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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