The Indian Health Service (IHS) Public Health Nursing (PHN) Scope of Work (SOW) describes population-based program components, goals, objectives and activities. The levels of PHN practice include individual/family, community and systems. The focus of PHN services are on primary, secondary and tertiary prevention interventions. An overview of the PHN program and services are provided in the following tables: Table 1: Maternal Child Health Preconception counseling Prenatal case-management low risk Prenatal - high risk Age-appropriate anticipatory counseling Well child care Special needs Parenting education Depression screening High risk postpartum management & referral Family planning education Domestic Violence (DV) screening High risk newborn Immunization education & management Breastfeeding SIDS prevention Environmental assessment Postpartum assessment Newborn care management & referral Newborn assessment Revised May 2009 Page 1
Table 2: Child & Adolescent Health Conception prevention Risk behavior screening: tobacco; drug/alcohol; unprotected sex; abstinence High risk behavior referral Age-appropriate anticipatory counseling Nutrition & exercise screening Special needs management & referral Parent education Family planning education Immunization education & management Healthy lifestyle choices Depression screening Domestic Violence (DV) screening School health screenings Assessment & referral Risk behavior prevention Suicide prevention School health education staff/parents/students Revised May 2009 Page 2
Table 3: Chronic disease (diabetes, cardiovascular disease, cancer) Safety education Screening: Blood pressure; Blood sugar; Blood cholesterol; BMI; Vision; Depression; Drug/ETOH; FAS; Oral health; tobacco Fall risk management Nutrition Nutrition assessment/referral Medication management Smoking prevention Pre-chronic disease education Self-care/home management Breastfeeding Advocacy Behavioral health/coping Drug/ETOH prevention education Immunizations Referral & coordination of resources Advocacy Parenting education Preconception counseling Healthy Lifestyle Exercise; nutrition; stress reduction Revised May 2009 Page 3
Table 4: Communicable disease Immunization Hygiene education Hand washing Food preparation STI prevention Screening Tuberculosis Sexually transmitted infections Risk communication Outbreak containment Interagency coordination Surveillance Case Finding Treatment follow-up Investigation & Reporting Community outreach education Environmental risk assessment Drug/ETOH screening Risk reduction education Revised May 2009 Page 4
Table 5: Population-based community focus (changes community norms, attitudes, beliefs, practices & behaviors) Primary Secondary Tertiary Community education Community assessment Health protection & promotion Collaboration, partnerships, outreach, advocacy, social marketing & coalition building Community assessment Detects & treats problems through collaboration, partnerships, outreach, advocacy, social marketing, consultation & coalition building Targets high risk populations Limits further negative effects from problems through collaboration, partnerships, outreach, advocacy, social marketing, coalition building & consultation Table 6: Population-based systems focus (changes organizations, policies, laws and power structures) Primary Secondary Tertiary Development of, or changes in policies, laws & power structures that protect & promotes the health of the community Development of, or changes in policies, laws, & power structures that detects, treats and/or reduces health risks & threats in the community Development of, or changes in policies, laws, power structures that limit further negative effects in the community Revised May 2009 Page 5