An evidence-based curriculum to prepare students for global nursing practice.

ABSTRACT This article describes a curriculum designed to prepare nurses for global public health practice. Designed to be adapted to meet the needs of either undergraduate or graduate students, the curriculum uses the Internet to provide the knowledge and skills needed by nurses to effectively practice in areas around the globe. This course offering integrates the disciplines of nursing and public health with state-of-the-art technology to teach nurses how to identify the health care needs of populations, prioritize national and international responses, and design health care delivery services to meet these needs.

WHAT DO THE WEST NILE VIRUS, WHICH SINCE 1999 HAS SICKENED 83 INDIVIDUALS IN THE UNITED STATES AND KILLED NINE PEOPLE IN THE NEW YORK AREA (1), A PUBLIC WATER SUPPLY CONTAMINATED WITH POTENTIALLY DEADLY LEVELS OF CRYPTOSPORIDIUM BACTERIA, WAR IN TAJIKISTAN, AN OUTBREAK OF HIGHLY CONTAGIOUS SPINAL MENINGITIS IN A SCHOOL, AND A BIOTERRORIST ATTACK HAVE IN COMMON? THE ANSWER? All require a major public health response. The primary difference between these health problems is the level at which the response must be mounted. Local county health departments adequately deal with selected public health issues. Others, like the recent outbreak of the 133st Nile virus in New York City and its surrounding boroughs, require involvement at the state and regional levels (2). Some necessitate federal involvement, and others, such as the AIDS pandemic, require the involvement of large international health agencies such as the World Health Organization (WHO).

Historically, it has been nurses who have rendered public health almost exclusively in this country (3). Today, abundant opportunities exist in global public health practice for nurses who have the requisite skill set and knowledge.

Globalization has become a major concern for the nursing profession, as well as for educators in general, for various reasons. Although more and more United States citizens travel, work, and live overseas, our national workforce is often grossly unprepared for the demands of international employment. Few Americans speak a second language, and many have little knowledge or appreciation for cultures outside their own. The need to integrate regular and international education across disciplines, and to make this educational preparation vibrant and relevant, is a major priority for the U.S. Department of Education's Office of Post-secondary Education (4).

As a discipline, nursing has lagged in efforts to adequately prepare our graduates for practice beyond the borders of the United States. As we struggle to define our profession more clearly to the public and to recruit new members into the nursing workforce, an opportunity exist, to demonstrate leadership in the global health care arena. Collaboration between American nurses and international nurses has already demonstrated its ability to yield benefits for both (5), and must continue.

The curriculum described in this article offers an exciting introduction to global health care organizations and educational resources specifically focused on public health decision-making, health economics, and issues in maternal and child health. It presents strategies for maximizing information retrieval through the use of the Internet while minimizing time spent searching Web resources. The curriculum employs an evidence-based approach for identifying the health care needs of populations through a review of international epidemiological studies and introduces the theory of Epidemiological Transition, along with skills needed by nurses to conduct culturally aware needs assessments in foreign populations. Health policy analysis and health care planning for service provision are covered through international case reviews.

This course may be taken as an elective or as a core course for a combined master's in nursing/master's in public health program of study. The importance of professional nursing's leadership role in meeting the demands of the rapidly changing global health landscape is highlighted throughout.

Course Overview To function successfully in the international health care arena, nurses must be able to identify the health care needs of populations and establish priorities for national and international response. They must also be able to design health care delivery services to meet these needs within their appropriate …