The Public Health Nursing Knowledge and Skills Framework 2017 (Te Rākau o te Uru Kahikatea) is being welcomed by public health nursing leader Lizzie Farrell for recognising that public health nurses can not only treat a child’s skin infection but can also work with schools and communities to reduce the risk of skin infections occurring in the first place.

Jenny Hugtenburg, the co-ordinator for the project, said the public health nurse working group, which Farrell was also a member of, had spent about two years developing the framework with the support of the Public Health Association of New Zealand (PHANZ).

She said it provided a baseline of the knowledge and skills that public health nurses require and reflected the broad scope of practice that can vary between regions and between different employers. For example some public health nurses across the country have a more personal health focus of working face-to-face with children and families while others take a more population health focus working on disease prevention programmes and health promotion.

Farrell, who is clinical nurse manager for Counties Manukau’s Kidz First Public Health Nursing, said for a long time public health nursing leaders had wanted public health nursing competencies that included both the personal and population health roles.

She said sometimes the wider population and preventative health side of the role can be overlooked in the rush to treat skin infections or sore throats. Public health nurses can take a population health approach to working with families, iwi, church groups and schools to reduce the spread or risk of disease and improve the health and wellbeing of a community. Farrell said the framework provides a baseline for the skills required by public health nurse whose roles can include educating parents on the importance of hearing and sight screening on their children’s future and responding to public health emergencies like the gastro outbreak in Havelock North last year.

Public health nursing began with the passing of the Public Health Act in 1900 creating a tradition of public health nurses working to prevent the spread of infectious diseases, promote healthy communities and provide health education in schools.

Another framework working group member, MIT senior nurse lecturer Evelyn Hikuroa, also points out in foreword to the framework that public health nursing had its roots in Māori health, with ‘Māori health nurses’ or ‘native health nurses’ being the pioneer public health workforce who were tasked with reaching Māori in remote communities being hit by outbreaks of influenza, tuberculosis and typhoid.

Hugtenburg said it was hoped that the new knowledge and skills framework would be rolled out across the country and picked up by public health units and district health boards across the country to guide professional development for public health nurses, both those new to the sector and established public health nurses.

The framework sets out knowledge and skills competencies required to be competent, proficient or expert in areas like the Treaty of Waitangi, public health policy and legislation, using research, effective communication and advocacy skills.

Hugtenburg said while some competencies were specific to public health others were generic and of use to all nurses.

She said the Public Health Association had been ‘hugely supportive’ in developing the framework and is considering setting up a special interest group for public health nursing. The working group also had the support of the New Zealand College of Primary Health Care Nurses NZNO and NZNO professional nursing advisor Angela Clark.

Clark said NZNO and the College congratulated all who had contributed to developing the framework that added value to the role of public health nurses by describing the depth and breadth of what they did in a multidisciplinary environment. She said community health integration extends far beyond health and public health nursing influences the practice environment of community health and the integration of the many services and providers in the wider community health field.

The Te Rākau o te Uru Kahikatea Public Health Nursing Knowledge and Skills Framework 2017 framework can be downloaded here.


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