Development of a new graduate public health nurse residency program using the core competencies of public health nursing.

BACKGROUND: Due to the continued shortage of public health nurses, some local public health agencies have begun hiring new graduate baccalaureate nurses into the public health nurse role. These new graduates require an increased level of support for transition to practice. AIMS: The goal of this project was creation of a transition to practice program designed specifically to meet the needs of new graduates hired in public health settings. METHODS: The core competencies of public health nursing were used as a framework to develop this residency program. A group of public health staff, supervisors, and faculty met monthly for three years to develop this program. Key features include general orientation, preceptors, looping experiences, case studies and peer support. RESULTS: The program is available as a web resource beginning spring 2018. In order to evaluate this program, data on job satisfaction, employee retention and level of competence in the core competencies of public health will occur using instruments administered prior to beginning and immediately following completion of the new graduate residency. DISCUSSION: The components of the program mirror best practices for new graduate residencies and are based on core competencies for public health nursing. This residency program is an important step for enhancing the professional development of new baccalaureate graduates in public health settings, and preparing the next generation of public health nurses. CONCLUSION: Through the increased support and intentional education of the residency program, public health agencies will be able to attract and retain new graduates who develop the essential knowledge and skills to provide safe and effective care in the public health setting.

Local health department factors associated with performance in the successful implementation of community-based strategies: a mixed-methods approach.

OBJECTIVES: We examined which local health department (LHD)-level factors contributed to successful implementation of policy, systems, and environmental change strategies in Minnesota. METHODS: We used a retrospective mixed-methods design to evaluate the relationship between the Statewide Health Improvement Plan (SHIP) grant initiative and key predictor variables (2009-2011). We obtained quantitative capacity data for 91 cities and counties in Minnesota; in addition, we conducted 15 key informant interviews to examine factors that facilitated and acted as barriers to LHD performance. RESULTS: Grantee performance was distributed as follows: exceeds expectations (29.7%), meets expectations (55.0%), and is approaching expectations (15.3%). Organizational quality improvement (QI) maturity was strongly positively associated with grantee performance on SHIP. Organizations with high QI maturity, effective leadership, efficient decision-making, and successful regional or cross-jurisdictional partnerships were more likely to be rated as exceeding expectations. CONCLUSIONS: This study successfully translated practice-based research findings into tangible outcomes, including new system-level performance measures for local public health and recommendations for shaping the statewide initiative examined in this study. The approach taken in this study to systematically monitor communications, dissemination, and translation may be a model for others.

Measuring the authority of local public health directors in the context of organizational structure: an exploratory, multimodal approach.

CONTEXT: Studies have reported a relationship between the organization of public health services and variability in public health practice at the local and state levels. A national research agenda has prioritized practice-based research to understand pathways that lead to this variation and examine the impact of these differences on outcomes. OBJECTIVES: To measure the extent to which Minnesota local health directors report having key authorities and examine the relationship between organizational structure and authority of local health directors. DESIGN: : Multimodal. SETTING: Minnesota local health departments. PARTICIPANTS: Directors of Minnesota local health departments. MAIN OUTCOME MEASURE(S): Director authorities. RESULTS: Most Minnesota local health directors reported having 6 key authorities related to budget preparation and modification and interaction with local elected officials (n = 51, 71%). Twelve directors (16%) reported that they have 4 or fewer of the 6 authorities. The authority most commonly reported as lacking was the authority to initiate communication with locally elected officials (n = 15, 21%). The percentage of directors who reported having all 6 authorities was higher among those in stand-alone departments (82%) than those in combined organizations (50%). CONCLUSIONS: This descriptive study illustrates that emerging practice-based research networks can successfully collaborate on small-scale research projects with immediate application for systems development. Study findings are being used by local public health officials to help articulate their role, aid in succession planning, and inform elected officials, who need to consider the public health implications of potential changes to local public health governance and organization. More studies are needed to refine measurement of authority and structure.

Baccalaureate nursing students' intention to choose a public health career.

OBJECTIVE(S): To determine nursing students' public health career intentions, and to determine recruitment strategies and other factors that influence students' public health career intentions. DESIGN AND SAMPLE: Descriptive, correlational design. 354 junior and senior baccalaureate nursing students. MEASURES: Students completed a researcher developed survey about choosing public health career intentions and recruitment incentives. RESULTS: Students indicated that they were likely or very likely to consider a career in public health immediately following graduation (21.1%), 1 year after graduation (26.4%) and more than 1 year after graduation (35%). Significant variables influencing career choice immediately following graduation were enrolling institution [t(3,340) = 2.66, p = .008] and traditional clinical site [t(3,340) = -2.306, p = .022]. One year after graduation, traditional public health clinical site [t(3,340) = -2.648, p = .008], and more than 1 year after graduation enrolling institution [t(4,339) = -2.364, p = .019] and gender [t(4,339) = 2.094, p = .037] were significant variables influencing career intentions. The top three recruitment strategies ranked by students were comparable wages, flexible scheduling, and tuition reimbursement. CONCLUSIONS: Identifying priority recruitment strategies for public health students will enhance the ability of public health leaders to recruit graduate registered nurses to public health. Faculty should continue to evaluate both clinical and classroom experiences to stimulate excitement and interest for public health as a career choice.

School-based influenza immunization.

Annual influenza vaccination of schoolchildren will protect individual vaccines and, with high coverage, may protect entire communities. Because schoolchildren are more difficult to reach than preschoolers, school-based immunization programs may be needed to reach a high percentage of children. We offered free live, attenuated influenza vaccine to all healthy schoolchildren (K-12) in three Minnesota counties. Counties vaccinated from 33% to 58% of students. Overall, 41% of enrolled children were vaccinated. Elementary students were vaccinated at higher rates than older students. Administrative costs averaged $9.78 per dose delivered. School-based immunization programs offer the potential to achieve higher vaccination coverage of schoolchildren at modest cost.