Description of the Clinical Practice of Advanced Practice Nurses in Family‐Centered Early Intervention in Two Rural Settings

Abstract

The purpose of this study was to describe the scope of clinical practice of advanced practice nurses who were involved in a project designed to increase access of families with at-risk and disabled young children, newborn to 3 years of age, to early intervention services in rural Washington State. The findings from this study are based on the retrospective review of records of clients seen by the advanced practice nurses. Nursing diagnoses and nursing interventions were assigned to chart recordings. The most frequently occurring nursing diagnoses assigned to parents were Altered Parenting, Altered Family Processes, Fear, Noncompliance, and Knowledge Deficit. The most frequently occurring nursing diagnoses assigned to children were Impaired Physical Mobility, Impaired Verban Communication, Altered Nutrition: Less than Body Requirements, Sensory-Perceptual Alteration, and Altered Thought Processes. Categories of nursing intervention recorded most frequently were Monitoring, Planning and Information. Discussion of findings addresses the roles and reimbursement of advanced practice nurses who provide family-centered early intervention services in rural communities.

Patient Problems and Advanced Practice Nurse Interventions During Transitional Care

“…The amount of attention the APNs devote to initial assessment and on‐going monitoring for this high‐risk population is consistent with findings of studies involving other vulnerable groups. (Beyerman, 1988; Brooten et al, 1991; Cohen, Arnold, Brown, & Brooten, 1991; Martin et al, 1993; Kang, Barnard, & Oshio, 1994; Brooten, Bowles, Kirby, & Miovech, 1997). The remaining interventions were fairly evenly divided between Teaching, Guidance, and Counseling (20%) and Case Management (14%) with very few devoted to Treatments or Procedures.…”

“…Only recently has the quest to demonstrate the unique contributions of expert practitioners focused the attention of researchers on measurement of the outcomes of advanced practice nurses (APNs) (Naylor & Brooten, 1993; Kang, Barnard, & Oshio, 1994; Brooten et al, 1995; Adams et al, 1997; Marek, 1997; Nemcek & Egan, 1997; Taylor, Resick, D'Antonio, & Carroll, 1997; Byers & Brunell, 1998). Certainly, outcome measurement is essential to demonstrate that expert practice makes a difference (Adams et al, 1997).…”

Association Between Nonparenting Adult’s Attachment Patterns and Brain Structure and Function

“…Nurses’ interest has historically attended to the importance of parenting (especially mothering; Mercer, 1985, 1995; Rubin, 1967) and understanding how early relationships with caregivers shape developmental outcomes for better or worse (Barnard et al., 1988; Oxford & Finlay, 2013). This understanding has underpinned public health nursing interventions for young childbearing families for decades (Booth, Spieker, Barnard, & Morisset, 1992; Kang, Barnard, & Oshio, 1994; Mitchell et al., 1988; Olds et al., 2007).…”