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运用专业实践模式重新定位公共卫生护士的实践

Reorienting Public Health Nurses' Practice With a Professional Practice Model.

作者信息

Cusack Cheryl, Cohen Benita, Mignone Javier, Chartier Mariette J, Lutfiyya Zana

机构信息

1 Winnipeg Regional Health Authority, Winnipeg, MB, Canada.

2 Faculty of Health Sciences, College of Nursing, University of Manitoba, Winnipeg, MB, Canada.

出版信息

Can J Nurs Res. 2017 Mar;49(1):16-27. doi: 10.1177/0844562116686003. Epub 2017 Jan 4.

Abstract

Purpose Documents articulating public health nurses' (PHNs') roles, including Canadian standards and competencies, depict a broad focus working at multiple levels to improve population outcomes through the promotion of health equity. Conversely, Canadian experts depict a looming crisis, based on the rising disconnect between daily activities and ideal practice. While perfectly positioned, PHNs' skills and abilities are under-utilized and largely invisible. The intention of this study was to develop a model to support the full scope of equity-focused PHN practice. Method A participatory action research approach was used. Qualitative data were gathered using semistructured interview guides during audio-recorded meetings. The data were coded into central themes using content analysis and constant comparison. A researcher reflexive journal and field notes were kept. A significant feature was full participant involvement. Results The outcome was a professional practice model to reframe the PHN role to focus on population health and equity. The model was imperative in promoting full scope of practice, dealing with workload pressures, and describing PHNs' value within the organization and broader health system. Conclusion Professional practice models hold promise as frameworks to depict autonomous practice activities, situated within organizations and healthcare systems, and underpinned by nursing knowledge.

摘要

目的 阐述公共卫生护士(PHN)角色的文件,包括加拿大的标准和能力要求,描绘了一个广泛的工作重点,即在多个层面开展工作,通过促进健康公平来改善人群健康状况。相反,加拿大专家基于日常活动与理想实践之间日益加大的脱节现象,描绘了一场迫在眉睫的危机。尽管公共卫生护士具备理想的条件,但他们的技能和能力未得到充分利用,而且在很大程度上不为人所见。本研究的目的是开发一个模型,以支持全面的、以公平为重点的公共卫生护士实践。方法 采用参与式行动研究方法。在录音会议期间,使用半结构化访谈指南收集定性数据。通过内容分析和持续比较,将数据编码为核心主题。研究人员保留了反思日记和实地笔记。一个显著特点是所有参与者都充分参与。结果 研究成果是一个专业实践模型,该模型重新界定了公共卫生护士的角色,使其侧重于人群健康和公平。该模型对于促进全面实践、应对工作量压力以及描述公共卫生护士在组织和更广泛的卫生系统中的价值而言至关重要。结论 专业实践模型有望成为一种框架,用于描述在组织和医疗系统中开展的、以护理知识为支撑的自主实践活动。

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