A New Wave in Delivering Maternal Child Health Home Visitation

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A New Wave in Delivering Maternal Child Health Home Visitation
Delivering Maternal - Child
Health Home Visitation
Services In
Passaic County, NJ
- Barbara Scanlon, CNM/MSN
– Deana Generals, BS/RN
– Susanne Fischer, MSN/RN
-Racquima Hinton, BS/RN
- Teresa Lebron-Correa, BS/RN
– Martha Amarante, ABA/ CI Coordinator
The Passaic County Nurse Family Partnership Team
The History Of Paterson,
Passaic County, NJ
 It all started with the Falls—at the end of the last Ice Age,




about 13,000 years ago, the retreating glaciers left a
moraine in the path of the Passaic River.
The river managed to escape and carved a new route,
and ultimately creating the 77-foot Great Falls.
The Lenni-Lenape Indian people were the original
inhabitants of the Paterson area. Drawn by ample
opportunities for hunting,
The Lenape also began to dabble in small-scale agriculture.
In the 1620s, intrigued by a description given by friendly
Indians, Dutch missionaries and trappers began to settle
near the Great Falls on the Passaic River.
Pasterson, NJ
 Rich in cultural diversity, Paterson has been
and still is a melting pot for those who sought
refuge for various reasons, or drawn by the
promise of work in its industry.
 Some Paterson Firsts: water-powered cotton
spinning mill in NJ (1793), continuous roll paper (1812),
Colt revolver (1837), the Roger's Locomotive (1837),
and the Holland Submarine (1878).
 The machinery was set in motion to propel Paterson's
Renaissance with President Ford's official designation
of the 119 acre "Great Falls of thePassaic/S.U.M.
Historic District" as a National Historic Landmark in 1976.
Nurse-Family Partnership
(NFP) is an evidence-based, nurse home visitation
program that improves the health, well-being
and self-sufficiency of low-income, first-time
parents and their children.
These mothers are visited by registered nurses
who encourage self efficacy while providing
health education and support.
The family is visited throughout the mother’s
pregnancy, after the birth of the baby, and
through to the child’s second birthday.
Health education and effective parenting
skills are taught to encourage appropriate
child health and development.
PROVEN OUTCOMES
Improved prenatal health
Fewer childhood injuries
Improved school readiness
Fewer subsequent pregnancies
Increased maternal employment
Increased intervals between births
Passaic County NFP
Program History
May 2007 – Awarded Funding From DCF
To Implement NFP In Passaic County
August 2007 - Central Intake System Initiated
& Nurses Trained By NFP-NSO
September 2007 – First NFP Client Enrolled
November 14,2007 –Arrival Of First NFP Babies (Twins)
March 2008 – Full-Time Supervisor Arrived
August 19, 2008 – First NFP Sponsored Event
(Scrap Booking)
February 2009 – New Mom’s Group Began
March 2009 - Full Team Of Nurses
June 6, 2009 - CPR Event
October 2, 2009 – 2nd Annual Scrap-book Event
GOALS
Improve Pregnancy Outcomes
Improve Child Health And Development
Improve The Economic Self-sufficiency
Of Each Family
Increase Social Networking Skills Of
Clients Enrolled In The Program
Assess New Mothers At Risk For Post
Partum Depression
Address Health & Psychosocial Needs
Of First Time, Low Income Mothers
PROCESS
Identify A Population In Need:
Low Income, First Time Mothers In Passaic County
Identify Barriers To Accessing MCH Services:
Implemented A Central Intake System
To Improve Access To Programs
Assess Individual Client Needs (With Emphasis On)
1. Maternal Child Health
2. Improving Parenting Skills
3. Increasing Social Networks
Demonstrate Innovative Ways To Improve
Access To Maternal Child Health Services
Describe “Hands On” Interventions Utilized
To Achieve The Program Outcomes
CIS Implementation
CIS Coordinator
Community Relations
Develop & Maintain Data Base
Receiving Referrals
Site Visits to Referring Agencies
Updating Client Status & Statistics
CIS Referral Sources
& Agencies
Local Clinics
Local Hospitals
Self Referrals
Middle and High Schools
PHM-HB Outreach Educator
Passaic County Board of Social Services
Women, Infant, and Children (WIC)
Other Sources in the Community
Passaic County
Home Visitation
Passaic County NFP Referrals
Received by City
5%
73%
5%
17%
Clifton
Passaic
Paterson
Surrounding
NFP Enrollment
Requirements





Low Income
First Time Mother: At Any Age
Pregnancy Through 28 Weeks
Gestational Age
The Program Is Totally Voluntary
There Is No Cost To The Clients
Client Age at Enrollment
25 to 29 Years
9
41
20 to 24 Years
34
18 to 19 Years
41
Number of Clients = 142
8
30 Years or Older
15 to 17 Years
9
Less than 15 Years
0
Less than 15 Years
5
15 to 17 Years
10
15
18 to 19 Years
20
25
20 to 24 Years
30
35
25 to 29 Years
40
45
30 Years or Older
NFP Clients By Ethnicity
African American
7% 5%
60%
28%
Hispanic/Latina
Caucasian (White
Non-Hispanic
Other
Primary Language at Enrollment
100
80
60
40
20
0
Total
ENG
SPAN
Other
85
47
4
ACTIVITY
Clients Stay Engaged In The Program Through Creative Venues
Home Visits By Nurses – Improve Access To Care; Provide Health
Education; Refer Clients To Resources In The Community For
Support; Offer Psychosocial Support; Promote Self-efficacy To
Empower New Mothers To Achieve Goals.
Outreach – Outreach To Health Care Providers, And Community
Agencies Regarding The Program. Educate The Community About
Our Program; & Provide Collaboration Of Client Services.
Networking - With Community Agencies To Provide Support
Services, Food, Clothing, Furniture, Education, Social Connections,
Day Care & Employment Opportunities For Our Clients.
Creative Arts – Provide Activities That Creatively Promote Bonding
& Learning For Mother And Child: Crafts, Scrapbooking, Reading,
Pipe Lessons & Activities, Photography, Group Events.
Incentive Items – Provide Clients With Needed Baby Care & Self
Care Items… Books, Car Seats, Cribs, Diapers, Diaper Bags, Baby
Wipes, Strollers, Sippy Cups, Pens, Notebooks, Baby Clothes,
Baby Toys.
Central Intake System – Screening Referrals of Clients For
Placement Within Programs: NFP / HF-TIP.
EVENTS – Provide educational sessions while
engaging clients in social networking
with other young mothers:
Pregnant and New Moms Support Group – an informal,
safe atmosphere to screen for post partum depression, and
provide an opportunity for socializing & peer support.
Ongoing - group meets every 2 weeks
Pregnant Pause – focus on abstinence from alcohol &
substance use during pregnancy; Post Partum Depression &
Domestic Violence education included in program as well
Scrapbooking Event – craft workshop with a focus on the
importance of reading to children; enhances maternal bonding
Holiday Event – focus on indoor safety and activities for
young children during the winter months; Holiday gifts given
to children, & pictures with Santa
Summer Safety Event – focus on outdoor activities and
safety and safety in the home & community
EVENTS –
Fall Festival – families participate in arts
& crafts activities
Infant & Child CPR Education – Teaching clients
how to perform CPR, Choking relief measures (Heimlich
maneuvers), First Aid & Safety measures in a controlled
environment
Mother’s Day – Pampering, self-reflection & refueling for
Mother’s in our programs
Father’s Day – Promoting & Celebrating fatherhood
Oral Health Seminar – Dental Hygiene information
for families
Teen Health Fair – High School Students are educated
on health issues & resources in the community.
NFP PROGRAM STATISTICS
156 – Total Clients Enrolled
83 – Infants & Toddlers
Average Age of Client = 19 years
Average Gestational Age at
Enrollment = 20 weeks
Total Completed Visits 870
Total Attempted Visits 173
Total Contact Time (hrs) 1121.92
9/23/2009
Infant Birth Weights
100
80
60
% Less than 2500 grams
40
% 2500 grams or greater
20
0
Frequency
Percent
Frequency
Percent
% Less than 2500 grams
8
10
% 2500 grams or greater
75
90
Gestational Age At Birth
90
70
90
80
70
60
50
40
10
9
30
20
10
0
Frequency #
Less than 37 weeks
Percent %
37 weeks or greater
2008 NFP Program Totals
128 – Clients/Mothers served
53 – Infants & Toddlers in
Program
472 - Completed home visits
Average Age of Client = 19 years old
Average gestational age
at initial visit = 20 weeks
Client Contacts by Year
2000
1500
Clients Enrolled
1000
Completed Visits
500
Attempted Visits
0
2007
2008
2009
TOTAL
Clients Enrolled
Completed Visits
Attempted Visits
2007
10
38
6
2008
102
788
157
2009
46
870
163
TOTAL
156
1696
326
2007
2008
2009
TOTAL
Our Program Outcomes
High Percentage Breast Feeding
Initiation
Low Rate Of Premature Births
Few Low Birth Weight Infants
Low Incidence Of Domestic Violence,
Low Rate Of Substance Use
Low Subsequent Pregnancy Rate
Decrease In Smoking
Breastfeeding
Clients
19%
Breastfeeding
Initiated
Formula Only
81%
CONCLUSIONS
Implemented a Central Intake System
to increase access to care
Providing an innovative model
of care for the community
Increased social networking
Increased access to community
resources for Clients
Improved access to Maternal & Child
Health Care services in Passaic County, NJ
Central Intake Administrator
Martha Amarante
Paterson Healthy Mothers, Healthy Babies /
Nurse Family Partnership
1 Ottilio Terrace, Suite 2
Paterson, NJ 07502
Ph. 973-904-0856 / 973-942-3630
Fax 973-942-5974
Nurse-Family Partnership
•
•
•
•
Barbara L. Scanlon, CNM/MSN
Nurse Family Partnership Supervisor
1 Ottilio Terrace, Paterson, NJ 07502
Phone: (973)904-0856 Fax: (973)942-5974 Cell
Phone: 201-321-7356
• Email: [email protected]
• http://www.maternalchildhealth.org/
• http://www.nursefamilypartnership.org/index.cfm?
fuseaction=home

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