Chapter 2 Core Functions of Public Health Nursing

Public Health • Institute of Medicine (IOM) Report – The Future of Public Health – Committee recommendations • • Mission of public health Government role Responsibilities of government Elements required to implement the above 2 Copyright © 2008 Delmar. All rights reserved.

Ecological Model of Health • Ecological model of health involves various domains – Physical

Core Functions of Public Health • Assessment – Collect and analyze unbiased information on the community • Policy development – Support health promotion and protection • Assurance – Enforce laws that support health and safety 4 Copyright © 2008 Delmar. All rights reserved.

Federal Health Obligations • • • Support dissemination of data Establish national health objectives Provide state assistance Allocation of funds to states Ensure services are in the public interest 5 Copyright © 2008 Delmar. All rights reserved.

IOM State Level Recommendations • State level core responsibilities – Assessment based on statewide data – Adequate base for health activities – Statewide health objectives – Provision of necessary services – Guarantee of essential services – Support of local services through subsidies 6 Copyright © 2008 Delmar. All rights reserved.

IOM Local Level Recommendations • Five types of local public health agencies (LPHA) 1. 2. 3. 4. 5. County based Town/township City/municipal Multi/county/district/regional City-county 7 Copyright © 2008 Delmar. All rights reserved.

Recommendations • Role of local public health agency recommendations – Assessment of local health problems – Policy development – High quality services accessible by all 8 Copyright © 2008 Delmar. All rights reserved.

Recommendations • Health services pyramid – Population-based public health services – Primary health care

Public Health in America Functions Steering Committee • Essential Service Document (1994) – Blueprint for local, state, national health goals – Mission is to promote physical/mental health, prevent disease, injury and disability – Envisions linkage of public health systems to meet goals 10 Copyright © 2008 Delmar. All rights reserved.

CDC Model of Public Health System • Social connections that form a community web

CDC Model of Public Health System • System includes private, public, and voluntary •

Turning Point Initiative • Funded by Robert Wood Johnson and Kellogg Foundations • Offers funding and assistance to promote system change by promoting partnerships • Based on idea that everyone has a stake in public health 13 Copyright © 2008 Delmar. All rights reserved.

Turning Point Initiative • Network of 23 public health partners • Brought health conscious people and organizations together • State Turning Point partners • Formed five national excellence collaboratives 14 Copyright © 2008 Delmar. All rights reserved.

Other Collaborative Efforts • Community Based Participatory Research (CBPR) – Replace community mistrust and include organizations and populations as partners – Resource sharing and develop incentives – Increase partner knowledge of CBPR process 15 Copyright © 2008 Delmar. All rights reserved.

Other Collaborative Efforts • Healthy Cities Model for Health Promotion 16 Copyright © 2008

Eight Domains of Core Competencies 1. 2. 3. 4. 5. 6. 7. 8. Analysis and assessment Policy development and program planning Communication Cultural competency Community dimensions of practice Basic public health sciences Financial planning and management Leadership and systems thinking 17 Copyright © 2008 Delmar. All rights reserved.

Public Health Nursing Competencies • Quad Council determined how public health nursing would apply

Public Health Nursing Competencies • Public health nurse practice standard is integrated with: – Definition of public health nursing – Scope and standards – Core competencies of public health 19 Copyright © 2008 Delmar. All rights reserved.

Levels of Competency • Generalist – Entry level Baccalaureate prepared nurse • Awareness • Knowledge • Proficiency – Specialist • Masters prepared nurse 20 Copyright © 2008 Delmar. All rights reserved.

Levels of Competency • Tenets of public health nursing – Based on population focused public health nursing practice (See box 2 -7) • Minnesota wheel – Public Health Interventions • Cornerstones of public health nursing practice (See box 2 -8) 21 Copyright © 2008 Delmar. All rights reserved.

Policy Development • Incorporates public health services – Directs day-to-day activities • Advocates –

Policy Development • To promote health and protection the nurse must: – Mobilize community partnerships – Develop policies that support, promote, and protect health 23 Copyright © 2008 Delmar. All rights reserved.

Assurance • Involves four essential public health services – Enforcement of laws and regulations – Immunizations – Assurance of competent public health workers – Evaluates 24 Copyright © 2008 Delmar. All rights reserved.

Evaluation and Partnership • National Public Health Performance Standards Program – Promotes and evaluates public health system quality at state and local level – Uses specific state and local instruments to assess performance 25 Copyright © 2008 Delmar. All rights reserved.

Challenges • Advancement of public health • Progress in the infrastructure – Information/communication – Capacity • Workforce capacity • Activities to reduce nursing shortage (See box 2 -11) – Organizational/systems capacity 26 Copyright © 2008 Delmar. All rights reserved.