Department of General Pediatrics, Stanford University, USA
Received date: Apr 14, 2016; Accepted date: Apr 23, 2016; Published date: Apr 30, 2016
Citation: Marques N, Rodriguez E (2016) Partnerships in Public Health Nursing as an Effective Means to Promote Health Services in Schools. J Comm Pub Health Nurs 2:119. doi:10.4172/2471-9846.1000119
Copyright: © 2016 Marques N et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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It takes a village to raise a child and if we want to improve health services in schools, we need to bring together a variety of constituencies: community, educators, health professionals, universities and politicians, to name a few. We need partnerships.
Partnerships are not a new concept in the profession of nursing. In fact, partnerships in nursing education are a well-established practice since the 18th and 19th centuries . What seems to be new is a shift, in the past decades, from a model of partnerships that was focused on building workforce to a model that aims at supporting advocacy efforts to improve health services for children, their families and communities.
These partnerships were first founded by pioneers such David Olds and the Nurse-Family Partnership program in Colorado . Gradually, since the 70s, these partnerships are more institutionalized with hundreds of university programs of community learning/community engagement working with partnerships in nursing across the country.
Public health nursing focuses on improving population health by emphasizing prevention, while attending to multiple determinants of health and addressing issues of social justice. Community collaborations are at the core of public health nursing working to “improve population health in the environments where people live, work, learn, and play” . As a discipline, public health nursing could play a central role in planning, and sustaining the type of partnerships needed to improve health services at underserved schools.
Community-based organizations partner with health professionals, research centers and universities to design and implement interventions, carry on health assessments, and inform public policy . These partnerships are key to achieving sustainable provision of health services at school and influencing public policy at the local and state levels. And school health care services need all the help they can get.
The number of children with complex health care needs (including chronic and physical conditions such as diabetes and asthma but also developmental, behavioural or emotional challenges) has increased significantly in the U.S. . Many of these conditions are directly linked to socio-economic and political changes affecting children and their families as well as ethnicity, generational status and length of time since immigration .
School nurses promote wellness and disease prevention as well as perform early interventions such as screenings for vision, hearing and dental problems. They also assess immunization compliance and follow up with those under treatment. Nurses have a positive impact on student’s health with in turn affect school absenteeism, and academic outcomes . Yet, there is a growing shortage of school nurses in many U.S. states and health partnerships could supplement important services in underserved school districts. Schools districts with strong health partnerships have shown improvements in “attendance, academic performance, and increased access to mental, dental, vision, and health supports for their students” . Public health nursing is in a unique position to take a leadership role in these efforts
There has been some progress in documenting these new partnerships and community engaged learning initiatives, but systematic reporting and evaluation of these programs is still limited in the literature.
In general, these recent partnerships in nursing initiatives include three main pillars. (1) Collaboration that seeks to identify and meet health care needs of community members based on respect, social justice and human rights; (2) Engagement with students in some of the most critical issues and societal needs of our times promoting student’s empathy and ability to meet the health care needs of vulnerable/ underserved populations; (3) Development through critical analysis and reflection for individual civic identity as well as the means to construct a new social reality.
Based on these three pillars, it is easy to see how partnerships in public health nursing, when done right, are a win-win situation for individuals and communities, even in times of budgetary restrains. The savings resulting from providing nursing services in schools included medical procedure costs, teachers’ productivity loss costs, and parent’s productivity loss . To these benefits, we may add other indirect benefits or externalities associated with educational attainment such as reduced absenteeism, school dropout and higher grade promotion.
The challenges to improve health care services in the U.S. are deeply entangled with situations of disparities in income, education, race, gender and many other social problems including allocation of public resources. In addition, schools also have to respond to increasing complex care needs among children and new situations of possible pandemics. In this scenario, supporting and complementing the work of school nurses while shifting the focus from the health of the individual to the health of the community, is critical. It is a shift that proposes a new approach of integrated efforts between academia and community in the form of stable partnerships.
Examples of successful models that could provide strategies to the creation of long term partnership of Public Health Nursing programs with underserved schools nationwide includes the Stanford Youth Diabetes Coaches Program (SYDCP). The SYDCP is an innovative approach to train high school students to become diabetes selfmanagement coaches for their diabetic family members and friends provided by medical residents. It has been proved to be of value to both children and families , to physician trainees , and it has helped implement partnerships with 11 medical institutions and 17 high schools in the US and Canada. This program and several others provide examples of how Public Health Nursing programs are uniquely positioned to take the lead in accomplishing the mission of improving community health by developing partnerships of their trainees with underserved schools, in a sustainable and significant manner.
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