Community Health Nurse Scholars Program Toolkit
ABOUT US ..................................................................................................................................................... 3
PROGRAM DESCRIPTION .............................................................................................................................. 6
Background .............................................................................................................................................. 6
Vision ........................................................................................................................................................ 7
Mission ..................................................................................................................................................... 7
Goal .......................................................................................................................................................... 7
Project Description ................................................................................................................................... 7
SECTION 1: BUILDING THE FOUNDATION ................................................................................................... 8
Getting Started ......................................................................................................................................... 8
Assumptions ............................................................................................................................................. 9
Mentoring and Academic Support ........................................................................................................... 9
Marketing ............................................................................................................................................... 10
Pathway Comparisons ........................................................................................................................ 10
SECTION 2: PATHWAY TO COMMUNITY HEALTH NURSING ...................................................................... 13
Overview ................................................................................................................................................ 13
Phase B ................................................................................................................................................... 16
Phase C ................................................................................................................................................... 17
Phase D ................................................................................................................................................... 18
Phase E ................................................................................................................................................... 19
SECTION 3: EVALUATION ........................................................................................................................... 21
SECTION 4: KEEPING IT GOING .................................................................................................................. 22
SECTION 5: RESOURCES ............................................................................................................................. 23
Early College Resources .......................................................................................................................... 23
Marketing and Outreach Exemplars ....................................................................................................... 23
Mentoring Resources ............................................................................................................................. 23
Phase A Resources ................................................................................................................................. 24
Phase B Resources .................................................................................................................................. 25
APPENDICES (MODELS/EXEMPLARS/CHECKLISTS) ..................................................................................... 27
Appendix A: Needs Assessment Checklist .............................................................................................. 27
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Appendix B: High School (Phase B & C) Sample Curriculum ................................................................... 30
Appendix C: Parent Engagement ............................................................................................................ 32
Appendix D: Project Cost Worksheet ..................................................................................................... 32
Appendix E: Enrollment and Retention Worksheet ............................................................................... 34
Appendix F: Applications: Summer Program (Sample) .......................................................................... 35
Appendix G: Health Internships ............................................................................................................. 39
Appendix H: Community Health Competencies ..................................................................................... 41
Appendix I: Financial Aid/Loan Forgiveness Worksheet ........................................................................ 42
BIBLIOGRAPHY ............................................................................................................................................ 44
GLOSSARY ................................................................................................................................................... 46
ACKNOWLEDGEMENTS .............................................................................................................................. 47
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ABOUT US
We are five Robert Wood Johnson Executive Nurse Fellows who are commited to eliminating health
disparities. Our group spans from coast to coast, and represents hospitals, schools, clinics, and
academia. This program is the outcome of an 18-month collaborative process, including consultation
with high school educators, pipeline organizations, and experts in health disparities. We have created
this toolkit to guide those interested in implementing this program in their respective communities.
Aara Amidi-Nouri, PhD, RN
Associate Professor & Chair, BSN Program, Director of Diversity
Samuel Merritt University (SMU), School of Nursing, Oakland, CA
Aara Amidi-Nouri oversees the Bachelor of Science Program at SMU, one of the largest BSN programs in California.
She has served as the Project Director of the Robert Wood Johnson Foundation New Careers in Nursing scholarship
program at SMU since 2009. She is also the Project Director for The California Wellness Foundation grant, Bridging
The Gap. To date she has secured approximately $950,000 in grant funds for underrepresented nursing students
for scholarships and innovative programs for student retention. She teaches in both bachelor's and master's
programs. Her clinical expertise is in pediatrics, particularly hematology/oncology, and end of life. She is deeply
committed to providing culturally responsive care to children and their families, and teaches extensively on this
topic, and authored a chapter on Culturally Responsive Care in Berman and Snyder's Nursing Fundamentals
Textbook. Her past service includes president of the faculty governing body and chair of the Admissions and
Progression Committee. She was awarded the Strommen-Dillashaw Award for outstanding service to the
University. She earned her PhD in Nursing at the University of California, San Francisco. She earned her nursing
undergraduate and master's degrees from Samuel Merritt University, and her first undergraduate degree in
psychology from Occidental College.
[email protected]
Malia Davis, MSN, RN, ANP
Director of Nursing Services and Clinical Team Development,
Clinica Family Health, Lafayette, CO
Malia Davis is the Director of Nursing Services and Clinical Team Development at Clinica Family Health. Malia has
practiced in community health and healthcare for the homeless clinics for 14 years. Malia was selected as a Robert
Wood Johnson Foundation Executive Nurse Fellow for the years 2014-2017. Malia has a deep appreciation and
commitment to work in underserved areas in primary care that support interprofessional practice and nurse
leadership, especially regarding innovations in care delivery. Prior to her nursing career, Malia worked for the
Colorado Outward Bound School as a wilderness instructor and course director for six years, where she discovered
her deep interest in the human capacity to overcome adversity and challenge in order to heal, strengthen and
change. Malia completed her undergraduate degree in Sociology and Women's Studies at The Colorado College.
She earned her master's degree in nursing at Yale School of Nursing in 2002. Malia received a Yale School of
Nursing distinguished Alumnae award in 2014. Malia lives in Denver, Colorado with her husband and 2 young sons.
[email protected]
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Darcy Jaffe, MN, ARNP, NE-BC, PMHCNS-BC
Chief Nursing Officer, Senior Associate Administrator
Harborview Medical Center(HMC), Seattle, WA
Darcy Jaffe has been at HMC for over twenty years in multiple leadership positions including Administrator for
Psychiatry and Behavioral Health Science and has been an active partner with Washington State and King County in
planning and implementing healthcare. In her current role she is responsible for nursing practice and several
clinical departments throughout HMC. Darcy Jaffe is also adjunct Clinical Faculty at the University of Washington
School of Nursing. Darcy was selected as a Robert Wood Johnson Foundation Executive Nurse Fellow for the years
2014-2017. Prior to HMC, she was a registered nurse with Public Health Jail Health Services. Her current
appointments include the Washington State Speaker of the House Mental Health Task Force, King County Mental
Illness and Drug Dependency Oversight Committee, the King County Community Alternatives to Psychiatric
Boarding Task Force and Seattle-King County Opiate and Heroin Addiction Task Force. A lifetime resident of the
Puget Sound area, she earned her undergraduate and master’s degree at the University of Washington School of
Nursing.
[email protected]
Kathleen Johnson, DNP, RN-BC, NCSN
Manager
Seattle Public Schools, Seattle, WA
Kathleen (Katie) Johnson is the Student Health Services Manager for Seattle Public Schools (SPS) supervising a
team of 90 nurses as direct reports, which serves over 53,000 students in 95 schools in a culturally and ethnically
diverse community. Previously, Dr. Johnson was the Interim Health Services Supervisor (School Nurse Consultant)
for the Washington State Office of the Superintendent of Public Instruction (department of education). She was a
school nurse for 9 years in the Edmonds School District, and has worked as a visiting nurse and in a Burn ICU. She
earned a Doctor of Nursing Practice (DNP) in Advanced Practice Community Health Systems Nursing from the
University of Washington Seattle where her research focused on school health data in Washington State and
nationally. Previously she earned a Master of Nursing at the University of Washington Bothell, and earned her BSN
at the University of Rochester, NY. She is national board certified in school nursing and nursing informatics. Katie
was selected as a Johnson & Johnson School Health Leadership Fellow in 2013 and was the National Board
Certified School Nurse of the Year in 2013. She was honored by the Washington State March of Dimes as
Distinguished Nurse of the Year in 2010, and was awarded the National Association of School Nurses (NASN)
Research Award in 2012 for her research on school health data collection in Washington State and nationally
“School Health Data Collection: The Wisdom of School Nurse Administrators.” Katie has published extensively on
school nursing and informatics and presents regularly at the NASN Conference. She is the current Secretary of the
National Board for the Certification of School Nurses and is a founding member of the Steering Committee for the
National Association of School Nurses Step Up Be Counted - an initiative to collect nationally standardized data on
school health services. Katie’s passion is facilitating efficient and effective school health services to support the
health and well-being of our children.
[email protected]
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Lisa Stambolis, MS, M.Ac., L.Ac., CPNP
Director of Pediatrics
Healthcare for the Homeless, Inc., Baltimore, MD
Lisa Stambolis, RN, CPNP, is Director of Pediatric and Adolescent Medicine at Health Care for the Homeless, Inc. a
federally qualified health center serving homeless youth, children and adults in Baltimore. She leads a pioneering
primary care clinic using a Nurse Practitioner-driven model of care aimed at reaching the most vulnerable
homeless children/youth and their families, as well as offering somatic and behavioral health services at a fixed-
site clinic and at numerous outreach sites (such as emergency family and domestic violence shelters, youth drop-in
centers, encampments or on the street). Lisa is nationally recognized as an advocate for homeless children and
teens. In 2012, she was honored as a White House “Champion of Change” in the Fight against Child and Youth
Homelessness. Her work as an advocate was instrumental in passing a Maryland State law allowing
unaccompanied youth the right to consent to comprehensive medical treatment. She continues to promote state
and national policies that advance the rights of unaccompanied youth and increase access to health care and
housing for homeless children and families. Lisa is committed to expanding the traditional role of the advanced
practice nurse while meeting the needs of underserved children and families. She is a preceptor and mentor for
students in graduate nursing programs at the Johns Hopkins School of Nursing and the University of Maryland’s
School of Nursing. Stambolis was a MATCH (Manpower Access to Community Health) Fellow of the National
Association of Community Health Centers and received the University of Maryland Graduate Pediatric Primary
Care Nursing and Community Nursing Service Award. Active in several community coalitions helping homeless
children/youth, Ms. Stambolis sits on the Community Advisory Board for the Youth Empowered Society (YES) and
serves as a memembr of the HIV/AIDS Commission for Baltimore City. Her experience in serving homeless children
led her to co-author a report on the emotional and cognitive impact of chronic homelessness in children for the
National Health Care for the Homeless Council. Lisa is also an expert in complementary and alternative medicine
and has a private acupuncture practice. She earned undergraduate and graduate degrees at University of
Maryland School of Nursing and has a Master’s degree in Acupuncture from the Maryland University of Integrated
Health.
[email protected]
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PROGRAM DESCRIPTION
Background
A healthy community is a place where people are thriving, living long happy and productive lives. The
foundation of a healthy community starts in our homes, in our schools, places of work, worship, and our
neighborhoods. How robust a community is can be linked to its resources. But not all communities
have equal access to resources. Substandard, or lack of, resources can leave individuals and
communities in despair. Our individual health is determined in large part by where we are born and
access to social and economic opportunities; the resources and supports available in our homes,
neighborhoods, and communities; the quality of our schooling; the safety of our workplaces; the
cleanliness of our water, food, and air; and the nature of our social interactions and relationships
(Healthy People, 2020; World Health Organization). Without addressing these underlying causes of ill
health, the risk of perpetuating a cycle of inequity, disparity, and inequality will remain for generations
to come The forces and systems that shape the conditions of daily life include economic policies,
development agendas, cultural and social norms, social policies, and political systems. (IOM, 2016,
2002).
A culture of health requires addressing these social determinants of health (SDH) to improve individual
and community health and overall health equity (RWJF, 2014). Healthy People 2020 recommends the
creation of social and physical environments that promote good health as key to promoting healthy
communities. The framework identifies five (5) key areas: economic stability, education, social and
community context, health and health care, neighborhood and built environment. The Community
Health Nurse Scholars (CHNS) program impacts each of these components in meaningful and sustainable
ways, thereby improving the social fabric of our communities. The end result will be communities where
all people are living longer, happier and more productive lives.
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Vision
Communities that are affected by health inequities and poverty will have access to equitable health care
and become sustained communities of health.
Mission
We address the root causes of poverty through helping low-income youth attain community health
nursing careers to improve both the educational and career trajectory of the individual and the health of
the community.
Goal
To increase the impact of community health nurses in improving the health of underserved communities
by educating youth from underserved communities to serve their own communities as community
health nurses.
Project Description
This project is an accelerated nursing pathway for low-income youth to become community health
registered nurses (CHN). The key components to students’ success in the pathway include: mentorship,
academic support, curricular continuity, completion of a Bachelor in Science Nursing degree (BSN), and
financial aid and loan repayment options. This pathway begins in middle school and continues through
successful attainment of a nursing career. This pathway is grounded in a collaborative process with the
communities where these future nurses reside.
The expected impact of our project includes:
• Increased high school and college graduation rates for low income youth through creation of a
pipeline to a health career in CHN
• Increased diversity of the CHN workforce
• Improve the health of underserved communities through the future community health nurses
who complete the pathway and serve their communities
This program is implemented in partnership with middle and high school educators, community leaders,
community clinics including school based health centers, community colleges, pipeline agencies, and
schools of nursing. Our project is locally based, and can be tailored to meet the needs of varying
communities across the nation.
Eligibility: low-income youth who are pell-grant eligible.
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SECTION 1: BUILDING THE FOUNDATION
Getting Started
This section provides an overview of the program and the elements needed to create the structure
before launching the program.
1. Complete the Needs Assessment Checklist (see appendix A)
2. Review entire pathway, and brochure
3. Meet with key stakeholders for each of the phases
a. 6-12 educators: middle school summer program & high school curriculum
b. Community health providers: summer internships/academic year if relevant
c. Community college educators: determine whether early college/dual enrollment
programs exist or can be created
d. School of nursing educators: determine prerequisites required, and admissions process
for students in pathway, identify strategies the school uses for NCLEX prep (this may
need to be supplemented by the CHNS program)
e. Community leaders: interest, facilities, funding, marketing
f. Human resources directors: identify a person who would be willing to provide
workshops to students on building their careers
4. Create the curriculum for middle school summer program and high school years (Appendix B,
sample curriculum, see phase A for details, and resources section)
5. Identify a director for the project, and project assistant: consider office of diversity at
universities/schools of nursing, health department: health disparities/equities; department of
education at local level
6. Meet with parent group to discuss pathway and determine interest within your community
(Appendix C)
7. Identify mentors for the project who can also serve as an advisory group to the project:
professional mentors and academic mentors
8. Determine whether funding is needed, and if so how much funding (Appendix D)
9. Determine retention plan and number to enroll (Appendix E)
10. Market in relevant ways to youth and their families to garner interest; review all materials to
ensure relevance to community served
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Assumptions
This project is based on the following assumptions that are supported by the literature and current
nurse workforce demographics.
• Mentorship is key to ensuring successful completion of college for low-income youth
• Academic support is needed in math and science to help low-income youth enter nursing, as
admission into schools of nursing is highly competitive
• Financial barriers drive a disproportionate number of low-income youth to unlicensed assistive
personnel job pathways (medical assistants, nursing assistants, etc.)
• Nursing licensure examinations change every three years to meet the increasing complexity of
the healthcare needs of patients in hospital settings, making entry into the workforce harder
• Care is increasingly moving to the community health setting where there is a nursing shortage
• Community health nurses must have a Bachelor of Science in nursing at minimum
Mentoring and Academic Support
Sustained mentorship has been identified as key to academic success for students from underserved
communities. Many high schools in underserved communities lack the resources to sufficiently prepare
students for the rigors and challenges of the college environment. Students need a solid foundation of
effective study habits, test-taking skills, and verbal participation skills well before entry into college.
Academic and social adjustment to the college environment is critical to decreasing student attrition, as
students are particularly vulnerable to isolation and academic failure if they are unfamiliar with how to
navigate the academic system. Formal mentorship and advising is critical in helping students prepare
for the rigors of college. The current national ratio of students to high school college counselors is 478:1,
resulting in woefully little time per student to pave a path towards college. Thus, mentorship is an
essential component of our program. Each scholar is assigned two mentors: an academic mentor, and a
professional nurse mentor.
(Campinha-Bacote, 2010; Childs et al., 2004; NACAC, 2014; Sedlacek et al., 2007, White & Fulton, 2015)
Academic mentoring is provided beginning in middle school to assure that math, science and writing
skills progress to a level needed to support success in the BSN curriculum. Academic mentors will track
student progression, identify tutoring needs that arise, and serve as a liaison between students, parents,
and teachers as needed. Mentors will have a strong foundation in math and science.
Nurse mentoring provides the aspiring Community Health Nurse with a professional role model from
the nursing field, through all the phases of the program and continues through the first year of
employment as a nurse. Students will benefit from mentoring to smooth the transitions in academic
progression in nursing. Mentors can help students understand the relevance of academic programs to
nursing practice, and help students navigate the college preparation, application, and experience.
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Marketing
1. Determine who the partners should be to launch the project. Communication and marketing
efforts need to be tailored to each stakeholder based on what their interest is, i.e. for nursing
schools highlight the diversity aspect, for 6-12 educators emphasize the increase in high school
and college graduation rates, for communities focus on the CHN aspect of improving the health
of the community.
2. Determine the “timeline” for Step 1 – it will depend on the community and the political and
social environment. In some areas it could take 1-2 two years just to coordinate the above stake
holders.
3. Develop KEY Core Message-should not be more than 3 bullet points, they are to be used in all
communication/marketing materials and tailor as needed but keep the 3 core messages the
same. CHNS core message:
• Increase high school and college graduation rates for low income youth by creating a
pipeline to a health career in community health nursing
• Increase the diversity of the CHN workforce
• Improve the health of underserved communities through the community health nurses
who complete the pathway and serve their communities
4. Strategies:
• Repeat core message over and over
• Identify the “what” and the “why” in the message
• Determine “who” are key/core audiences for each phase
• Identify milestone timeline
• Identify the medium for communication strategies: i.e. print, web, video, social media,
twitter, Instagram, paid advertising, organizational round tables, etc.
Pathway Comparisons
Nursing pathway comparisons are a useful strategy in helping understand the true cost of a nursing
career, and how current pathways are not sufficiently diversifying the nursing workforce. Many low-
income youth are counseled into ladder pathways in high school, with the asssumption that nursing
assistant and medical assistant positions lead to licensed practical/vocational nurse jobs (LPN/LVN),
which in turn lead to registered nursing careers. There is no curricular continuity between these
programs, and youth end up spending their adult years in a job pathway with little prospect for growth.
The following table outlines the various pathways, the duration, typical cost, and years worked as RN.
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Pathway Comparisons
Ladder Typical 2 Year 4 Year 2 Year CHNS
Pathway Pathway ADN BSN BSN Pathway
Year 10 - 12 years 6 - 8 years 4 years 4 years 4 years 2 years
9th - 12th Prerequistes:
Grade Graduate HS Graduate HS Graduate HS Graduate HS Graduate HS Enrolled in
Enroll in CC Apply to 4 year Enroll in CC BSN Program
1st Year Enroll in MA/CNA Enroll in CC Nursing Program HS - 11th & 12th
after HS Program
First Year
Work as Nursing Nursing First Year Nursing Nursing
MA/CNA Prerequistes Prerequistes Nursing Prerequistes Program
Program
2nd Year LVN prereq Nursing Nursing prereqs: Second Year Nursing prereqs: Second Year
after HS while working Prerequistes apply to ADN Nursing Program apply to BSN Nursing Program
Nursing Program Nursing Program Pass NCLEX
apply for
LVN school
3rd Year Year 1 LVN Nursing First Year Third Year First Year EMPLOYMENT
after HS Prerequistes Nursing Program Nursing Program Nursing Program
4th Year as RN
after HS
Year 2 LVN Nursing prereqs: Second Year Fourth Year Second Year EMPLOYED
5th Year pass licensure apply to Nursing Program Nursing Program Nursing Program
after HS gain employment ADN /BSN
6th Year Pass NCLEX Pass NCLEX Pass NCLEX
after HS nursing program
Work as LVN First Year EMPLOYMENT EMPLOYMENT EMPLOYMENT EMPLOYED
Nursing Program
as RN as RN as RN
Nursing prereqs Second Year EMPLOYED EMPLOYED EMPLOYED EMPLOYED
need 2 years Nursing Program
plus 2 yrs for RN Pass NCLEX
program, obtain
RN at year 10
Cost for Tuition $30,000- $10,000- $5000- $160,000 $20,000- $10,000-
(Approximate) $140,000 $110,000 $10,000 $95,000 $80,000
Financial Aid 50-100% 100% 100% 100% 100% 100%
(if eligibile)
Wages Earned Zero $120,000 $120,000 $120,000 $260,000
RN first 6 years
(approximate)
Stats: average student takes 6-8 yrs to graduate from college, 75% of students from underserved
communities take 8 years to complete community college AA or AS
11
30 Ladder
25 Typical
20 A.D.N
15 BSN:4
10 BSN:2
CHNS
5
0 Tuition (in 10K) RN income (in 10k)
Years to RN
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SECTION 2: PATHWAY TO COMMUNITY HEALTH NURSING
Overview
Community Health Nurse Scholars Program
An accelerated pathway to community health nursing for low-income
youth that ensures curricular continuity and academic support
Phase C: Phase D: Phase E:
Outcomes: Hs diploma, Outcome: BSN degree Outcome: career as CHN &
entry into college Pathway 1: admission CHNS program mentor
11-12 grades into 2 year BSN program* Career: resume/interview
Health internship Pathway 2: completion of skills
continues remaining prereqs and Passing NCLEX
Pathway 1:Dual entry into 2 year BSN* Attainment of first job as
enrollment, completion of Summer internships RN
prereqs for BSN program Certified Nursing Mentor to 9thgrader in
Goal: Associates degree Assistant option after 1st pathway
Pathway 2: completion of semester in BSN
Phase B: science reqs for BSN program*
program LVN option after first year
Outcome: Math & completion of BSN
Science readiness program*
9-10 grades
Professonal & Academic
mentor assigned
Phase A: Health internship
Outcome: enroll
into Phase B
Middle School *Dependent on program availability in city/state
Summer Program
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A: 8th B: 9/10 C: 11/12 D: BSN E: CHN
Phase A Target Audience: Pell-grant eligible rising 9th graders/families interested in health careers
Outcome: Stakeholders/partners: parents1, students, middle & high schools, counselors (middle & high
Identify Pell-grant eligible rising 9th graders to start pathway school), clinics, nursing students, CPR/First aid instructors, nursing schools, community leaders
Create understanding of why BSN is goal
Exemplars: See resources page
Description: Nursing considerations:
Summer program for middle schoolers (specifically: Pell-grant Student nurses, CH nurses, implied enhancement
eligible rising 9th graders) interested in health careers with
emphasis on community health nursing (CHN). Barriers/Challenges:
1. Cost
Recommended elements to be included in curriculum: 2. Venue
• Understanding of the community health nurse specialty: 3. Liability
4. Meals
o History of nursing, where do nurses work 5. Family-centered
o Movies, panel of CHN & nursing students 6. Transportation
o Interview a CHN Marketing:
o Nurse who does a newborn visit 1.Recruitment of students (presentations at schools/after school programs)
o Palliative care hospice nurses 2.Informing teachers/parents1/community leaders (brochures)
o BSN pathway Implementation:
• RN ambassador program, creating your own community
video SEE APPENDIX C: PARENT ENGAGEMENT
• Activities: SEE APPENDIX D: PROJECT COST WORKSHEET
• Scavenger hunt/photo voice SEE APPENDIX E: ENROLLMENT AND RETENTION WORKSHEET
• Skills activities (blood pressure/first aid) SEE APPENDIX F: APPLICATION FOR SUMMER PROGRAM (SAMPLE)
• Community service activity RESOURCES SECTION: Marketing/Mentoring/Phase A
• Health education (e.g., teach nutrition thru grocery 1Parent could be a guardian or other involved adult in the student's life
shopping)
Bloodborne pathogen/CPR & First Aid certification
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Phase A Implementation:
It is recommended that students apply for the summer program (see Appendix G for sample). Typically such applications are due at the end of
fall semester in the 8th grade year (December), and students are notified in March (including whether waitlisted). All students and parents must
attend an orientation prior to start of program which will include an overview of the entire pathway. Successful completion of the program
includes CPR/First aid certification, and opportunity to apply for the CHN high school pathway.
If your community has an existing program, recommendation is to enhance it rather than create new program.
If planning a new program the following need to be considered:
• Orientation planning (e.g., timing of orientation to achieve optimal attendance, what is most realistic to meet the needs of the
community, will language interpretation be needed)
• Length of program: two weeks minimum is recommended
• Parent surveys/focus groups, high school counselors, affiliate groups as sources of expertise to plan program
• Venue and student transportation to/from the program: may want to hold it at the middle school, or high school, or university campus,
or a venue within the community not affiliated with any school
• Invite families, school counselors, teachers & local CHNs to open houses and group presentations to learn about program
• Outcomes at end of session: real life tools (CPR/First Aid, overview of college, financial aid, etc.)
• Cost: fee? Sliding scale? Full scholarships?
• Remainder of summer options: volunteer/work opportunities with community agencies/ local health services agency
• Field trips: partnership with health agencies
Staffing needs:
• Use the enrollment and retention worksheet to determine how many students to enroll in camp, taking into consideration
availability of staff
• Volunteers: nursing students, teachers, community health nurses (for nurse panel)
• Program instructors: there may be a cost associated with instruction depending on what is taught
• Ideally 1:10 ratio of staff to students
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Phase B B: 9/10 C: 11/12 D: BSN E: CHN
A: 8th
Phase B Target Audience: 9th & 10th graders
Outcome: Math and Science readiness for 9th & 10th graders Stakeholders/partners: High school teachers, SBHC (student based health centers),
Description: nurses, pipeline agencies, students, parents, community youth groups, mentors, tutors,
Students are assigned a professional mentor and an academic schools of nursing
mentor. Opportunity for health internships are offered for summer Exemplars: See Phase B resources
and/or academic year. Students develop academic and social support
plan for 9th & 10th grade. Barriers/Challenges:
Strategies 1. Cost
2. Mentor selection and availability: professional mentor, and academic mentor
• Academic 3. Choosing the right pipeline to partner with
o Required classes are completed by targeted dates 4. Effects of trauma on academic success (ACE Study)
o Meeting state standards in math & science, esp. algebra Marketing:
o Tutoring: what is currently available, and which services 1. During Phase A: application to all summer participants
need to be enhanced/created 2. Included as total package with initial marketing campaign
o Support educational and career planning 3. Math and Science middle school and high school teachers and counselors
o Giving access to academic mentor to determine 4. Community and pipeline groups
student’s progression Implementation:
o Enhancing study skills
o Value of BSN: why CHN requires BSN SEE APPENDIX B: HIGH SCHOOL SAMPLE CURRICULUM
SEE APPENDIX G: HEALTH INTERNSHIPS
• Social RESOURCES SECTION: Early College, Phase B
o Identification of individual student barriers and
interventions to promote success inclusive of trauma-
informed and restorative justice approaches
o Parent and Community engagement
o Support and affinity groups (Health Clubs, etc.)
o Visualizing and long-term goal planning skills
o Financial aid planning for college
o Involvement with school nurse/health center (if any)
o Establish group ceremonies/rituals to build community,
celebrate milestones, and anticipation for next steps
o Summer program service component
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Phase C B: 9/10 C: 11/12 D: BSN E: CHN
A: 8th
Phase C Target Audience: 11th & 12th graders, community colleges, nursing programs,
Outcome: community health agencies.
1. Prerequisite course work for Nursing School is Stakeholders/partners: community colleges, BSN programs, ADN programs, high
school college counselors, college admissions counselors, teachers, nurses, nurse
progressing toward completion or is complete mentors, clinics, SBHC, pipeline agencies, students, parents.
2. High School Graduation Exemplars: Bard high school: http://www.bard.edu/earlycollege/
3. Applied & accepted to college Marketing:
4. Student and Family scholarship/loan repayment and 1. Community colleges (ensuring placement for students)
2. Nursing programs (buy-in from BSN programs)
financial planning strategies outlined 3. Community health agencies
Implementation:
Description: Consider dual enrollment/early college programs that enable students to take college
This phase occurs during 11th and 12 th grade, with a level courses in high school, which also count towards high school credits needed for
focus on completing nursing school pre-reqs during the graduation.
last two years of high school. Students will gain
increasing responsibilities in their health internships. SEE APPENDIX G: HEALTH INTERNSHIPS
Mentorship continues. SEE APPENDIX I: FINANCIAL AID/LOAN FORGIVENESS WORKSHEET
Pathway 1: pre-reqs completed: apply directly to
BSN (2 year).
Pathway 2: progressing toward pre-req completion:
continue to college for prereq completion, or enter
4-year BSN program.
Health Internships:
Build relationships with community health agencies and
match student interests to agency. (SEE APPENDIX H)
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Phase D B: 9/10 C: 11/12 D: BSN E: CHN
A: 8th
Phase D Target Audience: pre-nursing, and nursing students, schools of nursing, CHN, and
Outcome: clinics.
BSN attainment with CHN Focus Stakeholders/partners: community colleges, BSN programs, students, nurse mentors,
Description: CHN, clinics.
Students in this phase are in their BSN programs, Exemplars: BSN programs, two year and four year, ADN to BSN programs, see
whether that is pathway 1 or 2, and gain workforce Resources section.
readiness through community health summer Barriers/Challenges:
internships, and have opportunities to become a CNA 1. Curricular continuity
after completion of health assessment/fundamentals, 2. Retention for pathway 2
and LVN by the third semester of the BSN program. 3. Retention of nurse mentors
Nurse mentors continue to meet with students. 4. Successful admission and enrollment into BSN program
5. Internship placements
Pathway 1: BSN (in 2 years) Marketing:
Pathway 2: AA- BSN (3years) or BSN (4 years) or Community health agencies
AA-ADN-BSN (5 years) Schools of Nursing
Implementation:
Align community health rotations/capstone/preceptorships in BSN programs with
student areas of interest, such as health department, primary care community health
clinics, mobile clinics, school based clinics, etc.
SEE APPENDIX F: HEALTH INTERNSHIPS
SEE APPENDIX G: COMMUNITY HEALTH NURSE COMPETENCIES
SEE APPENDIX I: FINANCIAL AID/LOAN FORGIVENESS WORKSHEET
18
Phase E B: 9/10 C: 11/12 D: BSN E: CHN
A: 8th
Phase E Target Audience: community health agencies, new grads.
Outcome:
Begin career as CHN in Own Community Stakeholders/partners: community health agencies, faculty, HR recruiters, nurse
Join alumni group mentors, summer camp participants, 9th graders.
Serve as mentor to high school students
Exemplars: stories of success: Gabby and Mariah and Claire and Guadalupe and
Description: Shanda.
In this phase the student has completed the BSN
program, and will need to pass licensure (NCLEX) and Barriers/Challenges:
obtain a position. NCLEX readiness is built into nursing 1. Identifying job opportunities
programs already; however, based on results of 2. Cost for NCLEX support
readiness assessment students will qualify for additional 3. Retention of students
support (online, and f2f), including the development of 4. Policies related to job entry
an NCLEX study plan with the nurse mentor. Career 5. Getting CH agencies to hire new grads (internships can remove these barriers)
readiness in the form of workshops, resume building,
mock interviews, are integrated into this phase. After Marketing:
passing the NCLEX, the new graduate will be expected 1. CH agencies: outlining achievements of the pathway students, and the number of
to become a nurse mentor to the rising 9th graders in
the pathway and participate in the middle school hours already completed in CH during the program
summer camp. 2. HR recruiters: value in providing career building workshops
3. Recruitment fair
Student loan repayment options, financial management, 4. Appreciation dinner for nurse mentors
forebearance options, etc. 5. Achievement celebration for new grads
Implementation:
Internship sites become sites where the new grads are hired.
Workshops offered by HR departments to assist with career building skills.
19
Phase E implementation:
Continue to foster relationships with local clinics, hospitals and public health departments. Establish reputation for next cohort of CHNS.
Emphasize benefit to the health agency to offer internships to scholars who may be future nurse for the organization.
Mentorship training for new grads to mentor entering scholars at specific internship opportunities.
Financial Aid: Loan forgiveness programs, hardship forbearance options as needed
• Support for loan repayment through National Health Service Corps or State Loan repayment programs when working with underserved
populations.
• Clinics that qualify as a medically underserved area (MUA)
• Collaborate with financial aid counselors from schools of nursing so that burden is not solely CH partners/organizations to create
seamless transitions.
• Collaborate with alumni organizations, as alumni can also serve as resources in navigating the loan forgiveness process
20
SECTION 3: EVALUATION
To effectively evaluate the CHNS program, data must be collected throughout each phase of the
program. The instruments used for collection can include surveys with both quantitative and qualitative
measures, in addition to focus groups at each phase:
• Demographic information regarding student’s grade level, school, gender, GPA, and
race/ethnicity should be included, while ensuring participant anonymity/confidentiality.
• Enrollment data should include number of applicants, as well as attrition rates throughout all
phases of the program. Barriers to academic progression should be identified on an annual
basis.
• Costs should be tracked, including volunteer time. An annual report of costs related to the
program should be made available to all key stakeholders.
• Program satisfaction surveys should be given to both parents and students.
Phase specific evaluations:
Phase A
• Pre and post surveys should be administered to measure the knowledge gained by activities,
and usefulness. Such surveys provide continual evaluation of the program, and can help identify
areas of strength and growth.
• Middle school summer camp participants and their parents should be surveyed regarding
college and career plans. This survey can also be administered annually for comparison
purposes, and to obtain longitudinal data.
Phase B/C/D
• Mentorship effectiveness:
o High school students should be surveyed at the end of each academic year, since the
impact of mentorship and tutoring may not be realized until those services have been
delivered consistently over a longer period of time.
o College students should be surveyed every semester.
o Both mentors and mentees should be surveyed.
o Data regarding GPA will be obtained from the school to determine academic
progression: specifically, math and science grades in addition to cumulative GPA.
GPA/exam grades will be used as a measure of evaluating the impact of academic
support.
• Agencies offering internship/volunteer opportunities should be evaluated after each internship
opportunity to determine strengths and areas for growth. Agencies should provide input into
restructuring the program as needed.
Phase E
• Students should be surveyed regarding licensure and career readiness to identify barriers and
areas for program improvement
21
SECTION 4: KEEPING IT GOING
Sustainability is key in assuring success for the CHNS program, which supports youth from middle school
through attainment of a community health nursing career. While initial funding may support the
resources needed to launch the program, it is crucial to integrate the program into schools and
community organizations to create a self-sustaining program that minimizes costs. Robust data
collection and program achievements can help sustain funding.
Consider the following:
Mentorship
• Invite graduates from the CHNS program to serve as mentors, or build in a requirement for
service into the CHNS program.
• Enlist the help of retired science and math teachers (including college professors) to tutor
students in the program (many colleges will provide a list of their professor emeriti)
• Reach out to retired nurses (from practice and academia) to serve as professional and academic
tutors
• Offer opportunities to junior and senior students from college prep high schools to tutor CHNS
students in math and science
Summer Camps
Collaborate with schools of nursing to recruit nursing students to lead health related activities, offer
leadership hours for the nursing leadership course if possible
• Determine whether a local university/college can host/co-sponsor the camp
• Ask public transportation agencies for bus pass donations, and provide a supervised walk from
the bus stop to the summer camp venue
Academic Progression
• Create a list of free online resources that explain common math and science concepts, that are
readily accessible through a mobile device
• Create a ‘text buddies’ program to have student check in with each other to ensure
homework/assignment completion
• Create study groups within the CHNS cohort in 9th grade so that students can help each other
throughout the high school years
Entry into College
• Invite local nursing students, faculty, financial aid officers to a workshop/panel annually to
provide guidance to students
• Recruit volunteers to help with completion of college and financial aid application
Administrative
• Enlist the help of CHNS program parents
• Reach out to community organizations
• Provide opportunities to CHNS program participants to gain job skills by delegating tasks such as
poster creation, organizing meetings, creating surveys, etc.
22
SECTION 5: RESOURCES
Early College Resources
Bard Early College
The Bard Early Colleges are founded on the belief that many high-school-age students are eager and
ready for the intellectual challenges of a college education. The Bard Early Colleges provide adolescents
with a rigorous, credit-bearing, tuition-free college course of study in the liberal arts and sciences
following the 9th and 10th grades.
Texas Early College High School
Early College High School (ECHS) is a school reform model that targets students at risk of dropping out of
school. ECHS blends high school and college work to enable students to graduate with a high school
diploma and an associate degree or 60 college credit hours toward a baccalaureate degree. General
information about this program can be found in the Texas ECHS Map, and What is ECHS sections of this
website. Those interested in designing and planning a new ECHS will find in-depth resources organized
by topic in our Resource Guide.
Marketing and Outreach Exemplars
The Road Map Project
The Road Map Project is a community-wide effort aimed at improving education to drive dramatic
improvement in student achievement from cradle to college and career in South King County and South
Seattle. The project builds off of the belief that collective effort is necessary to make large-scale change
and has created a common goal and shared vision in order to facilitate coordinated action, both inside
and outside school.
Strive Together
Strive Together provides a framework for aligning resources, coordinate practices and direct resources
towards common goals, to create a collective impact. Their four pillars include: shared community
vision; evidence-based decision making; collective action, and investments and sustainability.
Mentoring Resources
FACES for the future
The FACES Coalition supports a collaborative of national programs, all based upon the FACES model,
which work to address health equity for all communities through the training and empowerment of
young people. FACES for the Future is a comprehensive approach to student learning and well-
being. Focused on transitioning youth into the health professions, FACES programs create tomorrow’s
health leaders by offering health career exploration, academic support, psycho-social intervention and
youth leadership development.
23
New Careers in Nursing, Robert Wood Johnson Foundation
An innovative initiative to diversify the nursing workforce in collaboration with AACN, offering
scholarships, mentorship and leadership support to underrepresented nursing students. Comprehensive
toolkits are available on the site, including a mentorship toolkit that details how to choose mentors, how
to build and sustain the mentor/mentee relationship.
U.S. Department of Education Mentoring Resource Center
The goal of the National Mentoring Resource Center is to improve the quality and effectiveness of
mentoring across the country by supporting youth mentoring practitioners. The National Mentoring
Resource Center serves as a comprehensive and reliable resource for mentoring tools, program and
training materials, and information. In addition to accessing online resources, mentoring programs can
apply for no-cost training and technical assistance to support them in more deeply incorporating
evidence-based practices, ultimately leading to greater positive outcomes for youth.
Washington Center for Nursing
Increasing the racial and ethnic diversity of nursing students and faculty in Washington is one of the
priorities, and programs include developing strategic alliances with minority nursing organizations, and
mentoring programs to improve recruitment and retention of diverse, low income students in K-12 and
higher education.
Phase A Resources
The following resources will be beneficial to the student at the beginning of the program, or during
Phase A.
Samuel Merritt University (SMU) Nursing Summer Success Seminar
A three-day seminar offered in the summer at the nursing school for prospective students. It includes
presentations from nursing faculty, admissions councilors, and staff from the Office of Diversity, as well
as participation in a tour of SMU’s state of the art Health Sciences Simulation Center, and a chance to
meet current SMU nursing students. Students will learn about topics ranging from the admission and
financial aid process, to reducing health disparities and international nursing. For more information,
please visit Samuel Merritt University (SMU) Nursing Summer Success Seminar .
Seattle Skills Center
The Seattle Skills Centers are public schools offering technical and professional training. Classes are
taught by teachers who are industry professionals, and also in partnership with business and industry
advisors. To fill out an application, please go to: The Seattle Skills Center
SEEK: Summer Engineering Experience for Kids
This program aims to increase elementary school students’ aptitude in math and science, as well as their
interest in pursuing STEM (science, technology, engineering, math) career fields, by having them engage
in interactive, team-based engineering projects. It was started in 2007 in Washington, DC and has since
expanded to 12 cities across the US and has served more than 3,500 students since its inception. They
also include an application, and parent orientation materials. For more information, please visit
http://www.nsbe.org/Seek/About-SEEK.aspx.
24
Sutter Health Youth Bridge Program
The Youth Bridge Career Development program is geared toward youth in low income areas of the San
Francisco East Bay area. It gives students an opportunity to explore real-life health care careers within a
medical center environment, while connecting them to their peers who have similar interests, and
matching them with a mentor. The Youth Bridge Curriculum includes career focused classes, leadership
development, a paid summer internship, and community service opportunities. For more information,
please visit www.altabatessummit.org/youthbridge.
University of Washington Nurse Camp
This program is a free week-long day camp available to current high school sophomores and juniors of
all socio-economic backgrounds. Its intent is to increase access and opportunities in nursing to minority
and low-income students. Some of the activities include shadowing nurses, completing CPR certification,
and learning about infection control, how to take blood pressure, becoming familiar with a simulation
lab, and preparation for college.
For more information, please visit https://nursing.uw.edu/community/uw-nurse-camp/ or to fill out an
application 2016-Nurse-Camp-Application.
Phase B Resources
These resources will be beneficial to students who are further along in the pathway program, or Phase B.
The Alameda County Health Pipeline Partnership (ACHPP)
ACHPP is a group of organizations that provide pathway programs to disadvantaged and minority youth.
Their main goal is to increase the diversity of the healthcare workforce by providing mentorship,
academic support, leadership development, and career exposure to young students who may otherwise
not get the necessary resources. For more information, please visit www.acphd.org.
GIRLS INC. of Alameda County
GIRLS INC. supports girls in underserved Alameda County communities by providing support and
academic programs in literacy, math and science, health and fitness, pregnancy prevention, leadership,
and self-advocacy. For more information, please visit http://www.girlsinc-alameda.org
Health Sciences Career and Technical Education (CTE)
Through the Washington Office of the Superintendent of Public Instruction, Health Sciences CTE
provides a pathway to the following careers:
• Biotechnology research and development
• Diagnostic services
• Health informatics
• Support services
• Therapeutic services
Students are offered opportunities to diversify their high school education, be involved in
apprenticeships, as well as two year, four year, and graduate college programs. For more information,
please visit http://www.k12.wa.us.
25
Project Lead the Way
Project Lead The Way is a program that provides academic support for K-12 students across the US.
Their goal is to empower students to be more involved with their education, and encourage them to
seek out information and build upon their skill set. For more information, please visit
https://www.pltw.org
Rainier Scholars
The Rainier Scholars program provides both academic and socio-economic support for students over a
14-month period. This includes individual meetings with advisors, weekly tutoring, social and cultural
activities with other Rainier Scholar participants, family meetings to address college preparation,
community engagement, and ongoing academic support. For more information, please visit
http://www.rainierscholars.org.
Rhode Island Nurses Institute Middle College
RINIMC is a charter high school that is preparing a diverse group of students to become the highly
educated and professional nursing workforce of the future. They foster a supportive learning
environment, and are committed to developing the skills, knowledge, and passion necessary to excel in
the nursing and allied health professions. http://www.rinimc.org
THRIVE Foundation for Youth
This organization uses the following principles in order to support disadvantaged youth, and set them up
for success:
Empathize with the youth, to better understand real needs
• Define opportunities for support
• Ideate innovative solutions by bringing together different perspectives and resources
• Prototype elements of our ideas with our partners
• Test concepts
For more information, please visit http://www.thrivefoundation.org/innovation.
Washington State High School & Beyond Plan
The High School & Beyond Plan is a graduation requirement set up by the Washington Office of the
Superintendent of Public Instruction. It is a set of documents that students complete, with the goal of
getting students to think seriously about their future after high school. The plan includes having
students write about their interests and career goals, a plan to ensure graduation requirements are met,
a list of exams the student needs to complete, student research of higher education programs related
the students’ goals, a resume, and a budget. For more information, please visit www.k12.wa.us.
Summer Engineering Experience for Kids (SEEK)
This program aims to increase elementary school students’ aptitude in math and science and their
interest in pursuing STEM (science, technology, engineering, math) career fields, by having them engage
in interactive, team-based engineering projects. It was started in 2007 in Washington, DC and has since
expanded to 12 cities across the USA and has served more than 3,500 student’s since it’s inception.
www.nsbe.org
26
APPENDICES (MODELS/EXEMPLARS/CHECKLISTS)
Appendix A: Needs Assessment Checklist
This checklist can help determine whether there is a need for a CHNS program in your community, and
sufficient resources within the community (or close proximity) to implement the program. Complete the
blank spaces in each category. You do not have to complete each section if it is not deemed as relevant
to your community setting. You may include numbers/percentages/ other pertinent information.
I. Overview of local demographics:
• Registered Nurse workforce (information can be found through Board of registered nursing):
Website/source of information: _________________________
Gender
Ethnicity
Community health nurses
School nurses
Percentage of local high school students admitted and enrolled in RN programs:
___________ (obtained from admissions office of RN programs)
• Unlicensed assistive personnel (UAP) health workforce (Bureau of labor statistics, and local
programs):
Website/source of information: _________________________
Gender
Ethnicity
Pathway enrollment:
MA (medical Assistant)
CNA (nursing assistant)
EMT (emergency medical technician)
Other
Enrollment into UAP programs
Percentage of local high school students admitted and enrolled in UAP/paraprofessional
programs: ___________
• High Schools (published in district annual reports):
Website/source of information: _________________________
Gender
Ethnicity
Graduation rate
Standardized test scores
State standardized test scores
National standardized test scores
27
II. Local resources:
• Middle and High Schools (list names and key contacts, college counselors):
Middle Schools
High Schools
• School district (key leaders):
Key leaders (names and title)
Current educational pathway
initiatives
• Post-secondary institutions (list names & key contacts):
Community colleges
4-year universities
Schools of nursing
• Associates Degree
• Bachelor of Science
Paraprofessional schools
(EMT/CNA/MA,etc)
Dual Enrollment/early college
• Department of Public Health (key leaders and health initiatives - can be found on DPH
website):
Key leaders (names and title)
Current health initiatives
• Summer programs (names of programs, and key contact):
Middle School
High School
Specific to health careers
• Academic year programs (names of programs, and key contact):
Middle School
High School
Specific to health careers
Specific to math/science
28
• Clinics/school-based health centers:
Key leaders (names and title)
Current health initiatives
• Parent groups (parent organizations at schools, faith-based organizations):
Key leaders (names and title)
Current initiatives
• Community organizations: Name & key leaders
Type of organization
Faith-based
School-based
District/county based, such as
parks and rec department
After-school programs; activity
centers
Health and wellness centers
Pipeline programs for youth
Other
III. Determine need:
a. Are there enough key contacts on the checklist to create an advisory group? Yes/No
b. Are there schools of nursing, community colleges, or other pathways to RN education
within your community/city? Yes/No
c. Are there already initiatives/programs in place for youth related to health, education, or
academic progression? Yes/No
If you have answered ‘no’ to 2 or more items in section III, you may need to help establish
that foundation before proceeding forward with the program.
29
Appendix B: High School (Phase B & C) Sample Curriculum
CHNS Sample Curriculum Sequence
Please note that the sequence is a sample only. Requirements vary across states and universities.
Completion of this dual enrollment pathway results in an AS (not AA) from community colleges because
of the heavy emphasis on science over humanities. The curriculum is built so that the BSN prerequistes
are completed by high school graduation, enabling the students to enter into a two-year BSN program
upon completion of high school (or ADN program if desired). Students will also be eligibile to apply to
any college for any major, and apply as direct-transfers to four-year universities for the upper division
courses. An option to slow down the path, to finish high school in 5 years is also possible, as is the
option to finish high school in 4 years, and complete prerequisites at a community college before
applying to nursing programs.
• GenEds at community colleges require English/Math (those are highlighted in blue), and other
courses to meet the minimum number of units. After the minimum (19 units) is reached, students
have options to take courses to meet the total credit requirement (60 total). Some GenEds are
required for the specific major (those are highlighted in green and blue). 18 units are required for
the major (highlighted in green)
• Early college high schools: provide dual credit for college courses taken (high school and college,
reduces redundancy), can take up to 5 years to finish high school if needed
• Note: completing the prerequisites for nursing school exceeds AS requirements (except for gen bio
requirement for AS)
(See next page for chart)
30
High School Community BSN CHNS CHNS
College AS
(230 credits, each class = 5) Prerequisites Pathway by subject by year: 3 & 4 are college
(units: 60 for AS, incl. 18 (number of courses:18) unless HS indicated
History = 30 for major & 19 GenEd) (HS year grouped by color)
English Composition
• World (10) English Composition History: History:
• US (10) (GE-3)
• Econ (5) English Literature English Lit/Critical 1: HS English
• Govt (5) (GE-3) Thinking 2: HS Science: Physical
English = 40 credits
Math = 30 credits (3) 3 Interpersonal Interpersonal
• Algebra/Geometry/Stats or Trig Communication Communication
Science=30
Humanities (3) Humanities 3: College X 2 Math: Algebra
• Biology = 10
• Physical = 10 Fine Arts (3) Fine Arts Theory English World Language
• Additional = 10 American History (3) American History 1: HS History
World language = 20 Modern World History (3) Modern World History 2: HS English
Science: Biological
(needs to be same language) 3 Diversity/Ethnic Diversity/Ethnic Studies 3: HS Math: Geometry
Studies
Physical Education = 20 Gen Sociology/ 4:
3 Gen Sociology/ Cultural Anthropology College X 2
College Prep/Electives = 50 Cultural Anthropology
3 Philosophy/ Ethics Philosophy/ Ethics Science World Language
3 General Psychology General Psychology
1: HS: Physical Visual Art / *Fine Arts
Sciences Theory
3 Life Span Psychology Life Span Psychology 2: Gen Bio Micro
HS: Biology Sciences
3 Nutrition Nutrition 3: Gen Psych Chem
Micro/Chem/Gen Bio
Math (3) Statistics 4: World World
Human Anat & Phys Language Language
Chemistry Chemistry with Lab Math HS English HS English
(GenEd-3) w/Lab = 5
Microbiology (5) Microbiology with Lab 1: HS: Algebra Stats Math
Human Anatomy (5) Human Anatomy w/ Lab 2: Anatomy Physiology
HS: Geometry
Human Physiology (5) Human Physiology +Lab 3: Dev. Psych Nutrition
College: Stats (Alg. 2)
General Biology (5) 4: Optional History History
(25 for major, need 18 AS)
World Language Ethics Sociology
(21 for GenEd, need 19 AS) = x 2-3 yrs
(21 addt’l for prereqs )
Visual Arts: English English
Total=67 (need 60 for AS)
2:Fine Arts Theory Humanities x 1
(can be in summer)
Electives: 3: Gen Psychology
4: Ethics, Soc., Humanities, Lifespan, Nutrition
Appendix C: Parent Engagement
Parent/family involvement is a key component to the CHNS program. The role of parents in supporting
their children as they navigate the academic process is vital to their individual success and the success of
the program as a whole. Research shows that parent engagement in schools is closely linked to better
student behavior, higher academic achievement and enhanced social skills (Centers for Disease Control
and Prevention. Parent Engagement: Strategies for Involving Parents in School Health. Atlanta, GA: U.S.
Department of Health and Human Services; 2012). For the purpose of our program the concepts and
strategies for parent engagement as outlined in the following resources are applicable. The CDC’s three
key strategies of Parent Engagement: connection, engagement and sustainability are based on research
and present an evidence based approach to cultivating parent involvement in the CHN Scholars
pathway.
The CDC has several useful publications to guide strategies for engaging parents. Use the following links
to connect to their website for a comprehensive list of related resources:
http://www.cdc.gov/healthyyouth/protective/pdf/parent_engagement_strategies.pdf
http://www.letsgo.org/wp-content/uploads/K5Tab11D02-Parent-Engagement-Guide.pdf
http://www.hhs.gov/ash/oah/oah-
initiatives/teen_pregnancy/training/Assests/2014%20Conference/parent_engagement.pdf
Parent engagement strategies from Division of Adolescent and School Health:
http://www.hhs.gov/ash/oah/oah-
initiatives/teen_pregnancy/training/Assests/2014%20Conference/parent_engagement.pdf
Appendix D: Project Cost Worksheet
Project cost worksheet:
This worksheet is meant as a guideline and is not exhaustive. Please review Section 4 (Keep it going) for
suggestions on sustainability and cost containment.
In the first year, it is anticipated that time will be spent in developing the program, so the costs may be
primarily related to release time for the director of the program.
A. Program Director:
It is expected that the project director will spend more time initially to develop the program and
launch phase A & B, and less time as personnel and support are in place. The cost is based on
the salary of the person who is directing the program.
Cost in year one: __________
Cost in year two: __________
Subsequent years: _________
32
B. Other Personnel:
a. Tutors: if not already provided, tutoring may need to be supplemented by CHNS
program. Tutor costs range from $15-$30/hour
Hours of tutoring x enrollment x cost/hour= _____________
b. Staff support: administrative support may be needed, determine weekly/monthly
support, includes survey development/tracking, outreach, etc.
Hours of support ____ x $rate/hour _____= ___________________
c. Summer camp counselors/staff: this will depend on number of students enrolled, a
minimum of 1 staff member for 10 students is recommended:
Length of camp (days) ___ x 8 hours x $rate/hour _____x number of staff ___= _______
C. Program Costs:
a. Materials and Supplies
b. Field Trips
c. Transportation
d. Meals
e. Stipends for health internships (if possible)
33
Appendix E: Enrollment and Retention Worksheet
Enrollment and Retention Worksheet
Use the information from Checklist (Appendix A) to determine enrollment.
1. What is the retention rate (expressed as a percentage) at the high school(s) where CHNS
program will be held? (If a school provides attrition rates instead of retention rates, subtract the
attrition rate from 100 to find the retention rate)
a. 10th grade ______
b. 11th grade ______
c. 12th grade ______
d. Completion (HS diploma) _______
e. Percent of students enrolling in 2 or 4 year colleges: ______
f. Average retention rate: Sum of a through e, divided by 5 (a+b+c+d+e /5) = _________
2. Does retention decrease over time? Yes/No
3. Determine minimum program goal (a range of 5-10 students completing all phases within 7
years for phase A is recommended): __________ (number of students)
4. Enrollment in CHNS: Determine average enrollment needed in phase A to achieve program goal
from step 3. Formula for enrollment: Program enrollment x retention rate= program goal
a. What is the average retention rate (from step 1): _______
b. Convert retention rate to a decimal (example: 60% is 0.6): _______
c. Calculate enrollment: Program goal/retention rate=program enrollment
i. Example: You hope that a minimum of 10 students will complete the pathway,
so your program goal number is 10
ii. The average retention rate from a particular high school is approximately 60%,
which is 0.6 expressed as a decimal
iii. Plug the numbers into the formula: 10 divided by 0.6 equals approximately 17,
so you would need to enroll a minimum of 17 students in summer camp for
phase A
iv. The lower the retention rate, the higher the enrollment needs to be.
5. How many students needs to be enrolled in phase A: ___________
6. If you expect there to be significant attrition from summer camp, you may want to increase
enrollment using the same formula, but substituting step 5 for the program goal from step 3.
a. Example: you need 17 students to enroll in CHNS program in 9th grade to have 10 finish
at the end of high school and progress to college (phase D), but you expect that only
60% (0.6) of the summer campers will want to move forward into phase B. So you take
your goal of 17, and divide 17 by 0.6 (17/0.6 =28) to determine how many you need for
summer camp. In this example you would need almost 30 students to enroll in summer
camp (28 to be exact).
34
Appendix F: Applications: Summer Program (Sample)
35
36
37
38
Appendix G: Health Internships
The following are ideas that might apply to your community or local resources that involve nursing in
the community and/or programs that address community health from a population perspective.
Considerations:
• Find out if there is a volunteer coordinator at the agencies through which you seek internship
opportunities
• Pick appropriate projects and hours so that the internship is mutually beneficial to the student
and the organization
• Prioritize relationships with organizations who qualify for federal and/or state Loan repayment
programs.
Phase Outcomes • Activities Progressive Competencies
Phase A 8th • Health/Medical
grade See phase A for exposure • Organize field trip to CHC (or
(summer to nursing / meeting CHNs. • similar) Terminology
between 8- Help students to • CPR/First Aid certified
9th grade) understand all types of Meet volunteer coordinator
organizations that serve • Communication
Phase B ‘health’ Determine if there is an skills/Bilingual abilities
9/10th opportunity for 1-3 days of depending on population
grade Emphasize and match • volunteering. Some non-profit
internship organization / organizations do fundraisers, • Culturally responsive to
mission / vision / or do service days (soup population
population served to kitchen, etc.). Idea is exposure
student. to local population in need and • Mandatory reporting rules
resources available. • Patient confidentiality
•
• 2-4 week internships that helps rules/HIPPA
your local CHC (or similar)
accomplish a quality measure
they are already working on.
Outreach to patients with
chronic illnesses (HTN, DM,
asthma)
Assist with group visits for
weight loss or diabetes
Work on immunization rates
for school physicals at SBHC
Phase C Increasing responsibilities 11th grade: start to shadow team • Teamwork
11/12th within internships up to 1- members, •
grade 4 weeks in length, maybe 12th grade: increase responsibilities, Inter-professional
rotate sites 1 week each consider p/t employment in clinic • collaborations / ability to
Broaden internship Internship ideas: • function in team based
possibilities: care settings
• School vaccines and physicals •
• Local primary care • Registering new patients for Multitasking
clinics including CHC
and healthcare for the portals or telehealth Identifying local resources
Homeless for underserved/no
• TB screening at homeless insurance/limited
• Hospitals shelters / day shelters, jails resources
• Public Health
• Immigration support services Durable medical supplies
Department for new community members
• Community wellness programs
39
Phase D • Immigration services • Nursing Homes • Nursing assessment
BSN • Mobile clinics • Recreation Centers • Nurse protocols
• Community Centers • Care coordination
Phase E Partner EARLY with health • YWCA/YMCAA • Ability to assess/triage
CHN organizations that qualify • Summer camp counselling over phone
for federal or state loan • Skilled nursing centers • Patient education
repayment programs and • Food banks • Vaccines and IM injections
prioritize these as you •
foster internship sites and • Local School Based Health • Wound care
relationships Clinics • Contraception
Market CHC pathway and • Local federally qualified • Pre-natal care
internship at this phase as community health centers • HPI / history taking
2 years of related • Local Primary care clinics Understanding of basic
experience. • Nursing and or Medical School • chronic illnesses like DM,
based clinics • HTN, asthma, depression
Many organizations end
up hiring students who Screening guidelines
volunteer and who they Drug and alcohol use /
precept abuse
Use idea of residency Mental Health
“match” model to Intimate Partner Violence
organization / internships. (DV) screening
Progressive responsibilities
increases likelihood of Outpatient rapid response
hiring and being a good fit training
with organization
How to interpret labs and
Develop skills in nursing • diagnostic studies to help
student to match • inform patients
internship organization
needed •
•
•
Internships completed Encourage new CHNs to provide
internship opportunities to scholars
coming up through pathway
40
Appendix H: Community Health Competencies
Nurse: Clinica Family Health Services
PERFORMANCE REVIEW RN ORIENTATION and COMPETENCIES CHECKLIST
Supervisor:
Clinic: Hire Date:
This skill checklist is a required component of orientation, used to verify competence to perform skills. This checklist must remain in the clinic at all times. The employee is responsible for using the
orientation checklist each orientation day and ensuring skills are validated by his/her preceptor/educator. The preceptor is responsible for initialing and dating each MET/NOT MET column and
for documenting signature with initials on the last page at the close of the orientation period. If performance is unable to be validated, the preceptor must note this in the comment section and
notify the manager/director or designee. SECTIONS 1 – 4 TO BE COMPLETED WITHIN THE FIRST 90 DAYS & BEFORE NURSE WORKS INDEPENDENTLY. REMAINDER OF
ITEMS TO BE CHECKED OFF WITHIN 6 MONTHS FROM DATE OF HIRE.
The employee is responsible for performing the self-evaluation. The employee should circle the number that BEST corresponds to his/her experience.
Self-Evaluation Supervisor Evaluation
(Initial)
CRITICAL BEHAVIORS 1 2 34 Met Not Date/Comments
Met*/NA 3 = Knowledge/Done with assistance
4 = Knowledge/Done independently
1. COMMUNICATION & PRODUCTIVITY Key: 1 = No knowledge/Experience
Competency: Communicates effectively with other members of the health care team, patients, and 2 = Knowledge/No experience 3 = Knowledge/Done with assistance
family members. 4 = Knowledge/Done independently
Education/advice given is culturally sensitive. 1 2 34
Presents patient case to provider w/ appropriate detail & efficiency. 1 2 34
Respectful language and tone used w/ patients & other staff 1 2 34
(hospitality)
Assist Nurse Team Managers with pod patient flow, including nurse 1 2 34
visits, co-visits and group visits.
Provide direct patient care through maintaining own schedule of nurse 1 2 34
visits using nursing protocols.
Manage daily nurse schedule in conjunction with Nurse Team 1 2 34
Manager; participate in daily pod huddles and weekly team meetings.
Demonstrates understanding & appropriate use of active schedule 1 2 34
management principles.
Address all tasks per guidelines, requesting assistance from other team
members & delegating as necessary to complete tasks in appropriate 1 2 3 4
time frame.
Huddles with care team &/or provider at the beginning of the shift. 1 2 34
2. TELEPHONE TRIAGE
Competency: Using standardized nurse triage protocols, review & respond to patient
messages or calls respectfully/appropriately, assess symptoms properly, and provide Key: 1 = No knowledge/Experience
appropriate guidance for follow-up 2 = Knowledge/No experience
*If competency is initialed as ‘NOT MET’, Manager/Director or designee must be contacted for follow-up Page 1
JSR 01-06-14
Self-Evaluation Supervisor Evaluation
(Initial)
CRITICAL BEHAVIORS 1 2 34 Met Not Date/Comments
Met*/NA 3 = Knowledge/Done with assistance
4 = Knowledge/Done independently
Telephone Triage 1 2 34
- Using the triage books 1 2 34 Page 2
- What kind of insurance does the pt have?
- Which urgent cares have Spanish speaking staff?
- Completing tasks in a timely manner
- Consulting with team appropriately
- Appropriate Triage documentation
6 most common triage complaints for:
- OB patients,
- pediatric patients,
- newborn complaints,
- cold/flu….
- Derm
- Chest Pain
3. PATIENT EDUCATION
Competency: Educate patients with evidence based practices on prevention of disease & promotion Key: 1 = No knowledge/Experience
2 = Knowledge/No experience
of health maintenance. Maintain up to date knowledge of Clinica nurse protocols & evidence based
practices for common patient complaints
Breastfeeding 1 2 34
Asthma Education & Nebulizer treatments 1 2 34
Diabetes 1 2 34
- Diet & exercise (plate method) 1 2 34
- Glucometer Teaching
- Insulin Teaching
WCC/Anticipatory Guidance
Paps 1 2 34
- Frequency 1 2 34
- f/u (Colpo & LEEP education)
Hypertension
Hypo/Hyper Thyroidism 1 2 34
Chlamydia & Gonorrhea 1 2 34
OBs - review normal development 1 2 34
STI’s 1 2 34
Up to date nurse protocols utilized & reliable resources for ed. 1 2 34
*If competency is initialed as ‘NOT MET’, Manager/Director or designee must be contacted for follow-up
JSR 01-06-14
Self-Evaluation Supervisor Evaluation
(Initial)
CRITICAL BEHAVIORS 1 2 34 Met Not Date/Comments
Met*/NA 3 = Knowledge/Done with assistance
4 = Knowledge/Done independently
4. Nurse Visits: Key: 1 = No knowledge/Experience
Competency: Provide direct patient care through nurse visits and the use of nursing protocols 2 = Knowledge/No experience 3 = Knowledge/Done with assistance
4 = Knowledge/Done independently
Conjunctivitis Nurse Visit 123 4
3 = Knowledge/Done with assistance
Emergency Contraception Nurse Visit 1 2 34 4 = Knowledge/Done independently
Otitis Media Nurse Visit 1 2 34 Page 3
Rapid Strep Nurse Visit 1 2 34
UTI Nurse Visit 1 2 34
Wound care Nurse Visit 1 2 34
5. DOCUMENTATION – NEXTGEN CHARTING & USE Key: 1 = No knowledge/Experience
Competency: Maintain proper & up to date documentation of phone triage, NVs & Co-visits. 2 = Knowledge/No experience
Continually improve abilities to utilize electronic health record for efficient, complete, and accurate
documentation of all types of encounters.
Medication Contraindications (reviewing w/ provider & 1 2 34
acknowledging)
Nurse labs, ER report & ACO report 1 2 34
- Printing the reports
- Opening patient encounter to check for presumptive tx
and/or follow-up appts
- Treating per protocol
o Sending rx
o Calling/educating pt
o FYI to PCP
Care Planners 1 2 34
- Printing for same day scheduled pts
INR visits and correct documentation 1 2 34
Medication Reconciliation (also covered in MA training?) 1 2 34
Working INR registry for anti-coag patients
6. CLINICAL SKILLS: Key: 1 = No knowledge/Experience
2 = Knowledge/No experience
Competency: Performs medication administration & other clinical procedures as delegated by
Provider, reports findings and appropriately documents outcomes.
Oxygen and how to start a patient 123 4
4
IVs 1 2 3
*If competency is initialed as ‘NOT MET’, Manager/Director or designee must be contacted for follow-up
JSR 01-06-14
Self-Evaluation Supervisor Evaluation
(Initial)
CRITICAL BEHAVIORS 1 2 34 Met Not Date/Comments
Met*/NA
3 = Knowledge/Done with assistance
Catheters 1 2 34 4 = Knowledge/Done independently
1 2 34
Cast Removal 1 2 34 Page 4
INR Point of Care tests 1 2 34
IM injections 1 2 34
- Locating ventro gluteal location for volume > 1ml 1 2 34
- Z-track
- IM med cheat sheet
Rapid response skills (including emergency transfers)
Wound Care including wrapping legs & post toe-nail removal care.
NST 1 2 3 4
OB Fundal Height Measurement & Fetal Heart Tones 1 2 34
7. SKILLS/PROCEDURES- Advanced Co-visits & NextGen
Competency: Demonstrates full competency in conducting all types of co-visits and fully supports Key: 1 = No knowledge/Experience
2 = Knowledge/No experience
role in PODs 2.0.
Using My Plan & My Phrases appropriately & efficiently 1 2 34
Co-visit charting (accurate, complete, up to standard) 1 2 34
Using the care planner to identify opportunities for patient care. 1 2 34
Successfully presenting patient case to provider 1 2 34
Opening correct templates for registries 1 2 34
- Obtaining thorough HPI/ROS efficiently 1 2 34
- Asthma 1 2 34
- Depression 1 2 34
- DM 1 2 34
- WCC/Anticipatory Guidance 1 2 34
Working at pace that keeps provider on time. 1 2 34
*If competency is initialed as ‘NOT MET’, Manager/Director or designee must be contacted for follow-up
JSR 01-06-14
Self-Evaluation Supervisor Evaluation
1 2 34 (Initial)
CRITICAL BEHAVIORS Met Not Date/Comments
Met*/NA 3 = Knowledge/Done with assistance
4 = Knowledge/Done independently
Complex Care Management 1 2 34
3 = Knowledge/Done with assistance
A&P Review 12 3 4 4 = Knowledge/Done independently
8. OTHER TOPICS Key: 1 = No knowledge/Experience Page 5
Competency: Demonstrates knowledge of clinic routines and functional assignments. 2 = Knowledge/No experience
Crash Cart 1 2 34 1 = No knowledge/Experience
Confidential Teens 1 2 34 2 = Knowledge/No experience
Language Line & other important Phone numbers 1 2 34
Location of Policies, Lab Manual, Protocols 1 2 34
Managing Walk in patients 1 2 34
Mental/Behavioral Health (72H holds, mandatory reporting, MI, etc) 1 2 3 4
PAPR 1 2 34
Personal Protective Equipment (PPE) 1 2 34
Sharps Safety 1 2 34
VFC & Cancer Screening 1 2 34
9. QUALITY METRICS Key:
Competency: Understands Meaningful Use (MU) metrics, productivity goals, and other key Clinica
targets. Contributes to pod efforts to achieve and exceed goals. Include quality metrics from care
team
Adult Obesity 1 2 34
Antithrombotic (new 2014) 1 2 34
Asthma treatment 1 2 34
Cervical Cancer Screening 1 2 34
Childhood Immunizations 1 2 34
*If competency is initialed as ‘NOT MET’, Manager/Director or designee must be contacted for follow-up
JSR 01-06-14
Self-Evaluation Supervisor Evaluation
(Initial)
CRITICAL BEHAVIORS 1 2 34 Met Not Date/Comments
Met*/NA
3 = Knowledge/Done with assistance
Colorectal Cancer Screening 12 34 4 = Knowledge/Done independently
34
Diabetes 12 34 3 = Knowledge/Done with assistance
34 4 = Knowledge/Done independently
HIV Diagnosis & Follow Up 12 34
34
Hypertension 12 34
34
Lipid Therapy 12
Low Birth Weight 12
Tobacco Assessment & Counseling 12
Universal Depression Screening 12
10. GROUP VISITS Key: 1 = No knowledge/Experience
Competency: Performs nurse role in group visits as defined by site guidelines. 2 = Knowledge/No experience
New Patient Group Visits 1 2 34
Cold/Flu Group Visits 1 2 34
Coumadin 1 2 34
11. Key Outcomes – Combined Clinical/Operations Key: 1 = No knowledge/Experience
Competency: Describe contributions to the key outcomes of the organization as well as area 2 = Knowledge/No experience
where the employee missed opportunities
Access 1 2 34
Patient Outcomes 1 2 34
Customer Service 1 2 34
Our People 1 2 34
Facilities 1 2 34
Financial Stability 1 2 34
*If competency is initialed as ‘NOT MET’, Manager/Director or designee must be contacted for follow-up Page 6
JSR 01-06-14
Self-Evaluation Supervisor Evaluation
(Initial)
CRITICAL BEHAVIORS 1 2 34 Met Not Date/Comments
Met*/NA
3 = Knowledge/Done with assistance
12. Organizational Performance – Combined Clinical/Operations Key: 1 = No knowledge/Experience 4 = Knowledge/Done independently
Competency: Describe how the employee supported the organization’s values OR opportunities 2 = Knowledge/No experience
for the employee to improve his or her modeling of Clinica’s values.
Service to Others 1 2 34
Creativity 1 2 34
Diversity 1 2 34
Excellent Teamwork 1 2 34
Do the Right Thing 1 2 34
Make Clinica a great place to work 1 2 34
OTHER COMPETENCY: Demonstrates… Key: 1 = No knowledge/Experience 3 = Knowledge/Done with assistance
2 = Knowledge/No experience 4 = Knowledge/Done independently
I have the opportunity to do what I do best at work 1 2 34
Results of NTM audit of chart & co-visits 1 2 34 What I do best is:
- 3 charts per month reviewed
- 1 co-visit per month observed
*If competency is initialed as ‘NOT MET’, Manager/Director or designee must be contacted for follow-up Page 7
JSR 01-06-14
Performance & Development Planning:
Manager-Employee Agreements
Goals: What are your main goals and how will you measure your performance?
Learning: What specific things do you want to learn?
Alliances: How will you build your alliances with others?
Performance & Development Goal: Date
PLEASE SIGN:
Clinic Orientation Checklist Completed on ______________________________ (Date)
RN Signature: ___________________________________________________________________ Date ________________
Nurse Team Manager Signature: ________________________________________________________ Date ________________
Assistant Nursing Director Signature: ____________________________________________________ Date ________________
Clinic Operations Director Signature: ____________________________________________________ Date ________________
UPON COMPLETION OF ORIENTATION THIS DOCUMENT MUST BE PLACED IN EMPLOYEE’S FILE IN MANAGER’S OFFICE AND A COPY ARCHIVED
WITH HUMAN RESOURCES
*If competency is initialed as ‘NOT MET’, Manager/Director or designee must be contacted for follow-up Page 8
JSR 01-06-14
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