also the worst. The students' statements were characterized by underlying assumptions about health in society, with a focus on "healthism". No major differences between the student groups were found. CONCLUSION: This study serves as a step towards increased understanding of health perceptions among future professionals working with children and adolescents.

Práticas de enfermagem: contexto ambiental e a relação com o materialismo histórico dialético / Nursing practices: environmental context and the relationship with dialectical historical materialism / Prácticas de enfermería: contexto ambiental y la relación con el materialismo histórico dialéctico

Objetivo: Descrever as práticas dos enfermeiros em nossa sociedade e sob as circunstâncias que podem contribuir para a inclusão das práticas avançadas. Métodos: Estudo descritivo, de abordagem qualitativa e delineamento transversal, sob a perspectiva da teoria do materialismo histórico-dialético de Karl Marx, estruturada pela utilização do instrumento COREQ. Resultados: O campo de atuação do enfermeiro na atenção primária à saúde é diversificado, extrapola os muros do consultório. Muitas vezes o dinamismo das atividades traduz o empenho de obter os melhores resultados por meio de sua assistência. E o materialismo histórico-dialético reflete justamente a busca por uma assistência de qualidade e as mudanças no ambiente laboral, onde a interação de diversos fatores contribuem de forma direta no ambiente laboral e social. Conclusão: Os enfermeiros da atenção primária à saúde brasileira atuam nos mais diversos territórios, desse modo, precisam dinamizar os seus atendimentos para contemplar as necessidades sociais. Perante esses aspectos, as diversidades sociodemográficas brasileiras demonstraram que a escassez de recursos em regiões remotas é um dos fatores que fortalece a inclusão das práticas avançadas de enfermagem na atenção primária à saúde no Brasil. (AU)

Objective: To describe the practices of nurses in our society and under circumstances that may contribute to the inclusion of advanced practices. Methods: Descriptive study, with a qualitative approach and cross-sectional design, from the perspective of Karl Marx's dialectical historical materialism theory, structured by using the COREQ instrument. Results: The nurse's field of action in primary health care is diverse, it goes beyond the walls of the office. Often the dynamism of activities translates the effort to obtain the best results through their assistance. And dialectical historical materialism precisely reflects the search for quality care and changes in the work environment, where the interaction of several factors directly contribute to the work and social environment. Conclusion: Brazilian primary health care nurses work in the most diverse territories, therefore, they need to streamline their care to address social needs. In view of these aspects, Brazilian sociodemographic diversity has shown that the scarcity of resources in remote regions is one of the factors that strengthens the inclusion of advanced nursing practices in primary health care in Brazil. (AU)

Objetivo: Describir las prácticas de los enfermeros en nuestra sociedad y en circunstancias que puedan contribuir a la inclusión de prácticas avanzadas. Métodos: Estudio descriptivo, con enfoque cualitativo y diseño transversal, desde la perspectiva de la teoría del materialismo histórico dialéctico de Karl Marx, estructurado mediante el uso del instrumento COREQ. Resultados: El campo de actuación del enfermero en la atención primaria de salud es diverso, va más allá de las paredes del consultorio. Muchas veces el dinamismo de las actividades se traduce en el esfuerzo por obtener los mejores resultados a través de su asistencia. Y el materialismo histórico dialéctico refleja precisamente la búsqueda de cuidados de calidad y cambios en el ambiente laboral, donde la interacción de varios factores contribuyen directamente al ambiente laboral y social. Conclusión: Las enfermeras brasileñas de atención primaria de salud actúan en los más diversos territorios, por lo tanto, necesitan optimizar su atención para atender las necesidades sociales. Frente a estos aspectos, la diversidad sociodemográfica brasileña ha demostrado que la escasez de recursos en regiones remotas es uno de los factores que fortalece la inclusión de prácticas avanzadas de enfermería en la atención primaria de salud en Brasil. (AU)

Strategies for tobacco-free survivorship after breast cancer: The possible weaving of preoperative care and public health policies.

Among smoker women with breast cancer quitting smoking has been shown to increase survival and surgical outcomes. Where surgery is indicated, the preoperative seems to be a crucial moment for smoking cessation interventions as it enhances recovery after surgery and motivates prolonged tobacco abstinence. Timing and frequency of preoperative quitting conversations were variables associated with quitting. An early, multidisciplinary, and personalized approach is recommended. A solid integration between primary care services and specialized care is challenging but feasible, implementing prehabilitation pathways that include tobacco treatment routinely as an integral part of breast cancer care. Smoking cessation programs before surgical procedures impact recidivism prevention, survivorship improvement, public health, and cost savings. The contribution of healthcare professionals can make a difference in tobacco control, collaborating with organizations, public health, and nursing research. Integrated solutions in oncological clinical care pathways might help patients build and maintain tobacco abstinence after breast cancer. Future research shall study when patients should abstain from smoking before oncological breast surgery.

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.

The needs of multiple birth families during the first 1001 critical days: A rapid review with a systematic literature search and narrative synthesis.

OBJECTIVE: Supporting families during the first 1001 days from conception to the age of two is vital for setting the emotional, cognitive, and physical building blocks for children's futures. Families with twins, triplets, or higher order multiples (multiple birth families) have unique challenges due to caring for more than one baby at the same time. Therefore, identifying the needs of multiple birth families is necessary to provide optimum support during the first 1001 critical days. DESIGN: A rapid review was undertaken to synthesize knowledge of the needs of multiple birth families in the United Kingdom (UK) during the first 1001 critical days. Findings from five databases (MEDLINE, APA PsycArticles, APA PsycInfo, CINAHL, and Web of Science) for peer-reviewed studies and grey literature published between 2012 and 2022 were synthesized. Fifteen studies were reviewed using narrative synthesis. RESULTS: Multiple birth families have unique and complex emotional and practical needs across the first 1001 critical days, and in particular, the first-year post birth, impacted further by complicated pregnancies and prematurity. Needs were identified within the four key themes: high risk pregnancy and birth; transformed reality of raising multiples; inadequate support; and positively affecting experiences. Health professional support was inconsistent and particularly lacking in intrapartum, postnatal, and community care including transition. CONCLUSION: Multiple birth families' needs should be considered in the design and delivery of care within the first 1001 critical days, especially within the first year after birth. Multiples specific advice across the first 1001 critical days is needed and training for health professionals to adapt universal advice for this population is one way to achieve this. Further research is needed to ensure this advice is evidence based and effective.

Broadcast health: Leveraging YouTube for community health education.

OBJECTIVE: In community health, there is great demand but limited time for the delivery of staff and patient education. During the COVID-19 pandemic, evolving needs necessitated that health education be provided in an accurate and timely manner. This paper describes the development, implementation, and evaluation of a YouTube channel designed to disseminate health education to a wide audience of public health workers and patient populations. METHODS: This project, divided into three phases, originated within shelter-based care, providing education to shelter staff (Phase 1) and overtime has evolved to provide education within the Community Health Worker Hub at a major teaching hospital for community health workers (Phase 2) and the populations they serve (Phase 3). Further, during phase 3, the project developer used an artificial intelligence (AI) platform to increase the reach of the YouTube channel. RESULTS: Over a span of 21 months, 18 unique videos have garnered 489 views. CONCLUSIONS: Clinicians and educators can leverage technology platforms for health education delivery, increasing the reach of their work while meeting the demands of the profession. While the quality of some information on YouTube may be poor, patients and students turn to this platform for health education. It is imperative that public health nurses embrace this medium, rather than push against it. By creating high-quality content, educating students and patients about DISCERN and PEMAT tools, and guiding patients to credible sources, public health nurses may ameliorate the standards of health education on YouTube.

Prediction of drinking water quality with machine learning models: A public health nursing approach.

OBJECTIVE: The aim of this study is to use machine learning models to predict drinking water quality from a public health nursing approach. DESIGN: Machine learning study. SAMPLE: "Water Quality Dataset" was used in the study. The dataset contains physical and chemical measurements of water quality for 2400 different water bodies. The process consists of four stages: Data processing with Synthetic Minority Oversampling Technique, hyperparameter tuning with 10-fold cross-validation, modeling and comparative analysis. 80% of the dataset is allocated as training data and 20% as test data. ML models logistic regression, K-nearest neighbor, support vector machine, random forest, XGBoost, AdaBoost Classifier, Decision Tree algorithms were used for water quality prediction. Accuracy, precision, recall, F1 score and AUC performance metrics of ML models were compared. To evaluate the performance of the models, 10-fold cross-validation was used and a comparative analysis was performed. The p-values of the models were also compared. RESULTS: N this study, where drinking water quality was predicted with seven different ML algorithms, it can be said that XGBoost and Random Forest are the best classification models in all performance metrics. There is a significant difference in all ML algorithms according to the p-value. The H0 hypothesis is accepted for these algorithms. According to the H0 hypothesis, there is no difference between actual values and predicted values. CONCLUSION: In conclusion, the use of ML models in the prediction of drinking water quality can help nurses greatly improve access to clean water, a human right, be more knowledgeable about water quality, and protect the health of individuals.