Public Health Epidemiology Paper

Public Health Epidemiology Paper

See the Quad Council Competencies for Public Health Nurses document. Imagine you are the nurse consultant at the state department of health. This presentation has been sent by an advocacy group to the Governor for him to make the program funding requests and recommendations. As the nursing director, you have been assigned to the “Fact Check” which includes checking for accuracy of all the information. Based upon your research, select two core competencies and summarize for the Governor the need for the services and how this may positively impact public health.  Public Health Epidemiology Paper

Your initial posting should be 250 to 350 words in length and utilize at least one scholarly source other than the textbook.

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The Quad Council of Public Health Nursing Organizations is comprised of:Q g g p • The Association of Community Health Nurse Educators (ACHNE) • The Association of State and Territorial Directors of Nursing (ASTDN) • The American Public Health Association ‐ Public Health Nursing Section (APHA) • The American Nurses Association’s Congress on Nursing Practice and Economics (ANA)

The Quad Council of Public Health Nursing Organizations was founded in the early  1980’s to address priorities for public health nursing education, practice,  leadership, and research, and as the voice for public health nursing.

 Michelle Cravetz, MS, RN-BC  Joyce Krothe, PhD, RN  David Reyes, MN, MPH, RN  Susan M. Swider, PhD, APHN-BC

Introduction The Quad Council of Public Health Nursing Organizations is comprised of the Association of Community Health Nurse Educators (ACHNE), the Association of State and Territorial Directors of Nursing y ( ), g (ASTDN), the American Public Health Association Public Health Nursing Section (APHA) and the American  Nurses Association’s Congress on Nursing Practice and Economics (ANA).  The Quad Council of Public Health  Nursing Organizations was founded in the early 1980’s to address priorities for public health nursing education,  practice, leadership, and research, and as the voice for public health nursing.

Methods In 2010, Quad Council undertook revision of the “Core Competencies for Public Health Nursing” (YR), in part  because the Council on Linkages between Academia and Public Health Practice (CoL) revised its “Core  Competencies for Public Health Professionals.”

We have kept this Core Competencies for Public Health Nursing (CCPHN) document consistent with the  “Definition of Public Health Nursing” adopted by the APHA’s Public Health Nursing Section in 1996 and the  Scope and Standards of Public Health Nursing (Quad Council, 1999).  Therefore this CCPHN may be used at all   levels and in a variety of practice settings.  We planned competencies that could be useful for  agencies/organizations employing PHNs and educational institutions and other agencies engaged in educatingagencies/organizations employing PHNs, and educational institutions and other agencies engaged in educating  PHNs.  For example, this CCPHN could be used for initial PHN educational experience, orientation to a new  agency, or meeting PHN continuing education needs Public Health Epidemiology Paper.

In undertaking the revision process, Quad Council adopted the Council on Linkages (CoL) structure for  competencies: eight recognized domains spanned by three tiers of practice As we developed the CCPHN wecompetencies: eight recognized domains spanned by three tiers of practice.  As we developed the CCPHN, we  assumed that PHNs practice at the intersection of population‐focused nursing care and public health practice.   Proceeding from this assumption, we used the CoL document to determine how PHNs should demonstrate  core competencies for public health professionals at all three levels: the basic or generalist level (Tier 1); the  specialist or mid‐level (Tier 2); and at the executive and/or multi‐systems level (Tier 3).

Further, we maintained each of the eight domains in the CoL document.  Of course, some redundancy is inevitable, given the encompassing nature of public health and PHN practice.  Competencies in some domains,  such as Community Dimensions of Practice, reappear in virtually all domains.

Throughout the composition of this CCPHN, we solicited public feedback and carefully considered it.  Feedback  came from a broad array of PHNs in practice and academia, primarily members of the Quad Council member  organizations What resulted was a useful organized list of knowledge attitudes behaviors and skills thatorganizations.  What resulted was a useful, organized list of knowledge, attitudes, behaviors, and skills that  provide the floor for PHN practice at the three levels of service.  The Quad Council gratefully acknowledges all  those PHNs who invested their time in reviewing our drafts and commenting thoughtfully Public Health Epidemiology Paper.

Levels of Practice PHNs practice in diverse settings and environments.  Thus these competencies represent the continuum of  evolving PHN practice roles, responsibilities, and functions for which PHNs may have to account.

The baccalaureate degree in nursing (BSN) is the established educational preparation for entry level PHN  practice (ACHNE, 2009; ANA, 2007; Quad Council, 2004). The BSN provides an essential framework of liberalpractice (ACHNE, 2009; ANA, 2007; Quad Council, 2004).  The BSN provides an essential framework of liberal  arts and sciences education that serves as a foundation for PHN practice.  From this framework, PHNs  understand how social and ecological determinants affect the health of individuals, communities, and  populations.  BSN education prepares PHNs both didactically and clinically.  As in the previous iteration of these  competencies, the Quad Council reaffirmed that a PHN generalist has entry‐level preparation at the  b l t l l fl t d b Ti 1 t i T i f th US k i blibaccalaureate level, reflected by Tier 1 competencies.  True, in many areas of the US, nurses work in public  health without the BSN.  However, the Quad Council believes that those nurses may require a job description  that reflects a differentiated level of practice and/or may require extensive orientation and education to  successfully achieve generalist competencies in Tier 1. Public Health Epidemiology Paper

Tier 1 Core Competencies apply to generalist public health nurses who carry out day‐to‐day functions in state and local public health organizations, including clinical, home visiting and population‐based services, and who are not in management positions.  Responsibilities of the PHN may include working directly with at risk populations carrying out health promotion programs at allResponsibilities of the PHN may include working directly with at‐risk populations, carrying out health promotion programs at all levels of prevention, basic data collection and analysis, field work, program planning, outreach activities, programmatic support,  and other organizational tasks. Although the CoL competencies and the Quad Council competencies are primarily focused at the  population level, public health nurses must often apply these skills and competencies in the care of individuals, families, or  groups.  Therefore, Tier 1 competencies reflect this practice.

Tier 2 Core Competencies apply to PHNs with an array of program implementation management and/or supervisoryTier 2 Core Competencies apply to PHNs with an array of program implementation, management and/or supervisory   responsibilities, including responsibility for clinical services, home visiting, community‐based and population‐focused programs.   For example, responsibilities may include:  implementation and oversight of personal, clinical, family focused, and population‐ based health services; program and budget development; establishing and managing community relations; establishing timelines  and work plans, and presenting recommendations on policy issues.  Public Health Epidemiology Paper

Tier 3 Core Competencies apply to PHNs at an executive/senior management level and leadership levels in public healthTier 3 Core Competencies apply to PHNs at an executive/senior management level and leadership levels in public health  organizations.  In general, these competencies apply to PHNs who are responsible for oversight and administration of programs or operation of an organization, including setting the vision and strategy for an organization and its key structural units, e.g., a public  health nursing division.  Tier 3 professionals generally are placed at a higher level of positional authority within the  agency/organization, and they bring similar or higher level knowledge, advanced education, and experience than their Tier 2  counterparts.

The following assumptions guided the Quad Council’s work: While the CoL Competencies document was the basis for reformatting the competencies for Public Health Nursing, this  document is designed to reflect the unique practice of PHNs, at the intersection of both public health and nursing practice.  The Quad Council adopted the CoL definition of core competency: “The individual skills desirable for the delivery of  Essential Public Health Services. “ Public Health Nursing is defined as the practice of promoting and protecting the health of populations, using knowledge  from nursing, social, and public health sciences.  PHNs engage in population‐focused practice, but can and do often apply  the CoL concepts at the individual and family level. PHNs must first possess basic generalist nursing competencies common to all baccalaureate graduates. PHNs also  accomplish all CoL competencies, but from the unique perspective of public health nursing.

Competencies are written to be demonstrable and measurable.  Tier 1 reflects PHN practice primarily directed at  individuals, families, and groups in the community/public health setting; Tier 2 reflects PHN practice primarily with  communities or populations; Tier 3 reflects organizational and systems level PHN leadershipcommunities or populations; Tier 3 reflects organizational and systems level PHN leadership Public Health Epidemiology Paper.

The tiers are defined on a continuum, so PHN practice in each tier assumes mastery of the competencies of the previous  tier.

This CCPHN supports the scope and standards of practice for public health nursing.  We used the Public Health Nursing:   Scope and Standards of Practice (ANA, 2007) document as a reference to ensure continuity and consistency with those  standardsstandards.

Competencies are not intended to limit PHN practice.  They reflect minimum competencies at each of the three tiers of  practice within each domain.

Conversely, the basic competencies do not necessarily reflect the practice of exceptional nurses in each tier.  Job  descriptions for PHNs may reflect components from each level, depending on agency size, needs, structure, leadership, and  services.

As noted in the CoL document, for workers within each competency, intended levels of mastery (and therefore learning  objectives) will differ depending upon the workers’ backgrounds, job duties, and years of experience.

Application to Practice These competencies have relevance to all PHNs and the agencies that employ them.  PHNs will benefit from using  these competencies as a foundation for accountable PHN practice.  Agencies will benefit from these competencies in  designing job descriptions, orientation plans, and professional staff development options.  Educators will find the  competencies useful for designing curricula that reflect current practice needs, ensuring that their graduates have the  knowledge and skills to perform the core functions and essential services of public health, and enabling thoseknowledge and skills to perform the core functions and essential services of public health, and enabling those  graduates to thrive in the public health workforce.  Most importantly, the CCPHN provides the basis for public health  nursing’s efforts to meet the needs of the populations we serve, and to protect and promote the health of communities  locally and globally.

Assumptions ‐ The following assumptions supported the Quad Council work: 

Public Health Nursing is defined as the practice of promoting and protecting the health of populations, using knowledge g p p g p g p p , g g from nursing, social and public health sciences.  PHNs engage in population‐focused practice, but can and do often apply the  Council on Linkages concepts at the individual and family level.

While the Council on Linkages Competencies document was the basis for reformatting the competencies for Public Health  Nursing, this document is designed to reflect the unique practice of PHNs, the intersection of both public health and  nursing. g

Competencies are written to be demonstrable and measurable.  Tier 1 reflects PHN practice primarily directed at  individuals, families, and groups in the community; Tier 2 reflects PHN practice primarily directed at communities or  populations; Tier 3 reflects systems‐level leadership demonstrated by PHNs.

PHNs must first possess basic generalist nursing competencies. PHNs also accomplish Council on Linkages competencies,  but from the unique perspective of public health nursing.but from the unique perspective of public health nursing.

The tiers are defined on a continuum, so PHN practice in each tier assumes the competencies of the previous tier.

The Public Health Nursing Core Competencies support the scope and standard of practice for public health nursing.  The  Public Health Nursing: Scope and Standards of Practice document was used as a reference to ensure continuity and  consistency with those standards.

i i d d li i i h fl b i i h f h h i f iCompetencies are not intended to limit PHN practice.  They reflect basic competencies at each of the three tiers of practice  within each domain.  Competencies reflect the standards for PHN practice at each level, not necessarily the practice of  exceptional nurses in each tier.  Job descriptions for PHNs may reflect components from each level, depending on agency  size, structure, leadership, and services Public Health Epidemiology Paper.

Tier 1 Quad Council  Public Health Nursing Competencies

Tier 2 Quad Council Public Health Nursing Competencies

Tier 3 Quad Council Public Health Nursing Competencies

Tier 1 Core Competencies apply to generalist  public health nurses who carry out day‐to‐ day functions in state and local public health  organizations, including clinical, home  visiting and population‐based services, and  who are not in management positions.

Tier 2 Core Competencies apply to PHNs with  an array of program implementation,  management and/or supervisory  responsibilities, including responsibility for  clinical services, home visiting, community‐ based and population‐focused programs.  For

Tier 3 Core Competencies apply to PHNs at  an executive/senior, management level and  leadership levels in public health  organizations.  In general, these  competencies apply to PHNs who are  responsible for oversight and administration

Responsibilities of the PHN may include  working directly with at‐risk populations,  carrying out health promotion programs at  all levels of prevention, basic data collection  and analysis, field work, program planning,  outreach activities, programmatic support,

example, responsibilities may include:   implementation and oversight of personal,  clinical, family focused, and population‐based  health services; program and budget  development; establishing and managing  community relations; establishing timelines

of programs or operation of an organization,  including setting the vision and strategy for  an organization and its key structural units,  e.g., a public health nursing division.  Tier 3  professionals generally are placed at a higher  level of positional authority within the , p g pp ,

and other organizational tasks. Although the  CoL competencies and the Quad Council  competencies are primarily focused at the  population level, public health nurses must  often apply these skills and competencies in  the care of individuals families or groups  Public Health Epidemiology Paper

y ; g and work plans, and presenting  recommendations on policy issues.

p y agency/organization, and they bring similar  or higher level knowledge, advanced  education and experience than their Tier 2  counterparts.

the care of individuals, families, or groups.   Therefore, Tier 1 competencies reflect this  practice.

Click on the Domain Number below you wish to view. Domain 1: Analytic and Assessment skills D i 2 P li D l t/P Pl i Skill

Domain 5: Community Dimensions of Practice D i 6 P bli H lth S i SkillDomain 2: Policy Development/Program Planning Skills

Domain 3: Communications Skills Domain 4: Cultural Competencies Skills

Domain 6: Public Health Science Skills Domain 7: Financial Planning and Management Skills Domain 8: Leadership and Systems Thinking Skills

 

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Domain 1:  Analytic and Assessment Skills

1. Identifies the determinants of health and illness of  individuals and families, using multiple sources of

1. Assesses the health status of populations and  their related determinants of health and illness.

h l h l h f l

1. Conducts comprehensive, in‐depth  system/organizational assessment as it relates to

data.   Partners with populations, health professionals,  and other stakeholders to attach meaning to  collected data.

population health.

2. Uses epidemiologic data and the ecological  perspective to identify health risks for a population.  Identifies individual and family assets and needs, values and beliefs,

d l t i t l

2. Develops Public Health Nursing diagnoses for  individuals, families, communities and populations. Uses a synthesis of nursing, public health, and  system science/theory when characterizing

l ti l l h lth i k

2. Uses organizational and other theories to guide  development of system wide approaches to reduce  population‐level health risks.  Designs systems that identify population assets and

d l d b li f d l tresources and relevant environmental factors.

population‐level health risks.  Assures that assessments identify population  assets and needs, values and beliefs, resources  and relevant environmental factors.   Derives population diagnoses and priorities based  on assessment data, including input from  populations.

needs, values and beliefs, resources and relevant  environmental factors.

3 Identifies variables that measure health and public 3 Utilizes a wide variety of relevant variables to 3 Utilizes a comprehensive set of relevant3. Identifies variables that measure health and public  health conditions.

3. Utilizes a wide variety of relevant variables to  measure health conditions for a community or  population.

3. Utilizes a comprehensive set of relevant  variables within and across systems to  measure health conditions.

4. Uses valid and reliable methods and instruments for  collecting qualitative and quantitative data from  multiple sources. Develops a data collection plan using appropriate  technology to collect data to inform the care of

4. Develops a data collection plan using models and  principles of epidemiology, demography, and  biostatistics, as well as social, behavioral, and natural  sciences to collect quantitative and qualitative data  on a community or population

4. Develops systems that support the collection  of valid and reliable quantitative and  qualitative data on individuals, families, and  populations.

technology to collect data to inform the care of  individuals, families, and groups.

on a community or population.   Uses methods and instruments for collecting valid  and reliable quantitative and qualitative data.

5. Identifies sources of public health data and  information. Collects, interprets and documents data in terms that  are understandable to all who were involved in the  process, including communities.

5. Uses multiple methods and sources when  collecting and analyzing data for a comprehensive  community/population assessment. Assures that assessments are documented and  interpreted in terms that are understandable to

5. Designs systems that assure that assessments are  documented and interpreted in terms that are  understandable to all who are involved in the  process, including individuals, communities, and  populations.process, including communities.  interpreted in terms that are understandable to

all who were involved in process, including  communities.

populations. Designs data collection system that uses multiple  methods and sources when collecting and analyzing  data to ensure a comprehensive   assessment  process.

6. Uses valid and reliable data sources to make  comparisons for assessment.

6. Critiques the validity, reliability, and comparability  of data collected for communities/populations.

6. Designs systems to assure the validity, reliability, and  comparability of data. Revises systems to assure optimal validity, reliability, y p y y and comparability of data.

Domain 1: (Continued)

7. Identifies gaps and redundancies in data sources in a  7. Identifies gaps and redundancies in data sources  7. Identifies gaps and redundancies in sources of data  community assessment through work with  individuals, families, and communities.

used in a comprehensive community/population  assessment. Examines the effect of gaps in data on PH  practice/program planning.

used in a comprehensive organizational assessment. Strategizes with relevant others to address data gaps.

8. Applies ethical, legal, and policy guidelines and  principles in the collection, maintenance, use, and  dissemination of data and information.

8. Assures the application of ethical, legal, and policy  principles in the collection, maintenance, use, and  dissemination of data and information.

8. Ensures information disseminated is understandable  to the community and stakeholders.   Establishes systems that incorporate ethical, legal,  d li i i l i h ll iand policy principles into the collection,

maintenance, use, and dissemination of data and  information.

9. Describes the public health nursing applications of  quantitative and qualitative data.

9. Synthesizes qualitative and quantitative data during  data analysis for a comprehensive  community/population assessment.  Uses various data collection methods and qualitative  d tit ti d t t d t

9.  Synthesizes qualitative and quantitative data during  data analysis for a comprehensive organizational  assessment. Uses multiple methods and qualitative and

tit ti d t f h iand quantitative data sources to conduct a  comprehensive, community/population assessment.

quantitative data sources for a comprehensive  system/organizational assessment.

10. Collects quantitative and qualitative data that can  be used in   the community health assessment  process.  Assesses data collected as part of the community  assessment process to make inferences about  individuals families and groups

10. Incorporates an ecological perspective when  analyzing data from a comprehensive  community/population assessment. Partners with groups, communities, populations,  health professionals, and stakeholders to review  and evaluate data collected

10. Incorporates ecological perspective when analyzing  data from a comprehensive, system/organizational  assessment as it relates to population health.

individuals, families, and groups. and evaluate data collected.   11. Utilizes information technology to collect, analyze,

store, and retrieve data related to public health  nursing care of individuals, families, and groups.

11. Utilizes information technology effectively to  collect, analyze, store, and retrieve data related to  care of communities and populations.

11. Collaborates with others in the design of data  collection processes and applications that facilitate  the collection, use, storage, and retrieval of data.

12. Practices evidence‐based Public Health Nursing to  promote the health of individuals, families and  groups.

12. Practices evidence‐based Public Health Nursing to  promote the health of communities and  populations.

12. Practices evidence‐based Public Health Nursing to  create and/or modify systems of care. Utilizes data to address scientific, political, ethical,  and social public health issuesand social public health issues.

13. Uses available data and resources related to the  social determinants of health when planning care  for individuals, families, and groups.

13. Collects data related to social determinants of  health and community resources to plan for  community‐oriented and population‐level  programs. Analyzes those data. Incorporates the results of those analyses into  program planning.

13. Evaluates organization/system capacity to analyze  the health status of the community/population  effectively. Allocates organization/system resources to support  the effective analysis of the health status of the  community/population.

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Domain 2:  Policy Development/Program Planning Skills

1. Identifies policy issues relevant to the health of  individuals, families, and groups.

1. Identifies valid and reliable data relevant to health  policies targeted to communities and populations.

1. Establishes methods to collect and analyze public  health and public policy information.

Describes the structure of the public health system  and its impacts on individuals, families, and groups  within a population.

Conducts and uses policy analysis to address specific  public health issues.

2. Identifies the implications of policy options on public  health programs and the potential impacts on  individuals, families, and groups within a population.

2. Plans population‐level interventions guided by  relevant models and research findings.

2. Synthesizes complex policy options to plan public  health services at the systems level.

3 Identifies outcomes of health policy relevant to PHN 3 Conducts and uses policy analysis to address public 3 Conducts and uses policy analysis to address specific3. Identifies outcomes of health policy relevant to PHN  practice.

3. Conducts and uses policy analysis to address public  health issues.  Incorporates a wide range of policy options into the  planning and delivery of health services and  interventions to groups, communities, and  populations.

3. Conducts and uses policy analysis to address specific  public health and systems issues.

4. Collects information that will inform policy decisions.   Describes the legislative policy development process.

4. Plans population‐level interventions guided by  relevant theories, concepts, models, policies, and

4. Conducts policy analysis to address specific public  health and systems issues.Describes the legislative policy development process.

Identifies outcomes of current health policy relevant  to PHN practice.

relevant theories, concepts, models, policies, and  evidence.  Uses planning models, epidemiology, and other  analytical methods in evaluating population‐level  interventions.  Critiques the evidence for population‐level  interventions. Conducts and uses policy analysis to address specific

health and systems issues.

p y y p public health issues.

5. Uses existing models and evidence to develop  policies for public health systems within the  framework of the organization’s governing body.

6. Selects an appropriate method of decision analysis  for an issue relevant to an identified group,

it l ti

6. Develops a system of decision analysis using the  strengths and appropriateness of various models and  methods.community, or population.

Uses planning models, epidemiology, and other  analytical methods in the development and  implementation of population level interventions.

methods.  Critiques health and public policy in order to address  current and emerging public health problems and  issues.

 

 

Domain 2:  Policy Development/Program Planning Skills (Continued) 7. Describes the structure of the public health system. Identifies public health laws and regulations relevant

7. Manages the delivery of community/population‐ based health services.

7. Establishes public health programs and services that are  consistent with laws and regulations.

to PHN practice. Provides public health nursing services in a manner  consistent with laws and regulations.

Evaluates and ensures compliance with public  health laws and regulations.

8. Participates as a team member in developing  organizational plans to implement programs and  policies.

8. Develops plans to implement programs and organizational policies. Works as part of an interdisciplinary team to  implement relevant policies into

8.  Implements a system for monitoring the effectiveness  and efficiency of policies and programs.   Leads team to implement health policy in population  health interventions and health systems operations.

community/population level interventions. 9. Participates in teams to assure compliance with  organizational policies.

9. Manages the implementation of organizational  policies and programs for areas of responsibility.

9.  Oversees the implementation of organizational policy  throughout the organization.

10. Assists in the design of an evaluation plan for an  individual‐, family‐, or community‐focused program. Participates as a team member to evaluate programs  to individuals families and groups for their  Public Health Epidemiology Paper

10. Designs an evaluation plan that addresses  multiple variables, includes both process and  outcome measures, and uses multiple data

10. Oversees an evaluation of the program’s overall  effectiveness, quality, and sustainability.  Designs systems‐level quality initiatives and evaluation  plans that foster pro ram s stainabilitto individuals, families, and groups for their

effectiveness and quality.  collection methods. Conducts evaluation of care delivery to  communities and populations served by the  organization.   Provides feedback on the organization’s quality  improvement program.

plans that foster program sustainability. Incorporates quality and cost measures into agency  program evaluation. Serves as a resource on quality improvement and  program evaluation.  Promotes the development of systems to use  technology in the evaluation of program quality and  effectivenessEstablishes methods to utilize technology to

collect data to monitor and evaluate the quality  and effectiveness of programs for communities  and populations.

effectiveness.

11. Understands methods and practices used to identify  and access public health information for individuals,  families, and groups.

11. Identifies a variety of sources and methods to  access public health information for a community  or population.

11. Serves as a resource for others in the identification and  use of public health informatics for communities and  populations.families, and groups.  or population.

Utilizes technology to collect data to monitor and  evaluate the quality and effectiveness of  programs for populations.

populations.  Utilizes technology to collect data to monitor    and evaluate the quality and effectiveness of  programs and systems.

12.  Understands that quality improvement is important  to the practice of public health nursing.    Participates in quality improvement teams. Describes various approaches used to improve

12.  Develops quality improvement indicators and  core measures as part of the process to improve  public health programs and services.  Utili lit i t i di t

12.  Implements organizational and system‐wide  strategies for continuous quality   improvement and performance  management. pp p

public health processes and systems.    Utilizes quality indicators and core measures to  identify and address opportunities for improvement  in the care of individuals, families, and groups.

Utilizes quality improvement indicators      and core measures as part of the process  to improve public health programs and      services.

g

Domain 3:  Communications Skills

1. Assesses the health literacy of the individuals, families and groups served

1. Assesses the health literacy of  communities/populations served

1. Ensures health literacy principles are integrated  into all agency communicationfamilies, and groups served. communities/populations served. into all agency communication.

2. Communicates effectively in writing, orally, and    electronically.  Communicates in a culturally responsive and  relevant manner. Communications are characterized by critical         thinking

2. Communicates effectively in writing, orally, and  electronically. Communications are characterized by critical  thinking and complex decision making.

2. Communicates effectively in writing, orally, and  electronically. Communications are characterized by critical  thinking and decision making at the systems  level.

thinking. 3. Solicits input from individuals, families and  groups when planning and delivering health  care.

3. Solicits input from community/population    members and stakeholders when planning  health care programs.

3. Solicits input from organizational partners and       stakeholders when planning health care  programs.

4. Utilizes a variety of methods to disseminate  public health information to individuals,  families, and groups within a population.

4. Utilizes a variety of methods to disseminate            public health information tailored to  communities/ populations

4.Utilizes systems level methods to widely  disseminate public health information tailored  to varying audiences. , g p p p / p p y g

5.Demonstrates presentation of targeted health  information to multiple audiences at a local  level, including to groups, peer professionals,  and agency peers.

5.Demonstrates presentation of targeted health  information and outcomes of Evidence Based  Practice (EBP) to multiple audiences, including  to community and professional groups.

5.Demonstrates presentation of  targeted health    information to multiple audiences, as well as to  a  variety of organizations. Mentors others in presentation/dissemination  skills.

6.Communicates effectively with individuals,  f ili d d b f i

6.Communicates effectively with community  d i f i l

6.Communicates effectively with systems leaders  d k k h ldfamilies, and groups and as a member of inter‐

professional team(s). groups, partners, and inter‐professional teams. and  key stakeholders.

Communicates effectively as member or leader  of inter‐professional team, both internally and  externally.

7. Articulates the role of public health  nursing to internal and external    audiences

7. Articulates the role of public health within  the overall health system to internal and    external audiences

7.Ensures system/organizational capacity to  articulate the role of public health.

audiences. external audiences.

 

 

Domain 4:  Cultural Competency Skills

1. Utilizes the social and ecological determinants  of health to work effectively with diverse

1. Utilizes social and ecological determinants of  health to develop culturally responsive

1. Ensures recognition and respect for diversity is  integrated into the organizational cultureof health to work effectively with diverse

individuals, families, and groups.  health to develop culturally responsive  interventions with communities and  populations.

integrated into the organizational culture. Recognizes the dynamic nature of a diverse  workforce and the necessity for on‐going  responsiveness to the changing needs of diverse  populations.

2. Uses concepts, knowledge, and evidence of the  social determinants of health in the delivery of

2. Uses epidemiological data, concepts, and other  evidence to analyze the social determinants of

2. Develops systems level health programs using  knowledge of social determinants of health.social determinants of health in the delivery of

services to individuals, families, and groups. Utilizes information technology to understand  the impact of the social determinants of health  on individuals, families, and groups.

y health when developing and tailoring  population‐level health services. Applies multiple methods and sources of  information technology to better understand  the impact of the social determinants of health  on communities and populations

g Facilitates the use of Community Based  Participatory Research (CBPR) and other  methods to evaluate effectiveness of strategies  in reducing the impact of social determinants of  health. Assures system access to technology thatAssures system access to technology that  provides information on the cultural, social, and  behavioral factors in determining the delivery of  public health services.

3. Adapts public health nursing care to  individuals, families, and groups based on  cultural needs and differences.

3. Plans health services to meet the cultural  needs of diverse communities and populations.

3. Plans for health services delivery at the systems  level to address the needs of culturally diverse  populations.

4. Explains factors contributing to cultural       diversity.

4. Explains the interplay of multiple forces  contributing to cultural diversity.

4. Explains the complexity and dynamic nature of  the forces contributing to cultural diversity.

5. Articulates the benefits of a diverse public  health workforce.

5. Serves as an advocate to build a diverse public  health workforce.

5. Contributes to plans and actions that foster a  diverse public health workforce.

6. Demonstrates culturally appropriate public  health nursing practice with individuals

6. Uses evidence and awareness of cultural  models to tailor interventions to diverse

6. Assures organizational/system adherence to  standards policies and practices for culturalhealth nursing practice with individuals,

families, groups, and community members. Contributes to promoting culturally responsive work environment.

models to tailor interventions to diverse  populations.  Evaluates current population health programs  for evidence of cultural tailoring.  Evaluates staff  development needs related to cultural  competency.

standards, policies, and practices for cultural  competency. Evaluates agency practices and policies for  cultural competence.

7.Uses evidence and  cultural models to tailor  7. Uses evidence‐based models to enhance the  program level interventions.  organization’s cultural competence.

 

 

Domain 5:  Community Dimensions of Practice Skills

1. Utilizes an ecological perspective in   health  1. Utilizes an ecological perspective in health  1. Utilizes an ecological perspective to evaluate   assessment, planning, and interventions with  individuals, families, and groups.

assessment, planning, and interventions with  communities and populations.

community linkages  and relationships across         agencies and systems.

2. Identifies research issues at a community level. Functions effectively as a member of a  Community Based Participatory Research  (CBPR) team.

2. Provides population health expertise for BPR  teams.

2. Integrates CBPR approaches to support  evidence‐ based practice  within organizations  and systems.

3 Identifies community partners for PHN practice 3 Identifies need for community involvement 3 Establishes organizational relationships3. Identifies community partners for PHN practice  with individuals, families and groups.

3. Identifies need for community involvement  and partners to create community  groups/coalitions.

3. Establishes organizational relationships,  processes, and system improvements to  enhance collaboration and cooperation among  stakeholders in population‐focused health  policies.

4. Collaborates with community partners to  promote the health of individuals and families

4.  Identify mechanisms for enhancing  collaboration among stakeholders in

4. Establishes collaborative relationships and/or  partnerships with key stakeholders, both p

within the population. g

population‐focused health interventions. Develops partnerships with key stakeholders  and groups.

p p y , internal and external. Evaluates the effectiveness of collaborative  relationships and partnerships within  organizations and systems. Seeks new partnerships to facilitate system‐level  goals.

5 P ff i l i h k k h ld d 5 P ff i l i h k k h ld 5 P ff i l i h k k h ld d5. Partners effectively with key stakeholders and  groups in care delivery to individuals, families,  groups.

5. Partners effectively with key stakeholders  and groups in care delivery to  communities/populations.

5. Partners effectively with key stakeholders and  groups in development of population‐focused  health policies.

6. Participates effectively in activities that  facilitate community involvement

6. Identifies areas for community involvement  in agency programs and initiatives.  Critiques the evidence on approaches to  fostering community partnerships and

6. Implements mechanisms for ongoing and  meaningful community involvement in  population health issues. Demonstrates proficiency in the use of groupfostering community partnerships and

involvement. Uses evidence‐based guidelines and effective  group processes to partner with community  members and groups.

Demonstrates proficiency in the use of group  processes that facilitate community  involvement. Provides leadership in partnering with groups  across systems. Functions as a resource in methods to foster  community involvement.

 

 

Domain 5: Community Dimensions of Practice Skills (Continued)

7 Describes to individuals families and groups 7 Explains to community groups and partners 7 Influences the role of government the private7. Describes to individuals, families, and groups  the role of government and the private and  non‐profit sectors in the delivery of community  health services.

7. Explains to community groups and partners  the role of government and the private and  non‐profit sectors in the delivery of  community health services.

7. Influences the role of government, the private  sector, and non‐profit sectors in the delivery of  community health services.

8. Utilizes community assets and resources to  promote health and to deliver care to  individuals, families, and groups.

8. Utilizes community assets and resources to  promote and to deliver care to  communities/populations.

8. Utilizes community assets and resources in the  agency and/or system health care programs. Implements strategies to seek resources for g p p p p g efforts to promote the health of populations.

9. Seeks input from individuals, families, and  groups and incorporates it into plans of care.

9. Uses input from a variety of  community/aggregate stakeholders in the  development of public health programs and  services.

9. Assures the comprehensive inclusion of input  from the community served when developing  policies and programs.

10. Supports public health policies, programs, and  10. Advocates for public health policies,  d th t b tt

10. Advocates for national and global public  h lth li i d th tresources.

Identifies opportunities for population‐focused  advocacy for individuals, families, and groups.

programs, and resources that better serve  populations.

health policies, programs, and resources that  impact service population.  Demonstrates leadership in advocacy efforts for  public health priorities that improve population  health and/or impact health care systems.

11. Evaluates effectiveness of community  t t t i bli h lth li iengagement strategies on public health policies,

programs, and resources.

 

 

Domain 6:  Public Health Sciences Skills

1. Incorporates public health and nursing science in the  1. Utilizes public health and nursing science in practice  1. Serves as an expert in utilizing public health and  delivery of care to individuals, families, and groups. at population and community level. nursing science in the design of public health practice

environments. 2. Describes the historical foundation of public health  and public health nursing.

2. Describes the influence of sentinel events on  current public health nursing practice.

2. Leads change in public health systems and practice  that is informed by historical learning.

3. Describes how individual‐, family‐, and group‐ focused programs contribute to meeting the core  public health functions and the 10 essential services

3. Uses evidence‐based practice to assure population  level programs contribute to meeting core public  health functions and the 10 essential services

3. Uses epidemiology and other methods to appraise  the organization’s contribution to meeting the core  public health functions and the 10 essential servicespublic health functions and the 10 essential services.   health functions and the 10 essential services.  public health functions and the 10 essential services.

4. Uses basic descriptive epidemiological methods  when conducting a health assessment for individuals,  families, and groups.

4. Uses descriptive and analytical methods, and public  health sciences to design, implement, and evaluate  interventions at community and population level.

4. Uses analytical methods when benchmarking  practice and organizational outcomes.

5. Interprets research relevant to public health  interventions for individuals, families, and groups.

5. Synthesizes research across disciplines related to  public health concerns, and population‐level  interventions.

5. Collaborates with others to address gaps in evidence  for preventing health threats at the population level. Evaluates and promotes organizational effectiveness  in translating research into practicein translating research into practice.

6. Accessing public health and other sources of  information using informatics and other information  technologies.

6. Identifies gaps in the scientific evidence related to  public health issues, concerns, and population‐level  interventions.

6. Serves as an expert resource for others in the  identification and use of public health informatics.

7. Identifies gaps in research evidence to guide public  health nursing practice.

7. Identifies a wide variety of sources and methods to  access public health information, e.g., GIS mapping. Identifies gaps and inconsistencies in research  evidence for practice.

7. Strategizes with others to address limitations of  research findings.

p 8. Complies with the requirements of patient  confidentiality and human subject protection.

8. Incorporates the requirements of patient  confidentiality, human subject protection, and  research ethics into data collection and processing.

8. Serves as an expert in the design of data collection  methods that incorporate the requirements of  patient confidentiality, human subject protection,  and research ethics.

9. Participates in research at the community level to  build the scientific base of public health nursing.

9. Disseminates theory‐guided and/or evidence‐based  practice outcomes in peer reviewed journals and  national level meetings.

9. Develops new approaches to theory‐guided and/or  evidence‐based practice in public health. Evaluates theory‐guided and/or evidence‐based

Facilitates research projects within organization.  practice in public health. Disseminates new evidence‐based practices in public  health.

10. Establishes partnerships with academic and other  organizations to expand the public health science  base and disseminate research findings.

 

 

Domain 7:  Financial Management and Planning Skills

1.Describes the interrelationships among local,  state tribal and federal public health and

1.Collaborates with relevant public and/or  private systems for managing programs in

1.Identifies potential funding sources and support  to meet community and population healthstate, tribal, and federal public health and

health care systems.  private systems for managing programs in  public health.

to meet community and population health  needs. Leverages relationships to form alliances across  public and private health care systems that  advance population health.

2. Describes the structure, function, and  jurisdictional authority of the organizational

2. Supervises the operations of health programs  within federal, state, tribal, and local public

2. Develops health programs within federal, state,  tribal, and local public health agencies.j y g

units within federal, state, tribal, and local  public health agencies.

p health agencies.

p g

3.  Adheres to the organization’s policies and  procedures, including emergency preparedness  and response.

3. Develops partnerships with communities and  agencies within the federal, state, tribal ,and  local levels of government that have authority  over public health situations, such as

d

3. Provides leadership across agency partnerships    within the federal, state, tribal, and local levels  of  government that have authority over public  health situations or with specific issues, such as

temergency preparedness. emergency events. 4. Implements the judicial and operational  procedures of the governing body and/or  administrative unit designated with oversight of  public health organizational operations.

4. Manages the implementation of the judicial  and operational procedures of the governing  body and/or administrative unit designated  with oversight of public health organizational  operations

5. Provides data for inclusion in a programmatic 5. Develops a programmatic budget. 5. Develops an organization‐wide budget.5. Provides data for inclusion in a programmatic  budget.

5. Develops a programmatic budget. 5. Develops an organization wide budget. Defends an organization‐wide budget.

6. Describes the impact of budget constraints on  the delivery of public health nursing care to  individuals, families, and groups.

6. Manages care delivery to  communities/populations within current and  forecasted budget constraints.

6. Administers the delivery of agency services  within current and forecasted budget  constraints.

7. Provides input into budget priorities.  7.   Develops strategies for determining budget  priorities based on financial input from federal

7. Evaluates strategies for determining budget  priorities.priorities based on financial input from federal,

state, tribal, and local sources.

priorities. Recommends strategies for determining budget  priorities.

 

 

Domain 7:  Financial Planning and Management Skills (Continued)

8. Assesses the impact of organizational budget  8. Assesses the impact of organizational budget  priorities on public health nursing programs and  practice. Establishes organizational PHN resource  priorities that assure effective public health  nursing practice.

priorities on public health systems and practice. Determines budgetary priorities for the  organization.

9. Provides data to evaluate care and services for  individuals families and groups

9. Designs evaluation plans for population‐ focused programs

9. Evaluates program performance at the  organizational/systems level for qualityindividuals, families, and groups.

Contributes to the evaluation plan for a  program targeting individuals, families, and/or  groups.

focused programs.  Implements evaluation plans for population‐ focused programs.

organizational/systems level for quality,  effectiveness, efficiency, safety, and  sustainability.

10. Adapts the delivery of public health nursing  care to individuals, families, and groups based  on reported evaluation results.

10. Leads revisions to population‐focused  programs based on formative and summative  evaluation results.

10. Utilizes program evaluation data to improve  organizational and system quality and  performance. p p

11. Provides input into the fiscal and narrative  components of proposals for funding from  external sources.

11. Develops proposals for funding from  external sources.

11. Approves proposals for submission to external  funding sources.

12. Applies basic human relations and conflict  management skills in interactions with peers  and other health care team members.

12. Applies basic human relations and conflict  management skills in interactions with direct  reports, other professionals, and health care

b

12. Applies basic human relations skills to the  management of organizations, motivation of  personnel, and resolution of conflicts.

team members.  Establishes policies and procedures for basic  human relation and conflict management  throughout the system.

13. Utilizes public heath informatics skills relative  to the public health nursing care of individuals,  families & groups.

13. Identifies opportunities to use health care  technologies and informatics to improve  public health program and business

i

13.Leads processes to design and improve public  health programs and business operations using  informatics and health care technologies.

operations. Incorporates health care technology and  informatics to improve public health program  and business operations.

 

 

Domain 7:  Financial Planning and Management Skills (Continued)

14 Provides input into contracts and other 14 Assists in the development of contracts and 14 Approves contracts and other agreements for14. Provides input into contracts and other  agreements for the provision of services.

14. Assists in the development of contracts and  other agreements for the provision of  services.

14. Approves contracts and other agreements for  the provision of services.

15. Delivers public health nursing care within  budgetary guidelines.

15. Describes how cost‐effectiveness, cost‐ benefit, and cost‐utility analyses affect  programmatic prioritization and decision  making.

15. Utilizes cost‐effectiveness, cost‐benefit, and  cost‐utility analyses in decision making and  prioritizing programs across organizations and  systems.g

Employs cost‐effectiveness, cost benefit, and  cost‐utility analyses for programmatic  prioritization and decision making.

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16. Utilizes data and information to improve  organizational processes and performance.

17. Participates in implementation and evaluation  17. Establishes performance management p p of performance management systems.

p g systems across programs throughout the  organization.

 

 

Domain 8:  Leadership and Systems Thinking Skills

1 Incorporates ethical standards of practice as 1 Addresses ethical issues related to the public 1 Incorporates ethical standards of practice as1. Incorporates ethical standards of practice as  the basis of all interactions with organizations,  communities, and individuals. Incorporates ethical standards into all aspects  of public health nursing practice.

1. Addresses ethical issues related to the public  health nursing care of  communities/populations.

1. Incorporates ethical standards of practice as  the basis of all interactions with organizations,  communities, and individuals. Models accountability for ethical standards of  public health practice as the basis of all  interactions with organizations, communities,  and individuals.

2. Applies systems theory to PHN practice with  individuals, families, and groups.

2. Applies system theory to PHN practice with  communities and populations.

2. Integrates systems thinking into public health  practice. Evaluates new approaches to public health  practice that integrate organizational and  systems theories.

3. Participates with stakeholders to identify  i i l d i i l f it

3. Leads team and community partners in  id tif i i i l d i i l f

3. Partners with stakeholders to determine key  l d h d i i idi i i lvision, values, and principles for community

action. identifying vision, values, and principles for  community action.

values and a shared vision as guiding principles  for community action. Integrates a shared vision, values, and  principles for community action across the  organization and the health care system.

4. Identifies internal and external factors affecting  PHN practice and services.

4. Analyzes internal and external factors that may  impact the delivery of essential public health

4. Designs solutions that address internal and  external problems that affect the delivery ofPHN practice and services. impact the delivery of essential public health

services.  Implements strategies to assure quality,  collaboration, and coordination in delivery of  PHN services.

external problems that affect the delivery of  essential public health services.  Maintains systems that assure quality,  collaboration, and coordination in the delivery  of essential public health services.

5. Uses individual, team, and organizational  learning opportunities for personal and

5. Leads inter‐professional team and  organizational learning opportunities.

5. Assures development of learning opportunities  at the levels of individual, inter‐professional

professional development as a public health  nurse.

Provides leadership in staff development. team, and organization.

6. Acts as a mentor, coach, or peer  advisor/reviewer for public health nursing staff. Maintains personal commitment to lifelong  learning and professional development.

6. Implements opportunities to mentor, advise,  coach, and develop peers, direct reports, and  other members of the public health workforce.

6. Establishes mentoring, peer advising, coaching,  and professional development systems for the  public health workforce.

 

 

Domain 8:  Leadership and Systems Thinking Skills (Continued)

7. Participates in quality initiatives that identify  opportunities for improvement

7. Uses evidence‐based models to design and  implement quality initiatives

7. Develops systems to measure, report, and  improve quality of care and organizationalopportunities for improvement.

Provides data to measure, report, and improve  organizational performance.

implement quality initiatives. Establishes indicators to monitor organizational  performance.

improve quality of care and organizational  performance. Maintains systems to measure, report, and  improve quality of care and organizational  performance.

8. Adapts the delivery of public health nursing  care in consideration of changes in the public

8. Adapts program delivery to  communities/populations in consideration of

8. Establishes organizational practices that reflect  the changes in the public health system and the g p

health system, and the larger social, political,  and economic environment. Maintains knowledge of current public health  laws and policies relevant to public health  nursing practice. Public Health Epidemiology Paper

p p changes in the public health system, and the  larger social, political, and economic  environment. Assesses outcomes of current health policy  relevant to public health and public health  nursing practice.

g p y larger social, political, and economic  environment.

9 Eff ti l l d i ti l d t9. Effectively leads organizational and systems  level change.

  • Tiers
  • Domain 1: Analytic and Assessment Skills
  • Domain 2: Policy Development/Program Planning Skills
  • Domain 3: Communications Skills
  • Domain 4: Cultural Competency Skills
  • Domain 5: Community Dimensions of Practice Skills
  • Domain 6: Public Health Sciences Skills
  • Domain 7: Financial Management and Planning Skills
  • Domain 8: Leadership and Systems Thinking Skills