Community Health Nurses of Canada Integrating Public Health Nursing Competencies into Practice March 2011 Developed for the Community Health Nurses of Canada By Innovative Solutions Health Plus

Funding for this publication was provided by the Public Health Agency of Canada. The opinions expressed in this publication are those of the authors and do not necessarily reflect the official views of the Public Health Agency of Canada.

This slide show is designed to showcase the Community Health Nurses of Canada (CHNC) Public Health Nursing Discipline Specific Competencies and to highlight the advantages of integrating competencies into individual practice and organizational systems.

At the completion of the presentation, participants will: have an increased awareness of the benefits of integrating competencies into individual and organizational practice. have an opportunity to review the 8 categories of the public health discipline specific competencies. have the opportunity to improve their understanding of the competencies through the use of examples and probing questions that encourage reflection and discussion. Presentation Objectives:

Standards & Competencies Standards: Standards define the scope and depth of practice by establishing criteria for acceptable nursing practice (adapted from CNA and CHNC Standards of Practice). Competencies: Competencies define the integrated knowledge, skills, and attributes of the practitioner required to achieve the standards and inform the roles and activities of individual practitioners and organizations.

This presentation is focused on the Public Health Nursing Discipline Specific Competencies, Version 1.0.

What are Competencies? Competencies… describe the skills, attributes and knowledge required to perform specific activities and to practice safely and ethically. are broad in scope and apply in multiple settings. can be used to develop position descriptions and performance appraisal tools.

What Are the Benefits of Integrating Competencies at the Individual Level? Competencies… provide a solid foundation for job descriptions and interview questions. support the development and implementation of performance evaluation tools. link the practitioner’s role to the mission of the organization and assist them to plan and manage their career paths. allow both managers and employees to identify gaps and staff development/training needs.

What Are the Benefits of Integrating Competencies At the Organizational Level? Competencies…. can be used to identify the appropriate number and mix of practitioners in a given setting. support the development and implementation of frameworks for evaluation and quality assurance. provide rationale for securing funds to support workforce development. improve organizational performance.

The following slides provide a brief overview of the Public Health Nursing Discipline Specific Competencies. Public Health Nursing Competencies… Image obtained from Santa Cruz County Health Services Agency

There are 66 public health nursing discipline specific competencies divided into eight (8) categories: 1.Public Health and Nursing Sciences 2.Assessment and Analysis 3.Policy and Program Planning, Implementation and Evaluation 4.Partnerships, Collaboration and Advocacy 5.Diversity and Inclusiveness 6.Communication 7.Leadership 8.Professional Responsibility and Accountability Public Health Nursing Competencies

1. Public Health and Nursing Sciences Competency in this category requires the ability to apply knowledge in practice. This category has 7 competencies.

Example: PH and Nursing Science Competency 1.4 A public health nurse is able to critically appraise knowledge gathered from a variety of sources. Practice Example: Evidence from a recent research study results in the need to change current practice related to pain management techniques for administering immunization.

2. Assessment and Analysis These competencies are required to make evidence-based decisions, prepare budgets and reports, conduct investigations and make recommendations for policy and program development. This category has 9 competency statements.

Example: Assessment and Analysis Competency 2.2 Identify relevant and appropriate sources of information, including community assets and resources. Practice Example: After visiting a couple of families in the Weston community and learning that they were not able to access the food bank in their neighboring community because of limited access to public transportation, the public health nurse brought together a group of community leaders to explore the feasibility of advocating for increased public transportation to the community or establishing a community based food bank.

3. Policy and Program Planning, Implementation and Evaluation This category describes the core competencies needed to effectively choose options, and to plan, implement and evaluate policies and/or programs in public health. This category has 27 competencies and is divided into the following areas: 3(A) - Policy Development (8 competencies) 3(B) - Program Planning (3 competencies) 3(C) - Implementation And Intervention (11 competencies) 3(D) – Evaluation (5 competencies)

Example: 3 A) Policy Development Competency 3(A).1 Support community action to influence policy change. Practice Example A public health nurse provides current evidence and works with the school health committee to influence change through the adoption of a school policy to remove soda pop drinks from the school’s vending machines.

Example: 3 B) Program Planning Competency 3(B).3 Develop a plan in collaboration with individuals, families groups and communities to implement a course of action that is responsive to needs taking into account relevant evidence, legislation, emergency planning procedures, regulations and policies. Practice Example: The public health nurse works with local emergency measures team and community stakeholders to develop a community evacuation plan in the event of environmental threats such as a forest fire or flood.

Example: 3 C) Implementation and Intervention Competency 3(C).4 Participate in collaborative, interdisciplinary and intersectoral partnerships to enhance the health of individuals, families, groups, communities and populations. Practice Example The public health nurse participates as an active member on a community advisory committee to enhance community safety.

Example: 3 D) Evaluation Competency 3(D).1 Evaluate and action, policy or program in a systematic and continuous manner by measuring its effect on individuals, families, groups or communities. Practice Example For example, the public health nurse worked with key stakeholders in the community to evaluate the implementation of a smoke-free workplace program at a local grocery store.

4. Partnerships, Collaboration and Advocacy This category captures the competencies required to influence and work with others to improve the health and well being of the public through the pursuit of a common goal. This category has 5 competency statements and includes the concepts of: social justice, partnership and collaboration and advocacy.

Example: Partnership, Collaboration and Advocacy Competency 4.2 Use skills such as team building, negotiation, conflict management and group facilitation to build partnerships. Practice Example The public health nurse uses her negotiation and conflict resolutions skills to facilitate a discussion between two co-workers who have different approaches in working with the same family.

5. Diversity and Inclusiveness This category identifies the competencies required to interact effectively with diverse individuals, families, groups and communities in relation to others in society as well to recognize the root causes of disparities and what can be done to eliminate them. This category has 3 competency statements.

Example: Diversity and Inclusiveness Competency 5.2 Address population diversity when planning, implementing, adapting and evaluating public health programs and policies. Practice Example The public health nurse engages in outreach activities to locate and immunize hard to reach vulnerable populations.

6. Communication Communication involves an interchange of ideas, opinions and information and includes written, verbal, non-verbal and listening skills. It also includes: computer literacy; providing appropriate information; working with the media and social marketing. This category has 3 competency statements.

Example: Communication Competency 6.2 Interpret information for professional, non-professional and community audiences. Practice Example The public health nurse develops an immunization fact sheet written in plain language that includes pictures for people for whom English is a second language.

7. Leadership This category focuses on leadership competencies that build capacity, improve performance and enhance the quality of the working environment. This category has 6 competency statements.

Example: Leadership Competency 7.2 Contribute to developing key values and a shared vision to assess, plan and implement public health programs and policies in the community by actively working with health professionals and in partnership with community partners to build capacity. Practice Example The public health nurse invites and supports community members and their adolescent children to develop a committee to lobby for smoke free grounds at a local community center.

8. Professional Responsibility and Accountability This category focuses on a number of dimensions including the recognition that nurses are accountable for their actions and are responsible for making sure they have the required knowledge and skills needed to ensure the delivery of safe, compassionate, competent and ethical care. This category has 7 competencies.

Example: Responsibility and Accountability Competency 8.3 Consult as needed to determine the best course of action in response to ethical dilemmas, safety issues, risks to human rights and freedoms, new situations and new knowledge. Practice Example: A client discloses, to the public health nurse, that she is being intimidated by her landlord who is threatening to report her to social assistance because her partner is secretly living with her.

In summary: Discipline specific competencies define the integrated knowledge, skills, and attributes required to practice as a public health nurse in Canada.

A copy of the discipline specific competencies for Public Health nurses can be found on the CHNC website at:

Sources of information: Community Health Nurses of Canada (2009). Public Health Nursing Discipline Specific Competencies Version 1.0. Retrieved from Canadian Nurses Association (no date). Standards and best practices. retrieved from aiic.ca/CNA/practice/standards/default_e.aspxhttp:// aiic.ca/CNA/practice/standards/default_e.aspx Community Health Nurses of Canada (2011). Canadian community health nursing standards of practice. Available from Ontario Public Health Association. Core Competencies for Public Health in Canada – Orientation Module. Retrieved from Public Health Agency of Canada (2008). Core Competencies for Public Health in Canada: Release 1.0. Retrieved from aspc.gc.ca/ccph-cesp/stmts-enon-eng.phphttp:// aspc.gc.ca/ccph-cesp/stmts-enon-eng.php