Public Health Nursing in Wisconsin
What is a public health nurse?
Public health nursing is defined as the practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences. (American Public Health Association, Public Health Nursing Section, 2013; American Nurses Association (2022), Public Health Nursing: Scope and Standards of Practice.)
“The public health nursing specialty employs all levels of prevention, with an emphasis on primary prevention. Public health nursing focuses on improving health outcomes by addressing social, physical, environmental, and other determinants of health. Public health nursing includes, but is not limited to assessment, program planning, evaluation, advocacy, outreach, cross-sector collaboration, research, policy development, and assurance at the levels of individual, family, group, community, population, and systems. Public health nursing addresses health through the application of theory and evidence and the creation of multi-sectoral partnerships. Public health nurses have a commitment to social and environmental justice, health equity, and community well-being.” (American Nurses Association (2022), Public Health Nursing: Scope and Standards of Practice.)
Wisconsin's public health nurses apply nursing and public health principles to assess, develop, implement, and evaluate care plans and health programs related to health promotion, disease prevention, and health protection services for individuals, families, and the community (Wis. Admin. Code ch. DHS 139).
How would you define a “general public health nursing program”?
All local health departments (LHDs) in Wisconsin are required to conduct a general public health nursing program. Wis. Admin. Code § DHS 140.03(5) defines a program as follows:
“General public health nursing program” means the organization and delivery of public health nursing services by public health nurses qualified under Wis. Stat. § 250.06 (1), and Wis. Stat. § DHS 139.08 to individuals within the jurisdiction of the local health department.
For determining and evaluating how such a program is conducted, Wis. Admin. Code § DHS 140.04(1)(i) provides the following parameters:
Public health nursing services. Conduct a general public health nursing program which shall apply nursing and public health principles to collaboratively assess, develop, implement, and evaluate the services required in pars. (a) to (h), in cooperation with the local board of health.
The required services of paragraphs (a) to (h) – which are required of all Wisconsin LHDs Wis. Admin. Code § DHS 140.04(1):
(a) Surveillance and investigation
(b) Communicable disease control
(c) Other disease prevention
(d) Emergency preparedness and response
(e) Health promotion
(f) Human health hazard control
(g) Policy and planning
(h) Leadership and organizational competencies
Level II Wis. Admin. Code § DHS 140.05(1)(f) and Level III Wis. Admin. Code § DHS 140.06(9) LHDs are required to “apply nursing and public health principles to collaboratively assess, develop, implement, and evaluate” the additional required services pertaining to their LHD level (paraphrased below):
Level II Wis. Admin. Code § DHS 140.05
(a) Address Communicable disease control, Chronic disease and injury prevention, Environmental public health, Family health, and Access and linkage to health services.
(b) Develop and maintain a workforce development plan.
(c) Conduct quality improvement (QI).
(d) Provide QI training and resources.
(e) Establish LHD performance measures.
Level III Wis. Admin. Code § DHS 140.06
(1) Lead the collection of data.
(2) Provide public health expertise.
(3) Identify and address population health.
(4) Develop, advocate, adopt, and implement policies or strategies to improve the physical, environmental, social, and economic conditions affecting health.
(5) Establish and implement an environmental health program.
(6) Provide or arrange for other services that address the state public health agenda.
(7) Develop and implement performance management methods.
(8) Develop and implement a QI plan.