This reflection paper examines how an RN-BSN program reshaped one nursing student's understanding of healthcare delivery models and public health programs. The paper discusses support for acute care, transitional care, and collaborative payer models, in which nurses function as care coordinators. It also explores two community-based public health interventions — the Immune LA Kids Coalition and Healthy Eating, Active Communities (HEAC) — and reviews how coursework addressed evidence-based practice outcomes related to nursing research, physical activity and health promotion, inter-professional collaboration, and the integration of scientific evidence into clinical judgment.
Since commencing this RN-BSN program, my perception of healthcare delivery models and the role of nurses in public health programs has evolved considerably. Prior to undertaking the course, I was unaware that different healthcare delivery models exist; I believed that healthcare delivery was essentially about providing care services to patients. I also believed that public health programs were simply policies enacted by the government to promote health. However, the course has changed my perception by helping me understand that there are distinct healthcare delivery models, each assigning different roles to members of the clinical team.
Through the lessons learned in this course, the healthcare delivery models I support are the acute care model, the transitional care model, and the collaborative payer model. I support these models because they represent innovative approaches through which nurses become care coordinators rather than care providers (Beattie, 2016). This shift in role is significant: it expands the scope of nursing practice beyond direct bedside care and positions nurses as central organizers of patient-centered care across settings and provider teams.
The course has also helped me understand that public health programs are diverse and pursue different objectives in relation to health promotion and disease prevention. The public health programs I am most familiar with are the Immune LA Kids Coalition and Healthy Eating, Active Communities (HEAC). These programs are similar in that they are both community-based public health interventions and were founded as part of the CDC's initiative to fund communities in reducing the burden of chronic diseases among children (Trust for America's Health, n.d.).
However, they differ in their specific focus. The Immune LA Kids Coalition concentrates on promoting the use of culturally appropriate immunizations. In contrast, Healthy Eating, Active Communities (HEAC) focuses on reducing disparities in diabetes and obesity by enhancing access to nutritious food and opportunities for physical fitness among school-age children.
My academic work has enabled me to achieve several evidence-based practice outcomes, including Outcomes #2, #5, #6, and #7.
In relation to Outcome #2, I conducted an exploration of how nurses utilize research studies and evidence in their clinical and operational procedures. This exploration provided a foundation for understanding the role of research and scientific evidence in nursing practice. The two core elements identified through this process were robust scientific evidence and compassionate, effective care. As I noted in that work, "For most in the nursing profession, the guiding principle is often the delivery of compassionate and effective care so as to ensure that the patients' needs are met in the best way possible. In essence, robust research evidence presents to the nursing professional reliable information on what works and what does not. It therefore follows that scientific evidence ought to be put to its most beneficial and effective use" ([Student], 2017e, p. 1).
"Outcomes 2, 5, 6, and 7 addressed through coursework"
Trust for America's Health. (n.d.). Examples of successful community-based public health interventions (state-by-state). Retrieved September 29, 2017, from http://www.healthyamericans.org/assets/files/Examplesbystate1009.pdf
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