Public Health Nursing Activities: Visible or Invisible?

OBJECTIVE: To promote visibility of public health nurses (PHNs), this study identified public health nursing activities and explored PHN perceptions of the impact of their activities on the health of the communities they serve. DESIGN AND SAMPLE: Two surveys with questions focusing on PHN activities were made available electronically. Following the initial survey, the second survey had more detailed questions about PHN activities, including time spent and frequency of activities as well as open-ended questions. Sixty staff level PHNs, representing 29 states, completed the first survey; 49 completed the second survey. MEASURES: Demographic variables and PHN activities were analyzed by population, setting, program, intervention, essential services, and prevention level using descriptive statistics. Themes or categories were determined through a content analysis of responses to three open-ended questions. RESULTS: PHNs reported a wide variety of activities that included: (1) individual/family, community, and systems intervention levels, (2) primary, secondary, and tertiary prevention, and (3) all 10 Public Health Essential Services. PHNs perceived they perform work that is essential for community health. CONCLUSION: PHNs do work that is both visible and invisible. PHNs need to be proactive in promoting all their work to increase the visibility of their contributions to population health.

Cornerstones of public health nursing.

The "Cornerstones of Public Health Nursing" describe the values and beliefs that underlie the practice of Public Health Nursing, which is a synthesis of public health and nursing. The impetus for the development of the Cornerstone framework originated from the need to advocate for public health nursing programs, positions, and funding. Grounded in practice, their development engaged stakeholders from the public health nursing community at every phase. The Cornerstone framework has been used over the past decade by educators to teach public health nursing and by administrators in state and local health departments for orientation and continuing education. The Cornerstones have been nationally and internationally disseminated. This paper describes the development and dissemination of the Cornerstones framework by public health nurses in Minnesota and features exemplars from practice.

Consumer health informatics: from genomics to population health.

Innovations in health information technology have ushered in a new era of health care. The use of emerging information and communication technology to improve or enable health and health care is the central focus of consumer health informatics (CHI). Traditionally, CHI interventions to promote health and well-being have targeted the individual or family. Advances in genomic health and the emergence of public health informatics call for broadening the scope of CHI. The authors discuss CHI from the point-of-view of the consumer (e.g., from individuals to policy makers) and the level of health data from the subcellular (e.g., genetic or protein structures) to population (e.g., geographically-referenced information).

Population-based public health interventions: practice-based and evidence-supported. Part I.

The Intervention Wheel is a population-based practice model that encompasses three levels of practice (community, systems, and individual/family) and 17 public health interventions. Each intervention and practice level contributes to improving population health. The Intervention Wheel, previously known as the Public Health Intervention Model, was originally introduced in 1998 by the Minnesota Department of Health, Section of Public Health Nursing. The model has been widely disseminated and used throughout the United States since that time. The evidence supporting the Intervention Wheel was recently subjected to a rigorous critique by regional and national experts. This critical process, which involved hundreds of public health nurses, resulted in a more robust Intervention Wheel and established the validity of the model. The critique also produced basic steps and best practices for each of the 17 interventions. Part I describes the Intervention Wheel, defines population-based practice, and details the recommended modifications and validation process. Part II provides examples of the innovative ways that the Intervention Wheel is being used in public health/public health nursing practice, education, and administration. The two articles provide a foundation and vision for population-based public health nursing practice and direction for improving population health.

Population-based public health interventions: innovations in practice, teaching, and management. Part II.

The Intervention Wheel is a population-based practice model that encompasses three levels of practice (community, systems, and individual/family) and 17 public health interventions. Each intervention and practice level contributes to improving population health. The Intervention Wheel, previously known as the Public Health Intervention Model, was originally introduced in 1998 by the Minnesota Department of Health, Section of Public Health Nursing (PHN). The model has been widely disseminated and used throughout the United States since that time. The evidence supporting the Intervention Wheel was recently subjected to a rigorous critique by regional and national experts. This critical process, which involved hundreds of public health nurses, resulted in a more robust Intervention Wheel and established the validity of the model. The critique also produced basic steps and best practices for each of the 17 interventions. Part I describes the Intervention Wheel, defines population-based practice, and details the recommended modifications and validation process. Part II provides examples of the innovative ways that the Intervention Wheel is being used in public health/PHN practice, education, and administration. The two articles provide a foundation and vision for population-based PHN practice and direction for improving population health.

A population-based approach to pediculosis management.

Pediculosis is a population-based problem that is a priority concern for many communities. Public health nurses in a county health department collaborated with epidemiologists, nursing students, and faculty to design and implement an effective population-based pediculosis management project. The focus of the project was the development of pediculosis treatment and prevention guidelines based on recognized best practices that were acceptable to both epidemiologists and practicing public health nurses. Public health nurses disseminated these guidelines to community providers and reinforced their use through consultation and educational sessions. Two critical changes occurred as a result of the project. First, community providers significantly changed their recommendations for the treatment of pediculosis after nursing intervention. Second, public health nurses increased their population-based practice skills, continued to use those skills to address pediculosis, and extended those skills to additional population-based initiatives.

Assessment, program planning, and evaluation in population-based public health practice.

Public health practitioners in Minnesota developed and implemented a population-based public health practice model for community assessment, program planning, and evaluation. The ultimate goal of this process is improvement in population health. Major challenges to the implementation of a population-based model are addressed through the use of a theory of action; interventions at community, systems, and individual levels; and intermediate evaluation indicators. Examples of resulting changes in public health practice are described.