Comparing Maternal Child Health Problems and Outcomes Across Public Health Nursing Agencies

Abstract

To use aggregated data from health informatics systems to identify needs of maternal and child health (MCH) clients served by county public health agencies and to demonstrate outcomes of services provided. Participating agencies developed and implemented a formal standardized classification data comparison process using structured Omaha System data. An exploratory descriptive analysis of the data was performed. Summary reports of aggregated and analyzed data from records of clients served and discharged in 2005 were compared. Client problems and outcomes were found to be similar across agencies, with behavioral, psychosocial, environmental and physiological problems identified and addressed. Differential improvement was noted by problem, outcome measure, and agency; and areas for enhancing intervention strategies were prioritized. Problems with greatest improvement across agencies were Antepartum/postpartum and Family planning, and least improvement across agencies were Neglect and Substance use. Findings demonstrated that public health nurses address many serious health-related problems with low-income high-risk MCH clients. MCH client needs were found to be similar across agencies. Public health nurse home visiting services addressed important health issues with MCH clients, and statistically significant improvement in client health problems occurred consistently across agencies. The data comparison processes developed in this project were useful for MCH programs, and may be applicable to other program areas using structured client data for evaluation purposes. Using informatics tools and data facilitated needs assessment, program evaluation, and outcomes management processes for the agencies, and will continue to play an integral role in directing practice and improving client outcomes.

Standardized Nursing Terminology Use in Electronic Health Records in Minnesota

“…This finding likely is the result of earlier grass-roots efforts to establish interoperability among Minnesota's local public health agencies in the 1990's [15][16][17][18][19][20][21][22]. Such widespread adoption has enabled progress towards interoperability in community care settings that exceeds that of acute care settings despite federal mandates and incentives [1][2][3][4][15][16][17][18][19][20][21][22]. Despite the fact that few respondents mentioned use of SNOMED CT as a standardized terminology, respondents may not have been aware of previous mapping of the Omaha System and SNOMED CT.…”

“…Scholars assert that the use of standardized nursing terminology is essential for documentation of nursing interventions, outcomes, continuity of care, and nursing research [7,[12][13][14][15] In 1997, nursing leaders from local public health departments in Minnesota encouraged adoption of nurse-centric clinical documentation systems for public health nurses [16]. This effort fostered the widespread use of standardized nursing terminologies in home care and public health nursing in Minnesota [17][18][19][20]). In 2001, public health nurses and Minnesota Department of Health leaders who were users of these clinical systems self-organized, beginning the first Omaha System Users Group.…”

Home Visit: Care Technology Used by Nurses to Advocate for Child's Health

“…Despite the numerous difficulties, the HV can do much when it comes to necessary actions in these serious health problems. 6 Our findings suggest the need for improvement of the policy guidelines that follow FHS teams and the health needs of families, such as the case of a Center for Psychosocial Support for Alcohol and Drugs (CAPSad), aiming to integrate the developed actions. 23 Brazilian laws and public policies, such as the 1988 Brazilian Constitution, the Statute of Children and Adolescents, the National Policy toward the right of children to living with the family and in a community, recommend that all children and adolescents need to have a family whose bonds are protected by the state and society; whereas in the face of social vulnerability or personal and family fragility, interventional strategies should prioritize actions to strengthen or renew ties, or even stimulate their formation, combining socio-economic support for the development of new forms of interaction and access to public goods and services; recognizing the need for multidisciplinary and intersectional vision to provide answers to the complexity of those situation.…”

“…[4][5][6][7] In child health, the HV is identified as a tool aimed at the promotion of health to achieve a healthy growth and development, 4 to assess mother-child interaction and the care of children, 5 and to identify vulnerable situations, 6 as well as to contribute to the improvement of women's journeys as mothers and to support children and families. 7 However, some aspects of the HV related to the advocacy for the right to health of children are hardly widespread, particularly in the area of nursing.…”

Os cuidados primários à saúde da criança com diabetes mellitus tipo 1 em serviços públicos de saúde: percepção de mães e cuidadores

“…Nesse processo, é relevante dividir com a família seus anseios, dúvidas e abrir espaços para a mesma se colocar e, desse modo, construir o cuidado a ser ofertado à criança (COHEN;McKAY, 2012;DEZZOTI et al, 2013). Em saúde da criança, a VD é abordada com a finalidade de promover a saúde para o crescimento e desenvolvimento saudável (HENDERSON, 2009), avaliar a interação mãe-filho e a atenção à criança (APPLETON et al, 2013), identificar situações vulneráveis (MONSEN et al, 2010), bem como para colaborar com a melhoria das trajetórias de mulheres, crianças e famílias (MONSEN et al, 2011 Quando a APS está bem organizada evita a sobrecarga dos serviços especializados, que muitas vezes é mais caro para os sistemas de saúde (SCHÄFER et al, 2011). A APS tem uma abordagem generalista que leva em conta o contexto familiar e social, continuidade e integralidade, sendo a protagonista na superação da fragmentação dos cuidados de saúde.…”