35.3: Carving a Path Forward
By the end of this section, you should be able to:
- Explain the importance of population health in nursing education and practice.
- Discuss ways to transform nursing practice to provide diverse populations safe, quality, and equitable care.
- Describe how nurses may lead change to advance health across the continuum from public health prevention to disease management of populations.
- Discuss the key to achieving positive health outcomes.
The nursing workforce must be prepared to rise to the challenge of adapting to changing health care and social support systems. With the increasing demand for nurses and the need for diverse and intensive nursing care across multiple settings, nurses must be equipped to address the negative impacts of social determinants of health on well-being (NASEM, 2021). The American Association of Colleges of Nurses (AACN) recognizes the importance of population health in nursing education and practice. AACN promotes and supports the integration of population health concepts and competencies into nursing curricula to prepare nurses to address the health needs of diverse populations. According to AACN (2021a), population care requires proficiency in six core areas as outlined in Table 35.6.
| Competency | Proficiency |
|---|---|
| Manage population health |
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| Engage in effective partnerships |
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| Consider the socioeconomic impact of the delivery of health care |
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| Advance equitable population health policy |
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| Demonstrate advocacy strategies |
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| Advance preparedness to protect population health during disasters and public health emergencies |
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Population care requires the nurse to be prepared to promote health and prevent disease across the health care continuum, including public health, community health, acute care , ambulatory care , and long-term care . Population health also encompasses collaborative activities among all relevant individuals and organizations involved in care, including clients and communities, to improve a population’s health status (AACN, 2021a).
To deliver safe, equitable, and high-quality care to diverse client populations, nursing practice must prioritize a holistic approach that considers clients in the context of their families and communities. This involves recognizing how social, political, and economic factors impact health, focusing on what is most essential for well-being, fostering a compassionate and healing relationship, and always upholding personal dignity, choice, and meaning (AACN, 2021a).
Transforming Nursing Practice
The Future of Nursing 2020–2030 report by the National Academies of Sciences, Engineering, and Medicine (2021) has identified several crucial areas where the nursing profession must improve to overcome the challenges of the next decade. These areas include the nursing workforce, leadership, nursing education, nurse well-being, emergency preparedness and response, and the nursing profession’s responsibilities concerning the determinants of health at both the structural and individual levels. Table 35.7 highlights the obstacles that need to be addressed to achieve health equity in the next decade. The ultimate goal is to achieve health equity in the United States, which can be accomplished by strengthening nursing capacity and expertise.
| Area for Improvement | Challenges |
|---|---|
| Addressing systematic issues |
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| Lifting barriers to expand the contributions of nursing |
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| Designing better payment models |
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| Strengthening nursing education |
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| Valuing community and public health nursing |
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| Fostering nurses’ roles as leaders and advocates |
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| Preparing nurses to respond to disasters |
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| Supporting the health and well-being of nurses |
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Social Responsibility as a Global Citizen
The role of nurses as global citizens goes beyond providing local health care. Nurses must embrace their responsibility to contribute to positive global health outcomes, promote health equity, and address global health challenges. Nurses are prepared to interact with populations from around the world. Being culturally competent and sensitive allows nurses to provide care that respects cultural beliefs, practices, and values. Global citizenship in nursing involves advocating for equal access to quality health care for all individuals regardless of their geographical location, socioeconomic status, or cultural background. Nurses can advocate for policies that address health disparities and promote health equity globally. They also promote global health by educating individuals and communities about disease prevention, hygiene, nutrition, and healthy lifestyles. This knowledge can have a positive impact on public health outcomes worldwide. Additionally, nurses are often at the forefront of responding to disasters and humanitarian crises around the world, providing emergency medical care, supporting displaced populations, and delivering essential health care services.
Global citizenship encourages nurses to collaborate with health care professionals and policymakers across borders, fostering international partnerships that facilitate knowledge-sharing, capacity-building, and skill-sharing projects. Nurses can contribute to global health by participating in educational initiatives and training programs in underserved areas such as third-world communities, helping to strengthen health care systems and empower local health care professionals (Figure 35.6). They can also engage in global public health initiatives, such as promoting sanitation, safe drinking water, and hygiene practices to prevent spreading infectious diseases. Above all, nurses must prioritize the well-being of clients and communities, even in challenging and resource-limited environments.
Nurses must continuously learn about and adapt to global health issues, emerging diseases, and evolving health care practices. They should advocate for health equity, promote global health initiatives, collaborate internationally, and provide health care services in diverse settings to improve global health outcomes.
Key to Achieving Positive Health Outcomes
Population health covers public health, acute care, ambulatory care, and long-term care for local, regional, national, and global communities. It involves collaboration between individuals and organizations involved in care, including clients and communities, with a focus on achieving health equity and improved health for all and an emphasis on diversity, equity, inclusion, and ethics. Everyone involved shares accountability for outcomes, as various factors can influence the health of a specific group. Ultimately, a population health perspective is essential in promoting the health and well-being of the community (AACN, 2021a).
Population health encompasses a broad range of health care services, from public health initiatives aimed at preventing diseases to managing the health of entire communities. Population health management involves systems thinking and incorporating health promotion and illness prevention to achieve population health goals.
Nurses advocate for and implement policies that impact population health on a global and local level, and they respond to emergencies, crises, epidemics, or pandemics. This requires a particular focus on surveillance , prevention , and containment of factors contributing to the emergency, with competencies tailored to each situation.
A skilled community/public health nurse carries out many essential functions in community organizations or state and local public health organizations. These functions range from providing clinical services, home visits, and population-based services to conducting health promotion programs at all levels of prevention. The community/public health nurse works directly with at-risk population s, using their population-level competencies to provide services to individuals, families, or groups. Additionally, they perform critical tasks such as primary data collection and analysis, fieldwork, program planning, outreach activities, programmatic support, and other organizational tasks. Although their focus is primarily on population-level competencies and community/public health, nurses apply these skills and competencies across all levels of prevention, making them indispensable members of the health care infrastructure (Quad Council Coalition Competency Review Task Force, 2018).
Community and public health nurses hold the key to achieving positive health outcomes in an era of increasing challenges. By working together and fostering a culture of inclusivity, nurses can create a society where everyone has equal access to health care and can attain their best possible state of wellness.