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Chapter 35 Public Health Nursing: Pioneers of Healthcare Reform

History of Public Health Nursing

Early healthcare reform

Mary D. Osborne

Commonwealth Fund

Hospital and Reconstruction Act of 1946

Social Security Act of 1935

The later years

Social and political unrest

Budget cuts

Public Health Nursing Philosophy

Community strengths, needs, and expectations

Scientific knowledge

Available resources

Accepted criteria and standards of nursing practice

Agency purpose, philosophy, and objectives

Participation, cooperation, and understanding of the population

Institute of Medicine Study

Government’s role in ensuring the public’s health


Policy development


Conceptual Basis for Public Health Nursing Practice

Conceptual model

Milbank Report

Construct for Public Health Nursing: A Framework for the Future




Essential Public Health Services

Monitor the health status of populations.

Diagnose and investigate community health problems and health hazards.

Inform, educate, and empower the people about health issues.

Mobilize community partnerships to identify and solve health problems.

Develop policies and plans that support individual and community health efforts.

Essential Public Health Services (cont.)

Enforce laws and regulations that protect health and ensure safety.

Link people to needed personal health services.

Ensure people receive needed personal health services.

Evaluate effectiveness, accessibility, and quality of personal and population-based health services.

Research for new insights and innovative solutions to health problems.

Challenges and Issues for Public Health Nursing in the 21st Century

Impact of the nursing shortage on public health nursing

Further development of public health nursing models and competencies

National public health performances standards

Other challenges for public health nursing

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