Public Health Nurses’ (PHNs) Perceptions of their Role in Early Postpartum Discharge

Abstract

Objectives: Following the introduction of hospital early postpartum discharge (EPD), public health nurses (PHNs) have provided large-scale in-home follow-up to promote the safety and well-being of mothers and babies. Given high numbers of births per year, this program has affected PHNs' practice. This descriptive qualitative study aimed to explore PHNs' perceptions of EPD and its effects on their practice. Methods: Data were collected in focus groups (n=24) consisting of PHNs in four community health areas (CHAs) in the Winnipeg Regional Health Authority (WRHA). Audiotaped data were transcribed, entered into Microsoft Word XP, and analyzed using constant comparison. Results: The female participants had a mean of 10 years of PHN experience. Three main themes and 10 subthemes were identified. The main themes were: passion for the PHN role, influence of EPD on practice, and building a PHN future. The subthemes included: valuing public health nursing, building capacity and developing relationships, changes in practice, erosion of health promotion, a new role, proper tools, continuity of care, relationships with community partners, and resources to support public health programs. Conclusion: The PHNs indicated the introduction of EPD altered their practice by reducing their role in community-level intervention and health promotion activities. Although they identified benefits from undertaking EPD activities, they wanted resources and funding shifted into the public health system to better support PHNs' increase in scope of practice and historical roles in promoting the health of individuals, families and communities.

Vaginal delivery: how does early hospital discharge affect mother and child outcomes? A systematic literature review

“…In addition, the shift of the follow-up tasks from hospital to home with physically or virtually present carers raises concerns about medical responsibility and legal accountability. Finally, the availability of professionals to provide the home care is an essential prerequisite for the successful transition from hospital to postpartum home care without impairing the home care for other conditions [ 41 ], creating unmet needs, or using informal support workers as doulas [ 42 ]. Due to the risk of variations in content and quality of care provided by fragmented services across multiple carers, offering a seamless transition from hospital to home is challenging.…”

Public health nurses’ activities at a time of specialization in nursing—A national study

“…In the United Kingdom, these nurses’ activities in promoting healthy lifestyles for prevention of weight gain and identification of depression were investigated in several counties (Lazarou & Kouto, ). In Canada, public health nurses’ duties (Canadian Public Health Association, ) include home visits to enhance adjustment to and acceptance of a new infant in the family after mother's early discharge from hospital (Cusack, Hall, Scruby, & Wong, ). In Australia, nurses’ roles center on family care with the focus on maternal psychology, parent‐child relations, and child development (Fraser, Grant, & Mannix, ).…”