Essential public health competencies in nursing during the COVID-19 pandemic: A Delphi study
Abstract
Background & Aim: Nursing practice, characterized by its multifaceted nature, encompasses diverse settings and situations in public health, making it difficult to clearly define the role of nurses in this setting. The study aimed to determine the applicability and relevance of the Regional Core Competency Framework for Public Health in nursing practice during the COVID-19 pandemic.
Methods & Materials: Study based on the Delphi methodology, a structured approach to the systematic collectión of expert opinions, to obtain group agreements. Twenty-one nurses working in public health areas during the pandemic participated.
Results: The competencies most applied by the nurses were in the domain of health situation analysis and surveillance and risk and damage control. 95% of the nurses were involved in care actions to prevent contagion; 71% analyzed social determinants of health, 100% were involved in the domain of policies, planning, regulation, and control, and 86% in the domain of health promotion. 89% made decisions to favor access to preventive and health care services. 78% valued social participation actions and 76% implemented immediate responses to COVID-19.
Conclusion: The main public health competencies used by nursing for dealing with the COVID-19 pandemic are the management of educational processes, health promotion, primary health care, analysis of social determinants, management of health policies, information analysis, and management of immediate responses to challenges generated by COVID-19.
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13. Haldane V, Jung A, Neill R, Singh S, Wu S, Jamieson M, et al. From response to transformation: how countries can strengthen national pandemic preparedness and response systems. BMJ. 2021:375:e067507. https://doi.org/10.1136/bmj-2021-067507.
14. Kneipp SM, Edmonds JK, Cooper J, Campbell LA, Little SH, Mix AK. Enumeration of public health nurses in the United States: Limits of current standards. American Journal of Public Health. 2022 Jun;112(S3):S292-7. https://doi.org/10.2105/AJPH.2022.306782
15. Edmonds JK, Kneipp SM, Campbell L. A call to action for public health nurses during the COVID‐19 pandemic. Public Health Nursing. 2020 May;37(3):323-24 .https://doi.org/10.1111/phn.12733
16. Keeney S, Hugh A, McKenna H, Felicity H. The Delphi technique in nursing and health research. John Wiley & Sons, 2011.
17. García Valdés M, Suárez Marín M. El método Delphi para la consulta a expertos en la investigación científica. Revista cubana de salud pública. 2013;39:253-67.
18. Diamond IR, Grant RC, Feldman BM, Pencharz PB, Ling SC, Moore AM, Wales PW. Defining consensus: a systematic review recommends methodologic criteria for reporting Delphi studies. Journal of Clinical Epidemiology. 2014 Apr 1;67(4):401-9. doi:https://doi.org/10.1016/j.jclinepi.2013.12.002
19. Spranger J, Homberg A, Sonnberger M, Niederberger M. Reporting guidelines for Delphi techniques in health sciences: A methodological review. Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen. 2022 Aug 1;172:1-1. https://doi.org/10.1016/j.zefq.2022.04.025
20. Holroyd E, Long NJ, Appleton NS, Davies SG, Deckert A, Fehoko E, Laws M, Martin‐Anatias N, Simpson N, Sterling R, Trnka S. Community healthcare workers' experiences during and after COVID‐19 lockdown: A qualitative study from Aotearoa New Zealand. Health & Social Care in the Community. 2022 Sep;30(5):e2761-71. https://doi.org/10.1111/hsc.13720
21. National Academies of Sciences, Engineering, and Medicine. The future of nursing 2020–2030: Charting a path to achieve health equity [Internet]. Washington, DC.: National Academies Press; 2021 [cited 2024 Feb 23]. Retrieved from: https://nap.nationalacademies.org/read/25982/chapter/1
22. Norful AA, Tucker S, Miller PS, Roberts H, Kelley MM, Monturo C, O'Mathúna D, Smith J, Zadvinskis IM, Zellefrow C, Chipps E. Nursing perspectives about the critical gaps in public health emergency response during the COVID‐19 pandemic. Journal of Nursing Scholarship. 2023 Jan;55(1):22-8. https://doi.org/10.1111/jnu.12795
23. Schroeder K, Norful AA, Travers J, Aliyu S. Nursing perspectives on care delivery during the early stages of the COVID-19 pandemic: A qualitative study. International Journal of Nursing Studies Advances. 2020 Nov 1;2:100006. https://doi.org/10.1016/j.ijnsa.2020.100006
24. Zauche LH, Pomeroy M, Demeke HB, Mettee Zarecki SL, Williams JL, Newsome K, Hill L, Dooyema CA. Answering the Call: The Response of Centers for Disease Control and Prevention’s Federal Public Health Nursing Workforce to the COVID-19 Pandemic. American Journal of Public Health. 2022 Jun;112(S3):S226-30.
https://doi.org/10.2105/AJPH.2021.306703
25. Zauche LH, Pomeroy M, Demeke HB, Mettee Zarecki SL, Williams JL, Newsome K, Hill L, Dooyema CA. Answering the Call: The Response of Centers for Disease Control and Prevention’s Federal Public Health Nursing Workforce to the COVID-19 Pandemic. American Journal of Public Health. 2022 Jun;112(S3):S226-30. https://doi.org/10.1057/s41599-020-00701-w
26. Varghese A, George G, Kondaguli SV, Naser AY, Khakha DC, Chatterji R. Decline in the mental health of nurses across the globe during COVID-19: a systematic review and meta-analysis. Journal of Global Health. 2021;11:05009. https://doi.org/10.7189/jogh.11.05009
27. Hassmiller SB. Revitalizing public health nursing for the future. American Journal of Public Health. 2022 Jun;112(S3):S262-4. https://doi.org/10.2105/AJPH.2022.306874
28. Cunha C, Henriques A, Costa A. Community Health and Public Health Nurses: Case Study in Times of COVID-19. Sustainability. 2021;13(20):11149. https://doi.org/10.3390/su132011149
29. Abedi V, Olulana O, Avula V, Chaudhary D, Khan A, Shahjouei S, Li J, Zand R. Racial, economic, and health inequality and COVID-19 infection in the United States. Journal of racial and ethnic health disparities. 2021 Jun;8:732-42. http://dx.doi.org/10.1007/s40615-020-00833-4
30. National League for Nursing. NLN releases a vision for integration of the social determinants of health into nursing education curricula. Nursing Education Perspectives. 2019;40(6):390. https://doi.org/10.1097/01.NEP.0000000000000597
31. Persaud S. Addressing social determinants of health through advocacy. Nursing Administration Quarterly. 2018 Apr 1;42(2):123-8. https://doi.org/10.1097/NAQ.0000000000000277
32. Pan American Health Organization. Perspectives and Contributions of Nursing to the Promotion of Universal Health. [Internet]. Washington, D.C.: Pan American Health Organization; 2020. [cited 2024 Feb 21]. Retrieved from: https://iris.paho.org/handle/10665.2/52121?locale-attribute=es
33. Eghbali M, Negarandeh R, Froutan R. COVID-19 epidemic: Hospital-level response. Nursing Practice Today. 2020; 7(2):81-83. https://doi.org/10.18502/npt.v7i2.2728
2. World Health Assembly. Strengthening Essential Public Health Functions in Support of the Achievement of Universal Health Coverage. [Internet]. 2016. [cited 2024 March 22] Available from: https://apps.who.int/iris/handle/10665/252781
3. Myers CR. Promoting population health: Nurse advocacy, policy making, and use of media. Nursing Clinics. 2020 Mar 1;55(1):11-20. https://doi.org/10.1016/j.cnur.2019.11.001
4. Organización Panamericana de la Salud, Organización Mundial de la Salud. Competencias esenciales en salud pública: un marco regional para las Américas. Washington, D.C. [Internet]. 2013. [cited 2024 Jan 30] Available from: https://iris.paho.org/bitstream/handle/10665.2/28438/9789275318157_spa.pdf
5. World Health Organisation. Building Health Systems Resilience for Universal Health Coverage and Health Security During the COVID-19 Pandemic and Beyond. Geneva. [Internet]. 2021. [cited 2024 Feb 03] Retrieved from: https://iris.who.int/handle/10665/346515
6. Canales MK, Drevdahl DJ. A Sisyphean task: Developing and revising public health nursing competencies. Public Health Nursing. 2022 Sep;39(5):1078-88. https://doi.org/10.1111/phn.13077
7. Chaudry RV. The precautionary principle, public health, and public health nursing. Public Health Nursing. 2008 May;25(3):261-8. https://doi.org/10.1111/j.1525-1446.2008.00703.x
8. Ashley C, Halcomb E, James S, Calma K, Stephen C, McInnes S, Mursa R, Williams A. The impact of COVID‐19 on the delivery of care by Australian primary health care nurses. Health & Social Care in the Community. 2022 Sep;30(5):e2670-7. https://doi.org/10.1111/hsc.13710.
9. Egry EY, Fornari LF, Taminato M, Vigeta SM, Fonseca RM. Indicators of Good Nursing Practices for vulnerable groups in Primary Health Care: a scoping review. Revista Latino-Americana de Enfermagem. 2021 Oct 29;29:e3488. https://doi.org/10.1590/1518-8345.5203.3488
10. Smith DL, Klein K, Smith M. The use of Community/Public Health Nursing Competencies during the COVID‐19 pandemic. Public Health Nursing. 2024 Mar;41(2):356-66. https://doi.org/10.1111/phn.13284
11. Reynolds NR, Baker D, D'Aoust R, Docal M, Goldstein N, Grubb L, Hladek MD, Koirala B, Kverno K, Ling C, Lukkahatai N. COVID‐19: implications for nursing and health care in the United States. Journal of Nursing Scholarship. 2023 Jan;55(1):187-201. https://doi.org/10.1111/jnu.12853
12. Wells KJ, Dwyer AJ, Calhoun E, Valverde PA. Community health workers and non-clinical patient navigators: A critical COVID-19 pandemic workforce. Preventive Medicine. 2021 May 1;146:106464. 2021;146:106464.https://doi.org/10.1016/j.ypmed.2021.106464
13. Haldane V, Jung A, Neill R, Singh S, Wu S, Jamieson M, et al. From response to transformation: how countries can strengthen national pandemic preparedness and response systems. BMJ. 2021:375:e067507. https://doi.org/10.1136/bmj-2021-067507.
14. Kneipp SM, Edmonds JK, Cooper J, Campbell LA, Little SH, Mix AK. Enumeration of public health nurses in the United States: Limits of current standards. American Journal of Public Health. 2022 Jun;112(S3):S292-7. https://doi.org/10.2105/AJPH.2022.306782
15. Edmonds JK, Kneipp SM, Campbell L. A call to action for public health nurses during the COVID‐19 pandemic. Public Health Nursing. 2020 May;37(3):323-24 .https://doi.org/10.1111/phn.12733
16. Keeney S, Hugh A, McKenna H, Felicity H. The Delphi technique in nursing and health research. John Wiley & Sons, 2011.
17. García Valdés M, Suárez Marín M. El método Delphi para la consulta a expertos en la investigación científica. Revista cubana de salud pública. 2013;39:253-67.
18. Diamond IR, Grant RC, Feldman BM, Pencharz PB, Ling SC, Moore AM, Wales PW. Defining consensus: a systematic review recommends methodologic criteria for reporting Delphi studies. Journal of Clinical Epidemiology. 2014 Apr 1;67(4):401-9. doi:https://doi.org/10.1016/j.jclinepi.2013.12.002
19. Spranger J, Homberg A, Sonnberger M, Niederberger M. Reporting guidelines for Delphi techniques in health sciences: A methodological review. Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen. 2022 Aug 1;172:1-1. https://doi.org/10.1016/j.zefq.2022.04.025
20. Holroyd E, Long NJ, Appleton NS, Davies SG, Deckert A, Fehoko E, Laws M, Martin‐Anatias N, Simpson N, Sterling R, Trnka S. Community healthcare workers' experiences during and after COVID‐19 lockdown: A qualitative study from Aotearoa New Zealand. Health & Social Care in the Community. 2022 Sep;30(5):e2761-71. https://doi.org/10.1111/hsc.13720
21. National Academies of Sciences, Engineering, and Medicine. The future of nursing 2020–2030: Charting a path to achieve health equity [Internet]. Washington, DC.: National Academies Press; 2021 [cited 2024 Feb 23]. Retrieved from: https://nap.nationalacademies.org/read/25982/chapter/1
22. Norful AA, Tucker S, Miller PS, Roberts H, Kelley MM, Monturo C, O'Mathúna D, Smith J, Zadvinskis IM, Zellefrow C, Chipps E. Nursing perspectives about the critical gaps in public health emergency response during the COVID‐19 pandemic. Journal of Nursing Scholarship. 2023 Jan;55(1):22-8. https://doi.org/10.1111/jnu.12795
23. Schroeder K, Norful AA, Travers J, Aliyu S. Nursing perspectives on care delivery during the early stages of the COVID-19 pandemic: A qualitative study. International Journal of Nursing Studies Advances. 2020 Nov 1;2:100006. https://doi.org/10.1016/j.ijnsa.2020.100006
24. Zauche LH, Pomeroy M, Demeke HB, Mettee Zarecki SL, Williams JL, Newsome K, Hill L, Dooyema CA. Answering the Call: The Response of Centers for Disease Control and Prevention’s Federal Public Health Nursing Workforce to the COVID-19 Pandemic. American Journal of Public Health. 2022 Jun;112(S3):S226-30.
https://doi.org/10.2105/AJPH.2021.306703
25. Zauche LH, Pomeroy M, Demeke HB, Mettee Zarecki SL, Williams JL, Newsome K, Hill L, Dooyema CA. Answering the Call: The Response of Centers for Disease Control and Prevention’s Federal Public Health Nursing Workforce to the COVID-19 Pandemic. American Journal of Public Health. 2022 Jun;112(S3):S226-30. https://doi.org/10.1057/s41599-020-00701-w
26. Varghese A, George G, Kondaguli SV, Naser AY, Khakha DC, Chatterji R. Decline in the mental health of nurses across the globe during COVID-19: a systematic review and meta-analysis. Journal of Global Health. 2021;11:05009. https://doi.org/10.7189/jogh.11.05009
27. Hassmiller SB. Revitalizing public health nursing for the future. American Journal of Public Health. 2022 Jun;112(S3):S262-4. https://doi.org/10.2105/AJPH.2022.306874
28. Cunha C, Henriques A, Costa A. Community Health and Public Health Nurses: Case Study in Times of COVID-19. Sustainability. 2021;13(20):11149. https://doi.org/10.3390/su132011149
29. Abedi V, Olulana O, Avula V, Chaudhary D, Khan A, Shahjouei S, Li J, Zand R. Racial, economic, and health inequality and COVID-19 infection in the United States. Journal of racial and ethnic health disparities. 2021 Jun;8:732-42. http://dx.doi.org/10.1007/s40615-020-00833-4
30. National League for Nursing. NLN releases a vision for integration of the social determinants of health into nursing education curricula. Nursing Education Perspectives. 2019;40(6):390. https://doi.org/10.1097/01.NEP.0000000000000597
31. Persaud S. Addressing social determinants of health through advocacy. Nursing Administration Quarterly. 2018 Apr 1;42(2):123-8. https://doi.org/10.1097/NAQ.0000000000000277
32. Pan American Health Organization. Perspectives and Contributions of Nursing to the Promotion of Universal Health. [Internet]. Washington, D.C.: Pan American Health Organization; 2020. [cited 2024 Feb 21]. Retrieved from: https://iris.paho.org/handle/10665.2/52121?locale-attribute=es
33. Eghbali M, Negarandeh R, Froutan R. COVID-19 epidemic: Hospital-level response. Nursing Practice Today. 2020; 7(2):81-83. https://doi.org/10.18502/npt.v7i2.2728
| Issue | Articles in Press | |
| Section | Original Article(s) | |
| Keywords | ||
| COVID-19; pandemic; nursing; public health; nurse's role | ||
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How to Cite
1.
Burbano López C, Sotelo-Daza J. Essential public health competencies in nursing during the COVID-19 pandemic: A Delphi study. NPT. 2024;:X-X.
