Community Health and Public Health Nursing

8/3/2019 Community Health and Public Health Nursing

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Community Health / PublicCommunity Health / PublicHealth Nursing and theHealth Nursing and the

Doctor of Nursing PracticeDoctor of Nursing Practice

Carolyn A. Williams, RN, PhD, FAANCarolyn A. Williams, RN, PhD, FAANDean and Professor, College of Dean and Professor, College of Nursing, University of KentuckyNursing, University of Kentucky


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Focus of the PresentationFocus of the PresentationThe Momentum for Change in GraduateEducation in NursingThe DNP as the Preparation for Specialization in Nursing by 2015Good News/Not So Good NewsThe DNP May Represent a Window of

Opportunity to Revitalize the Preparationfor Specialization in Community Health /Public Health Nursing


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A Paradigm Shift is Underway in A Paradigm Shift is Underway inGraduate Education in NursingGraduate Education in Nursing

A Number of Factors are Converging to Build Momentumfor a Major set of ShiftsThese Include: Aging of the Population; Expansion of Knowledge Underlying Practice; Increased Complexity of Patient Care; Major Concerns about Quality of Care andPatient Safety; Shortages of Nursing PersonnelDemanding a Higher Level of Preparation for LeadersWho Can Design and Assess Care and Lead;

Shortages of Prepared Nursing Faculty, Leaders inPractice, and Nurse Researchers, and IncreasingEducational Expectations for the Preparation of other Health Professionals


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Ferment and Change in GraduateFerment and Change in GraduateEducationEducation

From the Clinical Perspective - The ClinicalNurse Leader at the Masters Level; For Specialization The Doctor of Nursing PracticeFrom the Research Perspective ProposedStrategies to Encourage Nurses to Enter Doctoral Study at Younger Ages; Rethink theClinical Requirements for Entry into PhDPrograms; Expand the Pool for PhD Programsin Nursing and Increase the Number of PhDGrads


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National Academy of SciencesNational Academy of Sciences2005 Report2005 Report

Calls for a distinction between theeducational needs and goals of nursing as

a practice profession that requirepractitioners with clinical expertise fromNursing as an academic discipline andscience that requires independentresearchers and scientists to build thebody of knowledge (p.74)


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National Academy of SciencesNational Academy of Sciences2005 Report2005 Report

The need for doctorally preparedpractitioners and clinical faculty would be

met if nursing could develop a newnonresearch clinical doctorate, similar tothe M.D. and Pharm.D. in medicine andpharmacy, respectively.


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What is a DNP?What is a DNP?

The DNP was first conceptualized as aPost-Masters degree to prepare for

Leadership in Nursing Practice As we plan for the future, it is proposed asthe preparation for the highest level of preparation for practice in an area of specialization.


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It is about Nursing Practice!!!It is about Nursing Practice!!!It is About the Future !!!It is About the Future !!!


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Position Statement on thePosition Statement on thePractice Doctorate in Nursing Practice Doctorate in Nursing

October 2004October 2004


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Possible Parallels Between thePossible Parallels Between the

Nurse Practitioner Movement andNurse Practitioner Movement andthe DNPthe DNPMost would say that What Lee Ford Set in

Motion in the 1960s was a Major Paradigm Shift in Graduate Education inNursing and in Nursing PracticeOnly Time will tell if the DNP Represents aSustained Change in Graduate Educationin Nursing and in Nursing Practice


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From Chalk Up Another One, The Best of Sydney Harris , 1992


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The DNP EssentialsThe DNP Essentials

DNP Core Essentials Outcome CompetenciesEssential for all Graduates of a DNP ProgramRegardless of Speciality or Functional Focus

Speciality Competneices Those Clinical andDidactic Learning Experiences to Prepare the

DNP for a Particular Speciality. These areDelineated by National Speciality NursingOrganizations


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DNP Core EssentialsDNP Core Essentials

l. Scientific Underpinnings for Practice2. Organizational and Systems Leadership for Quality Improvement and Systems Thinking a

focus on the needs of a panel of pts, a targetpop, a set of pops, or a broad community3. Clinical Scholarship and Analytical Methodsfor Evidence-Based Practice

4. Information Systems/Technology and PatientCare Technology for the Improvement andTransformation of Health Care


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Core EssentialsCore Essentials

5. Health Care Policy for Advocacy inHealth Care

6. Interprofessional Collaboration for Improving Patient and POPULATIONHealth Outcomes7. Clinical Prevention and POPULATIONHealth for Improving the Nations Health8. Advanced Nursing Practice


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Advanced Nursing Practice Advanced Nursing Practice

Speciality preparation falls into twogeneral categories: Roles whichspecialize as an APN with a focus on careof inds in a speciality andRoles which specialize in practice at anaggregate, systems, or organizational

levelSome Specialities, such as CommunityHealth may blend these roles


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AACN Website for DNP AACN Website for DNP

www.aacn.nche.edu/dnp/index.htm


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Good News / Not so Good NewsGood News / Not so Good News

The Population Perspective is Catching onThroughout Nursing It is one of the KeyComponents of the Essentials for the DNPThe Not so Good News is what ishappening in Community/Public HealthNursing Programs

There is a Question of whether our Current CH/PHN Programs areSustainable


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2001 2002 2003 2004 2005

CommunityHealth CNS

2.1 3.2 3.0 3.3 3.3

CommunityHealth/PublicHealthMasters Major

3.3 3.9 2.6 2.8 2.8

AVERAGE GRADUATES PER PROGRAM FROMCOMMUNITY HEALTH/PUBLIC HEALTHMASTERS LEVEL PROGRAMS IN SCHOOLS OF NURSING

2001-2005

Source : American Association of Colleges of Nursing, Research and Data Center, 2006


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CHN/PHENROLLMENT

TOTALENROLLMENT

% of TOTAL

2001 910 30,512 3.7

2002 1011 34,062 2.9

2003 941 37,066 2.5

2004 974 42,646 2.3

2005 946 46,444 2.0

ENROLLMENT IN CHN/PH MASTERS PROGRAMS AND % OF TOTAL MASTERS ENROLLMENT

Source: American Association of Colleges of Nursing, Research and Data Center, 2006


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A Window of Opportunity A Window of Opportunity

The Time to Rethink the Preparation of Nursesfor Community/Public Health Practice is NOWThe DNP may Represent a Window of Opportunity to Revitalize Preparation for Community/Public Health NursingThe DNP with Specialization inCommunity/Public Health Nursing is a MoreViable Alternative for the Future than a DualDegree Model, Which Many are Advocating


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Luther Christman:Luther Christman:Imagine how different the present level of clinical care might be if all nurses hadearned professional doctorates for at least

the last two generations. It is almostimpossible to be an equal contributor when the present relative deprivationexists between nurses and other major providers.

Source: ( Imag e: Journ al of Nursin g Scho la rship, 1980)


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Creating the FutureCreating the FutureWe have a responsibility to createWe have a responsibility to createthe future for our patients, for ourthe future for our patients, for ourprofession, and for the health of theprofession, and for the health of thepublic.public.

Community Health and Public Health Nursing

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