Public Health Intervention Wheel (Nursing)

by Heide Cygan, DNP, RN

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    00:01 Today, I'm going to explain The Public Health Intervention Wheel.

    00:05 The public health intervention wheel was developed by the Minnesota Department of Public Health in the early 2000s.

    00:11 So because of this, you'll often hear it referred to as the Minnesota wheel.

    00:16 Now, this model is unique.

    00:18 It's unique in that it focuses on the specific tasks or responsibilities that public health nurses carry out in daily practice.

    00:26 The underlying assumption of the model is that it's population based.

    00:30 So no matter what intervention is conducted, or where the focus lies, the public health nurse uses this model to guide practice from a population health lens.

    00:39 This means the intent of the intervention is to improve the health of the population.

    00:45 Specifically, there are 17 interventions included on the wheel.

    00:49 Each is represented by what looks like a slice of pie.

    00:52 It's important to note that these interventions do not follow a sequential clockwise order.

    00:57 They can be used in whatever sequence best fit the needs of the population.

    01:02 Now, I know this is going to look overwhelming, but I don't want it to be that way.

    01:06 I'm going to walk you through each of the 17 interventions.

    01:11 The 17 slices of pie or interventions are grouped into five different wedges.

    01:18 Further, the interventions are carried out at three levels.

    01:21 The system, community level, and the individual level.

    01:26 And again, I'm going to tell you exactly what that means.

    01:29 The visual representation of the interventions empowers public health nurses to consider a variety of different interventions when developing action plans for population based care.

    01:39 Now, imagine you're a public health nurse.

    01:42 You've just started working in a new community.

    01:44 You've heard that there may be some concerns, some problems within the community, but you don't really know where to start.

    01:50 You feel overwhelmed.

    01:52 You can use the public health intervention wheel to guide your practice, to give you ideas of where to begin.

    01:58 So let's take a detailed look at each of the wedges and each of the interventions.

    02:03 Within the red wedge there are four interventions.

    02:06 The first is surveillance.

    02:07 With surveillance, the public health nurse describes and monitors health events through ongoing and systematic collection, analysis, and interpretation of health data.

    02:18 This is used for the purposes of planning, implementing and evaluating public health interventions.

    02:24 Next, we have disease investigation.

    02:27 This is the systematic gathering and analysis of data regarding threats to the health of the population.

    02:33 Here the public health nurse ascertains the source of the threat identifies cases, and those who are at risk and determines control measures.

    02:43 Then we have outreach.

    02:45 Here the public health nurse locates populations of interest or populations who are at risk and provides information about the nature of the concern, what can be done about it, and how services can be obtained.

    02:57 And then finally, we have screening.

    02:59 Here the public health nurse identifies individuals with unrecognized risk factors, or those who may be asymptomatic within the population.

    03:10 Together, these interventions contribute to case finding.

    03:14 This happens when the public health nurse locates individuals or families with identified risk factors and connects them with resources.

    03:22 This is considered the individual level intervention for surveillance, disease investigation, outreach, and screening.

    03:30 And next is the Green Wedge.

    03:32 Here there are three different interventions.

    03:35 First is referral and follow up.

    03:37 This is when the public health nurse assists individuals, families, groups, organizations, entire communities to identify and access necessary resources to prevent or resolve health problems.

    03:51 Next, we have case management.

    03:53 Here the public health nurse optimizes self care capabilities of individuals and the capacity of systems and communities to coordinate and provide services.

    04:04 The last intervention within the Green Wedge is the delegation of functions.

    04:08 These are the direct care tasks that are registered nurse carries out as allowed by law.

    04:14 Delegated functions also include any direct care tasks that are registered nurse trust other appropriate personnel to perform.

    04:24 The blue wdges next.

    04:26 First, within the blue edge is health teaching.

    04:29 When carrying out this intervention, the public health nurse communicates to change knowledge, attitudes, values, beliefs, behaviors and practices of individuals or entire communities.

    04:42 Next, we have counseling.

    04:44 Here, the public health nurse establishes an interpersonal relationship.

    04:48 Now remember, this could be a relationship with an entire community, a family or an individual.

    04:53 The intent here is to increase or enhance their capacity for self care and coping.

    04:58 Counseling engages everyone at emotoinal level.

    05:02 The last intervention within the blue wedge is consultation.

    05:06 This is when the public health nurse seeks information and generate solution to perceive problems or issues through interactive problem solving with the community.

    05:16 Okay, only two more wedges to go. Here's the orange wedge.

    05:20 The first intervention here is collaboration.

    05:23 This occurs when people or organizations work together to achieve a common goal through enhancing the capacity of one or more of the members to promote and protect health.

    05:35 Next is coalition building.

    05:37 Here the public health nurse promotes and develops alliances among organizations for a common purpose.

    05:44 It builds linkages, solves problems, and enhances local leadership to address health concerns.

    05:51 Last we have community organizing.

    05:54 Here the public health nurse helps community groups to identify common problems or goals, helps them mobilize resources and develop and implement solutions.

    06:04 Okay, finally, the last wedge the yellow wedge.

    06:09 The first intervention here is advocacy.

    06:11 Advocacy occurs when the public health nurse supports a particular cause or policy.

    06:16 The public health nurse often acts on someone else's behalf with a focus on developing the capacity to plead their own cause or act on their own behalf in the future.

    06:27 Next is social marketing.

    06:28 Social Marketing utilizes commercial marketing principles or technologies for programs designed to influence the knowledge, attitudes, values, behaviors, and practices of a population of interest.

    06:42 And very last, we have policy development and enforcement.

    06:46 Policy development results in policies and regulations that impact the health of populations.

    06:52 Policy Enforcement involves compelling others to comply with those policies and regulations.

    06:59 So altogether, this is what it looks like.

    07:02 17 different interventions that public health nurses can use to guide comprehensive population based care.

    07:09 Now, again, I know this probably feels overwhelming, but what I want you to do is consider this wheel as a guide.

    07:16 Use it as a resource or resource that you can use to generate ideas and how you can assess, implement and evaluate the care that you provide in the community.

    About the Lecture

    The lecture Public Health Intervention Wheel (Nursing) by Heide Cygan, DNP, RN is from the course Public Health Nursing Models and Theories (release in progress).

    Included Quiz Questions

    1. Population-based
    2. Intervention-based
    3. Individual-based
    4. Family-based
    1. It is also referred to as the Minnesota wheel.
    2. The interventions are grouped into five different sections.
    3. The wheel includes 17 different interventions.
    4. The interventions must be completed sequentially in clockwise order.
    5. The interventions on the wheel are carried out at five different levels.
    1. Outreach
    2. Referral and follow up
    3. Case management
    4. Medication administration
    5. Psychotherapy

    Author of lecture Public Health Intervention Wheel (Nursing)

     Heide Cygan, DNP, RN

    Heide Cygan, DNP, RN

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