The current federal administration has attempted to avert the collision course. While federal officials bicker over details and philosophy, nurses have been bringing to reality the true meaning of health care. Health care means just that: paying attention to one’s health from before birth so that when middle or old age arrives a person has hopefully never seen the inside of a hospital. It’s nurses giving citizens the education and tools to make smart decisions for a future of good health. It is prevention taken seriously for every citizen no matter their income or social class.
What would a true health care system look like? Nurses are giving us a glimpse into the future that is needed. Who are these nurses and what have they initiated in the name of health care? The American Academy of Nurses has a campaign called Raise the Voice involving their 1500 Fellows and partner organizations. Their position is that the health care system needs transformation not reformation. Here are a few profiles of nurses who are leading innovation in health care. These nurses and their new care models are named Edge Runners, and they are involved in all aspects of health care in the nation.
Good health can begin before a baby is born. Ensuring the health of an expectant woman will give a newborn the best possible start in life. But often low income, first time expectant mothers lack the proper knowledge, support, or access to services to raise their baby in an optimal manner.
For the past 6 years The Family Birth and Health Center gives these mothers an alternative to going to the hospital to give birth in the District of Columbia. It provides health care for women and children. Its successes include decreases in premature births, number of low birth weight babies, and caesarian births. It also provides after birth social support and care. If the FBHC concept was implemented to all Medicaid births nationwide the savings would be almost 2 billion dollars. But more importantly, child mortality would be less. Presently the US has an unacceptably high child mortality rate.
The Nurse Family Partnership is a non profit nurse home visiting program for these expectant women. It operates in 23 states, its goal is to go nationwide. Both nurse and client commit to 2.5 years in the program beginning with 14 prenatal visits. This is followed by 25 visits during infancy and 22 visits until the child is 2 years old.
The NFP improved pregnancy outcomes in the following ways: a reduction in premature births for pregnant smokers, fewer hypertensive pregnancy disorders, and decreased numbers of pregnant smokers. High risk pregnancies have been decreased due to longer time between successive pregnancies.
The RNs in the NFP have educated these new mothers and the result has been a decrease in childhood injuries including those that require an emergency room visit.
The nurse led education and empowerment of these at risk mothers and children has resulted in long term societal benefits, such as decreased crime rates, neglect, child and spousal abuse, and use of services such as welfare. These previously at risk children also have greater opportunities for future academic success.
A significant number of newborns discharged from intensive care end up back in hospital shortly after, often from preventable causes. In 1991, the Nurses for Newborns Foundation started the Bridge to the Future program to support low income parents of newborns with high medical needs. The goal of the program is to equip these parents through encouragement, knowledge, resources, and services to allow them to optimally care for their child. The transition from ICU to home becomes less daunting through nurse home visits. Ideally the clients are matched with a nurse living close by and who is of the same ethnic heritage. The nurse’s relationship with the parents allows them to meet the medical, physical, and emotional needs of their child with more confidence. This in turn decreases the probability of child neglect, abuse and developmental disability.
Has the prevalence of treatment options including drugs led to a complacency among citizens who believe there is a cure for all ills?
Prevention has a better chance of success if it is implemented in the community. What better place to start a prevention program than a location where most adults spend the majority of their time: the workplace.
Adapting the success of the fitness trainer/coach concept, 2 clinical nurse specialists developed a workplace program called Wise Health Decisions. The goal of the program is to improve lifestyle choices and behaviors to increase the opportunity to better or maintain good health. Another goal is to delay the onset of common preventable chronic diseases or to identify and manage the condition if the employee has one. RNs are on the jobsite during all working hours for screening and personalized coaching. Screening is conducted regularly to give incentive for employees to stick to their personalized program to positively modify their lifestyle. More frequent screenings will allow earlier diagnosis of risk factors associated with chronic conditions. Participants are encouraged to maintain a healthy weight, blood pressure and cholesterol levels.
Health Interconnexions is an employer health insurance employee partnership for profit program that also encourages prevention through lifestyle changes as aided by APNs. Through three steps, an online health assessment, blood tests, and BMI, weight and blood pressure measurement, an annual health goal is established for each participant.
The program targeted the 60-80% of less fit employees in three diverse organizations tailoring the program to each work population. Employee participation is encouraged by an electronic patient health record accessible and managed by the employee. This health record tracks blood pressure, weight, BMI records, lab tests, history and trends of medical events. The program has been successful in moving employees out of risk categories to good health through early identification of risk factors. Employees’ modification of health behavior is rewarded by not only improved health but lower health plan premiums, $1000+ for individuals and quadruple that for families. Employers get a break in both their portion of premiums and decreased number of .claims. This nurse driven program can be easily duplicated in any willing workplace.
Part two will discuss the so called golden years, and will highlight innovations in the care of senior citizens.
Some Sources: http://www.aannet.org/i4a/pages/index.cfm?pageid=3301; http://www.aannet.org/custom/edgeRunner/index.cfm?pageid=3303&showTitle=1
Article © 2010 My Nursing Uniforms.com / Young Lion Incorporated. Photo courtesy of kozumel
