Underserved populations face many barriers to health care that include lack of personal resources such as limited income, lack of or inadequate health care insurance, and limited community health care recourses. Nursing case management is an outcome-oriented model and is well suited to address these obstacles to care with interventions of resource identification, coordination of care, and promotion of self-sufficiency. This article will outline health care barriers for residents of a Housing First program, describe the implementation of a nursing case management model for these residents, discuss barrier reduction interventions, and present the related outcomes on acute care and preventative health care services. Implications of the model and outcomes are discussed.
The Building Healthy Urban Communities initiative presents a path for organizations partnering to improve patient outcomes with continuing education (CE) as a key component. Components of the CE initiative included traditional CE delivery formats with an essential element of adaptability and new methods, with rigorous evaluation over time that included evaluation prior to the course, immediately following the CE session, 6 to 8 weeks after the CE session, and then subsequent monthly "testlets." Outcome measures were designed to allow for ongoing adaptation of content, reinforcement of key learning objectives, and use of innovative concordant testing and retrieval practice techniques. The results after 1 year of programming suggest the stepwise skill reinforcement model is effective for learning and is an efficient use of financial and human resources. More important, its design is one that could be adopted at low cost by organizations willing to work in close partnership. J Contin Educ Nurs. 2016;47(6):283-288.
Care coordination for the older adult is growing based on increases in aging populations, fragmentation in healthcare systems, and the desire by many older adults to remain in their homes. Geriatric Care Managers (GCMs) guide older adults and families in navigating the complexities of the continuum of care and with finding available resources for long-term care planning. This article reviews the GCM role, which patients may be appropriate for the service, and patient benefits.
Housing first (HF) is a nationally recognized model that provides permanent housing to the hardest to serve of homeless individuals, those with mental illness and/or substance abuse disorders. This vulnerable population faces many challenges in obtaining needed health care services. Access to adequate health care and addressing health issues is an essential part of the stabilization and self-sufficiency process for previously homeless individuals. This article will review the rationale for implementing a nursing case management approach within a HF program, explain the case management model implemented to address the population’s needs, present the outcomes, and go on to discuss further development of the model over a 4-year period with related results.
Objective: Breastfeeding is an ideal way of providing infant nutrition. The aim of this study was to evaluate the effect of breastfeeding and nutrition education on breastfeeding attitudes using a support group model. Methods: Design: A descriptive comparative design was used to achieve the aim of this study. The study was conducted at a public school for pregnant and/or parenting young women located in a large metropolitan area. Participants: Pregnant or parenting female adolescents (n = 67) in 6 th through 12 th grade attending a nutrition breastfeeding support group. Instruments: Participants completed an evaluation survey and a breastfeeding questionnaire to assess the effectiveness of the support group and generate information on the group's breastfeeding attitudes and nutrition knowledge.Results: Breastfeeding attitudes improved as more support group meetings were attended. Public embarrassment due to breastfeeding for new group members was reported at 27% and as more meetings were attended dropped to zero with a significant likelihood ratio of .013. Breastfeeding attitude questions regarding never being able to give a bottle, being tired about hearing about breastfeeding, thinking breastfeeding is nasty, and hearing that breastfeeding is good all showed positive trends in breastfeeding attitudes.Conclusions: Attendance at a nutrition breastfeeding support group positively correlated to improved breastfeeding attitudes among adolescent mothers. Peer involvement in a support group environment is an effective intervention for improving breastfeeding knowledge and attitudes in the adolescent population.
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