Public Health Nursing Practice Manual
PUBLIC HEALTH NURSE (PHN) STANDARDS OF PRACTICE INSTRUCTIONS FOR USING THE EVALUATION FORMS AND WORKSHEETS
List each PHN that the PHNS supervises on one sheet.
Using “hash” marks, indicate the number of records evaluated according to standard of
practice. By the end of March and September:
Records are to be randomly selected according to the following parameters: a. TB records that have been in the PHN’s caseload for at least 90 days or are
closed. b. ACD and STD records at completion or those that are closed. c. Lead, SIDS, Newborn Screening that has been in the PHN’s caseload for at
least 90 days or is closed. d. Do not evaluate a previously evaluated record. If the PHN receives fewer cases for a standard of practice than the required minimum, the actual number evaluated will be entered in that section. a. If no cases are available to evaluate, enter “N/A.”
Each PHN should have the minimum number of records evaluated per the standard
Acute Communicable Diseases (ACD) Individual
ACD Outbreak Health Care Facility (HCF)
ACD Outbreak Non-HCF
Sexually Transmitted Diseases (STD)
Tuberculosis Suspect and/or Cases (TB 3/5)
TB Contact Follow-up Individual
TB Source Case Finding in a Documented Converter
Lead or Newborn Screening or Sudden
Infant Death Syndrome (SIDS)
2 cases 1 case 1 case 2 cases 2 cases 2 cases 1 case 1 case
Individual PHN Evaluation of Practice Summary Worksheet (Attachment B)
PHNS will use this worksheet to summarize outcomes of the evaluated records for individual PHN staff.
For each PHN, record on Attachment B the average % compliance for all evaluations completed under each Standard of Practice category. If no evaluations were completed for a given category, write in N/A.
If using Excel spreadsheet, the “total average percentage” will automatically be calculated.
If not using Excel spreadsheet:
Total the percentages under each standard of practice category.
Divide only by the number of standards evaluated.
Record calculation result in the “total average percentage” column.
Write comments if applicable.
Both PHN and PHNS should sign and date the worksheet.
PHNS should sign and date that copy of worksheet was given to PHN.
(See Review and Discussion Section VIII for additional instructions).
© 2007 LAC DPH-Public Health Nursing