Measuring Population-Based Competencies for Public Health Nursing

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Measuring Population-Based Competencies for Public Health Nursing

    Measuring Population-based Competencies for Public Health Nursing

    American Public Health Association Annual Meeting

    November 7, 2006 Poster Session 4281.0 4:30 PM

    Derryl Block, PhD, MPH, RN; Sharon Cross, MSPH, RN; LaVohn Josten, PhD, RN; Dawn Reckinger, PhD, MPH; Linda Olson-Keller, MS, RN; Sue Strohschein, MS, RN; Mary Rippke, MS, RN; Kay Savik, MS

Public Health Nursing Competency Instrument (PHNCI)

    ; Comprehensively describes PHN competencies essential for improving population health ; Measures PHNS’ knowledge and skills in population-based practice and changes in competence over


    ; Evaluates competencies of PHNS, nursing students, and the public health nursing workforce as an


    ; Grounded in concepts of population-based practice

    ; Defines population-based PHN practice and assesses professional competencies ; Consists of 195 measurable activities organized using the nursing process

    ; Confirmed by experts as a valid reflection of PHN practice

    ; Specificity measures changes in competence over time

    ; Is based on the Minnesota Public Health Intervention Model

Content Validity Testing

    ; Evaluation team delineated PHN competencies at individual/family, community, and systems levels. ; Chief PHNs and state consultants from 5 upper Midwest states identified PHN experts in practice or

    education to participate in the Advisory Committee.

    ; Initial PHNCI testing involved 40 regional nurses

    ; Revised tool used to evaluate the USPHS, HRSA, Division of Nursing continuing education course.

    120 participants and 33 preceptors completed the instrument pre- and six months post completion of

    the educational course.

    ; (75) 2001 ASTDN Annual Meeting participants and ACHNE Spring Institute participants reviewed the


    ; Based on feedback, the PHNCI was again revised to strengthen content, change terminology, and

    reorganize items using the nursing process.

    ; Resulting version of the PHNCI was critiqued for content validity by PHN faculty who were widely

    published leaders in the field of PHN from a southeastern state university.

Implications of Validity Testing

    ; The domain of PHN is a complex, complicated area of nursing practice requiring many different skills

    in order to achieve competency.

    ; PHN educators and practitioners can use this instrument to develop or change guidelines for

    education, practice, accreditation and certification.

    ; Community and systems levels of practice need to be strengthened in order to achieve a competent

    PHN workforce.

Instrument Sample Items


    1. I would need to be taught the skills to accomplish this activity.

    2. I do or could do this activity with assistance.

    3. I do or could do this activity.

    4. I teach or could teach others to accomplish this activity.

Sample Competency

    Engage and Re-engage Partners

    Establish a process for involving partner participation in the population-based process. 1 2 3 4

    Work with partners to develop strategies to bring together partners reluctant to participate in the population-based process.

    1 2 3 4

    Share assessment, planning, implementation, and evaluation findings with identified partners. 1 2 3 4

    Facilitate partner participation in the population-based process.

    1 2 3 4

    Encourage partners to allocate resources towards improving population health. 1 2 3 4

Instrument Uses

    ; The specificity of PHNCI defines and clarifies the integration of public health nursing practice and the

    nursing process, especially at the community and systems level.

    ; Agencies may use the instrument to assess specific competencies and to identify areas of program

    and professional need.

    ; Guided by community needs and available resources, PHNCI is useful in determining staffing needs,

    developing job descriptions, orientation, evaluating staff competencies, and planning continuing

    education offerings.

    ; For students, PHNCI is useful in planning population-based public health nursing curriculum as well

    as defining and measuring student competency. Its use of the nursing process assists students in

    understanding and integrating nursing and public health practice that is individual/family, community,

    and systems-focused.

    ; Delineation of specific activities and skills helps to direct course content and practicum experiences.

    The PHNCI can be used either by students in self-rating or by faculty to evaluate practicum


    ; Competencies’ list may also be useful with policy makers and other funding sources to describe how

    PHNs implement proposed interventions.

Future Steps

    ; Correlation of competency scores in various areas of the instrument

    ; Identification of critical items to assess whether the instrument can be shortened ; Relationship between PHN competencies and public health outcomes

    ; Factor analysis as well as test-retest reliability testing for the instrument as a whole and for subsets of

    the instrument

The current version of the PHNCI can be found at:

Additional information regarding instrument development may be found in:

    Cross, S., Block, D., Josten, L., Reckinger, D., Keller, L.O., Strohschein, S., Rippke, M., Savik, K. (2006). Development of the Public Health Nursing Competency Instrument. Public Health Nursing, 23(2), 108-114.

    If you are interested in participating in reliability testing of the PHNCI or in additional information, please contact:

    Derryl Block PhD, MPH, RN

    Sharon Cross MSPH, RN

    LaVohn Josten PhD, MN, RN

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