Converging Public Health and Primary Care Nursing: A Key Confluence to Enrich the Healthcare Waters

Background: Our nation’s underserved communities face rising costs, and declining life expectancies. In response, health care stakeholders seek to integrate primary care (PC) and public health (PH) nurses to meet these rising challenges. Navigating this convergence requires ambulatory care registered nurses (RNs) to execute both upstream and downstream nursing actions. Applying up-to-date knowledge of the integration of public health and primary care is vital to nurses in these settings, to improve health outcomes of their individual patients and their patient populations.

Learning outcomes: After a review of this poster, participants will be able to 1) describe the content of two newly developed modules that integrates PH and PC competencies for RNs in ambulatory care settings and 2) describe the post-module survey results.

Methods: An interprofessional team utilized an existing academic-practice partnership in a large local PH department and two federally qualified health centers (FQHCs) to develop 14 modules that integrate PC and PH content. 56 nursing contact hours were obtained using a free online platform, MoodleTM. The topics are 1) precepting, 2) PC, 3) PH, 4) integration of primary care and public health, 5) transitions of care and chronic disease management, 6) mental health and substance abuse, 7) cultural competence, 8) social determinants of health, 9) program development, 10) ambulatory care, 11) hospice and palliative care, 12) quality improvement, 13) population health, and 14) interprofessional education. Modules 3 and 4 cover PC and PH integration. Participants complete online surveys using Qualtrics® before and after the online training modules. Data will assess competence and application of PC/PH nursing integration.

Results: Two modules will be summarized with exemplars. Module 3 describes a) the tier 1, II, and III of PH nursing competencies and how they apply to practice, research, policy development and education; b) the council of linkages and its role between academics and PH practice; and c) PH nursing’s contribution to a healthy Michigan. Module 4 describes a) the reasons for the integration of PH and PC, b) the differences in how integration is defined, c) the World Health Organization’s (WHO) suggestions for how to integrate public health and primary care, and d) roles nurses play in the integration of public health and primary care. The modules were beta-tested by seven RNs with expertise in PC or PH in year one and year two of our grant, with two RNs from FQHC centers and five RNs from the PH department. Preliminary post-module qualitative and quantitative survey results from these beta testers will be provided. The final modules are being shared with a larger audience in our three partner sites and our college of nursing; we will provide outcomes from these additional RNs.

Conclusions: Public health and primary care academic-practice partnerships can enhance ambulatory care nurses’ knowledge, skills, and actions to improve population health. Nurses in both primary care as well as public health who apply knowledge of their respective specialties' value will launch both upstream and downstream actions to improve their patients’ and communities’ health.