Text Book Of Community Health Nursing Part 2 In PV Book In PDF File
Zoe Northcutt
Background: Virtual reality (VR) simulation in nursing education, especially about non-acute care including community health, is an emerging learning strategy; more research is needed about its effectiveness. Purpose: This study aimed to evaluate the effectiveness of an innovative community health nursing VR simulation on prelicensure students' knowledge about social determinants of health and cultural competence, with a goal of enhancing students' preparation for practice. Methods: In a convergent mixed methods study, 100 prelicensure nursing students in a community health nursing course at a Midwestern U.S., urban, public university completed a pretest, a VR simulation, a posttest, and an evaluation. Pre- and posttests containing content questions adapted from leading community health nursing text faculty resources were used to assess learning, and the Simulation Effectiveness Tool-Modified (SET-M) was used to assess perceived effectiveness of the intervention. Results: The majority of participants' posttest scores were higher than their pretest scores. Most participants strongly agreed that the VR simulation was effective, and reported on new knowledge/skills learned, material found most helpful, and benefit to their nursing practice. Conclusions: The community health nursing VR simulation was effective at increasing participants' knowledge and their confidence in their knowledge and abilities.
Text Book Of Community Health Nursing Part 2 In PV Book In PDF File
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An interpretive study conducted in a Midwestern metropolitan area was designed to examine expertise in everyday community health nursing (CHN) practice. Twenty-five nurses from three practice areas (traditional, nontraditional, and program development) participated in group and individual interviews and field observations, sharing stories of their practice. Transcribed interviews and field observation notes were analyzed as a text. One of the major findings of the study focused on experiences of the nurses as they developed the population aspects of their everyday practice. Part I describes the natural development of a population focus of CHN generalists whose care most often targeted individuals and families. The stories of how their practices evolved and were supported by their institutions provided insights into how nurses develop a broad population-focused practice perspective. Part II examines the practice of those CHN specialists who nurse their target populations from an intentional perspective. Their population-focused practice, in which they repeatedly displayed what the research team terms multilingual and multiperspectival skills, was solidly based in their prior individual and family-focused experience and expertise in program planning and evaluation.
During the past 2 decades, care of adolescent and young adult patients with PID has shifted from inpatient to outpatient settings based on the data from the PEACH study and subsequent health economic analyses using these data.9,10 Our analysis8 of data from 831 women in the PEACH study indicated that the overall outcomes for patients in the trial were suboptimal. Although 52% of enrolled participants experienced a live birth, a primary outcome assessment of well-being used by reproductive health researchers, 21% of participants experienced a recurrent STI or PID diagnosis, 40% of patients experienced CPP, and 21% of affected patients experienced infertility. Furthermore, among adolescents 19 years or younger in the trial, those who experienced recurrent disease were 5 times more likely to report CPP.8 Although research has demonstrated the significant cost differential between inpatient and outpatient treatment for PID, health economic analyses indicate that hospitalization of young women is no longer a cost-effective approach to management of mild to moderate PID.11 Adherence and longitudinal clinical outcomes from randomized trial data8,9 suggest that some additional intervention is merited.
These findings fill a particularly significant gap in the field given that more than half of the patients in the sample had prior STIs, which has the potential to compound the risk for sequelae in the context of recurrent disease. Many women seek services in emergency department settings but require close follow-up after their diagnosis to ensure recovery and to address related issues, such as STI and HIV risk reduction and contraceptive counseling. Community health nursing has been an effective strategy for treating adolescents and young adults who require ongoing support for management of clinical issues, such as asthma, teen pregnancy, and parenthood.20,21,22 Working with adolescents and young adults with complex STIs in the community must be navigated thoughtfully to preserve confidentiality, while also providing needed services. This study demonstrates that the TECH-N approach is safe and efficacious for adolescents and young adults with mild to moderate PID.
The use of technology as a part of the TECH-N design to support intervention patients is also in line with the notion of reaching adolescents where they are. National data demonstrate that 95% of adolescents have a smartphone and are online almost constantly.23 Furthermore, study findings suggest that the digital divide has closed for low-income urban youth owing to smartphone access. Only 3% of intervention participants required a study-provided mobile phone at enrollment. Technology access via a mobile phone is consistent with our prior research demonstrating that more than 95% of sexually active adolescent and young adult women have access to mobile phones with text messaging and internet access.24 This work provides information for the potential development of interventions that leverage technology for care management and decision support for serious conditions for which confidentiality and personalized support are essential.
A community health assessment (sometimes called a CHA), also known as community health needs assessment (sometimes called a CHNA), refers to a state, tribal, local, or territorial health assessment that identifies key health needs and issues through systematic, comprehensive data collection and analysis. Community health assessments use such principles as
A community health improvement plan (or CHIP) is a long-term, systematic effort to address public health problems based on the results of community health assessment activities and the community health improvement process. A plan is typically updated every three to five years.
Early in their development, both Minnesota and the United States recognized the role of the government in protecting the public's health, and each entity makes reference to this in their constitutions as part of a "general welfare" clause. Public health promotes the welfare of the entire population, ensures its security and protects it from the spread of infectious disease and environmental hazards, and helps to ensure access to safe and quality care to benefit the population.
Governmental responsibilities for public health extend beyond voluntary activities and services to include additional authorities such as quarantine, mandatory immunization laws, and regulatory authorities. The state's partnership functions by encouraging residents to do things that benefit their health (e.g., physical activity) or create conditions to promote good health, and requiring certain actions (e.g., food safety).
Minnesota's areas of public health responsibility within the Local Public Health Act follow. They describe what people in Minnesota should expect to receive from their local health department no matter where they live, and are used by community health boards for assessment and planning purposes.
Assuring an adequate local public health infrastructure means maintaining the basic capacities foundational to a well-functioning public health system such as data analysis and utilization; health planning; partnership development and community mobilization; policy development, analysis and decision support; communication; and public health research, evaluation and quality improvement.
Preparing and responding to emergencies means engaging in activities that prepare public health departments to respond to events and incidents and assist communities in recovery, such as providing leadership for public health preparedness activities within a community; developing, exercising and periodically reviewing response plans for public health threats; and developing and maintaining a system of public health workforce readiness, deployment, and response.
Assuring health services means engaging in activities such as assessing the availability of health-related services and health care providers in local communities; identifying gaps and barriers; convening community partners to improve community health systems; and providing services identified as priorities by the local assessment and planning process.
Public health is population-based. Although local health departments and community health boards provide services to individuals, the goal of a population-based approach is very different from that of a patient-based or client-based approach that addresses the needs or concerns of an individual. Since public health activities are based on community needs, resources, funding, and support, services vary among local public health departments.
The Minnesota Department of Health (MDH) is also responsible for monitoring, detecting, and investigating disease outbreaks; researching causes of illness and operating prevention programs; providing laboratory services; safeguarding the quality of health care, working to contain health care costs and assure that all Minnesotans have access to health care; safeguarding the quality of food, drinking water, and indoor air; developing strategies to improve the health of vulnerable populations; and working to eliminate health disparities.
In partnership with local public health entities, MDH helps with everything from developing guidelines, to providing technical assistance and support, to funneling state and federal funds to community health boards. Its specialists and scientists collect and analyze data that are used for research, resource development, and program development throughout the state. Public health system consultants provide specialized assistance on local and tribal public health to regions around the state.
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