Developing a comprehensive career development scale for public health nurses in Japan.

OBJECTIVES: This study aims to develop a scale that can comprehensively measure public health nurses'(PHNs) career development and to verify the validity and reliability of that scale. DESIGN AND SAMPLES: This study is a cross-sectional investigation. The participants were 1,009 PHNs working in a government facility in Japan. A total of 586 participants who had been working for more than 3 years as PHNs were analyzed. MEASUREMENTS: Anonymous self-response questionnaires included items on professional awareness, practical competency, and job satisfaction. We conducted exploratory factor analysis and confirmatory factor analysis to clarify the construct validity of the scale. The reliability was examined by the Cronbach's α coefficient. The validity was examined by an external reference relevant validity and the known-group method. RESULTS: The scale was structured with 32 items covering three factors: "community activities, policy, and management," "PHN identity," and "foundations as a PHN." The Cronbach's α coefficients were all greater than 0.9. In confirmatory factor analysis, the scale showed acceptable goodness of fit. CONCLUSIONS: The comprehensive career development scale for PHNs proved its reliability and validity. This scale may be useful to promote PHN identity and competency comprehensively in basic education and in-charge education.

Nurses' information practice in municipal health care-A web-like landscape.

AIM: To uncover the characteristics of nurses' information practice in municipal health care and to address how, when and why various pieces of information are produced, shared and managed. BACKGROUND: Nursing documentation in the electronic patient record has repeatedly been found unsatisfactory. Little is known about how the information practice of nurses in municipal health care actually is borne out. In order to understand why nursing documentation continues to fail at living up to the expected requirements, a better understanding of nurses' information practice is needed. DESIGN: A qualitative observational field study. The study complied with the Consolidated Criteria for Reporting Qualitative Research. METHODS: Empirical data were collected in three Norwegian municipalities through participant observations and individual interviews with 17 registered nurses on regular day shifts. The data were analysed through thematic content analysis. RESULTS: Nurses' information practice in municipal health care can be described as complex. The complexity is reflected in four themes that emerged from the data: (1) web of information sources, (2) knowing the patient and information redundancy, (3) asynchronous information practice and (4) compensatory workarounds. CONCLUSIONS: The complex and asynchronous nature of nurses' information practice affected both how and when information was produced, recorded and shared. When available systems lacked functions the nurses wanted, they created compensatory workarounds. Although electronic patient record was an important part of their information practice, nurses in long-term care often knew their patients well, which meant that a lot of information about the patients was in their heads, and that searching for information in the electronic patient record sometimes seemed redundant. RELEVANCE TO CLINICAL PRACTICE: This study provides contextual knowledge that might be valuable (a) in the further development of information systems tailored to meet nurses' information needs and (b) when studying patient safety in relation to nurses' information practice.

Factors affecting the performance of public health nurses in family nursing care

Objective: To determine factors that influence the nurses' performance in family nursing care in public health centers in Jambi City. Method: A cross-sectional study was conducted from April to October 2016 using questionnaire with public health nurses as participants. The survey included questions on knowledge, attitude, self-confidence, motivation, personality, and nurses’ performance in family nursing care, and was completed by 114 nurses. Data analyses used for this study were chi-square test and logistic regression. Results: The factors affecting the nurses' performance in family nursing care were attitudes (p 0.003; 95% CI 1.583-9.823), motivation (p 0.002; 95% CI 1.672-9.972), and personality (p 0.005; 95% CI 1.466-8.830). Conclusions: Need efforts to improve the attitude, motivation, and personality of nurses in providing family nursing care, such as training, supervision, and rewards

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Machine Learning Methods for Identifying Critical Data Elements in Nursing Documentation.

BACKGROUND: Public health nurses (PHNs) engage in home visiting services and documentation of care services for at-risk clients. To increase efficiency and decrease documentation burden, it would be useful for PHNs to identify critical data elements most associated with patient care priorities and outcomes. Machine learning techniques can aid in retrospective identification of critical data elements. OBJECTIVE: We used two different machine learning feature selection techniques of minimum redundancy-maximum relevance (mRMR) and LASSO (least absolute shrinkage and selection operator) and elastic net regularized generalized linear model (glmnet in R). METHODS: We demonstrated application of these techniques on the Omaha System database of 205 data elements (features) with a cohort of 756 family home visiting clients who received at least one visit from PHNs in a local Midwest public health agency. A dichotomous maternal risk index served as the outcome for feature selection. APPLICATION: Using mRMR as a feature selection technique, out of 206 features, 50 features were selected with scores greater than zero, and generalized linear model applied on the 50 features achieved highest accuracy of 86.2% on a held-out test set. Using glmnet as a feature selection technique and obtaining feature importance, 63 features had importance scores greater than zero, and generalized linear model applied on them achieved the highest accuracy of 95.5% on a held-out test set. DISCUSSION: Feature selection techniques show promise toward reducing public health nursing documentation burden by identifying the most critical data elements needed to predict risk status. Further studies to refine the process of feature selection can aid in informing PHNs' focus on client-specific and targeted interventions in the delivery of care.

There is more to perinatal mental health care than depression: Public health nurses reported engagement and competence in perinatal mental health care.

AIMS AND OBJECTIVES: To explore public health nurses' engagement, competence and education needs in relation to perinatal mental health care in Ireland. BACKGROUND: It is estimated that 15%-25% of women will experience a mental health problem during or postpregnancy, either as a new problem or a reoccurrence of a pre-existing problem. Public health nurses, or their equivalent, are ideally positioned to support women's mental health and improve health outcomes for the woman and baby, yet little is known about their role and engagement with mental health issues, other than with postnatal depression. The objectives of the study were to identify public health nurses' knowledge, skills and current practices in perinatal mental health and establish their education needs. DESIGN: The research used a descriptive design. METHOD: A total of 186 public health nurses completed an anonymous, online survey, designed by the research team. RESULTS: While public health nurses are positive about their role in supporting women's mental health, they lack the knowledge and skills to address all aspects of mental health, including opening a discussion with women on more sensitive or complex issues, such as trauma and psychosis and providing information to women. Those who received education reported statistically significant higher knowledge and confidence scores than those without. CONCLUSION: Public health nurses lack the knowledge and skills required to provide comprehensive perinatal mental health care to women. Future education programmes need to move beyond postnatal depression and address the range of mental health problems that may impact on women in the perinatal period. RELEVANCE TO CLINICAL PRACTICE: Without knowledge and skill among nurses in all aspects of perinatal mental health, women with significant mental health needs may be left to cope alone and lack the necessary prompt evidence-based interventions and supports.

La enfermera escolar y la enfermera de Atención Primaria. A propósito de la atención a la diabetes en la Escuela de Extremadura / The school nurse and primary health nurse, apropos the diabetes care at school in Extremadura

Los problemas crónicos de salud en estudiantes son cada vez más frecuentes (alergias alimentarias, diabetes mellitus, etc.). La existencia de una enfermera escolar en el centro educativo puede ser clave en el control y buen pronóstico de estos problemas de salud. Objetivo. Revisar el papel de la enfermera escolar a propósito de la atención a la diabetes en la escuela en Extremadura. Metodología. Revisión bibliográfica de la literatura científica y experiencia propia sobre la figura de la enfermera escolar y la atención a la diabetes en los centros educativos no universitarios. Resultados. Esta figura está establecida en muchos de los países de nuestro entorno y desarrolla actividades fundamentales en pro de la salud de los estudiantes, aunque su presencia física generalmente no es constante y requiere de algunas mejoras. Conclusiones. Se debe promover la instauración de la enfermera escolar en España, para prevenir y abordar muchos problemas de salud en edad infantil y juvenil, preferentemente con dependencia del sistema sanitario e integrada en los equipos de Atención Primaria, lo cual favorece el trabajo comunitario de enfermería (AU)

The amount of chronic health problems in students is increasing with the time (food allergies, diabetes mellitus...). The presence of a school nurse in the educational sites could be the key to control this kind of health issues. Objective. Overhaul the function of a possible nurse in the schools of our region, with the target of trying to control and prevent diabetes mellitus and other illnesses. Methodology. We have reviewed the figure of a school nurse and the diabetes care in non-university schools, using scientific sources of information and the own experience. Results. Many countries of the European environment are performing really important activities which have their benefits on the students’ health; using the figure of a school nurse. However, the presence of this person is generally not constant in the educational sites, and requires some improvements. Conclusions. We must promote the establishment of school nurses in Spain so that we can take care and prevent many health problems which mostly affect youth and childhood (AU)

Striving to provide the best start to every child.

IT IS IMPOSSIBLE to view Northern Ireland's approach to improving the health of children without seeing it through the prism of poverty. The legacy of the Troubles, the recession and a high cost of living mean that child poverty levels remain well above the UK average.