Confidence in public health nursing surge competencies: Comparing DONs and PHNs

Public health disaster preparedness requires a trained, self-assured public health nursing workforce. It is unclear how confident public health nurses (PHNs) and directors of nursing (DONs) of local health departments regard their ability to function in a public health surge event or their learning needs in this area. The purpose of this study is to compare PHNs self-perceived competencies concerning public health surge events with that of DONs and to identify areas in which educational efforts should be targeted. Participants in the study are enrolled in a two-pronged educational intervention– the PHN Surge Curriculum. This curriculum, which is based on the 25 Public Health Nurse Competencies Related to Surge Events, includes an independent study Trail Guide comprised of 12 Mileposts (action-based modules), and an in-class 6 hour Hiking Workshop consisting of three interactive modules. During the Hiking Workshop, which is completed early in the curriculum, participants are asked to complete the PHN Surge Competencies Survey in which they rate their confidence to perform each of the 25 competencies and their self-assessed need for training (1=low to 5=high) for each competency. To date, 37 PHNs and 40 DONs from Ohio completed the survey. DONs rated their confidence in their ability to perform 24 of the competencies significantly higher than the PHNs. PHNs indicated significantly higher training needs for 11 of the competencies. Both DONs and PHNs identified low confidence and high learning needs regarding: essential public health nursing care in a disaster, public health triage, correct use of emergency communication equipment, legal ethical issues related to PHN practice in surge, rapid needs assessment, and preservation of evidence and chain of custody. Additional PHN learning needs included understanding basic emergency/disaster terminology, understanding public health's legal authority in disaster, knowing the health department's disaster plan, and risk communication. Although federal and state initiatives and policies have been aimed at improving preparedness of public health agencies, these efforts have not been aimed at the largest public health workforce-PHNs. Policies and targeted programmatic efforts are needed to assure PHNs and DONs are confident in their ability to perform in a public health surge event.