Public Health Nursing Vol. 27 No. 4, pp. 371–382
0737-1209/r 2010 Wiley Periodicals, Inc.
doi: 10.1111/j.1525-1446.2010.00867.x
SPECIAL FEATURES: EDUCATION
Essentials of Baccalaureate Nursing
Education for Entry-Level Community/
Public Health Nursing
Education Committee of the Association of Community Health Nurse Educators
ABSTRACT Community/public health nursing (C/PHN) educators and practitioners need a framework
from which to plan, implement, and evaluate curriculum and community-based practice. The Association of
Community Health Nursing Educators (ACHNE) periodically updates the Essentials of Baccalaureate Nursing
Education for Entry Level Community/Public Health Nursing to reflect changes in core knowledge, basic
competencies, and practice. This update reflects relevance to 21st-century health care and to national
trends influencing nursing education. The 2009 revision is based on critical analysis of key C/PHN
literature and input from public health nursing educators and practitioners. A key assumption is that a
baccalaureate nursing degree is the minimum requirement for professional C/PHN. Fifteen essential con-
cepts for baccalaureate nursing education are delineated along with related competencies. Newly defined
essentials include communication, social justice, and emergency preparedness, response, and recovery.
Issues related to didactic and clinical experiences are addressed. The ACHNE Essentials is an important
guide for baccalaureate education curriculum planning and evaluation. The Essentials may be useful as a
baseline from which to develop competencies of graduate nursing programs. The document is also useful
for guiding practice setting orientation and professional development.
Key words: community health nursing, curriculum, public health nursing competencies, public
health nursing education, undergraduate nursing education.
The ACHNE Education Committee
This revision, the third edition of the Essentials of
Correspondence to: Baccalaureate Nursing Education for Entry Level
Bonnie Callen, ACHNE, Education Committee Chair
Community/Public Health Nursing Practice, is based
10200 W 44th Ave. #304, Wheat Ridge, CO 80033. on a careful review of documents pertinent to com-
E-mail:
munity/public health nursing (C/PHN) and baccalau-
Members of the committe are: reate generalist nursing education. First, the following
Bonnie Callen, Ph.D., P.H.C.N.S.-B.C., R.N., Associate Profes- documents were critically analyzed to delineate ap-
sor, University of Tennessee College of Nursing Knoxville, propriate concepts and competencies for this edition:
TN; Derryl Block, Ph.D., M.P.H., R.N., P.H.C.N.S.-B.C., the Essentials of Baccalaureate Nursing Education
Interim Dean, Professional & Graduate Studies and Profes-
for Entry Level Community/Public Health Nursing
sor, University of Wisconsin-Green Bay, Green Bay, WI; (Association of Community Health Nursing Educators
Barbara Joyce, Ph.D., C.N.S., R.N., Associate Professor, Beth-
[ACHNE], 2000), the Essentials of Baccalaureate
El College of Nursing & Health Sciences,University of Color- Education for Professional Nursing Practice (Ameri-
ado,Colorado Springs,CO; Jayne Lutz, M.S., P.H.C.N.S.-B.C.,
can Association of Colleges of Nursing, 2008a), Public
R.N., Clinical Professor, Community Practice Department, Health Nursing Scope and Standards of Practice
UNCG School of Nursing,Greensboro, NC; Nancy Brown- (American Nurses Association [ANA], 2007b), and
Schott, M.S.N.,C.N.S., R.N.-B.C., Assistant Professor, Univer- the Quad Council PHN Competencies (Quad Council
sity of Toledo College of Nursing, Toledo, OH; Claudia M. of Public Health Nursing Organization, 2004). Next,
Smith, Ph.D., M.P.H., R.N.-B.C., Assistant Professor, Univer- additional documents were examined and are cited
sity of Maryland School of Nursing, Baltimore, MD. in the reference section of this document. Finally,
371
, 372 Public Health Nursing Volume 27 Number 4 July/August 2010
education and practice experts from multiple regions ambulatory modalities organized around a district
of the United States contributed toward the develop- (geographically based) nursing model. Since the early
ment and revision of the document. This revision 1900s, school and occupational health nursing have
should be considered from the context of what is es- been considered specialized C/PHN practice. During
sential to generalist baccalaureate nursing education, this same era, the nursing services offered by public
graduate entry (prelicensure) nursing education, and health departments, VNAs, schools, and industry
entry-level C/PHN practice. were provided mostly ‘‘in the community’’ and incor-
porated public health principles with a population
focus. This emphasis on public health and popula-
Background tions set C/PHN apart from the individualized focus
The original purpose of the Essentials, as put forth in of acute and long-term care nursing provided in hos-
the first edition, was to ‘‘delineate the essentials of ed- pitals and other institutions.
ucation for entry level community health nursing Implementation of Medicare and Medicaid legisla-
practice’’ (ACHNE, 1990). This remains a core tion stimulated dramatic changes in reimbursement for
purpose of the document; however, the changing the U.S. medical care system and public health. During
health care system and the corresponding emergence the 1970s and 1980s, proprietary home health agencies
of issues in C/PHN education and practice necessitate grew exponentially while nonfederal funding sources
a revision of entry-level C/PHN essentials. The objec- diminished for voluntary agencies such as VNAs and
tives of the document are: public health departments. As a result, the specialty of
public health nursing, including visiting nursing, found
to provide a framework for nursing educators in it necessary to distinguish its practice from the individ-
planning and implementing baccalaureate nursing ual-focused, nongeographically based proprietary home
curricula relevant to 21st-century health care sys- health agencies, while at the same time embracing
tems and those nurses who identified with the specialty. The term
to communicate to the nursing, public health, and community health nursing emerged as inclusive lan-
other communities, the theoretical and clinical guage for the specialty; the philosophical and concep-
practice underpinnings necessary for C/PHN edu- tual tenets of population focus, public health, and
cation and practice. community context remained the cornerstones.
Since that time, a tension has existed within the
The term ‘‘C/PHN’’ is used to depict generalist specialty regarding the definition, scope of practice,
nursing C/PHN practice within the specialty. This and appropriate language to describe C/PHN. In the
practice is embedded in the continuously evolving en- current educational and practice environment, at-
vironment of the public being served. This document tempts to bring clarity to some of these issues have
provides the most current recommendations for edu- been suggested by use of the terms community-based
cators and others preparing novice professional and community-focused nursing (Zotti, Brown, &
nurses to practice C/PHN with appropriate knowl- Stotts, 1996). The current Public Health Nursing Scope
edge, skills, values, and competencies. and Standards (ANA, 2007b) defines public health
nursing as population-focused, a term selected because
Historical foundations of community/ it builds upon the American Public Health Association
public health nursing [APHA] (1996) Public Health Nursing Sections Defini-
Before the late 1960s, generalized C/PHN services tion and Role of Public Health Nursing and refers to
were primarily organized and delivered by public the population served rather than the place of practice.
health departments and not-for-profit visiting nurse Baccalaureate educational experiences should foster
associations (VNAs). Nurses working in these agencies the achievement of competencies in both community-
were known as public health nurses or visiting nurses. based and community-focused practice. The core com-
Their scope of practice included nursing care of acute petencies of C/PHN, which remain community and
and chronically ill individuals, health promotion for population focused, are based on a synthesis of the sci-
maternal and child populations, and communicable ence, values, and practice of nursing and public health.
disease surveillance and follow-up. Nursing services Events and trends during the first decade of the 21st
were primarily provided through home visitation and century require that community/public health (C/PH)
