the nurse family partnership program clarissa igle, rn
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The Nurse Family Partnership Program Clarissa Igle, RN Nurse Manager, Visiting Nurse Service of New York Nurse-Family Partnership March 26, 2009. Home Visit Overview. Maternal Role Mothering Role Physical Care Behavioral and Emotional Care Family and Friends - PowerPoint PPT PresentationTRANSCRIPT
The Nurse Family Partnership Program
Clarissa Igle, RNNurse Manager, Visiting Nurse Service of New York Nurse-Family Partnership
March 26, 2009
Home Visit Overview
Personal HealthHealth Maintenance PracticesNutrition and ExerciseSubstance Use Mental Health Functioning
Environmental HealthHomeWork, School, and Neighborhood
Life Course DevelopmentFamily PlanningEducation and Livelihood
March 2009
Maternal RoleMothering RolePhysical CareBehavioral and Emotional Care
Family and FriendsPersonal network RelationshipsAssistance with Childcare
Health and Human ServicesService utilization
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“There is a magic window during pregnancy…it’s a time when the desire to be a good mother and raise a healthy, happy child creates motivation to overcome incredible obstacles including poverty, instability or abuse with the help of a well-trained nurse.”
David Olds, PhD, Founder, Nurse-Family Partnership
March 2009
6.1
7.4
9.09.9
3.7
5.6
2.4
8.2
5.44.7
2.2
8.4
5
3.7
1.5
8.2
3.9
5.6
0.2
7.4
0
1
2
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5
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9
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Infant MortalityRate
Post PartumDepression
Intimate PartnerViolence
% LBW
Pe
rce
nt
Bronx
Manhattan
Brooklyn
Queens
Staten Island
Bronx Comparison to Other Boroughs: Key Indicators of Maternal/Infant Health
Source: IMR and LBW: NYC Vital Statistics, DOHMH (2007) . PPD and IPV- NYC PRAMS (Pregnancy Risk Assessment Monitoring System, 2006)
On markers of Maternal Infant Health, the Bronx is the borough most at risk.
VNSNY NFP – Impact on Women and Children in the Bronx
• Reduced domestic violence
• More women breastfeeding
• High immunization rates
• Lower rates of subsequent pregnancy
March 2009
Domestic Abuse During Pregnancy: Bronx NFP Results
32
19
32
18
0
5
10
15
20
25
30
35
Physical Abuse Fear of Partner
Intake36 weeks
Source: NYC NFP: Nurse-Family Partnership Data through 12/30/2008March 2009
There is a 41% decrease in reported physical abuse during pregnancy, and a 44% decrease in reported fear of partner.
9197
89 86
74
0
10
20
30
40
50
60
70
80
90
100
110
VNSNYBronx NFP
VNSNY LESNFP
NYC NFP NYC US
Pe
rce
nt
Breastfeeding Initiation Rate: VNSNY NFP, NYC and US
Source: NYC NFP: Nurse-Family Partnership Data through 12/30/2008 andNYC: First time births on Medicaid from PRAMS 2006.US: National Immunization Service (NIS), 2005
March 2009
Healthy people 2010 goal = 75%
Breastfeeding is optimal for the physical and cognitive development of the infant, and for maternal infant bonding. VNSNY NFP sites consistently exceed breastfeeding initiation rates when compared to New York City and the Healthy People 2010 goal.
89.2
70.576.1
0
10
20
30
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50
60
70
80
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Bronx NFP (0-12months)
NYC (<2) US (<2)
Cu
mu
lati
ve
Pe
rce
nt
Percentage of Children up to Date with Immunizations
Source: NYC NFP: Nurse-Family Partnership Data through Dec 30 2008- NYC and US comparisons from Citizen’s Committee for Children Status Report 2008
3
21
13
27
0
5
10
15
20
25
30
6 Months 18 Months
Cu
mu
lati
ve
Pe
rce
nt
VNSNY Bronx NFP
US
Cumulative Percent of Women with Subsequent Pregnancy 6 Months & 18 Months Postpartum New
York City NFP vs. US
Source: Source: US: CDC 2006 Pregnancy Nutrition Surveillance System (PNSS); NFP data from Nurse-Family Partnership (NFP) Data through 12/30/2008
Subsequent pregnancies that occur shortly after the original pregnancy put both the mother and infant at higher risk for health complications and economic hardships. The rates of subsequent pregnancy in the Bronx NFP are lower than the national average. Decreasing this rate even further at 18 months is currently an area of focus.
“This program saves money. It
raises healthy babies and creates better parents. It reduced childhood injuries and unintended pregnancies, increased father involvement and women's employment, reduced use of welfare and food stamps, and increased children's school readiness. And it produced more than $28,000 in net savings for every high-risk family enrolled in the program.”
Barack Obama,
U.S. President
March 2009