The purpose of this study was to evaluate whether a brief nurse home-visiting intervention offered postnatally would be beneficial in preventing emergency health care services and promote positive parenting. The participants were the parents of infants and infants who were delivered in one of the two hospitals in Durham, North Carolina between July 1, 2009 and December 31, 2010 and randomly assigned to either the intervention group or to a control group. The project was aimed at alleviating parental stress and among parents who attended an inner-city clinic. Participants were 199 parents of children 1 through 36 months of age. Serious life stress including poverty, low social support, personal histories of child- hood maltreatment, and substance abuse defined the parents at risk. Program effects were evaluated in terms of improvement in and observed parent-child interaction. Positive effects were docu- mented for the group as a whole and within each of three subgroups: two community samples and a group of mothers and children in a residential drug treatment program. Program attendance and the amount of gain in observed parenting skills were the factors related to a positive outcome.
Nurse Use This program was offered in partnership with academic researchers and the public clinic. The nurses in this agency can ensure better outcomes in parent- ing by providing a long-term program for high-risk parents.
Dodge K, Goodman B, Murphy R. et al: Impelementation and randomized controlled trial evaluation of universal postnatal nurse home visiting, AJPJ 104(Suppl 1) S136-143m 2014.
http://www.mc.uky.edu/tobaccopolicy/http://www.healthpeople..pdf15CHAPTER 1 Community and PreventionOriented, Population-Focused Practice
3. For philosophical, historical, and economic reasons, prevention-oriented population-focused practice is most likely to flourish in organizational structures that serve free-living populations (e.g., health departments, health maintenance organizations, health centers, schools, and workplaces). Whatrolesinthehealthcaresystemdopublichealthnursing
specialists (those in section A of Figure 1-4) have? Options includedirectorofnursingforahealthdepartment,directorof thehealthdepartment,statecommissionerforhealth,director ofmaternalandchildhealthservicesforastateorlocalhealth department, director of wellness for a business or educational organization, and director of preventive services for an inte- gratedhealthsystem.Nursescanoccupyalloftheseroles,but, with the exception of director of nursing for a health depart- ment, they are in the minority. Unfortunately, nurses who occupytheserolesareoftenseenasadministratorsandnotas public health nursing specialists. However, those who work in such roles have the opportunity to make decisions that affect the health of population groups and the type and quality of healthservicesprovidedforvariouspopulations.
Wheredoesthestaffpublichealthnurseornurseworkingin thecommunityfitonthediagraminFigure1-4?Thatdepends on the focus of the nurses practice. In many settings, most of the staff nurses time is spent in community-based direct care activities, where the focus is on dealing with individual clients and individual families, in which case the practice falls into sectionBofFigure1-4.Althoughastaffpublichealthnurseor anursepracticinginthecommunitymaynotbeapublichealth nurse specialist, this nurse may spend some time carrying out core public health functions with a population focus, and thus thatpartoftherolewouldberepresentedinsectionAofFigure 1-4.Insummary,thefieldofpublichealthnursingcanbeseen asprimarilyencompassingtwogroupsofnurses: Public health nursing specialists, whose practice is
institutions. Furthermore, the public health specialist should considerthematchbetweenthehealthneedsofthepopulation andthehealthcareresourcesinthecommunity,includingthose servicesofferedinavarietyofsettings.Althoughalldirectcare providers may contribute to the communitys health in the broadestsense,notallareprimarilyconcernedwiththepopula- tion focusthe big picture. All nurses in a given community, including those working in hospitals, physicians offices, and health clinics, may contribute positively to the health of the community.However,thespecialcontributionsofpublichealth nursingspecialistsincludelookingatthecommunityorpopu- lation as a whole; raising questions about its overall health status and associated factors, including environmental factors (physical, biological, and sociocultural); and working with the communitytoimprovethepopulationshealthstatus.
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