ChingMin Chen, RN, DNS

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Training Needs of Public Health Nurses Working in
Primary Health Care Settings

• Ching-Min Chen, RN, DNS
• Professor, College of Nursing
• Taipei Medical University

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Development of Public Health Nursing in Taiwan

• Health status of Taiwanese citizens have greatly
  improved
• Life expectancy
• 1961?62.3?66.8 ?2007?75.9?81.9
• Leading causes of death from acute and
  communicable diseases to chronic diseases
• Health Centers / clinics have been the basic unit
  for public health and diseases control since 1945

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Manpower of Public Health Nursing

• Largest segment of the public health workforce
  (almost 60), public health nurses are critical
  to the functioning of the overall public health
  system
• There are 2,573 PHNs worked in health centers
  (DoH, 2005) as center directors, head nurses,
  professional registered nurses and registered
  nurses, public health nurse specialists
  midwives.

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Tasks of PHNs working in Health Centers
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Many Changes and Challenges Public Health Nurses
are Facing

• Key forces affect health and contribute to
  challenges in service planning and delivery
  poverty, increased globalization, climate change,
  political unrest.
• These challenges shape the environments include
• The rising costs of health care
• Increasing consumer expectations and demands
• Changing demographics and ageing populations
• Nursing and other health worker shortages
• Legislation and/or political will to fully
  utilize nursings potential
• Social conflict and unrest which destabilize
  services and constrain resources
• Natural and manmade disasters
• Endemic and pandemic disease, as well as new and
  reemerging ones
• The surge in chronic diseases
• Making the shift to community-based care.

(ICN, 2008)
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International Nurses Day 2008 Delivering
Quality, Serving Communities Nurses Leading
Primary Health Care
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We hope they will help you see where you are
leading and where and how you might further lead
in strengthening PHC and serving your community
whether it is a community of the public or a
practice, education, research or management
community within the profession. It is only by
serving our communities that we can deliver
quality health outcomes for the individuals,
familiesand communities we care for.
Hiroko Minami, President of ICN Judith A. Oulton,
Chief Executive Officer
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If the millions of nurses in a thousand
different places articulate thesame ideas and
convictions about primary health care, and
cometogether as one force, then they could act
as a powerhouse for changeHalfdan Mahler,
Director General, World Health
Organization,1985.
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Nurses Contributions in PHC

• Improved access to care
• Improved prevention of chronic diseases
• Improved cost-effectiveness
• Improved outcomes
• Improved surveillance.

• Improved disaster recovery
• Improved patient compliance with care
• Leveraging technology for primary health care

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Core Principles of PHC

• Equal and universally accessible health services.
  Everyone should have reasonable access to
  essential health services with no financial or
  geographical barriers.
• 2. Community participation in defining and
  implementing health agendas. The public should be
  encouraged and empowered to participate in
  planning and making decisions about their own
  health care.
• 3. Intersectoral approaches to health.
  Professionals from various sectors, including the
  health sector, work interdependently with
  community members to promote the health of the
  community.
• 4. Appropriate technology. Technology and modes
  of care should be based on health needs, and
  appropriately adapted to the community's social,
  economic and cultural development.

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Nurses Role in PHC Practice

• To maintain links between individuals, families,
  communities and the rest of the health care
  system
• To work both autonomously and collaboratively to
  prevent disease and to promote health
• To provide first-point-of-contact care and
  disease management across the lifespan

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Training Needs for PHNs

• 2009 project Working Environment Improvement
  Project for Public Health Nurses in Health
  Centers.
• March-December
• Project Purposes
• To explore public health nursing service needs
  from citizens viewpoints
• To describe working environments of PHNs in
  Health Centers
• To recommend the improvement strategies
• To develop continue education programs for PHNs

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Methods

• Thorough research search
• ISI Web of Science public health nursing
  primary health care, health center
• Government Research Bulletin, GRB
• Focus group interview for those who are frequent
  users of public health nursing services
• Telephone interview
• Strata sampling for 1,600 community citizens

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Step 1 Thorough research search

• ISI Web of Science public health nursing
  primary health care, health center
• Government Research Bulletin, GRB
• ?annotated bibliography
• ?develop interview guide and questionnaire

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Step 2 Focus group interview

• Participants
• Frequent users of public health nursing services
• 8-15 participants per section (Polit Hungler,
  2000)
• 2 Public health nurses will also be invited
• Instruments
• Open-end Semi-structure interview guide
• List of tasks of public health nurses
• Data saturation

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Step 3 Telephone interview

• Cross-sectional research design
• Self-developed Instrument based on literature and
  results of focus interview
• Strata sampling based on city/county population
• Both users and non users needs for public health
  nursing services will be included
• Weighted sampling on those non-users
• At least 1600 valid questionnaire will be
  collected (Anderson, 2006)

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Thank you for your attention.