The Henry Street Consortium

Creating a Sustainable Partnership between Education and Practice for Population Health ACHNE, June 7, 2008

Bonnie Brueshoff, MSN, PHN Director Dakota County Public Health Department Carolyn Garcia, PhD, MPH, PHN Assistant Professor University of Minnesota Marjorie A. Schaffer, PhD, PHN Professor Bethel University Patricia M. Schoon, MPH, PHN Associate Professor College of St. Catherine

The Beginning January 2001

 12 Public Health Agencies and 1 VNA  Five Colleges  Minnesota Department of Health  Linking Project: Academic-Community Partnerships

To Compete or Collaborate?

That is the Question

 Academic history of competition for clinical sites  Agencies overwhelmed with requests for student placements

Web of Community Connections

Wright Anoka Chisago Bloomington Dakota Carver Isanti Kanabec Washington Ramsey Scott Sherburne Other Community Agencies Minnesota Visiting Nurse Agency

We chose collaboration!

The 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 Consortium

 This project was part of the Minnesota Department of Health initiative, Linking Public

Health Nursing Practice and Education to

Promote Population Health, and was partially supported by HRSA Grant # 5D11HP 00330 02.

Year One Planning and Development

Minnesota Department of Health Leadership

Developing Trust, Partnerships and Common Ground

Task Force Meetings Preceptor Training

Year Two Tool Development

 Development of Entry Level Public Health Nursing Competencies  Partnership Model for Clinical Education  PHN Clinical Menu

YEAR THREE IMPLEMENTATION

 Entry Level Population-Based Public Health Nursing Competencies  Clinical Menu  Faculty – Agency Mentor Partnerships

Year Three Henry Street Consortium Celebrates Successes

The Products

     Entry Level Public Health Nursing Competencies Guiding Principles for Student Clinical Experiences PHN Clinical Menu Student Orientation to Agencies Sustainable Partnerships

Henry Street Consortium Entry Level Population-Based Public Health Nursing Competencies

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

Entry Level Population-Based Public Health Nursing Competencies

 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.

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

    Determinants of health Use partnerships in planning Individual/family, community, and systems level interventions (Public Health Intervention Wheel) Short-term (behavior change, participation) and long-term indicators (change in health status) Project Example: Asthma Tool Kit for Parish Nurses

2. Utilizes basic epidemiological principles 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: Head Lice Treatment and Prevention Guidelines

3. Utilizes collaboration to achieve public health 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:

Teen Labor and Delivery Classes

Collaboration: Student 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. Works within the responsibility and authority of the governmental public health 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:

Emergency Preparedness Resource Manual

5. Practices public health nursing within the auspices of the Nurse 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: Dental Health Screening During Pregnancy

6. Effectively communicates with communities, systems, individuals, families, and 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: Teen Parent Program Client Satisfaction Survey

Effective Communication: Student 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. Establishes and maintains caring relationships with communities, systems, and individuals and

families.

   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: Revise Survey for Teen Pregnancy Free Club Participants

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

.

  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: Latino Health Survey

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

   Exploration of the influence of cultural, social, spiritual, religious, and behavioral factors The lens of another person’s perspective Knowledgeable, sensitive, and respectful interactions with persons from backgrounds different from their own

Project Example:

Early Childhood Screening & Outreach to African-American Families

10. Incorporates mental, physical, emotional, social, spiritual, and environmental aspects of health into assessment, planning, implementation, & evaluation.

 Holistic needs of individuals, families, communities, and systems

Project Example:

Safe Walking Paths

Holistic Aspects: Student 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 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 Minnesota Student Survey Results

Students Meet PHN Leaders

 Students attend Henry Street meetings  “I never realized these type of conversations occurred.”  “A room full of PHN leaders – awesome!”  Linking new graduates with PHN Agencies

Promoting Competency Development Through Student 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 Development Through Student 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 Development Through Student 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 competencies MDH, Public Health Interventions, 2001

Guiding Principles for Development of the PHN Clinical Menu

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

Guiding Principles for Development of the PHN Clinical Menu

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

Guiding Principles for Development of the PHN Clinical Menu

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 Development of the PHN Clinical Menu

Reflect community priorities

Clinical Learning Activities

Meet the learning needs of students Contribute to achievement of public health nursing goals Are meaningful to students

Population-Based Public Health Nursing Clinical Menu

    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 Preceptors Students

Population-Based Public Health Nursing Clinical Menu HEALTH TEACHING Health teaching communicates facts, ideas, and skills that change knowledge, attitudes, values, beliefs, behaviors, practices and skills of individuals, families, systems, or communities.

Systems

A level of practice designed to change organizations, policies, laws, and power structures.

Community

A level of practice designed to change community norms, attitudes, awareness, practices, and behaviors.

Individual/Family

A 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 Public Health Agencies

 Educational Dilemma – Less than half of baccalaureate nursing students attending colleges involved in Henry Street Consortium have clinical experiences in governmental public health agency.

– All students need some exposure to the mission and core functions of public health agencies.  Alternative Solutions – Provide orientation sessions for students with non-public health agency clinical experience.

– Establish core set of orientation content and expectations

Public Health Agency Perspectives

 Dilemma: committed to workforce development but have limited capacity  Staff feeling “pulled in many directions” to meet school/student requests

Public Health Agency Strategies

 Collaboration and partnerships by way of Henry Street  Better process and balance for student clinicals  Designated student clinical coordinator in agency

Academic 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 Strategies

 Maintain membership in Henry Street Consortium  Speak with common voice of consortium  Partner in creating student learning experiences with public health and community agencies  Partner with other colleges in shared clinical sites and learning activities.

Henry Street Consortium Vision for the Future

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

Henry Street Consortium Goals

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Assure strong and effective partnerships Strengthen Public Health Nursing Clinical Experiences to ensure a skilled nursing workforce to meet the needs of population based PH nursing practice Work towards clinical and educational consistency Advocate for Public Health Nursing partnerships between academia and practice

Henry Street Consortium

 This project was part of the Minnesota Department of Health initiative, Linking Public Health Nursing Practice and Education to Promote Population Health, and was partially supported by HRSA Grant # 5D11HP 00330-02.  1st Place Award 2002, Council on Linkages between Academia and Practice  Find out more about the Henry Street Consortium at http://www.health.state.mn.us/divs/cfh/ophp/consultation/ph n/henry_street.html