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.

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.].

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.

Competencia obstétrica en la atención prenatal: una mirada desde el trabajo interprofesional / Obstetric competence in prenatal care: a look from inter-professional work

RESUMEN Introducción: las actividades extensionistas en la educación médica tributan a la formación integral del estudiante y a la solución de los principales problemas de salud de la sociedad. Objetivo: describir los saberes de la competencia obstétrica en la atención prenatal, desde una mirada interprofesional en estudiantes de Licenciatura en Enfermería. Materiales y métodos: se realizó una investigación cualitativa con enfoque fenomenológico en 10 estudiantes de la ayudantía en Ginecobstetricia. Se aplicaron entrevistas y guías de observación validadas por expertos. El estudio se diseñó en tres fases: experiencias vividas en la sostenibilidad del Programa de Atención Materno Infantil, necesidades de aprendizaje sobre la atención prenatal y determinación de saberes obstétricos con enfoque interprofesional. Resultados: los estudiantes manifestaron como experiencia vivida la necesidad de superación continua. Se reforzaron valores como el humanismo y la responsabilidad en la práctica profesional. Se identificaron las necesidades de aprendizaje: valoración de exámenes y pruebas diagnósticas, orientación psicofísica y nutricional, sistemas de apoyo a la familia, medidas de seguridad a la gestante, e identificación y toma de conducta ante las complicaciones. Se determinaron los saberes a considerar en la competencia obstétrica a partir de un modelo con enfoque interprofesional. Conclusiones: el modelo propuesto permitirá el adecuado desempeño de los estudiantes de Licenciatura en Enfermería, al integrarse como agentes activos en las diferentes acciones de salud comunitaria, y al apropiarse de los saberes necesarios para un adecuado seguimiento de la embarazada en el nivel primario de salud (AU).

ABSTRACT Introduction: the extension activities in medical education contribute to the integral training of the student and to the solution of the main health problems of the society. Objective: to describe the knowledge of obstetric competence in prenatal care, from an inter-professional perspective in the students of Bachelor's degree in Nursing. Materials and methods: a qualitative research with a phenomenological approach was carried out in 10 students of the assistantship in Gynecobstetrics. Expert-validated interviews and observation guides were applied. The study was designed in three phases: experiences in the sustainability of the Maternal and Child Care Program, learning needs on prenatal care and identification of obstetric knowledge with an inter-professional approach. Results: the students expressed as lived experience the need for continuous improvement. Values such as humanism and responsibility in professional practice were reinforced. Learning needs were identified: assessment of examinations and diagnostic tests, psychophysical and nutritional counseling, family support systems, safety measures for pregnant women, and identification and behavior in the face of complications. The knowledge to be considered in obstetric competence was determined from a model with an inter-professional approach. Conclusions: the proposed model will allow the appropriate performance of the students of Bachelor´s degree in Nursing, while integrating them as active agents in the different community health actions, and by appropriating the necessary knowledge for an adequate follow-up of the pregnant woman at the primary health level (AU).

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.

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.

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.

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.

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.

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.

Evaluation of a Community-Based Nurse Residency.

Most nurse residency literature published on nurse residency evaluation comes from programs based in academic medical centers. Fewer studies exist on evaluation of nurse residencies in community hospitals. Secondary data analysis was used to evaluate a 12-month program based in a community hospital setting. Participants reported improvements in confidence, nursing skills, abilities, professional satisfaction, feeling supported, and decreased stress. Turnover decreased from 37% to <4% within 3 years.

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.

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.

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.

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.