Community Public Health Nurses Research Articles

New Modes of Practice: A Framework Analysis of School Nurses' Accounts of Working With Children and Young People During COVID-19.

To identify new and accelerated modes of practice used by school nurses during the COVID pandemic. To create a quick reference infographic bringing together experiential evidence on the range and considerations regarding different modes of practice for use by the school nursing community of practice. A descriptive qualitative secondary data analysis of open-ended questions in a survey, and focus groups with school nurses. The pragmatic aim was to focus on changes in school nurse modes of practice to ensure continued engagement with children and young people, and school nurses' experience of the benefits and challenges of these modes of practice. Data were collected from 98 school nurse participants across a United Kingdom-wide survey (n78) in April to May 2022, and focus groups (n20) in June to July 2022, within the School Nursing in the Time of COVID project. Data from the seven open-ended questions in the survey and four questions from the focus group were analysed using the framework approach. Modes of practice fell into two categories: individual assessment and support (video-calling platforms, telephone contact, virtual messaging, walk-and-talks and home visits) and group support (wellbeing approaches, social media). Considerations for these modes rooted in school nurses' experience are described. Interpretations were used to create the summarising evidence-based infographic as a quick reference resource for school nurses. There was no 'one size fits all' approach. The modes used by school nurses were adopted or developed out of necessity or resource availability and in response to the specific needs of individuals or groups. The developed infographic provides a quick reference guide to deliver the expressed need for knowledge exchange within the school nursing community by participants in the original studies and can be used to inform current school nurse practice. The developed evidence-based infographic has stand-alone value. It has the potential to raise awareness of the range of different strategies that can be used to facilitate and/or enhance engagement with children and young people, equip school nurses with knowledge to foster innovative and responsive practice and aid critical reflection in a complex post-pandemic landscape. The infographic is a unique resource and is a first step in knowledge exchange based on experiential learning. The resource will be used as the foundation for future work to develop a co-created training resource for school nurse students (undertaking the Specialist Community Public Health Nurses course) and/or continuing professional development resource for established school nurses. This study has been conducted and reported in accordance with COREQ guidelines for qualitative research. A consultation group was closely involved with the planning, conduct and analysis of the original studies. This group consisted of representatives from professional organisations SAPHNA (School and Public Health Nurses Association) and the CPHVA (Community Practitioners' and Health Visitors' Association), a school nurse and a member of the public. SAPHNA have continued in their consultative role for this study and has provided content and usability feedback regarding the infographic. Early findings have been presented to the SN community of practice, and feedback invited, through presentation separately at the CPHVA and SAPHNA annual conference.

Navigating the integration of knowledge and research evidence in clinical practice for children's foot health: A multi-professional survey.

Access to clinical services for children with foot and ankle problems are important, but unravelling the complexity of practice and service delivery can be challenging. The pursuit and implementation of research evidence is critical for driving positive change in practice, but little is understood about the approaches to knowledge and research acquisition in children foot health. The aim of the study was to: (1) explore multi-professional habits of knowledge and research evidence acquisition in children's foot health; and (2) understand how clinicians integrate information for children and their families into their practice. This was a descriptive, cross-sectional online survey. Participants were included if they worked in the UK and had experience of working within paediatric services. There were complete responses from 247 health professionals, representing physiotherapists (n=160), podiatrists (n=50), orthotists (n=25), nurses and specialists in community public health nurses (health visitors) (n=12). Three main themes were generated from the data: (1) Factors that influence knowledge and inform clinical practice. (2) The role of Professional Bodies in informing professional knowledge. (3) Health Professionals' views on managing health information for parents and caregivers. This work advances understanding of the value health professionals' place in the development of materials for informing professional knowledge, as well as highlighting some of the challenges with translation of knowledge into clinical practice. The findings offer a national perspective of health professionals working on children's foot health and have highlighted that some of the most valued influences on clinical practice come from peer-to-peer networking.

A higher education institution's response to the NMC Standards for Student Supervision and Assessment

This case study discusses how a higher education institution (HEI) responded to the Nursing and Midwfery Council's implementation of the Standards for Student Supervision and Assessment to support practice partners with their role in teaching and assessing students in clinical placements. In 2023, after consultation with key stakeholders, the HEI designed and implemented a new level 7 module aimed at enhancing clinicians' knowledge of teaching and assessing students in their practice-based learning environments. The module was designed to support clinicians working in a practice supervisor or practice assessor role in specialist community public health nursing, as there is recognition that this role requires advanced skills in decision-making and professional autonomy. The module has now completed its first year of delivery, with four separate cohorts having completed the taught sessions and the summative assessment. The cohorts have been a mix of health visitors, district nurses and school nurses from nationwide seconding NHS Trusts.

What does leadership mean to specialist community public health nurses?

Using the results of a survey of practice educators and assessors at a higher education institute, this article discusses leadership styles in the context of specialist community public health nursing

Culture: A determinant of breastfeeding in SCPHN practice

The health benefits of breastfeeding are well researched and are recognised by professional bodies both nationally and globally, yet breastfeeding rates for many countries globally fall short of their respective national targets. Efforts have been made within both maternity services and Specialist Community Public Health Nursing (SCPHN) practice to provide training for professionals to improve breastfeeding rates, yet in many areas there remains a focus on the biological factors more than cultural beliefs, despite culture being widely accepted as an integral aspect of needs assessment in the field of SCPHN practice. This article explores the literature to identify cultural beliefs surrounding breastfeeding from both positive and negative perspectives, which further highlighted how SCPHNs can improve their practice in sensitively approaching this subject with new and expecting mothers. The purpose of this review was to identify the significance of culture as a determinant of breastfeeding and highlight potential methods for improving SCPHN practice in this area.

The ESSENCE-Q: Can specialist supervision improve scoring agreement across specialist and public health nurses/nursery teachers?

This study aimed to explore whether the supervision of community public health nurses (PHNs) and nursery school teachers (NSTs) by a specialist, familiar with Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations (ESSENCE), improved the agreement of ESSENCE-Questionnaire (ESSENCE-Q) scoring, across raters. A PHN, two NSTs, and a speech-language pathologist (SLP), familiar with ESSENCE, independently assessed 32 children. The ESSENCE-Q results were divided into the first (child 1-18) and second groups (the 19th child and the following children). Changes in score discrepancies were analysed for ESSENCE-Q cutoff scores and total ESSENCE-Q scores across raters. The SLP scores were used as a reference to evaluate sensitivity and specificity. The total ESSENCE-Q scores of the PHN and NSTs showed higher concordance in the second group (p < 0.05). Comparisons of the differences between the PHN/NSTs and SLP in total ESSENCE-Q scores showed a significantly smaller difference in the NSTs' scores in the second group (p < 0.05). The findings suggest that specialist supervision may lead to a better agreement between PHN and NSTs regarding ESSENCE-Q scores.

Community-based nursing: a concept analysis with Walker and Avant’s approach

BackgroundCommunity-based nursing in recent years has received much attention from nursing schools in different countries as a suitable solution in response to existing and future problems and challenges, but there is yet no comprehensive and correct understanding of this concept and considering its importance, the present study was conducted to the aim of analyzing the concept of community-based nursing.MethodsConcept analysis was done using Walker and Avant's 8-step approach. Nursing dictionary, Persian dictionary, research articles, journals and conferences articles, dissertations, thesis, books, and other sources related to the concept of research were investigated through search engines and available databases using the keywords of nursing, community-based, concept analysis and Walker and Avant from 1990 to 2023. Finally, 54 articles related to the concept were reviewed and analyzed.ResultsThe results showed that community-based nursing has attributes such as individual-oriented/ family-oriented/ community-oriented, social partnership with the communities and stakeholders, social justice, and group and interprofessional cooperation, the community as the main activity setting, providing services based on cultural diversity, providing services according to the context, conditions and community needs, caring for individuals and families with health problems throughout life, responding to the community needs, community-based experiences and facing real-life issues in the context of community, using a problem-based and service-based approach, providing context-based care and considering factors affecting health. In this regard, borderline and related cases (community health nursing, community-oriented nursing, population-based nursing, and public health nursing) were also presented to clarify the concept. Antecedents of community-based nursing included: determining the position of community-based nursing, making infrastructure and structure, the partnership between university, hospital and community, identifying all settings, the presence of educators proficient in education, survey of community needs, having knowledge, communication and community-based skills, expanding the role of the nurse, stakeholders' attitude towards community-oriented nursing and management and financial support. Consequences of community-based nursing included: competence development in nurses, solving community-based nursing challenges, meeting the health needs of individuals, families and communities, social justice, and increasing access to health care services.ConclusionThe results of this study can provide an objective and understandable image of the use of community-based nurses and their education in practice. Conducting more quantitative and qualitative studies about community-based nursing is also recommended.

Emotional and informational social support from health visitors and breastfeeding outcomes in the UK

BackgroundShorter breastfeeding duration is associated with detrimental consequences for infant health/development and maternal health. Previous studies suggest social support is essential in maintaining breast/chest-feeding and helping to improve general infant feeding experiences. Public health bodies therefore work to support breastfeeding in the UK, yet UK breastfeeding rates continue to be one of the lowest globally. With this, a better understanding of the effectiveness and quality of infant feeding support is required. In the UK, health visitors (community public health nurses specialising in working with families with a child aged 0–5 years) have been positioned as one of the key providers of breast/chest-feeding support. Research evidence suggests that both inadequate informational support and poor/negative emotional support can lead to poor breastfeeding experiences and early breastfeeding cessation. Thus, this study tests the hypothesis that emotional support from health visitors moderates the relationship between informational support and breastfeeding duration/infant feeding experience among UK mothers.MethodsWe ran cox and binary logistic regression models on data from 565 UK mothers, collected as part of a 2017–2018 retrospective online survey on social support and infant feeding.ResultsInformational support, compared to emotional support, was a less important predictor of both breastfeeding duration and experience. Supportive emotional support with unhelpful or absent informational support was associated with the lowest hazard of breastfeeding cessation before 3 months. Results for breastfeeding experience followed similar trends, where positive experience was associated with supportive emotional and unhelpful informational support. Negative experiences were less consistent; however, a higher probability of negative experience was found when both types of support were reported as unsupportive.ConclusionsOur findings point to the importance of health visitors providing emotional support to bolster the continuation of breastfeeding and encourage a positive subjective experience of infant feeding. The emphasis of emotional support in our results encourages increased allocation of resources and training opportunities to ensure health visitors are able to provide enhanced emotional support. Lowering health visitors caseloads to allow for personalised care is just one actionable example that may improve breastfeeding outcomes in the UK.

Evaluating the use of reflective cafés in Specialist Community Practitioner and Specialist Community Public Health Nurse programmes.

Background: Specialist Community Practitioner (SCP) and Specialist Community Public Health Nurse (SCPHN) students are required to evidence their competency by the use of reflective practice as part of the NMC proficiencies. A reflective café trilogy comprising of three reflective teaching sessions was developed and introduced into a university programme to support and encourage alternative methods for deeper reflection within this student group. Aim: It was important for educators to evaluate if a reflective café met the student's needs and understand the usefulness of a 'reflective café' as a technique to support the process of reflecting on practice. Methods: Evaluation was undertaken using an online questionnaire. Findings: Students evaluated if the reflective café was useful for their own development and identified that the number of sessions met their developmental needs. Conclusion: The potential to develop alternative methods to reflect was recognised and the team plan to develop other reflective processes to support students in the future.

Why it's time to unite science-based and alternative care in holistic nursing

Sally Star, Holistic Health Practitioner and Nurse with specialisms in specialist community public health nursing, educator, and Founder Member, Holistic Nurses UK (www.linkedin.com/in/sallystaratbioelectriclife).

Nursing Care Offered to A Teenager at Risk of Gender Dysphoria and Suicide: A Community Mental Health and Public Health Nursing Approach

Young people who are gender dysphoria are often at risk for certain psychosocial problems as well as being victims of discrimination and stigmatization. Such problems include issues such as social isolation, social withdrawal, loneliness, dropping out of school, tendency to crime, substance abuse, and being subject to violence. It is thought that all these problems are especially important in personal and social lives of young people living in societies where traditional gender roles have been conserved. In this study, it was aimed to offer holistic nursing care interventions to a 17-year-old male person who stated that he had wanted to commit suicide and been subject to homophobic attitudes because of the confusion about his gender.

Mental health and emotional wellbeing education in school nursing practice

The emotional health and wellbeing (EHWB) of children and young people (C&amp;YP) are of particular significance to specialist community public health nurses (SCPHN) in the field of school nursing practice as they are key contributors to the health and development of children. This paper will discuss the findings of a strategy critique and a small literature review, aimed at determining if school-based mental health promotion positively influences C&amp;YP's EHWB and how this can affect school nursing practice in Wales.

Community Health and Public Health Nurses: Case Study in Times of COVID-19

The COVID-19 pandemic has given more relevance to identifying the common and specific competencies of specialized nurses in community health and public health, presenting and characterizing their interventions, relations with health indicators in the population, identifying factors that facilitate their performance, and their respective regulations. A qualitative case study was undertaken with 31 nurses from a group of health centers and data collection by interviews, direct observation, and documents analysis. The flow model and an interpretive matrix, with two strategies and two techniques, was used for the analysis and discussion. The majority of participants were female, who were aware of and familiar with the specific and defined competencies, which they put into practice. They recognize their activities as important and feel happy where they are and doing what they do. They have good a knowledge of the regulations that concern them. They consider themselves well prepared and available to intervene in many dimensions, such as epidemiological surveillance, management, and group empowerment, contributing to good health indexes and health sustainability. Expected changes are related to their potential contributions to advance the nursing profession, which this pandemic has highlighted.

Review of pre-registration standards

The specialist community public health nursing and specialist practice qualification standards are under review by the Nursing and Midwifery Council. Crystal Oldman urges you to share the opportunity to participate in the consultation

Awareness among health visitors of the association between postnatal depression and intimate partner abuse

Intimate partner abuse and postnatal depression (PND) are of particular significance to specialist community public health nurses in the field of health visiting practice as they are key contributors to the health and development of children. However, evidence regarding the association between these two phenomena is limited. A literature review was conducted to identify ways in which health visiting practice could be informed to identify and support women experiencing intimate partner abuse and PND. The review identified three main themes: a significant co-concurrence between intimate partner abuse and PND; a relationship between lifetime abuse and PND; and the impact of emotional abuse in relation to PND.

Promotion of professional quality of life through reducing fears of compassion and compassion fatigue: Application of the Compassionate Mind Model to Specialist Community Public Health Nurses (Health Visiting) training.

To identify whether a Compassionate Mind Model-based curriculum reduces students' perceived fears of compassion and improves their professional well-being. Enabling compassion is mandatory within nurse education but evidencing it is challenging. Research suggests that application of the Compassionate Mind Model might reduce students' fears of compassion and also decrease compassion fatigue. This study reports outcomes of a post-registration curriculum based on that model for training Specialist Community Public Health Nurses (Health Visiting). A quantitative, prospective evaluation of a 12-month training course for Health Visiting students. Reporting was guided by the STROBE checklist for observational studies. Fears of compassion scales were applied at course start (time 1), mid-point (time 2; +6months) and end (time 3; +12months) to evaluate fears of compassion of 26 post-registration student Health Visitors (81% of course cohort) who provided data at all three points. The Professional Quality of Life tool was administered simultaneously to evaluate compassion satisfaction and burnout/secondary traumatic stress (compassion fatigue). Between time 1 and time 3, mean fears of compassion scores decreased by 16.6-48.5% (repeated measures analysis of variance); mid-point scores were intermediary. At time 3, compassion satisfaction had increased slightly (+4.1%), negatively correlated with fears of compassion for self (r=-0.602; p=.001; n=26) and fears of receiving compassion from others (r=-0.568; p=.002; n=26). Burnout score decreased by 18.7%, correlated positively with fear of compassion for self (r=0.493; p=.011; n=26) and fear of receiving compassion from others (r=0.615; p=.001; n=26). Secondary traumatic stress score decreased by 16.5% but was not correlated with any fear of compassion. Findings suggest that application of the Compassionate Mind Model might reduce practitioners' fears of compassion linked to a decrease in risk of compassion fatigue. The Compassionate Mind Model could provide an effective vehicle to promote compassion and nurse well-being.

Community health and public health nursing

Community health and public health nursing is a relevant issue in the context of the Portuguese National Health System reforms. International organizations, such as the World Health Organization, have emphasized the importance of nurses in community and public health care, and international studies report ongoing changes in this area in many countries. Through a Systematic Literature Review, conducted in early 2019, following an Equator Network protocol, Systematic Reviews, CRD's guidance for undertaking reviews in health care, prepared by York University, we addressed the research issue: what has been published about community health and public health nurse competencies and interventions. The inclusion of articles followed PRISMA 2009 and 36 of the total number of publications were selected. The contributions refer to the expansion of nurses’ competences, events such as health fairs, nutrition, and caries assessments, performance in contexts of natural disasters, development of management skills, understanding and influencing the making of public health policies. With the ongoing public health reform taking place in Portugal, it is also a good opportunity for nursing to investigate, produce, innovate, and recreate itself.

Can community as a whole be a client for nurses?

Community Health Nursing and Public Health Nursing has a long history in the world. However, most of the times it is associated to care in community more than care to community [1].

Community well-being and public health nurses

Community well-being and public health nurses

A support package for parents of excessively crying infants: development and feasibility study.

Around 20% of 1- to 4-month-old infants cry for long periods without an apparent reason. Traditionally, this was attributed to gastrointestinal disorder ('colic'), but evidence shows that just 5% of infants cry a lot because of organic disturbances; in most cases, the crying is attributable to normal developmental processes. This has led to a focus on the impact of the crying on parents. Parental vulnerabilities influence how parents evaluate and respond to the crying and predict adverse outcomes. By developing evidence-based services that support parents, this study was designed to take the first steps towards national health services that enhance the coping and well-being of parents whose babies excessively cry. Related aims were to improve these infants' outcomes and how NHS money is spent. To develop a novel intervention package to support parents of excessively crying infants and to examine the feasibility of delivering and evaluating it in the NHS. Stage 1 of this study aimed to (1) complete a literature review to identify example support materials, (2) obtain parents' guidance on the support needed when a baby cries excessively, together with their evaluation of the example materials, and (3) develop a support package based on the results. Stage 2 aimed to (1) recruit 60 parents whose babies were currently excessively crying, (2) assess parents' and NHS professionals' willingness to complete a study of the support package, (3) measure the use and evaluation of the package components, (4) estimate the package component costs and (5) provide evidence on the feasibility and methods for a large-scale trial. Primary health care. Stage 1: 20 parents of previously excessively crying infants and 55 health visitors (HVs) or specialist community public health nurses (SCPHNs). Stage 2: 57 parents of currently excessively crying infants and 124 HVs/SCPHNs. The support package included a website, a printed booklet and a programme of cognitive-behavioural therapy-based sessions delivered to parents by a qualified practitioner. (1) Demographic data, (2) figures for parents' use of the package components and continuation in the study, (3) parents' and HVs'/SCPHNs' ratings of the package components and suitability for NHS use, (4) questionnaire measures of parental well-being and infant health and (5) costs. Most parents (95%) accessed the website or printed materials and half (51%) attended the practitioner sessions. All 52 parents and 85% of HVs/SCPHNs providing data would support the inclusion of the package in the NHS. It was associated with reduced parental frustration, anxiety, depression, reported infant crying and contacts with health professionals and increased knowledge about crying. Methods for a full trial and figures for the cost of excessive infant crying for the NHS and each package element were identified. No control group was included. Most of the recruited parents were white, well educated and in stable relationships. Parents and HVs/SCPHNs recognise the need for NHS provisions that support parents of excessively crying babies and consider the materials developed to meet that need. A full-scale randomised controlled trial is feasible and desirable. Current Controlled Trials ISRCTN84975637. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 56. See the NIHR Journals Library website for further project information.