Public health nursing and politics: Impacting state public health policy

The purpose of this abstract is to vividly present a replicable case study of the effectiveness of an academic-community health nursing partnership model on chronic illness outcomes, focusing on state level public health policy and political strategies. The partnership, Nurses in Action (NIA), was formed in 2000 between the University of Delaware's, School of Nursing and the Visiting Nurses Association. In Delaware, chronic illness contributes 10 million in annual health care costs and diabetes and heart disease are top mortality rates. The methods used in this case study evaluation design ('00-‘06) included a home health education intervention program with a convenience sample of chronically ill clients statewide (n = 255) for a series of visits and phone calls. Student nurses and community health nurses were trained (n=40) for 8 hours by a certified staff to educate and collect data using a variety of content validated tools for diabetes and other chronic illnesses (i.e. OASIS, Mini-Mental, Michigan Diabetes Knowledge and Care Profile, Dietary,& Activity logs). In turn, they were trained to provide valuable education, referral services (i.e., community resources, history, medications, meal planning), and public policy involvement. Findings support the programmatic and political value of NIA. UD Student Nurses performed over 400 client education visits (>$500,000), and increased their student test scores by 40%. Clients reported a 33% increase in self care and a 65% increase in motivation. VNA patient emergent care and unplanned hospitalizations fell for the first time below the national benchmark! Most importantly, state level public health policy was changed as a result of the NIA, nurse principal investigator (PI) and public health staff. The PI, who was elected in 2002 as a DE State Representative, introduced legislation that was signed into law, HCR 10, the Chronic Illness Taskforce. Due to the political strategies of nurses and students, the creation of a chronic disease public staff position, early screening programs, and school based public health programs were initiated. Implications for state level health policy, public health nursing, nursing academia are shared, and concluding statements provide a repertoire of tools for public health policy and politics.