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Population Health for Nurses

B | Community/Public Health Nursing [C/PHN] Competencies

Population Health for NursesB | Community/Public Health Nursing [C/PHN] Competencies

The core competencies of public health nursing are defined as the fundamental knowledge, skills, and attitudes that a person holds that allow for growth and success and guide all public health professionals. The definition and practice of public health nursing were updated in 2013 to address the evolving trends in the U.S. economy as well as the changing landscape of health practices, politics, and society.

According to public health professionals, the key elements of public health nursing practice include a focus on population-based health care needs with attention to many of the social determinants of health (SDOH), a comprehensive and systematic approach to assess populations with an emphasis on preventative strategies, and key interventions at the level of individuals, families, communities, countries, and across the globe.

American Association of Colleges of Nursing

The American Association of Colleges of Nursing (AACN) defines a population as a “discrete group that the nurse and others care for across settings at local, regional, national, and global levels.”

The AACN defines nursing competencies for managing the health of populations at the level of the entry-level nurse as well as for advanced practice nurses, called The Essentials.

American Nurses Association

The American Nurses Association (ANA) has defined the scope and standards for public health nursing. The ANA has published the third edition of its scope and standards for public health nursing, available for purchase at this link.

American Public Health Association

The American Public Health Association defines public health practice and public health nursing in its official statement.

Quad Council Coalition of Public Health Organizations

The Quad Council Coalition of Public Health Organizations was founded in 1988 to provide a united voice for the specialty of public health nursing practice. The coalition represents the joint efforts of the Alliance of Nurses for Healthy Environments (AHNE), the Association of Community Health Nursing Educators (ACHNE), the Association of Public Health Nurses (APHN), and the American Public Health Association – Public Health Nursing Section (APHA-PHN).

A thorough description of the Quad Council Coalition competencies is available at Quad Council Coalition Competency Review Task Force (2018) Community/Public Health Nursing Competencies.

These competencies are defined as the combination of observable and measurable knowledge, skills, abilities, and personal attributes that contribute to enhanced employee performance and ultimately result in organizational success. Core competencies are detailed in three tiers.

  • Tier 1 competencies are those performed by the generalist public health nurse.
  • Tier 2 competencies apply to public health nurses involved in management activities.
  • Tier 3 competencies apply to public health nurses in executive or senior management roles.

The core competencies are described by the Quad Council within the following eight domains:

  1. Assessment and analytic skills
  2. Policy development/program planning skills
  3. Communication skills
  4. Cultural competency skills
  5. Community dimensions of practice skills
  6. Public health sciences skills
  7. Financial planning
  8. Evaluation and management skills
  9. Leadership and systems thinking skills

For example, assessment and analytic skills are included as competencies in domain 1 for the entry-level public nurse and include the following:

1A1: Assessing the health status and health literacy of individuals and families, including determinants of health, using multiple sources of data.

1A2a: Use of an ecological perspective and epidemiological data to identify health risks for a population.

1A2b. Identifying individual and family assets, needs, values, beliefs, resources and relevant environmental factors.

1A3. Selecting variables that measure health and public health conditions.

1A4. Using a data collection plan that incorporates valid and reliable methods and instruments for collection of qualitative and quantitative data to inform the service for individuals, families, and a community.

1A5. Interpreting valid and reliable data that impacts the health of individuals, families, and communities to make comparisons that are understandable to all who were involved in the assessment process.

The Council on Linkages between Academia and Public Health Practice

The Council on Linkages between Academia and Public Health Practice is a collaborative formed by 24 national organizations, including the American Nursing Association (ANA). This council developed core competencies for public health professionals in 2021. The core competencies were developed in eight domains that include specific responsibilities at three levels: front line, program management, and senior management. Complete mapping of these competencies is available at this link. The eight domains are as follows:

  1. Data Analytics and Assessment Skills
  2. Policy Development and Program Planning Skills
  3. Communication Skills
  4. Health Equity Skills
  5. Community Partnership Skills
  6. Public Health Sciences Skills
  7. Management and Finance Skills
  8. Leadership and Systems Thinking Skills

For public health nurses seeking to build their competencies through graduate education with a master’s degree, this link provides important considerations regarding the roles and competencies of the public health practitioner, a public health physician, and a public health nurse.

Community-Based Participatory Research: In order to engage and collaborate with communities, specific competencies include the following (adapted from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9219558/):

  1. Involving community partners as members of the research team when identifying the research problem
    • For example, public health nurses may request discussion of a health concern at a city chamber of commerce meeting.
  2. Collaborating with the community during the creation of a study design as well as implementation to ensure accordance with local values and challenges
    • When planning to assess a community, respected local leaders in the community can provide clarity in how to best access individuals, families, and sub-communities.
  3. Building upon strengths and challenges in the community to help build capacity within the community as well the opportunities for the researcher
    • This competency may involve identifying and accessing current community organizations in order to build a coalition.
  4. The researchers and community partners convening to plan how a community-based health initiative will be disseminated and communicated to relevant audiences within the community served
    • While flyers in local restaurants may be helpful, some communities may be better accessed through local television or a particular form of social media.
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