The State and Future of Community and Public Health Nursing: An Integrative Literature Review

Open Access
Macnicol, Caitlin E
Area of Honors:
Bachelor of Science
Document Type:
Thesis Supervisors:
  • Harleah Graham Buck, Thesis Supervisor
  • Harleah Graham Buck, Honors Advisor
  • Donna Marie Fick, Faculty Reader
  • community health
  • public health
  • nursing
  • Affordable Care Act
The purpose of this paper was to conduct an integrative review to explore the changing role of community and public health nursing (C/PHN) in the United States today. The specific aim of the paper was to determine the current state of C/PHN supports and barriers, specifically in education, credentialing, and health policy. The search for literature was conducted using the terms community health nurse, public health nurse, role, perceptions, change, intervention, baccalaureate education, graduate education, curriculum, certification, Affordable Care Act, and health policy in PubMed, Web of Science, and CINAHL databases for studies conducted between January 2004 and October 2014. Inclusion criteria included that they must have been published in English and relevant to community and public health nursing (C/PHN) baccalaureate and graduate education, health policy, certification, intervention outcomes, or their changing role. A total of 26 articles were included in the review. It was found that more is known about C/PHN education (n=14) and intervention outcomes (n=6) than is known about health policy (n=3), credentialing (n=1), and the changing role of C/PHNs (n=2). Several themes emerged from the research related to education, health policy, certification, and intervention outcomes. It was found that the field of community and public health nursing is undergoing changes, with both supports and barriers for the role. Supports for the field include an increase in funding for public health and coverage of preventive services due to the implementation of the Patient Protection and Affordable Care Act, an arena in which C/PHNs may play an important role due to the significant impact they have been found to have on the health of communities and populations. However, recent judicial trends have limited the enforcement power of public health departments and traditional baccalaureate nursing programs may not provide an adequate foundation for practice in the community. At the same time, the number of C/PHNs is dwindling and all but one C/PHN credential have been discontinued as of January, 2014. Community and public nursing now has an opportunity to expand its impact on the nation’s health, but the field faces many barriers to expansion.