1. Challenges and Opportunities for Public Health Nursing: Present and Future

2. Lillian Wald

5. PHN in Emergency Preparedness

9. Unique contributions of PHN - focus on populations

10. “Worst Case Scenario” - Affects the entire state of Minnesota - Medications or vaccines dispensed to every citizen in 5 days or less - Clinics will operate 24/7

11. Spanish Influenza of 1918 - 1919

12. Unique contributions of PHN - systematic planning approach

13. Process for MDS Triage Bus Off-site Level 1 Screener Treatment Center (First Aid)

18. MDH Adjusted Standards of Mass Dispensing Matrix- Antibiotics Tier 1 (Example: BDS)Tier 2 (faster)Tier 3 (fastest) Triage1) Screen w/triage protocol 2) Form: “Triage Client Referral – Contained Exposure” 3) Refer to individual’s provider as indicated by algorithm. Same as Tier 1. Refer to pre-planned facility for true symptoms. Form: “Triage Client Referral – Large Scale Exposure” Same as Tier 2 with emphasis on public information “If ill, go to (preplanned facility).” Form: “Triage Client Referral – Large Scale Exposure” Meds dispensed to whom Individual and their minor dependents Individual and 9 others (with their acknowledgement and health data) Individual and _?__ others (with their acknowledgement and health data) Meds may be dispensed without complete information. Screening and Dispensing Staffing In order of preference Under direction of MD or Pharmacist Level 2: Pharmacist, MD, RN Level 1: Pharmacist, MD, RN Express: RNs, health care related professionals, trained non-health care volunteers Same as tier 1Under direction of MD or Pharmacist Level 2: RN, health care related professionals Level 1: RN, health care related professionals Express: RN, health care professionals, trained non-health care volunteers Process Screening and documentation with standard flow, form, and protocols Same as tier 1Families with no contraindications to or complications with doxy, go directly to Express – no form. For all others - Staff uses form as screening worksheet. FormRetained as record.Same as tier 1Client retains form. Bottle Labeling NDC# or lot # Label Pt. name Record on form Labeled by dispenser - name and pre- printed labels put on bottles Same as tier 1No record Dispenser or assistant puts name of client on Cipro bottle PediatricsSuspension for 2 year olds and under Cipro < 6 mo. olds (if available) Dispenser writes dosage on bottle Suspension for 2 year olds and under Cipro < 6 mo. olds (if available) Dispenser writes dosage on bottle Suspension for 2 year olds and under Cipro < 6 mo. olds Dispenser determines number of bottles Parent determines dose w/ chart. Data Compilation ClientsMIIC, manual tabulationsSame as tier 1Inventory count DrugsInventory management system, manual counting Same as tier 1 Education -One-on-one with written instruction.Written w/one-on-one for brief reinforcements only w/handouts Handouts, signs, media

19. Tier 1 (Example: BDS) Tier 2 (faster)Tier 3 (fastest) Screening and Dispensing Process Screening and documentation with standard flow, form, and protocols Same as tier 1 Families with no contraindications to or complications with doxy, go directly to Express – no form. For all others - Staff uses form as screening worksheet. MDH Adjusted Standards of Mass Dispensing Matrix- Antibiotics

20. Unique contributions of PHN - collaborate with community partners

22. Other unique contributions of PHN - understand communicable or infectious disease process - work across “silos” - experience and skill working with assistive and volunteer personnel

29. PHN’s as Business People

30. South Country Health Alliance

31. Primewest Coverage Map

32. PHN’s in Quality Improvement

33. Public Health Intervention Wheel

34. By the numbers… Population Mn Micropolitan – 14.7% of population Rural – 12.8% RN’s Mn Micropolitan – 12.4% of all RN’s Rural – 7.9% Median Age Mn 47 years old Micropolitan and rural – 49 years % of all Nurses between 55 years and 65+ Mn Micropolitan – 27.6% Rural – 28.5% PHN’s Mn – 2.9% of all RN’s Micropolitan – 5.3% Rural – 7.5%

35. Challenges - salary - multicultural communities - limited learning opportunities for students - aging workforce

36. Opportunities - Pay based on performance, outcome, market standards - new models for work - new model for education

37. References Columbia University School of Nursing Center for Health Policy. (November 2002) Bioterrorism and Emergency Readiness Competencies for all Public Health Workers. From http://www.cumc.columbia.edu/dept/nursing/chphsr/pdf/btcomps.pdfhttp://www.cumc.columbia.edu/dept/nursing/chphsr/pdf/btcomps.pdf Delaney,C. (2007,May 29). Health First – Build a refocused health system on the strengths of nurses [Letter to editor]. St.Paul Pioneer Press, p.B9. Office of Rural Health and Primary Care, Minnesota Department of Health. (July, 2006) Minnesota Registered Nurses Facts and Data 2006 Retrieved August 23, 2007 from http://www.health.state.mn.us/divs/chs/workforce/rn06.htm http://www.health.state.mn.us/divs/chs/workforce/rn06.htm