Public Health Nurses Tailor Interventions for Families at Risk

Monsen, Karen A.; Radosevich, David M.; Kerr, Madeleine J.; Fulkerson, Jayne A.

doi:10.1111/j.1525-1446.2010.00911.x

Cited by 43 publications

(50 citation statements)

References 18 publications

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“…The use of the CSHCN visit reports will generate large data sets that will enable further evaluation of the effectiveness of PHN interventions for these problems. Previous studies have described intervention tailoring and effectiveness for high risk families [19–21]. Further research is needed to identify approaches most successful in supporting families of CSHCN, so that resources can be used efficiently and effectively, and the NPM goals for CSHCN and their families can be achieved.…”

Section: Discussionmentioning

confidence: 99%

A Statewide Case Management, Surveillance, and Outcome Evaluation System for Children with Special Health Care Needs

et al. 2013

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Objectives. To evaluate the feasibility of implementing a statewide children with special health care needs (CSHCN) program evaluation, case management, and surveillance system using a standardized instrument and protocol that operationalized the United States Health and Human Services CSHCN National Performance Measures. Methods. Public health nurses in local public health agencies in Washington State jointly developed and implemented the standardized system. The instrument was the Omaha System. Descriptive statistics were used for the analysis of standardized data. Results. From the sample of CSHCN visit reports (n = 127), 314 problems and 853 interventions were documented. The most common problem identified was growth and development followed by health care supervision, communication with community resources, caretaking/parenting, income, neglect, and abuse. The most common intervention category was surveillance (60%), followed by case management (24%) and teaching, guidance, and counseling (16%). On average, there were 2.7 interventions per problem and 6.7 interventions per visit. Conclusions. This study demonstrates the feasibility of an approach for statewide CSHCN program evaluation, case management, and surveillance system. Knowledge, behavior, and status ratings suggest that there are critical unmet needs in the Washington State CSHCN population for six major problems.

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Section: Discussionmentioning

confidence: 99%

A Statewide Case Management, Surveillance, and Outcome Evaluation System for Children with Special Health Care Needs

et al. 2013

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“…Interventions are needed to address the needs of CSHCN who might benefit from tailored approaches incorporated into programs like ABCD. 35-36 Particularly when faced with budgetary constraints, which is common at the state level in the current fiscal environment, Medicaid policymakers should consider focusing on tailored dental programs that address the needs of the highest risk enrollees.…”

Section: Discussionmentioning

confidence: 99%

Preventive dental care use for children with special health care needs in Washington's Access to Baby and Child Dentistry program

Craig¹,

Scott²,

Slayton³

et al. 2019

The Journal of the American Dental Association

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Background. Low-income, preschool-aged children with special health care needs (CSHCN) are at increased risk for poor oral health. The study goal was to assess preventive dental care use for Medicaid-enrolled CSHCN within Washington state’s Access to Baby and Child Dentistry (ABCD) Program. Methods. We analyzed 2012 Medicaid eligibility and claims files for children under age 6 years in the ABCD Program (N=206,488). Medical diagnosis and eligibility data were used to identify each child’s special needs status (no/yes). The outcome was preventive dental care use (no/yes). Modified Poisson regression models were used to estimate crude and covariate-adjusted prevalence rate ratios (PRR). Results. Of the 206,488 children in the study, 2.1% were CSHCN and 114,570 utilized preventive dental care (55.5%). CSHCN utilized preventive care at similar rates compared to children without SHCN (54.7% and 55.5%, respectively; P=0.32). After adjusting for confounders, CSHCN were significantly less likely to utilize preventive dental care than children without SHCN (PRR: 0.91; 95% CI: 0.88, 0.94; P<0.001). Older preschoolers were significantly more likely to use preventive dental care than younger preschoolers. A significantly higher proportion of preventive medical care utilizers also utilized preventive dental care. Conclusions. Medicaid-enrolled CSHCN in Washington’s ABCD Program were less likely to utilize preventive dental care than Medicaid-enrolled children without SHCN. Practical Implications. Future intervention research should evaluate strategies to improve access to preventive dental care for CSHCN. Additional strategies may be needed to improve oral health behaviors for preschool-aged CSHCN in Medicaid.

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“…This feedback loop serves to reinforce evidence-based practice with every clinical encounter. By selecting pertinent interventions from the EB-SCP, the data demonstrate how clinicians tailor care to meet the individual needs of each patient [22].…”

Section: Clinical Decision Supportmentioning

confidence: 99%

Evidence-based Standardized Care Plans for Use Internationally to Improve Home Care Practice and Population Health

Monsen¹,

Foster²,

Gómez³

et al. 2011

Appl Clin Inform

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SummaryObjectives: To develop evidence-based standardized care plans (EB-SCP) for use internationally to improve home care practice and population health. Methods: A clinical-expert and scholarly method consisting of clinical experts recruitment, identification of health concerns, literature reviews, development of EB-SCPs using the Omaha System, a public comment period, revisions and consensus. Results: Clinical experts from Canada, the Netherlands, New Zealand, and the United States participated in the project, together with University of Minnesota School of Nursing graduate students and faculty researchers. Twelve Omaha System problems were selected by the participating agencies as a basic home care assessment that should be used for all elderly and disabled patients. Interventions based on the literature and clinical expertise were compiled into EB-SCPs, and reviewed by the group. The EB-SCPs were revised and posted on-line for public comment; revised again, then approved in a public meeting by the participants. The EB-SCPs are posted on-line for international dissemination. Conclusions: Home care EB-SCPs were successfully developed and published on-line. They provide a shared standard for use in practice and future home care research. This process is an exemplar for development of evidence-based practice standards to be used for assessment and documentation to support global population health and research. BackgroundStandardized terminologies (vocabularies) have potential to enable information exchange across populations and settings. They are defined as "a set of standardized terms and their synonyms that record patient findings, circumstances, events, and interventions with sufficient detail to support clinical care, decision support, outcomes research and quality improvement" [1]. Nursing scholars have led development of standardized interface terminologies since the 1970's. Currently, computer applications are driving widespread adoption of these terminologies to describe health assessments and health care interventions [2,3]. However, unless standards are used consistently across settings, data generated during clinician documentation are not likely to be comparable [3,4]. To enable optimal information exchange and meaningful use of data in research and program evaluation, standardized terminologies must also be used systematically to describe standards of care consistently across settings. Such efforts to promote evidence-based health care are essential to maximize clinician influence on population health outcomes. Disseminating research findings to practice settings is a daunting task [5]. Low success rates have been reported from passive dissemination such as publications and presentations. More effective approaches such as verbal reminders and educational outreach are needed in order to change practice behaviors of clinicians and other health care professionals [6,7]. However, these solutions are labor and cost-intensive, and are thus unrealistic in a resource-constrained health care environment. ...

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Public Health Nurses Tailor Interventions for Families at Risk

Abstract: Standardized terminologies and structured clinical data are useful tools to support PHN practice, and may be useful to advance health care quality research, program evaluation, policy development, and population health outcomes.

Cited by 43 publications

References 18 publications

A Statewide Case Management, Surveillance, and Outcome Evaluation System for Children with Special Health Care Needs

A Statewide Case Management, Surveillance, and Outcome Evaluation System for Children with Special Health Care Needs

Preventive dental care use for children with special health care needs in Washington's Access to Baby and Child Dentistry program

Evidence-based Standardized Care Plans for Use Internationally to Improve Home Care Practice and Population Health

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