1. Enhancing the Environmental Health Content in Community Health Nursing Sharon Burt, RN, PHN, DNSc Nancy Sweeney, RN, PHN, DNSc

2. This project was funded by a grant from the Association of Schools of Public Health under a cooperative agreement with the Health Resources and Services Administration Grant #H094-04104

3. Description of SDSU’s Nursing Program Part of the College of Health and Human Services along with the Graduate School of Public Health Community Health Nursing is a 6 unit course offered every semester to about 50 traditional and RN to BS students. Content in that course is carefully planned to meet the requirements for PHN certification. The course is comprised of 3 hours of lecture and 9 hours of clinical each week. Clinical is in groups of 10 students to 1 faculty member.

4. Traditional Community Health Nursing Course Content heavy in public health nursing with additional information about occupational health nursing, home health nursing, school nursing and epidemiology. Written assignments included a Family Analysis, a Community Assessment with presentation to the class, and a Teaching Project.

5. SDSU Proposal Included: Environmental content to be incorporated in the Community Health Nursing class Increased lecture content regarding environmental issues Clinical experience in environmental health area  Environmental health risk appraisal form developed to be included in family analysis

6. Project Objectives for the Grant Public Health and Nursing faculty revise the course to include substantial environmental health content including an understanding of the statutory mandates of environmental health agencies. The course is revised to include environmental health field experiences for all nursing students. Nursing faculty knowledge of environmental health is enhanced.

7. Achieving the Objectives Nursing faculty member enrolls in a graduate level environmental health course. Nursing faculty revise the course content with assistance from the Public Health Faculty. More modules are added to the course thus necessitating some of the former live class sessions to be converted to online modules.

8. Achieving the Objectives Public health faculty make initial contacts with environmental health professionals throughout the County seeking field placements. Nursing faculty plan and implement the placing of 54 nursing students in environmental health field placements. Nursing faculty author the Environmental Health Risk Appraisal Instrument which is then included in the Family Analysis assignment.

9. Achieving the Objectives Nursing faculty alter the Community Assessment to enhance environmental health concerns. The Community Assessment assignment is converted from a term paper format to a poster presentation. Evaluation data about the E.H. field placements is collected from students and environmental health preceptors.

10. The Details…. Blackboard software was used to create a web site for the course. Course materials placed there. Class schedule included a “map” of content to be presented live versus content to be learned from the Blackboard modules. Many external links for data collection provided. This year more external links were provided to environmental health web sites.

11. The Details…. Class content we added : 1. An overview of Environmental Health 2. Statutory mandates of E.H. 3. Laws pertaining to E.H. and their evolution 4. Content on air pollution, etc. 5. Guest speakers so that students could meet faculty and staff from the other discipline

12. Details of the New Instrument Environmental Health Risk Appraisal: 1. Gave life to the genogram assignment 2. Conveyed the concept of genetic predisposition 3. Demonstrated applicability of E.H. issues across the spectrum of nursing practice. 4. Enhanced student observational skills. 5. Made environmental health concerns real in student lives. 6. Significantly enriched the Family Analysis.

13. Details of the E.H. Field Placements Difficult to arrange for vast numbers E.H. professionals tend to be in the public sector and terribly underfunded. They have tiny offices thus fitting few students. E.H. professionals eager to educate new nurses about their discipline. E.H. professionals eager to lecture in class

14. More Details for Field Placements Look for placements at the big agencies first: 1. EPA, FDA, Air & Water Quality Control 2. County Environmental Health 3. E.H. professionals at your college and other local institutions 4. Private companies doing inspections

15. Class surveys regarding Environmental Health

16. Recommendations Add E.H. content to all Community Health Nursing courses. Make E.H. CEUs available to practicing RNs Permanent strong relationships among SONs, Schools of Public Health, and E.H. professionals

17. For more information: Dr. Sharon Burt: sburt@mail.sdsu.edusburt@mail.sdsu.edu Dr. Nancy Sweeney: nsweeney@mail.sdsu.edu nsweeney@mail.sdsu.edu