NURS 3100 Cultural Competency & Nursing Informatics
NURS 3100 Cultural Competency & Nursing Informatics
Apart from the population that is aging, there is a steady transformation towards bioinformatics. This is another trend in nursing whereby there is dependence on bioinformatic due to the changing technology. For instance the use of technology when it comes to recording medical information for accuracy and accessibility. This challenges most of the nurses because some may lack knowledge in technology. Additionally, the shortage of nurses is also a current issue because of lack of degrees and programmes that are advanced. This is an issue as it affects the patient especially when errors are made. The outcomes of the patients have also been affected by the introduction of evidence-based practices in the nursing profession. This encompasses the positive outcomes that promote the sense of ownership by nurses (Linda, Geraldine, & Katherine, 2012). NURS 3100 Cultural Competency & Nursing Informatics
Nursing is always changing—sometimes quickly, sometimes slowly. It’s helpful to step back once in a while and look at of some of the biggest developments in the field to know what’s ahead so you can be prepared to face new challenges and continue to thrive in your nursing career.
More Outpatient Care
Outpatient care is in demand due to a number of factors, including pressure to keep down costs and more effective technologies and treatments that have eliminated the need for overnight hospital stays. Financial constraints, such as high insurance deductibles, have also caused many patients to put off elective procedures. However, these patients often still require extensive medical attention, hence the need for more outpatient facilities and care. Nurses will also find opportunities in outpatient settings such as ambulatory care clinics, rehabilitation centers, and clinics attached to assisted-living facilities, and even telehealth providers. NURS 3100 Cultural Competency & Nursing Informatics
The Importance of Cultural Competency
At its core, health care is about people, and different people have different needs. That has never been more true in the U.S. health care system than today, when nurses are helping individuals, families, and groups from ever more diverse backgrounds. Nurses who are who are sensitive to the cultural habits, traditions, and beliefs of their patients will be able to provide care that takes these into account. For example, some patients may speak English as a second language, affecting their understanding of directions or medical terminology; patients from certain religions may have dietary restrictions; and some individuals come from cultures where they fare best when they are surrounded by family rather than isolated in a hospital room. NURS 3100 Cultural Competency & Nursing Informatics.
Preventive Health
Wellness continues to be a growing issue in health care, especially as organizations move to keep costs down as they improve outcomes. Patients are becoming savvier about maintaining their own wellness, from modifying their diets to wearing trackers that measure their activity levels. Nurses can help by focusing on measures to prevent chronic illnesses such as diabetes, slow down or mitigate the effects of aging on the body via exercise, and improve overall wellness—as well as by educating patients about what further steps they can take on their own to improve their health.
NURS 3100 Cultural Competency & Nursing Informatics
Increasing Consumer Sophistication
Patients are also extremely knowledgeable about where to turn for health information, often doing their own research on the Internet. Consequently, patients may come to appointments with their own possible diagnoses and suggested treatments and medications. Such awareness can be as potentially harmful as it is helpful, forcing nurses to sort through possibly flawed information and incorrect assumptions as they perform health assessments.
The Rise of Nurse Informatics
As technology produces more data, supports better record keeping, and allows for detailed analysis, health informatics has become increasingly important in health care. Similarly, nurse informatics can support evidence-based nursing practice and improved patient care through better data collection, information analysis, easier and faster collaboration between health care professionals, and identification of both large- and small-scale health and patient trends. As they are situated on the front lines of patient care, nurse informaticists are especially suited for playing a greater role in health care planning and decision-making. NURS 3100 Cultural Competency & Nursing Informatics
Nurses with higher education levels are better prepared to meet the fast-moving and frequently challenging nature of health care today. The online RN to Bachelor of Science in Nursing and online Master of Science in Nursing at the University of Saint Mary provide you with the nursing knowledge and critical-thinking skills required to succeed in today’s nursing environment. To find out more, request more information or call us at 877-307-4915 to speak to an admissions advisor.
The nursing profession continues to evolve and progress at a meteoric pace. The current trends in nursing and care are multifactorial including: the increase in the aging population, a transition to informatics, a nursing shortage, and an overarching emphasis on specific frameworks for the guiding of nursing practice, including integration of evidence based practice. It is estimated that 26% of the United States (U.S.) population are “Baby Boomers” [1]. As the “Baby Boomer” population ages, so does the increase in aging adults with complex health issues. Nurses today must be more adept than ever at caring for the aging adult while the healthcare environment struggles to accommodate this rapidly increasing population.
In addition to an increasing aging population, another trend is the increase reliance on informatics. The incorporation of technology into the healthcare arena may be a challenge for many nurses. The inclusion of the digital medical record has assisted facilities in providing for a more streamlined, accessible, and accurate health history. There also continues to be variation among facilities in the initiation of informatics leading to a lack of consistency from facility to facility. However, it is important to recognize that not all nursing professionals possess the necessary computer literacy skills needed for proficiency in understanding and utilizing informatics, especially those nurses that have been in the nursing profession for quite some time. This leads to consideration of the fact that many nurses are retiring without the numbers to replace them. NURS 3100 Cultural Competency & Nursing Informatics.
The current nursing shortage is impacted by the high number of nurses that are of retirement age coupled with the lower number of new nursing graduates. Contributing to the nursing shortage is the current nurse faculty shortage. A shortage in those nurses with advanced degrees and the ability or willingness to enter academia affects the ability of institutions of higher learning to educate more nursing students. In 2010, nursing schools denied admission to over 75,000 potential students due to a lack of adequate nursing faculty [2], without new graduates to replace retiring nurses, the burden of providing patient-centered care rests on the shoulders of those left at the bed-side. A nursing shortage then contributes to nurse fatigue and burnout, the potential for medical errors and compromised patient safety, and poor patient outcomes.
In terms of patient outcomes, the nursing profession has seen an increased emphasis on integration of evidence-based practice. The incorporation of best practices into nursing care has contributed to the individual nurse claiming more ownership in the achievement of positive health outcomes for patients. Nurses are now responsible for being a direct line in the conducting, reporting, and implementation of research. Most importantly, this responsibility has led to a paradigm shift in the way nursing is viewed. No longer is nursing viewed as task oriented discipline content on taking orders within the medical hierarchy. Nursing can now be considered a science; contributing to the research and discovery of new and innovative approaches to improving health outcomes.
As nursing continues to evolve, so does the current healthcare environment. Affected by a multitude of factors, nursing will forever be in a constant state of flux. Trends can be both negative and positive. Whether it is the changing face of the populations for which nursing cares for, a rapidly changing technological environment, nurse/faculty shortages, or an emphasis on evidence based research, nursing is up to the challenge and will forge ahead with vigor and accountability.NURS 3100 Issues & Trends in Nursing Assignment Paper
The paper aims at identifying one current nursing trend or issue that has had an impact on healthcare. The issue I intend to discuss is the implementation of evidence-based practices in the nursing profession. Evidence-based practices have enables the patients to have more positive results when receiving health care.
NURS 3100 Cultural Competency & Nursing Informatics
Background of the current trend or issue
According to Stevens (2013), implementing evidence-based practice (EBP) has had a huge impact on nursing as a profession. EBP has ensured that knowledge is applied in healthcare so that there can be improved outcomes for the patients. EBP is described as the integration of evidence that is dependent on research from the clinical expertise that ensures that the values of the patients are upheld. Through EBP, the preferences of the patients are included in healthcare. The definition of EBP touches on the clinician’s experience so that more knowledge is impacted in healthcare.
The process of EBP entails application of what has been researched in nursing as well as healthcare. This element ensures that advanced forms of evidence are obtained. The healthcare system is able to create new roles as well as teams. Shojania and Grimshaw (2005) affirm that EBP leads to other fields of sciences that help in building more evidenced-practices.NURS 3100 Issues & Trends in Nursing Assignment Paper
The introduction of EBP into the nursing arena has brought a major shift thus considered as a current trend or issue. The shift was seen in how nurses approach research in a bid to change healthcare in general. They have contributed significantly in discovering new approaches that help in creating positive results for the patients. Nurses have become owners of their individual achievements as they are more involved in implementing, reporting and conducting various aspects in healthcare.
National experts have called for other recommendations that will transform healthcare. Through this, more nurses have directed their efforts towards initiatives that make them more valuable such as engaging in research developing models and theories and adopting various practices.
Impact of EBP
EBP has affected the nursing practice as well as education and research. For successful implementation of EBP, healthcare professionals and nurses need to ensure the adoption of policy makers and providers of individual care. The policy makers include state, federal, local and other regulatory bodies.
After its introduction, nurses have revealed a positive attitude towards EBP because of the desire to acquire more skills and knowledge about healthcare. Nurses have continuously led inter-professional teams so that the systems of delivery may be competent and with EBP, they have been able to change healthcare. The competencies they consider ensure appropriate use of their knowledge in making clinical decisions. Thus research on EBP mainly provides the evidence of various interventions to other providers. The main competencies for professions in healthcare include the following:NURS 3100 Issues & Trends in Nursing Assignment Paper
Provision of care that is centered on patients-The differences, needs and preferences of the patients should be identified. This will help the professional to communicate effectively with the patient as well as their families.
Utilizing interdisciplinary groups-Working in teams is helpful when it comes to integrated care since it ensures continuity and reliability.
Use of evidence-based practice-The values of the patients should be considered thus use of the appropriate research that can be integrated into practice.
Use of informatics-This entails using technology to gather information and knowledge. Improvement of quality-Medical errors should be noted from time to time so that safety principles become applicable such as simplification and standardization.
EBP has helped in minimizing the issues of safety of the patients. However, there are certain challenges that are experienced when it comes to its implementation into nursing practice. First and foremost, a complex plan for implementation is required before the full adoption of evidence-based practice. Although a policy of agency can be set, sustaining it may bring more challenges.
Recommendations for managing evidence-based practice in nursing There are various models that were developed earlier when EBP was first introduced. The models were created by nursing scientists so that the different aspects regarding EBP could be understood. Also, the models are crucial in designing the approach towards making decisions when it comes to evidence-based practices. There are forty-seven EBP models that are prominent.
One important aspect is the Ace Star Model of Knowledge Transformation. According to Stevens (2004), the model was established to provide an easier approach for evidence to be translated into practice. This encompasses comprehending how EBP is transformed into nursing. NURS 3100 Cultural Competency & Nursing Informatics.
PHN I Under close supervision, to provide public health nursing services including the prevention and control of diseases, health education, and the promotion of health awareness; and to do related work as required.
PHN II Under supervision, to plan and conduct a variety of public health nursing clinics and services; to provide nursing services, health education, and health consulting services, including the prevention and control of diseases and the promotion of health awareness; and to do related work as required.
PHN III Under direction, to provide lead direction and work coordination for other professional nursing and support staff; to plan and conduct a variety of public health nursing clinics and services; to provide complex, specialized, and general nursing, health education, and health consulting services, including the prevention and control of diseases and the promotion of health awareness; and to do related work as required.
PHN IV Under general direction, to provide the most complex, specialized, and general nursing, health education, and health consulting services, including the prevention and control of diseases and the promotion of health awareness; to provide lead direction and work coordination for other professional nursing and support staff; to plan and conduct a variety of public health nursing clinics and services; and to do related work as required.
CHN I Under close supervision, to learn to plan and conduct a variety of community health nursing services to promote and preserve the health of the community; to provide nursing services, health education, and health consulting services, including the prevention and control of diseases and the promotion of health awareness; and to do related work as required. NURS 3100 Cultural Competency & Nursing Informatics
CHN II Under supervision, to plan and conduct a variety of community health nursing services; to promote and preserve the health of the community; to provide nursing services, health education, and health consulting services, including the prevention and control of diseases and the promotion of health awareness; and to do related work as required.
CHN III/IV Under direction, to plan and conduct a variety of community health nursing services; promote and preserve the health of the community; to provide complex, specialized and general nursing, health education, and health consulting services, including the prevention and control of diseases and the promotion of health awareness; to provide lead direction and some work coordination for other professional nursing and support staff and to do related work as required.
DISTINGUISHING CHARACTERISTICS
PHN I This is the entry and first working level in the Public Health Nurse class series. Incumbents must have requisite public health nursing certification, but have limited public health nursing work experience. As experience is gained, incumbents learn to perform the full scope of public health nursing duties. This class is distinguished from Public Health Nurse II in that the II’s have responsibility for more independently performing a larger scope of public health nursing duties and activities. When a Public Health Nurse I incumbent becomes familiar with the Department and demonstrates good sustained work performance, they may be promoted to the Public Health Nurse II.
PHN II This is the first journey level in the Public Health Nurse class series. Incumbents perform a wide scope of public health nursing duties. This class is distinguished from the Public Health Nurse I in that incumbents are expected to perform on a more independent basis. It is distinguished from Public Health Nurse III and IV in that Public Health Nurse III and IV incumbents perform more complex, specialized assignments, as well as provide lead direction, work coordination, and training for other professional nursing and support staff. NURS 3100 Cultural Competency & Nursing Informatics
PHN III This is an advanced journey level and a lead class in the Public Health Nurse class series. Incumbents provide the more complex public health nursing services in a specialized public health program, as well as provide lead direction and coordination for other professional nursing staff. This class is distinguished from Public Health Nurse II by assignment of a higher level of public health program responsibilities and the performance of lead responsibilities for other professional nursing staff. It is distinguished from Public Health Nurse IV in that Public Health Nurse IV incumbents perform more complex, specialized assignments. Both levels III and IV may provide lead direction, some work coordination, and training for other professional nursing and support staff.
PHN IV This is the advanced and highest level and a lead class in the Public Health Nurse class series. Incumbents provide the most complex public health nursing services in a specialized public health program, as well as provide lead direction and coordination for other professional nursing staff. This class is distinguished from Public Health Nurse III by assignment of a higher level of public health program responsibilities. Both levels III and IV may provide lead direction, some work coordination, and training for other professional nursing and support staff. NURS 3100 Issues & Trends in Nursing Assignment Paper
CHN I This is the entry and basic working level in the Community Health Nurse class series. Incumbents must have requisite nursing certification, but have limited community health nursing work experience. As experience is gained, incumbents learn to perform the full scope of community health nursing duties. This class is distinguished from Community Health Nurse II in that Community Health II’s have responsibility for more independently performing a larger scope of community health nursing duties and activities. Community Health Nurse II’s are also responsible for special programs such as School Nursing or Immunizations Clinic Coordination. When a Community Health Nurse I incumbent becomes familiar with the Department and demonstrates good sustained work performance, they may be promoted to the Community Health Nurse II. NURS 3100 Cultural Competency & Nursing Informatics
CHN II This is the first journey level in the Community Health Nurse class series. Incumbents perform a wide scope of community health nursing duties as well as have responsibility for special programs, such as School Nursing or Immunizations Clinic Coordination. This class is distinguished from the Community Health Nurse I in that incumbents are expected to perform on a more independent basis. It is distinguished from Public Health Nurse III and IV in that Public Health Nurse III and IV incumbents perform more complex, specialized assignments, as well as provide lead direction, work coordination, and training for other professional nursing and support staff.
CHN III This is an advanced journey level and lead class in the Community Health Nurse class series. Incumbents provide more complex community health nursing services in a specialized public health program, as well as provide lead direction and coordination for other professional nursing staff. Perform a wide scope of community health nursing duties as well as have responsibility for special programs. This class is distinguished from the Community Health Nurse II due to the assignment of a higher level of community health program responsibilities and the performance of lead responsibilities for other professional nursing staff. Both levels III and IV may provide lead direction, some work coordination and training for other professional nursing and support staff.
CHN IV This is the highest of the advanced journey level and lead class in the Community Health Nurse class series. Incumbents provide the most complex community health nursing services in a specialized public health program, as well as provide lead direction and coordination for other professional nursing staff. Performs a wide scope of community health nursing duties as well as have responsibility for special programs. This class is distinguished from the Community Health Nurse III due to the assignment of a higher level of community health program. Both levels III and IV may provide lead direction, some work coordination and training for other professional nursing and support staff.NURS 3100 Issues & Trends in Nursing Assignment Paper
REPORTS TO
PHN I-IV/CHN I-IV Director of Health, Director of Nursing Services, Supervising Public Health Nurse, or designee
CLASSIFICATIONS SUPERVISED
PHN I-II/CHN I-II This is not a supervisory class.
PHN III Provides lead direction and may provide work coordination for Public Health Nurse I, II.
PHN IV Provides lead direction and may provide work coordination for Public Health Nurse I, II, III.
CHN III/IV Provide lead direction and may provide work coordination for Community Health Nurse I/II.
TYPICAL PHYSICAL REQUIREMENTS
PHN I-IV/CHN I-IV Sit and stand for extended periods; normal manual dexterity and eye-hand coordination; lift and move objects weighing up to 50 lbs.; corrected hearing and vision to normal range; verbal communication; use of medical and office equipment, including computer, telephone, calculator, copiers, and FAX. NURS 3100 Cultural Competency & Nursing Informatics
TYPICAL WORKING CONDITIONS
PHN I-IV/CHN I-IV Work is performed in clinical, office, and home environments; exposure to communicable diseases and blood borne pathogens; continuous contact with other staff and the public. Incumbents are expected to follow universal precautions. Incumbents may be required to drive to remote areas of the County in all weather conditions Examples Of Essential Duties: (The following is used as a partial description and is not restrictive as to duties required.)
PHN I Learns to plan, organize, and provide public health nursing services, health instruction and counseling, and guidance for individuals, families, and groups regarding disease control, health awareness, health maintenance, and rehabilitation in a clinic setting May learn the procedures and policies and work within a special program such as California Children Services Provides referrals Teaches and demonstrates health practices to individuals and groups Learns to instruct clients in family planning, sexually transmitted disease prevention and follow-up, and immunization procedures Learns to identify individual and family problems which are detrimental to good health Works with families to alleviate health problems and promote good health habits Learns to refer and coordinate care of individuals and families with other public and private agencies Learns to identify special health needs for assigned cases, recommending and implementing services to meet needs Assists individuals and families with implementing Physician recommendations Learns to plan, direct, and perform epidemiological investigations in homes, schools, community, and public health clinicsNURS 3100 Cultural Competency & Nursing Informatics. Prepares appropriate health records and arranges follow-up services, based on findings Confers with physicians, nursing staff, and other personnel regarding public health programs, patient reports, evaluations, medical tests, and related items May work with community groups in identifying and developing public health services and improving existing public health services Prepares reports and documents health findings; Compiles statistical information for appraisal and planning purposes. Other duties as assigned.
PHN II Plans, organizes and provides public health nursing services, health instruction, counseling, and guidance for individuals, families, and groups regarding disease control, health awareness, health maintenance, and rehabilitation in a clinic setting; May work within a special program such as Maternal and Child Care, Community Health, or California Children Services identifying and interacting with local care providers; Develops plans and direct resources consistent to programs goals and objectives; provides referrals; teaches and demonstrates health practices to individuals and groups; Instructs clients in family planning, sexually transmitted disease prevention and follow-up, and immunization procedures; Identifies individual and family problems which are detrimental to good health; May make home visits to assess individual’s progress; Works with the families to alleviate health problems and promote good health habits; refers and coordinates the care of individuals and families with other public and private agencies; Identifies special health needs for assigned cases, recommending and implementing services to meet those needs; Assists individuals and families with implementing physician recommendations; May plan, direct, and perform epidemiological investigations in homes, schools, the community, and public health clinics; Prepares appropriate records and case documentation, arranging follow-up services based on findings; Confers with physicians, nursing staff, and other staff regarding public health programs, patient reports, evaluations, medical tests, and related items; may consult in multidisciplinary teams for the purpose of creating a plan of service for “at risk” families; Works with community groups in identifying public health needs, developing needed public health services, and improving existing public health services; Prepares reports and maintains records; Compiles statistical information for appraisal and planning purposes. Other duties as assigned. NURS 3100 Cultural Competency & Nursing Informatics.
PHN III Investigates outbreaks of communicable diseases; plans and implements programs for the prevention and control of communicable disease, including tuberculosis, sexually transmitted diseases, and AIDS; Develops procedures to control the spread of communicable diseases and identify people needing public health services; Provides interpretations of public health laws and regulations for others; Assesses individuals and families, using health histories, observations of physical condition, and a variety of evaluative methods to identify health problems, health deficiencies, and health service needs; Identifies psycho/social, cultural background, and environmental factors which may hinder health care services; Assists with determining funding needs for the program; Monitors budget expenditures; Plans and coordinates services for special programs such as perinatal, maternal, child and adolescent (MCAH), or family planning; Performs public health nursing activities to promote perinatal, child, and adolescent health; Provides local case management and coordination for State mandated programs; Participates in programs to enhance school children health; Works with community groups to identify needs, develop and facilitate a variety of health services, and improve existing programs; Refers individuals and families to appropriate agencies and clinics for health services; Participates in programs to enhance community health services and education; attends conferences and workshops related to community health issues; Assists with the preparation of program and service policies and procedures; May supervise paraprofessional staff and volunteers; prepares reports and maintains records; Complies statistical information for appraisal and planning purposes; Performs a wide scope of complex professional public health nursing services; Provides lead direction, training and work coordination for other professional nurses. Other duties as assigned. NURS 3100 Cultural Competency & Nursing Informatics.
PHN IV Investigates outbreaks of communicable diseases; plans and implements programs for the prevention and control of communicable disease, including tuberculosis, sexually transmitted diseases, and AIDS; Develops procedures to control the spread of communicable diseases and identify people needing public health services; Provides interpretations of public health laws and regulations for others; Assesses individuals and families, using health histories, observations of physical condition, and a variety of evaluative methods to identify health problems, health deficiencies, and health service needs; Identifies psycho/social, cultural background, and environmental factors which may hinder health care services; Assists with determining funding needs for the program; Monitors budget expenditures; Plans and coordinates services for special programs such as perinatal, maternal, child and adolescent (MCAH), or family planning; Performs public health nursing activities to promote perinatal, child, and adolescent health; Provides local case management and coordination for State mandated programs; Participates in programs to enhance school children health; Works with community groups to identify needs, develop and facilitate a variety of health services, and improve existing programs; Refers individuals and families to appropriate agencies and clinics for health services; Participates in programs to enhance community health services and education; attends conferences and workshops related to community health issues; Assists with the preparation of program and service policies and procedures; May supervise paraprofessional staff and volunteers; prepares reports and maintains records; Complies statistical information for appraisal and planning purposes; Performs a wide scope of complex professional public health nursing services; Provides lead direction, training and work coordination for other professional nurses. Other duties as assigned.
CHN I Learns to plan, organize and provide community health nursing services, health instruction, counseling, and guidance for individuals, families, and groups regarding prevention of illness, disease control, health awareness, health maintenance, and rehabilitation; Identifies and interacts with local community care resources and/or local school districts in providing mandated health screening for children; Learns to develop plans and direct resources consistent with program goals and objectives; provides referrals; Teaches and demonstrates health practices to individuals and groups; Instructs clients in sexually transmitted disease prevention and follow-up, and immunization procedures; Identifies individual and family problems which are detrimental to good health; May make home visits to assess individual’s progress; works with the families to alleviate health problems and promote good health habits; Refers and coordinates the care of individuals and families with other public and private agencies; Learns to identify special health needs for assigned cases, recommending and implementing services to meet those needs; may perform investigations in homes, schools, and the community; Prepares appropriate records and case documentation, arranging follow-up services based on findings; confers with physicians, nursing staff, and other staff regarding community health programs, patient reports, evaluations, medical tests, and related items; May consult with multi-disciplinary teams for the purpose of identifying and creating a plan of service for “at risk” families; works with community groups in identifying community health needs, developing needed health services, and improving existing services; Prepares reports and maintains records; Compiles statistical information for program evaluation and planning purposes. Other duties as assigned. NURS 3100 Issues & Trends in Nursing Assignment Paper
CHN II Plans, organizes and provides community health nursing services, health instruction, counseling, and guidance for individuals, families, and groups regarding prevention of illness, disease control, health awareness, health maintenance, and rehabilitation; May be responsible for special programs such as School Nursing or Immunizations Clinics; Identifies and interacts with local community care resources and/or school districts in providing mandated health screening for children; Develops, plans, and directs use of health resources consistent with programs goals and objectives; Provides referrals; Teaches and demonstrates health practices to individuals and groups; Instructs clients in sexually transmitted disease prevention and follow-up; Provides training in immunization procedures; Identifies individual and family problems which are detrimental to good health; May make home visits to assess an individual’s progress; Works with families to alleviate health problems and promote good health habits; Refers and coordinates the care of individuals and families with other public and private agencies; Identifies special health needs for assigned cases, recommending and implementing services to meet those needs; May perform investigations in homes, schools, and the community; Prepares appropriate records and case documentation, arranging follow-up services based on findings; Confers with physicians, nursing staff, and other staff regarding community health programs, patient reports, health evaluations, medical tests, and related items; May consult with multi-disciplinary teams for the purpose of identifying and creating a plan of service for “at risk” families; Works with community groups in identifying community health needs, developing needed health services, and improving existing services; May develop procedures/protocols for an assigned program; Orders and maintains clinic supplies, including immunization vaccines; Prepares grants, project plans, reports, and maintains records; Compiles statistical information for program evaluation and planning purposes. Other duties as assigned. NURS 3100 Cultural Competency & Nursing Informatics.
CHN III/IV Provides the more complex community health nursing services in a specialized public health program; Provides lead direction and coordination for other nursing staff; Plans, organizes and provides community health nursing services, health instruction, counseling, and guidance for individuals, families, and groups regarding prevention of illness, disease control, health awareness, health maintenance, and rehabilitation; may be responsible for special programs such as School Nursing or Immunizations Clinics; Identifies and interacts with local community care resources and/or school districts in providing mandated health screening for children; Develops, plans, and directs use of health resources consistent with programs goals and objectives; Provides referrals; teaches and demonstrates health practices to individuals and groups; instructs clients in sexually transmitted disease prevention and follow-up; Provides training in immunization procedures; identifies individual and family problems which are detrimental to good health; May make home visits to assess an individual’s progress; Works with families to alleviate health problems and promote good health habits; Refers and coordinates the care of individuals and families with other public and private agencies; Identifies special health needs for assigned cases, recommending and implementing services to meet those needs; May perform investigations in homes, schools, and the community; prepares appropriate records and case documentation, arranging follow-up services based on findings; Confers with physicians, nursing staff, and other staff regarding community health programs, patient reports, health evaluations, medical tests, and related items; May consult with multi-disciplinary teams for the purpose of identifying and creating a plan of service for “at risk” families; works with community groups in identifying community health needs, developing needed health services, and improving existing services; May develop procedures/protocols for an assigned program; Orders and maintains clinic supplies, including immunization vaccines; Prepares grants, project plans, reports, and maintains records; Compiles statistical information for program evaluation and planning purposes. Other duties as assigned. NURS 3100 Cultural Competency & Nursing Informatics
Typical Qualifications: Any combination of training and experience which would likely provide the required knowledge and abilities is qualifying. A typical way to obtain the required knowledge and abilities would be:
PHN I Completion of sufficient education and experience to meet State of California certification requirements.
Some nursing experience in a public health setting is highly desirable.
PHN II Completion of sufficient education and experience to meet State of California certification requirements.
One year of public health nursing experience comparable to a Public Health Nurse I with San Benito County.
PHN III Completion of sufficient education and experience to meet State of California certification requirements.
One year of public health nursing experience comparable to a Public Health Nurse II with San Benito County. NURS 3100 Cultural Competency & Nursing Informatics
PHN IV Completion of sufficient education and experience to meet State of California certification requirements.
One year of public health nursing experience comparable to a Public Health Nurse III with San Benito County.
CHN I Completion of sufficient education and experience to meet State of California certification requirements.
Some nursing experience in a community health setting is highly desirable.
CHN II Completion of sufficient education and experience to meet State of California certification requirements.
One year of community health nursing experience comparable to a Community Health Nurse I with San Benito County.
Graduation from an accredited college or university and completion of an approved public health nursing program.
CHN III Completion of sufficient education and experience to meet State of California certification requirements. One year of community health nursing experience comparable to a Community Health Nurse II with San Benito County. Graduation from an accredited college or university
CHN IV Completion of sufficient education and experience to meet State of California certification requirements.
One year of community health nursing experience comparable to a Community Health Nurse III with San Benito County.
Graduation from an accredited college or university
Special Requirements:
PHN I-IV Possession of a valid license as a Registered Nurse in California Possession of a Certificate as a Public Health Nurse issued by the California State Board of Registered Nursing. Possession of, or ability to obtain, an appropriate valid California Driver’s License.
CHN I-IV Possession of a valid license as a Registered Nurse in California. Certain positions may require a School Nurse Credential. Possession of, or ability to obtain, an appropriate valid California Driver’s License. Supplemental Information: Knowledge of:
PHN I Principles, methods, practices, and current trends of general/public health nursing. Community aspects of public health nursing including community resources and demography. Federal, State, and local laws and regulations governing communicable disease, public health, and disabling conditions. Environmental, sociological, and psychological problems related to public health nursing programs. Child growth and development. Causes, means of transmission, and methods of control of communicable diseases, including sexually transmitted diseases, AIDS, and tuberculosis. Methods of promoting child and maternal health and public health. Principles of public health education. NURS 3100 Cultural Competency & Nursing Informatics
PHN II Principles, methods, practices, and current trends of general and public health nursing and preventive medicine. Community aspects of public nursing including community resources and demography. Federal, State, and local laws and regulations governing communicable disease, public health, and disabling conditions. Environmental, sociological, and psychological problems related to public health nursing programs. Child growth and development. Unique psycho/social and cultural issues encountered in a rural health program. Causes, means of transmission, and methods of control of communicable disease. Methods of promoting child and maternal health and public health programs.
PHN III Principles, methods, practices, and current trends of general and public health nursing and preventative medicine. Community resources and demography influencing public health nursing services. Federal, State, and local laws and regulations governing communicable disease, disabling conditions, and public health nursing services. Environmental, sociological, and psychological problems related to public health nursing programs and services. Causes, means of transmission, and control of communicable diseases. Child growth and development. Unique psycho/social and cultural issues encountered in a rural health program. Principles of public health education. Program planning, evaluations and development principles. Principles of lead direction, program and work coordination, and training.
PHN IV Principles, methods, practices, and current trends of general and public health nursing and preventative medicine. Community resources and demography influencing public health nursing services. Federal, State, and local laws and regulations governing communicable disease, disabling conditions, and public health nursing services. Environmental, sociological, and psychological problems related to public health nursing programs and services. Causes, means of transmission, and control of communicable diseases. Child growth and development. Unique psycho/social and cultural issues encountered in a rural health program. Principles of public health education. Program planning, evaluations and development principles. Principles of lead direction, program and work coordination, and training.
CHN I Principles, methods, practices, and current trends of general nursing and preventive medicine. Federal, State, and local laws and regulations governing communicable disease, public health, and disabling conditions. Environmental, sociological, and psychological problems related to community health nursing programs. Child growth and development. Causes, means of transmission, and methods of control of communicable disease. Methods of promoting child and maternal health and community health programs. NURS 3100 Cultural Competency & Nursing Informatics
CHN II Principles, methods, practices, and current trends of general and community health nursing and preventive medicine. Community aspects of nursing including community resources and demography. Federal, State, and local laws and regulations governing communicable disease, public health, and disabling conditions. Environmental, sociological, and psychological problems related to community health nursing programs. Child growth and development. Unique psycho/social and cultural issues encountered in a rural health program. Causes, means of transmission, and methods of control of communicable disease. Methods of promoting child and maternal health and community health programs.
CHN III/IV Principles, methods, practices, and current trends of general and community health nursing and preventive medicine. Community aspects of nursing including community resources and demography. Federal, State, and local laws and regulations governing communicable disease, public health, and disabling conditions. Environmental, sociological, and psychological problems related to community health nursing programs. Child growth and development. Unique psycho/social and cultural issues encountered in a rural health program. Causes, means of transmission, and methods of control of communicable disease. Methods of promoting child and maternal health and community health programs. Program planning evaluations and development principles. Principles of lead direction, program and work coordination, and training
Ability to:
PHN I Learn to organize and carry out public health nursing activities in an assigned program. Develop and maintain public relations with clients, staff, community groups, and other government organizations. Collect, analyze, and interpret technical, statistical and health data. Analyze and evaluate health problems and take appropriate action. Provide instruction in the prevention of diseases. Communicate effectively orally and in writing. Develop and maintain health records and prepare clear and concise reports. Deal tactfully and courteously with the public, community organizations and other government agencies when explaining public health issues and providing public health services. Establish and maintain cooperative working relationships. Effectively represent the Nursing Division in contacts with public, other county staff and other government agencies. NURS 3100 Cultural Competency & Nursing Informatics
PHN II Plan, organize, and carry out public health nursing activities in an assigned program. Develop and maintain public relations with clients, staff, community groups, and other government organizations. Analyze and evaluate health problems and take appropriate action. Provide instruction in the prevention of diseases. Develop and maintain health records and prepare clear and concise reports. Communicate effectively orally and in writing. Deal tactfully and courteously with the public, community organizations, and other staff when explaining public health issues and providing public health services. Establish and maintain cooperative working relationships.
PHN III Plan, organize, and carry out public health nursing activities and services for an assigned service area or program. Develop and maintain public relations with clients, staff, community groups and other government organizations. Collect, analyze and interpret technical, statistical and health data. Analyze and evaluate health problems and take appropriate action. Provide work direction and coordination for other staff. Provide instruction in the prevention and control of diseases. Communicate effectively orally and in writing. Develop and maintain health records and prepare clear and concise reports. Deal tactfully and courteously with the public, community organizations, and other staff when explaining public health issues and providing public health services. Establish and maintain cooperative working relationships.
PHN IV Plan, organize, and carry out public health nursing activities and services for an assigned service area or program. Develop and maintain public relations with clients, staff, community groups and other government organizations. Collect, analyze and interpret technical, statistical and health data. Analyze and evaluate health problems and take appropriate action. Provide work direction and coordination for other staff. Provide instruction in the prevention and control of diseases. Communicate effectively orally and in writing. Develop and maintain health records and prepare clear and concise reports. Deal tactfully and courteously with the public, community organizations, and other staff when explaining public health issues and providing public health services. Establish and maintain cooperative working relationships. NURS 3100 Cultural Competency & Nursing Informatics
CHN I Learns the principles, methods, practices and current trends of community health nursing. Learns the community aspects of nursing including community resources and demography Learns to plan, organize, and carry out community health nursing activities in an assigned program. Learns the psycho/social and cultural issues encountered in a rural health program. Learn to analyze and conduct health assessment/problems and take appropriate action. Provide instruction in the prevention of diseases. Develop and maintain health records and prepare clear and concise reports. Communicate effectively orally and in writing. Deal tactfully and courteously with the public, community organizations, and other staff when explaining community health issues and providing community services. Establish and maintain cooperative working relationships.NURS 3100 Issues & Trends in Nursing Assignment Paper
CHN II Plan, organize, and carry out community health nursing activities in an assigned program. Develop and maintain public relations with clients, staff, community groups, and other government organizations. Analyze and conduct health assessment/problems and take appropriate action. Provide instruction in the prevention of diseases. Develop and maintain health records and prepare clear and concise reports Communicate effectively orally and in writing. Deal tactfully and courteously with the public, community organizations, and other staff when explaining community health issues and providing community services. Establish and maintain cooperative working relationships. NURS 3100 Cultural Competency & Nursing Informatics
CHN III/IV Plan, organize, and carry out community health nursing activities in an assigned program. Develop and maintain public relations with clients, staff, community groups, and other government organizations. Analyze and conduct health assessment/problems and take appropriate action. Provide work direction and coordination for other staff. Provide instruction in the prevention of diseases. Develop and maintain health records and prepare clear and concise reports. Communicate effectively orally and in writing. Deal tactfully and courteously with the public, community organizations, and other staff when explaining community health issues and providing community services. Establish and maintain cooperative working relationships.
Amid a resurgence of measles across the country, many physicians aren’t sure how to talk with patients whose confidence in vaccines has wavered as a result of the anti-vaccination movement.
Today, patients’ concerns about vaccinations fall along a spectrum, with some refusing all vaccines while others are more hesitant about specific immunizations like the MMR vaccine or receiving several vaccines at once. NURS 3100 Cultural Competency & Nursing Informatics
As vaccines have eradicated illnesses, some patients no longer view these diseases as threats. They may believe that real or perceived adverse events from vaccinations are a bigger threat than the illnesses themselves, says Saad Omer, MBBS, MPH, Ph.D., director of the Yale Institute for Global Health in New Haven, Conn., and a vaccination researcher.
Mistrust of government, drug companies, and healthcare providers as well as misinformation about vaccines spread by anti-vaccine advocates are also factors fueling vaccine hesitancy. Along with access and insurance issues, they could be contributing to a downward trend in vaccination rates.
CDC data show the percentage of unvaccinated children is rising, with 1.3 percent of children born in 2015 not receiving any recommended vaccinations, compared with 0.9 percent of children born in 2011.
Facing increased reluctance
Douglas DeLong, MD, FACP, chair of ACP’s Board of Regents and chief of general internal medicine at Bassett Medical Center in Cooperstown, N.Y., says his general internal medicine practice has not been affected by the anti-vaccination trend to the extent that many pediatric or family medicine practices have.
Still, he has sensed increasing reluctance among some of his patients to receive immunizations, particularly the influenza vaccine, which some erroneously believe causes the flu.
Like many practices aiming to boost immunization rates, DeLong’s office sends patient reminders when vaccinations are due, as well as recall notices when patients are overdue for their shots. When he encounters a patient who is reluctant to receive an immunization, he tries to discuss the science behind vaccines but says this strategy often fails to change minds.
Emphasizing vaccination as the norm
So which techniques can improve physicians’ chances of getting their patients vaccinated? One is by making a presumptive statement that assumes the patient will be vaccinated.
For example, rather than asking parents if they are ready for their child to get a shot, a physician might say, ‘It’s time for Johnny to get vaccinated.’ Such an approach doesn’t take away the parents’ choice to say no, says Yale’s Omer. “What it is doing is framing it as a routine procedure, which it is, based on its safety profile.”
Some studies have shown this technique can improve vaccine uptake.
Of course, presumptive announcements are not a solution for every patient. “You won’t get absolute vaccine refusers with this approach, but you will get a lot of parents who are on the fence,” says Sean O’Leary, MD, associate professor of pediatrics and infectious diseases at the University of Colorado Anschutz Medical Campus in Aurora, Colo. “By taking that presumptive approach, you’re emphasizing vaccination as the social norm.” NURS 3100 Cultural Competency & Nursing Informatics
Asking permission to share facts
If presumptive announcements fail, physicians can try motivational interviewing, in which they try to elicit the reasons why patients are refusing vaccines and then ask permission to share facts.NURS 3100 Issues & Trends in Nursing Assignment Paper
O’Leary explains how it works: The physician might ask an open-ended question such as, ‘What concerns do you have about the vaccine?’ After parents share why they are hesitant to vaccinate their child, the physician rephrases their concerns, then might say, ‘I’ve looked into this a great deal. Would it be OK with you if I shared what I’ve come to find out?’
“Simply asking that question makes people more receptive to the information that you are then going to impart,” O’Leary says.
In randomized trial results published in 2018 in JAMA Pediatrics, O’Leary and colleagues found that motivational interviewing helped improve HPV vaccine series initiation by 9.5 percent among parents who were resistant to vaccinating their teens.
Currently, O’Leary is collaborating on an NIH-funded study to investigate combining presumptive announcements and motivational interviewing to improve uptake of the infant series of vaccines.
Busting myths
O’Leary cautions that physicians should be careful when seeking to debunk vaccine myths because this strategy can backfire. In fact, talking too much about a myth can have the opposite effect of reinforcing the misinformation, experts say.
Yale’s Omer adds that when physicians want to counter a myth outright, they should be clear about labeling the myth as such. Then they can explain why it’s not true and offer an alternative explanation.
For example, if a parent believes that the MMR vaccine causes autism, the physician should say this is a myth. Then the physician can reference the wide body of evidence, mention that several genes have been linked to autism, and connect the increasing prevalence of autism to better diagnosis and monitoring of the disorder, Omer says.
Another strategy Omer suggests is for physicians to focus the discussion on the disease the vaccine prevents, not the vaccine itself. This helps build their credibility as disease experts. “If you’re talking about the disease, you’re on stronger ground than if you are going through the nitty-gritty of countering every myth,” he says.
Closing the doors to non-vaccinated patients
For practicality, patient safety or other reasons, some physicians are dismissing existing patients or refusing new ones if parents do not agree to follow the recommended vaccination schedule.
Paul Ehrmann, DO, medical director for the Family Health Care Center, a family practice in Royal Oak, Mich., is upfront with patients about maintaining a traditional immunization practice that requires full vaccinations. As such, the practice does not take new pediatric patients if their parents do not want them vaccinated.
NURS 3100 Issues & Trends in Nursing Assignment Paper
Ehrmann estimates that he has declined fewer than a dozen patients. However, he has not dismissed the handful of patients in his practice who are not immunized and joined the practice more than 30 years ago when the practice did not have specific guidelines.
His practice’s website describes its vaccination philosophy, and office staff are trained to convey it respectfully and without judgment on the phone with prospective patients. “We try to set the tone before we see the patient,” Ehrmann says.
When talking with patients who have concerns about vaccinations, Ehrmann favors a low-key approach that focuses on the benefits of vaccinating based on the research. “I try not to be argumentative or contentious in any way,” he says. However, he wants to make sure that there is no misunderstanding his pro-vaccine position.
When asked, Ehrmann will sometimes stagger shots for children under age two whose parents are reluctant to have them receive several shots at one time. “I respect that and don’t push that, but I try to get the kids caught up as soon as we can,” he says.
In Oakland County, where Ehrmann practices, more than 40 cases of measles had been identified at press time, but none in his practice. Given the threat of future outbreaks, he believes physicians have a responsibility to do what they can to improve immunization rates.
“We respect patients’ feelings, however, we are stewards of not only our patients but also the public health and community at large,” he says.
Collaborating on solutions
Of course, physicians are not the only ones who can reverse the anti-vaccination trend, experts say. Employers could offer on-site flu shots. Payers could start reimbursing providers for vaccine counseling even when a vaccine is not administered. The federal government could withhold health or education funding to states that do not eliminate non-medical vaccine exemptions. Social media platforms could step up their efforts to curtail false information about vaccines.
Although coordinating such efforts will not be easy, Yale’s Omer is optimistic about the outlook in the United States compared with European countries such as Germany, France, Great Britain, and Italy that have had national outbreaks of measles. He credits school-entry vaccine requirements and public health agencies for maintaining immunization rates and quickly responding to measles outbreaks in the United States, as well as professional medical societies for their strong vaccine advocacy. NURS 3100 Cultural Competency & Nursing Informatics
“There are a lot of things we don’t do well,” Omer says, “but this is one thing we do very well.”
Eliminating non-medical vaccine exemptions
In light of the recent measles outbreaks, it is likely that more states and localities will move to eliminate non-medical vaccination exemptions, says Lawrence Gostin, JD, professor and director of the O’Neill Institute for National and Global Health Law at Georgetown Law in Washington, D.C.
“The more measles is in the headlines, the more likely the government will be compelled to act,” says Gostin, who responded to questions via email. Oregon, for example, is considering eliminating non-medical exemptions, while cities such as Los Angeles and New York City now require vaccinations on university campuses and in Orthodox Jewish communities, he adds.
But state vaccination mandates will be ineffective if physicians fail to advise their patients to be vaccinated, actively discourage vaccination, or provide misleading information.