Congruence of position descriptions for public health nurses with essential services and with national professional standards

Background: This descriptive study explored the congruence of public health nursing (PHN) position descriptions (PD) with public health (PH) essential services and with national PHN standards. Methods: PDs (N=259) from 71 (57%) of Ohio's 125 PH departments were reviewed. Elements of the position descriptions were compared to the 10 Essential Services (ES) and 20 ANA PHN Standard/Sub-standards for Practice (ANA Standard). Two trained reviewers assessed each PD individually and resolved discrepancies to 100% agreement. Results: The majority of PDs (62%) were for staff PHN positions in urban PH departments (75%). Over 60% of the PDs addressed ES 3 and ANA Standard 5b (inform, educate, empower people about health issues; health education/health promotion) and ES 6 and ANA Standard 5d (implement/enforce PH laws and regulations). Fewer than 5% of the PDs addressed research. PDs for PHN managers noted developing policies and plans, enforcing laws and regulations, assuring a competent workforce, and evaluation significantly more often than staff PHNs. PDs from rural PH departments focused significantly more on monitoring health status, linkages, and evaluation while PDs from urban PH departments focused significantly more on mobilization and on enforcing laws and regulations. Comparisons by additional health department characteristics will be presented. Conclusions: PDs for PHNs do not adequately reflect essential public health services or professional nursing standards of practice. Given the move to national PH department accreditation and certification of PH practitioners, strengthening linkages between PHN practice and workforce standards would strengthen the credibility and relevance of PHN to public health.