ABSTRACT
OBJECTIVES: To integrate public health nursing (PHN) competencies into a comprehensive performance review instrument for nurses at multiple practice levels in an urban public health department. DESIGN: Based on thorough review of PHN competency literature, the tool evaluates performance for 5 nursing practice classifications (Staff RN, Public Health Nurse, Nurse Practitioner, Clinical Nurse Specialist, Nursing Supervisor) in eight PHN domains (assessment, policy development/program planning, evaluation, communication, cultural competency, partnership/collaboration, disease prevention/health promotion, leadership/systems thinking). SAMPLE: Tool was piloted with over 50 nurses from PHN workforce (n>400) of Public Health-Seattle & King County (Washington). METHOD: Pilot testing includes all components of the performance appraisal system: Public Health Competency Grid, statement of general workplace expectations, Nursing Performance Appraisal Tool, and supporting documents defining performance elements by job classification. RESULTS: Supervisors find the tool easy to use and report that it provides opportunity for real communication between employee and supervisor. Nurses at all practice levels report that it effectively describes/evaluates their practice. CONCLUSIONS: This tool is an efficient performance appraisal instrument providing meaningful feedback to nursing employees within a framework of PHN competencies. Adopting such tools in PHN practice can help nurses to better understand their role in population-based public health efforts.
Subject(s)
Clinical Competence/standards , Employee Performance Appraisal/methods , Public Health Nursing/standards , Attitude of Health Personnel , Communication , Community Health Planning/standards , Employee Performance Appraisal/standards , Feedback, Psychological , Humans , Interprofessional Relations , Leadership , Models, Nursing , Nurse Administrators/education , Nurse Administrators/organization & administration , Nurse Administrators/psychology , Nurse Clinicians/education , Nurse Clinicians/organization & administration , Nurse Clinicians/psychology , Nurse Practitioners/education , Nurse Practitioners/organization & administration , Nurse Practitioners/psychology , Nurse's Role , Nursing Assessment/standards , Nursing Evaluation Research , Nursing Methodology Research , Nursing Staff/education , Nursing Staff/organization & administration , Nursing Staff/psychology , Pilot Projects , Program Development/standards , Program Evaluation/standards , Public Health Nursing/education , Systems Analysis , WashingtonABSTRACT
OBJECTIVE: The King County Department of Adult and Juvenile Detention in Washington State, like many jail systems across the nation, implemented a suicide prevention program in response to high suicide rates. A review committee was formed to prospectively study the patterns of suicide attempts that occurred in the system after the program was implemented and to make recommendations for improvements. METHODS: All first suicide attempts per jail booking over a 33-month period in two of the department's jails were studied. For each attempt, characteristics of the individual and of the attempt were abstracted by trained staff. RESULTS: A total of 132 first suicide attempts were made by 124 individual inmates during the study period. The prevalence of mental illness among inmates who attempted suicide was 77 percent, compared with 15 percent in the general jail population. Seventy-five percent of the inmates who attempted suicide had received a mental health evaluation from jail personnel before the attempt. Suicide attempts that were made in observation units for suicidal inmates (42 percent of all attempts), particularly those made in group observation units, necessitated fewer visits to an emergency department than those that occurred in general areas of the jail. CONCLUSIONS: On the basis of these findings, the jails implemented interventions such as more suicide screening and treatment for inmates who have active substance abuse, greater consensus building in decisions about housing, and structural changes such as greater use of group-housing units and the use of barriers to prevent the inmates from jumping from balconies.
