The Henry Street The Henry Street

ConsortiumConsortium

Creating a Sustainable Creating a Sustainable Partnership between Partnership between

Education and Practice Education and Practice

for Population Healthfor Population Health

ACHNE, June 7, 2008ACHNE, June 7, 2008

Bonnie Brueshoff, MSN, PHNBonnie Brueshoff, MSN, PHNDirectorDirectorDakota County Public Health DepartmentDakota County Public Health Department

Carolyn Garcia, PhD, MPH, PHNCarolyn Garcia, PhD, MPH, PHNAssistant ProfessorAssistant ProfessorUniversity of MinnesotaUniversity of Minnesota

Marjorie A. Schaffer, PhD, PHNMarjorie A. Schaffer, PhD, PHNProfessorProfessorBethel UniversityBethel University

Patricia M. Schoon, MPH, PHN Patricia M. Schoon, MPH, PHN Associate ProfessorAssociate ProfessorCollege of St. CatherineCollege of St. Catherine

The BeginningThe Beginning January 2001 January 2001 12 Public Health 12 Public Health

Agencies and 1 VNAAgencies and 1 VNA

Five CollegesFive Colleges

Minnesota Minnesota Department of HealthDepartment of Health

Linking Project: Linking Project: Academic-Community Academic-Community PartnershipsPartnerships

To Compete or To Compete or Collaborate?Collaborate?

That is the QuestionThat is the Question

Academic history of Academic history of competition for competition for clinical sitesclinical sites

Agencies Agencies overwhelmed with overwhelmed with requests for requests for student placementsstudent placements

Web of Community Connections

Anoka

Bloomington

Carver

Kanabec

Ramsey

Scott

Sherburne

Minnesota Visiting Nurse Agency

Wright

Chisago

Dakota

Isanti

Washington

Other Community Agencies

We chose We chose collaboration!collaboration!

The Henry Street Consortium was born.The Henry Street Consortium was born.

The Henry Street Consortium was bornThe Henry Street Consortium was born

The Henry Street Consortium• Goals

– Development of Entry Level Public Health Nursing Competencies

– Partnership Model for Clinical Education

– Clinical Menu

Henry Street Henry Street ConsortiumConsortium This project was part of the Minnesota This project was part of the Minnesota

Department of Health initiative, Department of Health initiative, Linking Public Linking Public Health Nursing Practice and Education to Health Nursing Practice and Education to Promote Population Health,Promote Population Health, and was partially and was partially supported by HRSA Grant # 5D11HP 00330-supported by HRSA Grant # 5D11HP 00330-02. 02.

Year One Year One Planning and Planning and

DevelopmentDevelopment

Minnesota Department of Health Leadership

Developing Trust, Developing Trust, Partnerships and Common Partnerships and Common

GroundGround Task Force Task Force

MeetingsMeetingsPreceptor Training

Year TwoYear TwoTool DevelopmentTool Development

Development of Development of Entry Level Public Entry Level Public Health Nursing Health Nursing CompetenciesCompetencies

Partnership Model for Partnership Model for Clinical EducationClinical Education

PHN Clinical MenuPHN Clinical Menu

YEAR THREEYEAR THREE IMPLEMENTATION IMPLEMENTATION Entry Level Entry Level

Population-Based Population-Based Public Health Public Health Nursing Nursing CompetenciesCompetencies

Clinical MenuClinical Menu

Faculty – Agency Faculty – Agency Mentor Mentor PartnershipsPartnerships

Year ThreeYear ThreeHenry Street Consortium Henry Street Consortium

Celebrates SuccessesCelebrates Successes

The ProductsThe Products

Entry Level Public Health Nursing Competencies Guiding Principles for Student Clinical

Experiences PHN Clinical Menu Student Orientation to Agencies Sustainable Partnerships

Henry Street ConsortiumHenry Street ConsortiumEntry Level Population-Based Entry Level Population-Based Public Health Nursing CompetenciesPublic Health Nursing Competencies

Foundations–PHN Research–PHN Standards–Practice Models–Best Practices

Entry Level Population-Based Entry Level Population-Based Public Health Nursing Public Health Nursing CompetenciesCompetencies

Help frame learning and assess student accomplishment of the competencies

Provide a guide for public health nurse managers and supervisors to frame expectations for entry level performance for new PHNs

Assist health departments in designing nursing student learning experiences

1.1. Applies the public health Applies the public health nursing nursing process to process to communities, systems, communities, systems, individuals, and families.individuals, and families.

Determinants of healthDeterminants of health Use partnerships in planningUse partnerships in planning Individual/family, community, and Individual/family, community, and

systems level interventions (Public systems level interventions (Public Health Intervention Wheel)Health Intervention Wheel)

Short-term (behavior change, Short-term (behavior change, participation) and long-term indicators participation) and long-term indicators (change in health status)(change in health status)

Project Example:Project Example: Asthma Tool Kit for Asthma Tool Kit for Parish NursesParish Nurses

2.2. Utilizes basic epidemiological Utilizes basic epidemiological principles principles in public health nursing practice.in public health nursing practice.

The incidence, distribution, and control of disease in a population

Epidemiological triad of host, agent, and environment

Risk and protective factors Interpretation of data in planning

Project Example: Project Example: Head Lice Head Lice Treatment and Prevention Treatment and Prevention Guidelines Guidelines

3.3. Utilizes collaboration to Utilizes collaboration to

achieve public health achieve public health goals.goals. Interdisciplinary community partners work

to achieve common public health goals

Joint action using community assets to empower individuals, communities, and systems to promote change and effective outcomes

Project Example:Project Example:

Teen Labor and Delivery Teen Labor and Delivery ClassesClasses

Collaboration: Collaboration: Student StoryStudent Story

The community-based meeting was a wonderful example of public health officials collaborating with other groups to help solve problems. By having the different communities in the county come together, the County Human Services learned of issues that are important to the community.

Sometimes it is those issues that do not appear on paper that are the issues that are of most relevance to the community. The County Human Services and these community groups develop plans to meet the needs of the community that they serve. The groups represented at the meeting are also great resources to each other and offer each other support.

4.4. Works within the responsibility Works within the responsibility and authority of the and authority of the governmental public health governmental public health system.system.

Relationship among the federal, state, and local levels of the public health system

Essential Public Health Services and Core Functions.

Independent public health nursing role Legal issues such as public health

nuisance, quarantine, and commitment laws, data privacy, and mandated reporting

Project Example:Project Example: Emergency Emergency Preparedness Preparedness Resource ManualResource Manual

5.5. Practices public health nursing Practices public health nursing within the auspices of the Nurse within the auspices of the Nurse Practice Act.Practice Act. Independent nursing functions and

provisions of the Nurse Practice Act Delegated actions, both to and from Confidentiality for clients, families, and

groups Legal, ethical, and professional

accountability Professional boundaries

Project Example:Project Example: Dental Health Dental Health Screening During Pregnancy Screening During Pregnancy

6.6. Effectively communicates with Effectively communicates with communities, systems, communities, systems, individuals, individuals, families, and families, and

colleagues.colleagues. Communication with a variety of clients,

professionals, and community representatives

Communication of demographic, statistical, programmatic and scientific information

Competence in utilizing computerized charting systems and programs for data analysis

Project Example:Project Example: Teen Parent Teen Parent Program Client Satisfaction SurveyProgram Client Satisfaction Survey

Effective Communication: Effective Communication: Student StoryStudent Story

At the WIC clinic, the public health nurse is unarguably very dedicated, informed, and passionate about her work.

I was able to observe several interactions between the public health nurse and the clients. The public health nurse provided the clients with an array of information that would assist them in ensuring the health of themselves and their children.

There did not seem to be a question that went unanswered or a topic that went without discussion. In addition, the public health nurse demonstrated immense flexibility and sensitivity to cultural and language differences.

7.7. Establishes and maintains Establishes and maintains caringcaring relationships with relationships with communities, communities, systems, and systems, and individuals and individuals and familiesfamilies..

Demonstration of trust, respect, and empathy in interactions with clients and community organizations

Appropriate boundaries within the framework of a caring relationship

Accountable to seek assistance when concerned or challenged

Project Example: Project Example: Revise Survey for Revise Survey for Teen Pregnancy Free Club ParticipantsTeen Pregnancy Free Club Participants

8.8. Shows evidence of Shows evidence of commitment to social justice, commitment to social justice, the greater good, the greater good, and the public health and the public health

principlesprinciples.. The difference between social

justice and market justice Advocacy for those who do not

have a strong voice in making their own health needs known

Project Example: Project Example: Latino Latino Health SurveyHealth Survey

9.9. Demonstrates nonjudgmental Demonstrates nonjudgmental unconditional acceptance of unconditional acceptance of people different from self.people different from self.

Exploration of the influence of cultural, Exploration of the influence of cultural, social, spiritual, religious, and behavioral social, spiritual, religious, and behavioral factors factors

The lens of another person’s perspective The lens of another person’s perspective Knowledgeable, sensitive, and respectful Knowledgeable, sensitive, and respectful

interactions with persons from backgrounds interactions with persons from backgrounds different from their owndifferent from their own

Project Example: Project Example: Early Childhood Screening &Early Childhood Screening &Outreach to African-American Outreach to African-American FamiliesFamilies

10. Incorporates mental, physical, 10. Incorporates mental, physical, emotional, social, spiritual, and emotional, social, spiritual, and environmental aspects of health into environmental aspects of health into

assessment, planning, assessment, planning, implementation, & evaluation.implementation, & evaluation.

Holistic needs of individuals, families, communities, and systems

Project Example: Project Example:

Safe Walking PathsSafe Walking Paths

Holistic Aspects: Holistic Aspects: Student StoryStudent Story

We…began to prepare for this project by doing background research on the problem of obesity, what health problems came from being overweight, and the role of walking in reducing these problems. After that, we planned how we would implement our study…looking at city maps and selecting the routes that we wished to walk. We also got a standardized survey …. We proceeded to walk each of these paths and mark down the positive and negative attributes of each as we saw them. The data was presented to a group of city officials along with our conclusions so they could have some data to help guide them in the use of their grant money.

11. Demonstrates 11. Demonstrates leadership.leadership.

Collaborative and partnership work with others independently and autonomously in unstructured environments

Tolerance of ambiguity when needed, adaptation to change, and flexibility

Prioritization and organization of workload, time, materials, and resources.

Student Project: Analysis of Analysis of Minnesota Student Survey Minnesota Student Survey ResultsResults

Students Meet PHN Students Meet PHN LeadersLeaders

Students attend Henry Students attend Henry Street meetingsStreet meetings

““I never realized these I never realized these type of conversations type of conversations occurred.”occurred.”

““A room full of PHN A room full of PHN leaders – awesome!”leaders – awesome!”

Linking new graduates Linking new graduates with PHN Agencieswith PHN Agencies

Promoting Competency Promoting Competency Development Through Development Through Student Projects: PHN StaffStudent Projects: PHN Staff

Become familiar with student educational level and course objectives

Explain projects are determined by community and agency needs

Communicate value and usefulness of past student projects

Appoint a consistent staff liaison Explain connection of project goals to public

health outcomes

Promoting Competency Promoting Competency Development Through Development Through Student Projects: PHN StaffStudent Projects: PHN Staff

Reflect with students on application of public health nursing concepts

Facilitate student presentation of projects

Publicize student involvement through local media

Emphasize population focus of project vs. individual focus

Promoting Competency Promoting Competency Development Through Development Through Student Projects: FacultyStudent Projects: Faculty

Match projects to both agency and student needs Begin collaboration with agency staff early Clarify project goals and expectations from

partners Provide agency and students with contact

information Provide direction and consultation to students Communicate regularly with agency staff Provide information about relevant resources

Population-Based Public Health Nursing Clinical Menu

• Students use public health interventions at three levels of PHN practice to demonstrate achievement of population-based PHN competenciesMDH, Public Health

Interventions, 2001

Guiding Principles for Guiding Principles for Development of the PHN Development of the PHN Clinical MenuClinical Menu

All students will have some experience with communities, systems, individuals and families.

Guiding Principles for Guiding Principles for Development Development

of the PHN Clinical Menuof the PHN Clinical Menu

All students will have some exposure to home visiting during the PHN clinical or other nursing educational experiences.

Successful Student Experiences Include:

•Effective partnerships

•Clinical preceptors•Some experience in

governmental agencies

•Each clinical has potential to meet variety of competencies

Guiding Principles for Guiding Principles for Development of the PHN Development of the PHN

Clinical MenuClinical Menu

Guiding Principles for Guiding Principles for Development of the PHN Development of the PHN Clinical MenuClinical Menu

Reflect communit

y priorities

Contribute to achievement of public health nursing goals

Are meaningf

ul to students

Meet the learning needs of students

Clinical Learning Activities

Population-Based Public Population-Based Public Health Nursing Clinical Health Nursing Clinical MenuMenu

Agency identifies needs and learning activities

Faculty identify curricular needs

Preceptors and faculty negotiate activities

Students select activities based on interests

Clinical Education Partnership Model

• Faculty• Agency• Precept

ors• Student

s

Population-Based Public Health Nursing Clinical MenuHEALTH TEACHING

 

Health teaching communicates facts, ideas, and skills that change knowledge, attitudes, values, beliefs, behaviors, practices and skills of individuals, families, systems, or communities.

SystemsA level of practice designed to change organizations, policies,

laws, and power structures.

CommunityA level of practice designed to

change community norms, attitudes, awareness, practices,

and behaviors.

Individual/FamilyA level of practice designed to change knowledge, attitudes, beliefs, practices,

and behaviors of individuals. This practice level is directed to individuals alone or as part of a family, class, or group. Individuals receive services

because they have been identified as belonging to a population-at-risk.

Examples of public health nursing student activities available at Public Health Agency

Develop hand-washing curriculum for day care provider organizations.

Provide culturally sensitive health teaching at a health fair in the Hispanic community. The health teaching addresses the health status of the population.

Provides health teaching to pregnant teens during home visits.

Student documentation of health teaching interventions

     

Student Orientation to Governmental Student Orientation to Governmental Public Health AgenciesPublic Health Agencies

Educational DilemmaEducational Dilemma– Less than half of baccalaureate nursing students Less than half of baccalaureate nursing students

attending colleges involved in Henry Street Consortium attending colleges involved in Henry Street Consortium have clinical experiences in governmental public health have clinical experiences in governmental public health agency.agency.

– All students need some exposure to the mission and All students need some exposure to the mission and core functions of public health agencies. core functions of public health agencies.

Alternative SolutionsAlternative Solutions– Provide orientation sessions for students with non-Provide orientation sessions for students with non-

public health agency clinical experience.public health agency clinical experience.– Establish core set of orientation content and Establish core set of orientation content and

expectationsexpectations

Public Health AgencyPublic Health AgencyPerspectivesPerspectives

Dilemma: committed to workforce development but have limited capacity

Staff feeling “pulled in many directions” to meet school/student requests

Public Health Agency Public Health Agency StrategiesStrategies

Collaboration and partnerships by way of Henry Street

Better process and balance for student clinicals

Designated student clinical coordinator in agency

Academic PerspectivesAcademic Perspectives

Lack of clarity and consensus about needed population-based PHN competencies for baccalaureate nursing graduates among nursing faculty.

Nursing Programs expanding enrollment and limited Public Health Agency sites.

Long history of competitive model inisestablishing and maintaining clinical sites.

Academic StrategiesAcademic Strategies

Maintain membership in Henry Street Maintain membership in Henry Street ConsortiumConsortium

Speak with common voice of consortiumSpeak with common voice of consortium

Partner in creating student learning Partner in creating student learning experiences with public health and experiences with public health and community agenciescommunity agencies

Partner with other colleges in shared clinical Partner with other colleges in shared clinical sites and learning activities.sites and learning activities.

Henry Street ConsortiumHenry Street ConsortiumVision for the FutureVision for the Future

To maintain a dynamic sustainable partnership of public health nursing education and practice

Henry Street Consortium Henry Street Consortium GoalsGoals

1. Assure strong and effective partnerships

2. Strengthen Public Health Nursing Clinical Experiences to ensure a skilled nursing workforce to meet the needs of population based PH nursing practice

3. Work towards clinical and educational consistency

4. Advocate for Public Health Nursing partnerships between academia and practice

This project was part of the Minnesota Department of This project was part of the Minnesota Department of Health initiative, Health initiative, Linking Public Health Nursing Linking Public Health Nursing Practice and Education to Promote Population Health,Practice and Education to Promote Population Health, and was partially supported by HRSA Grant # 5D11HP and was partially supported by HRSA Grant # 5D11HP 00330-02. 00330-02.

1st Place Award 2002, Council on Linkages between 1st Place Award 2002, Council on Linkages between Academia and PracticeAcademia and Practice

Find out more about the Henry Street Consortium at Find out more about the Henry Street Consortium at http://www.health.state.mn.us/divs/cfh/ophp/consultatihttp://www.health.state.mn.us/divs/cfh/ophp/consultation/phn/henry_street.htmlon/phn/henry_street.html

Henry Street Henry Street ConsortiumConsortium