Domain 3: Population Health

Domain 3: Population Health

 Descriptor: Population health spans the healthcare delivery continuum from public health prevention to disease management of populations and describes collaborative activities with both traditional and non-traditional partnerships from affected communities, public health, industry, academia, health care, local government entities, and others for the improvement of equitable population health outcomes. (Kindig & Stoddart, 2003; Kindig, 2007; Swartout & Bishop, 2017; CDC, 2020). 

Contextual Statement: A population is a discrete group that the nurse and others care for across settings at local, regional, national, and global levels. Population health spans the healthcare delivery continuum, including public health, acute care, ambulatory care, and longterm care. Population health also encompasses collaborative activities among stakeholders – all relevant individuals and organizations involved in care, including patients and communities themselves - for the improvement of a population’s health status. The purpose of these collaborative activities, including development of interventions and policies, is to strive towards health equity and improved health for all. Diversity, equity, inclusion, and ethics must be emphasized and valued. Accountability for outcomes is shared by all, since outcomes arise from multiple factors that influence the health of a defined group. Population health includes population management through systems thinking, including health promotion and illness prevention, to achieve population health goals (Storfjell, Wehtle, Winslow, & Saunders, 2017). Nurses play a critical role in advocating for, developing, and implementing policies that impact population health globally and locally. In addition, nurses respond to crises and provide care during emergencies, disasters, epidemics, or pandemics. They play an essential role in system preparedness and ethical response initiatives. Although each type of public health emergency will likely require a unique set of competencies, preparedness for responding begins with a population health perspective and a particular focus on surveillance, prevention, and containment of factors contributing to the emergency. 

3.1 Manage population health. 

3.1j Assess the efficacy of a system’s capability to serve a target sub-population’s healthcare needs.

3.1k Analyze primary and secondary population health data for multiple populations against relevant benchmarks. 

3.1l Use established or evolving methods to determine population-focused priorities for care. 

3.1m Develop a collaborative approach with relevant stakeholders to address population healthcare needs, including evaluation methods. 

3.1n Collaborate with appropriate stakeholders to implement a sociocultural and linguistically responsive intervention plan. 

3.2 Engage in effective partnerships. 

3.2d Ascertain collaborative opportunities for individuals and organizations to improve population health. 

3.2e Challenge biases and barriers that impact population health outcomes. 

3.2f Evaluate the effectiveness of partnerships for achieving health equity. 

3.2g Lead partnerships to improve population health outcomes. 

3.2h Assess preparation and readiness of partners to organize during natural and manmade disasters 

3.3 Consider the socioeconomic impact of the delivery of health care. 

3.3c Analyze cost-benefits of selected population based interventions. 

3.3d Collaborate with partners to secure and leverage resources necessary for effective, sustainable interventions. 

3.3e Advocate for interventions that maximize cost effective, accessible, and equitable resources for populations. 

3.3f Incorporate ethical principles in resource allocation in achieving equitable health. 

3.4 Advance equitable population health policy. 

3.4f Identify opportunities to influence the policy process. 

3.4g Design comprehensive advocacy strategies to support the policy process. 

3.4h Engage in strategies to influence policy change. 

3.4i Contribute to policy development at the system, local, regional, or national levels. 

3.4j Assess the impact of policy changes. 

3.4k Evaluate the ability of policy to address disparities and inequities within segments of the population. 

3.4l Evaluate the risks to population health associated with globalization. 

3.5 Demonstrate advocacy strategies. 

3.5f Appraise advocacy priorities for a population.

3.5g Strategize with an interdisciplinary group and others to develop effective advocacy approaches. 

3.5h Engage in relationship-building activities with stakeholders at any level of influence, including system, local, state, national, and/or global. 

3.5i Demonstrate leadership skills to promote advocacy efforts that include principles of social justice, diversity, equity, and inclusion. 

3.6 Advance preparedness to protect population health during disasters and public health emergencies. 

3.6f Collaboratively initiate rapid response activities to protect population health. 

3.6g Participate in ethical decision making that includes diversity, equity, and inclusion in advanced preparedness to protect populations. 

3.6h Collaborate with interdisciplinary teams to lead preparedness and mitigation efforts to protect population health with attention to the most vulnerable populations. 

3.6i Coordinate the implementation of evidence-based infection control measures and proper use of personal protective equipment. 

3.6j Contribute to system-level planning, decision making, and evaluation for disasters and public health emergencies. 

(American Association of Colleges of Nursing, 2021, pp.33-36)

American Association of Colleges of Nursing. (2021). The essentials: Core competencies for professional nursing education. AACNnursing.   https://www.aacnnursing.org/Portals/0/PDFs/Publications/Essentials-2021.pdf

Related Evidence

For the course NURS 7115 Clinical Prevention and Health Promotion, I completed a group project with four fellow students. Our assignment was to design a health promotion program for Dallas County Arkansas. We first identified obesity, economic instability, and health care access as common health disparities in Dallas County. We then set out to construct a health promotion program to mitigate these disparities within Dallas County.

The first step in developing this program was a thorough county description including the following: geography, demographics, schools and educational facilities, churches and community organizations, recreational facilities and community centers, health resources (hospitals, clinics, insurance), income and economics, and industry and employment. After completing a county assessment and formulating a community diagnosis, our team then developed our program objectives and determined our process of program evaluation. For the purpose of conducting our program design and implementation plan, we referenced the Health Promotion Model. Our plan included specific interventions aimed at reducing disparities and securing needed resources, such as financial resources, facilities, and team members. Finally, our group identified measures of evaluation of the effectiveness of our program and sustainability.

This group project addressed several items in the Domain 3: Population Health of the Essentials: Core Competencies for Professional Nursing Education. Specifically, our project utilized item 3.1: “manage population health,” item 3.2: “engage in effective partnerships,” and item 3.3: “consider the socioeconomic impact of the delivery of health care” (American Association of Colleges of Nursing, 2021, pp. 33-36).

For the course, NURS 5205 Quantitative Epidemiology, I researched gestational diabetes mellitus (GDM), created a PowerPoint presentation slide, and presented that slide via recorded video to my instructors and fellow students. During this presentation I discussed general information regarding the disease process, prevalence, risk factors, potential short- and long-term complications for both mothers and infants, screening tools and diagnosis, and lifestyle modifications aimed at reducing the occurrence of GDM.

Reflection

The Dallas County Health Promotion Program group project was an excellent learning experience. First, it illustrated how important teamwork is when tackling large-scale projects. Without the help of my teammates, the Dallas County assignment would have been daunting and nearly impossible to complete on my own. This project also showed me how little experience and knowledge I had in determining a community diagnosis, designing appropriate interventions, and then effectively determining measures for program evaluation. With the help of my teammates, I was able to address item 3.1k” “Analyze primary and secondary population health data for multiple populations against relevant benchmarks,”  and item 3.1l, “Use established or evolving methods to determine population-focused priorities for care” (American Association of Colleges of Nursing, 2021, p. 33). Additionally, we were able to establish collaborative opportunities for members of the community and local organizations to improve the population's health, which is related to item 3.2d: “Ascertain collaborative opportunities for individuals and organizations to improve population health (American Association of Colleges of Nursing, 2021, p. 34). Finally, the Dallas County exercise allowed us to practice item 3.3d: “Collaborate with partners to secure and leverage resources necessary for effective, sustainable interventions” (American Association of Colleges of Nursing, 2021, p. 34). Indeed, this assignment introduced me to population health and the steps needed to perform community assessments, formulate diagnoses, and implement and evaluate program interventions.

The presentation on GDM addressed items in Domain 3: Population Health of the Essentials: Core Competencies for Professional Nursing Education. Specifically, item 3.4l: “Evaluate the risks to population health associated with globalization” (American Association of Colleges of Nursing, 2021, pp. 33-36). Recent research has revealed a significant link between the development of GDM and the modern Western diet. Health care providers have a unique opportunity to proactively educate women on lifestyle modifications that can significantly reduce the risk of developing GDM and the lifelong consequences associated with it. Even though I will not be delivering pregnancy related care in my future practice, as a psychiatric mental health nurse practitioner, I will have the opportunity to provide my patients with knowledge regarding healthy dietary choices.

References

American Association of Colleges of Nursing. (2021). The essentials: Core competencies for professional nursing education. AACNnursing. https://www.aacnnursing.org/Portals/0/PDFs/Publications/Essentials-2021.pdf