Congratulations on Your New Baby: A Nursing Model for Successful Family Transitions
- Identify 3 areas of need for the new family as they head home from the hospital
- Describe 2 ways nurses can fill the healthcare needs of postpartum women and their infants.
- Identify 1 cost-savings associated with early APN intervention in the postpartum period.
Today’s parents are bombarded with information on the birth experience, the importance of breastfeeding, whether or not to sleep with their infant, how to parent and more. The choices are overwhelming and support minimal. Simultaneously, Health Care Reform begs a look at the cost effectiveness of our delivery of health care. An innovative program exists with a long history of providing just that support and education in a cost saving department.
Framework for the talk:
For 26 years, a team of Advanced Practice Nurses (APNs) has been providing hospital and home-based nursing, medical and lactation services to 98% of the more than 5000 families who deliver annually within their HMO. Originally, the department was designed to provide follow up to women and infants who desired hospital discharge prior to 24 hrs post delivery. Over time, the need arose for hospital rounding on postpartum women and their newborns, lactation consultation, earlier NICU discharge, post partum mood disorder (PPMD) screening and treatment, and specialized care of the late preterm infant. This continuum of care provides the APN a rare opportunity to evaluate and educate the maternal-child dyad in the hospital, schedule follow-up home visits 1-2 days after discharge based on medical and psychosocial risk, and treat patients in their home for the most common postpartum and newborn conditions. Perinatal Hospital and Home Care (PHHC) encourages the new family to stay intact while reducing environmental exposure to nosocomial and iatrogenic risk.
Statistical data demonstrate a reduction in hospital stays, breastfeeding initiation and continuation rates that exceed national averages and Healthy People 2010 goals, significantly lower readmissions for mothers and infants than surrounding communities, shorter NICU stays, and a six-fold increase in diagnosis of PPMDs and subsequent treatment, all this while maintaining a 96% patient satisfaction rate.
Implications for practice:
By using a nursing model for the delivery of family-centered care, PHHC has provided a venue for APNs to practice in a highly satisfying environment as evidenced by tenures that reach to 25 yrs, as well as young RNs returning to APN programs in order to secure a position within the department. This design is evidence-based, cost-effective, patient satisfying and professionally fulfilling. This model serves ethnically, economically and culturally diverse families and could be tailored to meet the needs of many communities.
