1. Copyright © 2008 Delmar. All rights reserved. Chapter 2 Core Functions of Public Health Nursing

2. Copyright © 2008 Delmar. All rights reserved. 2 Public Health Institute of Medicine (IOM) Report –The Future of Public Health –Committee recommendations Mission of public health Government role Responsibilities of government Elements required to implement the above

3. Copyright © 2008 Delmar. All rights reserved. 3 Ecological Model of Health Ecological model of health involves various domains –Physical –Biological –Socioenvironmental –Behavioral

4. Copyright © 2008 Delmar. All rights reserved. 4 Core Functions of Public Health Assessment –Collect and analyze unbiased information on the community Policy development –Support health promotion and protection Assurance –Enforce laws that support health and safety

5. Copyright © 2008 Delmar. All rights reserved. 5 Federal Health Obligations Support dissemination of data Establish national health objectives Provide state assistance Allocation of funds to states Ensure services are in the public interest

6. Copyright © 2008 Delmar. All rights reserved. 6 IOM State Level Recommendations State level core responsibilities –Assessment based on statewide data –Adequate base for health activities –Statewide health objectives –Provision of necessary services –Guarantee of essential services –Support of local services through subsidies

7. Copyright © 2008 Delmar. All rights reserved. 7 IOM Local Level Recommendations Five types of local public health agencies (LPHA) 1.County based 2.Town/township 3.City/municipal 4.Multi/county/district/regional 5.City-county

8. Copyright © 2008 Delmar. All rights reserved. 8 Recommendations Role of local public health agency recommendations –Assessment of local health problems –Policy development –High quality services accessible by all

9. Copyright © 2008 Delmar. All rights reserved. 9 Recommendations Health services pyramid –Population-based public health services –Primary health care –Secondary health care –Tertiary health care

10. Copyright © 2008 Delmar. All rights reserved. 10 Public Health in America Functions Steering Committee Essential Service Document (1994) –Blueprint for local, state, national health goals –Mission is to promote physical/mental health, prevent disease, injury and disability –Envisions linkage of public health systems to meet goals

11. Copyright © 2008 Delmar. All rights reserved. 11 CDC Model of Public Health System Social connections that form a community web

12. Copyright © 2008 Delmar. All rights reserved. 12 CDC Model of Public Health System System includes private, public, and voluntary Community collaboration to ensure public health

13. Copyright © 2008 Delmar. All rights reserved. 13 Turning Point Initiative Funded by Robert Wood Johnson and Kellogg Foundations Offers funding and assistance to promote system change by promoting partnerships Based on idea that everyone has a stake in public health

14. Copyright © 2008 Delmar. All rights reserved. 14 Turning Point Initiative Network of 23 public health partners Brought health conscious people and organizations together State Turning Point partners Formed five national excellence collaboratives

15. Copyright © 2008 Delmar. All rights reserved. 15 Other Collaborative Efforts Community Based Participatory Research (CBPR) –Replace community mistrust and include organizations and populations as partners –Resource sharing and develop incentives –Increase partner knowledge of CBPR process

16. Copyright © 2008 Delmar. All rights reserved. 16 Other Collaborative Efforts Healthy Cities Model for Health Promotion

17. Copyright © 2008 Delmar. All rights reserved. 17 Eight Domains of Core Competencies 1.Analysis and assessment 2.Policy development and program planning 3.Communication 4.Cultural competency 5.Community dimensions of practice 6.Basic public health sciences 7.Financial planning and management 8.Leadership and systems thinking

18. Copyright © 2008 Delmar. All rights reserved. 18 Public Health Nursing Competencies Quad Council determined how public health nursing would apply the core competencies

19. Copyright © 2008 Delmar. All rights reserved. 19 Public Health Nursing Competencies Public health nurse practice standard is integrated with: –Definition of public health nursing –Scope and standards –Core competencies of public health

20. Copyright © 2008 Delmar. All rights reserved. 20 Levels of Competency Generalist –Entry level Baccalaureate prepared nurse Awareness Knowledge Proficiency –Specialist Masters prepared nurse

21. Copyright © 2008 Delmar. All rights reserved. 21 Levels of Competency Tenets of public health nursing –Based on population focused public health nursing practice (See box 2-7) Minnesota wheel –Public Health Interventions Cornerstones of public health nursing practice (See box 2-8)

22. Copyright © 2008 Delmar. All rights reserved. 22 Policy Development Incorporates public health services –Directs day-to-day activities Advocates –Educates people about health issues

23. Copyright © 2008 Delmar. All rights reserved. 23 Policy Development To promote health and protection the nurse must: –Mobilize community partnerships –Develop policies that support, promote, and protect health

24. Copyright © 2008 Delmar. All rights reserved. 24 Assurance Involves four essential public health services –Enforcement of laws and regulations –Immunizations –Assurance of competent public health workers –Evaluates

25. Copyright © 2008 Delmar. All rights reserved. 25 Evaluation and Partnership National Public Health Performance Standards Program –Promotes and evaluates public health system quality at state and local level –Uses specific state and local instruments to assess performance

26. Copyright © 2008 Delmar. All rights reserved. 26 Challenges Advancement of public health Progress in the infrastructure –Information/communication –Capacity Workforce capacity Activities to reduce nursing shortage (See box 2-11) –Organizational/systems capacity