lucille b. pilling, edd,mph, bsn, rn; m. harmon; b. joyce
TRANSCRIPT
Thomas Jefferson University Thomas Jefferson University
Jefferson Digital Commons Jefferson Digital Commons
College of Population Health Lectures, Presentations, Workshops Jefferson College of Population Health
11-6-2017
Global Health Nursing Imperative: Using Competency-Based Global Health Nursing Imperative: Using Competency-Based
Analysis to Strengthen Accountability for Population Based Analysis to Strengthen Accountability for Population Based
Practice, Education and Research Practice, Education and Research
Lucille B. Pilling, EdD,MPH, BSN, RN Jefferson School of Population Health; University of Pennsylvania School of Nursing
M. Harmon University of Pennsylvania
B. Joyce University of Kansas
R. Johnson University of Colorado
V. Hicks University of Colorado
See next page for additional authors
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Recommended Citation Recommended Citation
Pilling, EdD,MPH, BSN, RN, Lucille B.; Harmon, M.; Joyce, B.; Johnson, R.; Hicks, V.; and Brown-
Scott, N., "Global Health Nursing Imperative: Using Competency-Based Analysis to Strengthen
Accountability for Population Based Practice, Education and Research" (2017). College of
Population Health Lectures, Presentations, Workshops. Paper 54.
https://jdc.jefferson.edu/hplectures/54
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Authors Authors Lucille B. Pilling, EdD,MPH, BSN, RN; M. Harmon; B. Joyce; R. Johnson; V. Hicks; and N. Brown-Scott
This presentation is available at Jefferson Digital Commons: https://jdc.jefferson.edu/hplectures/54
GLOBALHEALTHNURSINGIMPERATIVE:USINGCOMPETENCY-BASEDANALYSISTOSTRENGTHEN
ACCOUNTABILITYFORPOPULATIONBASEDPRACTICE,EDUCATIONANDRESEARCH
L.PILLING1,M.HARMON1,B.JOYCE2, R.JOHNSON3,V.HICKS3,N.BROWN- SCHOTT4
1UNIVERSITYOFPENNSYLVANIA,2UNIVERSITYOFKANSAS, 3UNIVERSITYOFCOLORADO,4UNIVERSITYOFTOLEDO
APHANOVEMBER8,2017
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DISCLOSURES
• Thispresentationincludesfindingsfromresearchconductedbyamulti-siteteam(M.Harmon1,L.Pilling1,B.Joyce2, R.Johnson3,V.Hicks3,N.Brown- Schott4(1UniversityofPennsylvania(formernursingfacultyatUniversityofPennsylvania;nowVillanovaUniversity&ThomasJeffersonUniversity&stillCenterforPublicHealthInitiativesFellows),2UniversityofKansas, 3UniversityofColorado,4UniversityofToledo)
• Thisresearchwassupportedby:
• TheAssociationofCommunityHealthEducators(ACHNE)ResearchGrant(2016-2017)
• ZetaThetaChapter-at-LargeSigmaThetaTauInternationalAliceManionResearchGrantAward(2016-2017).
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LEARNINGOBJECTIVES
• Discusstheuniquechallengesofdevelopingacollaborativeglobalnursingworkforce.
• Comparethreesetsofcompetenciesforpublichealthnursing• Analyzetheresultsofthecomparisonofthethreesetsofcompetencies.• Discusshowtheanalysiscanbeusedtoguidecommunity/publichealthnursingeducation,practiceandresearchtoencompasslocal,nationalandglobalemphasis.
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BACKGROUND
4
AMULTI- SITECOLLABORATIVE
NancyBrown-Schott,MSN,CNS,RNBC
AssistantProfessor(Retired)UniversityofToledo
BarbaraJoyce,Ph.D.,CNS,ANEFAssociateProfessor
UniversityofColoradoColoradoSprings
VickiHicks,MS,APRN-CNS,RNClinicalAssociateProfessor
&Regina(Gina)Johnson,MSN,
RNClinicalInstructor
UniversityofKansasSchoolofNursing
MonicaHarmon,MSN,MPH,RN
SeniorLecturerAssociateFellow,CenterforPublicHealthInitiatives
&LucillePilling,Ed.D.,MPH,RNAssociateFellow,CenterforPubicHealthInitiatives
UniversityofPennsylvania
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CURRENTCHALLENGES
• PracticingPHNs andfacultymaybeunawarethatthePHN specialtyhasacommonsetofstandards,competencies,resources,andtools
• EvenifPHNsareawareofgoldstandardsforthespecialty,currentpracticemaynothavethemechanismtooperationalizethem(benchmarks)
• BroadrangeofclinicaloutcomesforpracticingPHNsandcommunity/publichealthnursingstudents
• DevelopingthenextgenerationofPHNworkforcemayproveevenmoredifficultwithoutmassiveattentionandactiontooperationalizecompetencyandbenchmarkusageineducation,practice,research,andpolicy.
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CHANGINGDIRECTIONS
Classroom
Practice
ResearchCommunityCollaborative
Disseminate
• QuantitativeMeasures:
• Tier12011QuadCouncilPublicHealthNursingCompetencies.
• UseofOmahaSystemtomeasurechangeinknowledge,behaviorandstatusofnursingfacultyandprofessionalnurses.
• PHNknowledge,skills,andattitudes
• QualitativeMeasures:
• Debriefingwithclinicalfaculty
• Didactic/ClassroomStrategies
• Studentclinicalperformance
• FormativeandSummativeEvaluationMethods:
• TeamReview
• DisseminationofFindings
• CollaborationwithNurseEducatorsatalllevelsandPracticePartnersforReplicationwithnursingandotherhealthcareersstudentsandprofessionals
• LearningCommunity7
21ST CENTURYHEALTHCAREDELIVERY
Education
Research
Practice
Policy
ImprovedHealth
Outcomes
ComprehensiveHealthCareDelivery
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WHOSHOULDBECONCERNEDWITHPOPULATIONHEALTH?
PopulationHealth
Nursing
HealthProfessionsEducation
Inter-professionalTeam
HealthPolicy&Research
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MISSION&VISION• Mission
• ToadvocatefortheuseoftheQuadCouncilCompetenciesinBaccalaureateeducationthatexpandseducation,practice,researchandpolicyinthespecialtyofC/PHN.
• Tosupport:
• Baccalaureatenursingfacultyincompetencyapplicationinclassroom,practice,andresearchinthespecialtyofC/PHnursing.
• Utilization ofstandardizedevaluationtoolsformeasuringoutcomesineducation,research,practiceandpolicy .
• Cultivatemulti-regionalresearchamongbaccalaureatefacultyteachingC/PHnursingandpracticingC/PHnurses.
• Vision• Tocreateanopportunityfordevelopinganattitudeofcollaborativeinquirythatwillenhancethesharedvalues,
conceptsandideasamongaC/PHNfacultylearningcommunityby:• Facilitationofgraduateeducationandpracticemodalitieslevelingandapplicationofcompetencies.• Discussion withpublichealthnurses/servicerelatedtobridgingacademiaandpractice.
• SupportanddevelopCommunity-basedparticipatoryresearchincorporatingthecompetencies .10
ESTABLISHING&MAINTAININGMULTI-SITECOLLABORATION&PARTNERSHIP
vPassion
vSpecialtyFocus
vWeeklyMeeting(Discussion,Brainstorming,StrategicPlanning)
vSharedLeadership(Leadsoneachassignment)
vSharedInstitutionalSupport(SurveyMonkey,IRB,webcasts)vSharedauthorshiponallworkandpresentations.
vAdditionalweeklymeetingtogetworkdone(manuscripts/presentations)
vAllworkreviewedbytheentireteam.(Signoff/Approval).11
CORECOMPETENCIESINPOPULATIONHEALTHNURSINGPRACTICE
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QUADCOUNCILCOMPETENCIESOFPUBLICHEALTHNURSES(2011)• Who?
• ComprisedofAPHN,ACHNE,APHAPHN,ANA,NASN
• Foundedinearly1980’stoaddressPHNeducation,practice,leadership,&researchasthe“voiceofPHN”.
• What?• InresponsetoCouncilonLinkagesbetweenAcademia&PublicHealthPracticerevisionofits“CoreCompetenciesforPublicHealthProfessionals”(2010)
• Why?
• TraditionallyCCPHNwasconsistentwiththe“DefinitionofPHN”(1996)and“Scope&StandardsofPublicHealthNursing”(QuadCouncil,1999)
• Tobeusedinavarietyofsettingsatdiverselevelsofpractice13
QUADCOUNCILCOMPETENCIESFORPUBLICHEALTHNURSES:TIER1
• Analytic and Assessment Skills (13)• Policy Development and Program Planning (12)• Communication Skills (7)• Cultural Competency Skills (6)• Community Dimensions of Practice (10)• Public Health Science Skills (9)• Financial Planning and Management Skills (15)• Leadership and Systems Thinking (8)
IMPERATIVEACTIONSStrengtheningtheInfluenceofQuadCouncilCompetenciesforProfessionalNursesinEducation,Practice,Researchwill:
• Improvepopulationhealthandpopulation-focusedcare.• Recognizecommonstandardstobeusedinacademia,practice,andresearch.• Promoteaunifiedfrontofeducatorsandhealthcareprofessionalscommittedtoincludingpopulationhealthcompetenciesinnursingeducationatalllevels,practice,research,andpopulation-focusedpolicies.
• Preparecurrentandfuturenursestobetransformativeandmeeteverexpandingchallengesofdeliveringhealthcareto21st centurypopulationsandcommunities.
• Advancecycleoftheacademicandprofessionalpipelinestoconstantlyenhancetheinclusionandutilizationofpopulationhealthcompetencies.
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THERESEARCH
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QUALITYIMPROVEMENTPROJECTPHASE ONE• Developed clinical evaluation tool for baccalaureate nursing students
utilizing Quad Council Public Health Nursing Competencies (2011).• Tested tool in 4 project sites (with faculty 7 students).• Oriented and debriefed faculty before and after each course.
PHASE TWO• Presented Quad Council Competencies to :
o CourseFaculty/Teachingteamo NursingDepartmentso ClinicalPreceptors
RESEARCHPROJECT:PHASEONE
Community/PublicHealthNurseFacultyKnowledge,SkillsandAttitudesofPublicHealthCompetencies
• Methodology
Funding:ZetaThetaChapter,SigmaThetaTau
IRBApproval:UniversityofColoradoColoradoSprings
SurveyMonkeyTool:Likertresponse
ResearchAssistantship(Spring,2016)&MPHThesisMentorship(Spring,Summer,&Fall2016)
• Presentations:AACN,CUGH,ACHNE,NBNA,StateNursesAssociation
• ManuscriptIn Review(PublicHealthNursing)
RESEARCHPROJECT:PHASETWO
Community/Public Health Nurses’ Knowledge, Skills and Attitudes of Public Health Nursing Competencies.• Methodology
Funding:ACHNE,2016
IRBApproval:University of Kansas SurveyMonkeyTool:Likertresponse
OutreachtoDirectorsofStatePublicHealthAgencies
• Presentations:AACN,ACHNE,NBNA,APHA,APHN,
• ManuscriptinProgress(PublicHealthNursing)
RESEARCHPROJECT:PHASETHREE
TheGlobalHealthNursingImperative:UsingCompetency-BasedAnalysistoStrengthenAccountabilityforPopulation-BasedPractice,Education,andResearch
• Methodology
Funding:ACHNE,2016
Crosswalkcomparisonandanalysisof3typesofcompetencies
• Presentations:GlobalPHNNetwork,CUGH,APHA
• Manuscript:Availableonline(AnnalsofGlobalHealth,August2017)
PHASETHREE:GLOBALHEALTHCOMPETENCIESCROSSWALKRATIONALE
• Increasedinternationalmobility,globalinterdependence,andglobalcollaborationcreateamomentumthatposeschallengestodevelopingacollaborativeglobalworkforce
• Globalclinical,communityandpublichealthnursingpracticumsareanintegralcomponentofundergraduatecommunityandpublichealthnursingprograms
• Incorporateglobalhealthcompetenciesintoclinicalevaluationdocument.
• GlobalisLocal.
ACTLOCALLY,THINKREGIONALLY,PARTICIPATEGLOBALLY
National
PartnersLocalhealthdepartments
HomecareagenciesSchools
PubliclibrariesCommunityclinics
Faith-basedorganizations
NGOs
AreasLocalities
MunicipalitiesUrban
SuburbanRural
International
PartnersMinistriesofHealth
INGOsRegional,national,&
globalalliancesFoundations
SchoolsofNursingFaith-basedorganizations
Clinics
CountriesBarbadosBotswanaCostaRicaGuatemala
IndiaUganda
GLOBAL HEALTH IS “LOCAL”
• 37 million foreign-born immigrants living in US (12% of total US population)o Mexico is largest group (31%)o 70% are legal (permanent residents with green cards, refugees, and
asylees)o 30% are illegal (undocumented: 11-12 million)
• 645,000 foreign-born veterans of US armed forces (3% of surviving veterans)
• 1.65 million households live on less than $2 per day (159% increase from 1996)
• Global+Local=Glocal
CONTENTANALYSIS:DOCUMENTCROSSWALK
Quad Council Competencies for Public Health Nurses (2011). 8 Domains
Global Health Competencies for Nurses in Americas (White et al, 2012). 6 Domains
Inter-professional Global Health Competencies (Jogerst et al, 2015). 11 Domains
PROCEDURESANDFINDINGS:
Quad Council Competencies did not address: • Environmental Health• Social Justice• Social, Cultural & Political awareness (necessary for partnership &
collaboration)• No domain to support multi-national work & health care practice.• No support for financial management skills in global health documents.
SUMMARY
• Universal common standards are in place for use by academia, practice, and research.
• Standards improve population health, population focused care, and community-based networks nationally and globally.
• Need to re-examine, re-focus, and re-design C/PHN education, practice, and research to address the challenges of an expanding 21st century health care delivery to populations and communities nationally and globally.
RECOMMENDATIONS
• SupportrevisionoftheQuadCouncilCompetenciestoreflectmulti-nationalhealthcarepartnershipsandcollaboration.
• Increaseemphasisonaglobalperspectivetoenhancecurricula,clinicalpracticumplanning,andimplementationbothlocallyandglobally
• Useresearchdatatovalidatecompetenciesforstandardizationofpublichealthnursingpracticeandpopulationhealthengagementinaformalclinicalevaluationtool.
• RevisetheClinicalEvaluationTooltoincludecompetenciesreflectedexplicitlyinGlobalHealthCompetencies.
INCONCLUSION
Preparingnursestoassumerobustrolesinpopulationhealthrequires:• Increasingawarenessanduseofpublichealthnursingcompetenciestostandardizepractice,
education,andimprovemeasurementofpopulationhealthcareoutcomes.
• Revisingthe2011QuadCouncilPublicHealthNursingcompetencies.
• Designingathematicapproachforpopulationandglobalhealthwithinnursingeducation.
• Usingastandardizedclinicalevaluationtooltoaddresscurrentgapsinpractice,education,andresearch.
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