Challenges and Opportunities in Maternal Infant

Challenges and Opportunities in Maternal Infant -...

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Unformatted text preview: Challenges and Opportunities Challenges and Opportunities in Maternal, Infant, and Child Health. Who am I? Who am I? Proud Graduate of USC Employed with Palmetto Health 20 yrs Always worked Women’s Health Currently Nurse Manager with Palmetto Health Women’s Center. • Also trained SANE Nurse (Sexual Assault Nurse Examiner) • • • • Community Nursing Community Nursing Nurses in this field work in government and private agencies, clinics, and other private settings. They focus on populations, working with individuals, groups, and families to improve the overall health of communities. They educate about health care issues, disease prevention, nutrition, and childcare, and also work with community leaders, teachers, parents, and physicians in community health education. Community Nursing Community Nursing It Takes a Whole Community to Take Care of Patients Today! RESOURCES ARE #1 NEED Foundations of Community Health Foundations of Community Health ­ ­ ­ ­ State Regulations Health Department Private Medical Offices Community Health Centers Department of Health and Department of Health and Environmental Control • Healthy Living and Prevention • Environment – Air and Water Qualities and Land Management • Services – Vital Statistics (birth/death certificates, Available Health Facilities and assistance. Department of Health and Department of Health and Environmental Control •Permits, Licenses, & Certifications ­ EMT programs, medical facilities, environmental issues •Regulatory Compliance­ EMT protocols, Environmental compliance • DHEC Programs DHEC Programs • • • • • Women’s and Children’s Services Children with Special Health Care Needs Perinatal Systems Women, Infants and Children Oral Health Women’s and Childrens Services Women’s and Childrens Services Family Planning (Fee’s based on sliding scale) • Goal – Prevent unintended pregnancies and to reduce the cost of high risk pregnant women and sick or preterm babies Women’s and Childrens Services Women’s and Childrens Services Family Planning (Fee’s based on sliding scale) • Counseling and education about planning and spacing pregnancies • Counseling relative to risk­taking behaviors including risks for HIV/AIDS • A comprehensive physical exam • Pap smear (cervical cancer screening test) • Screening and, if needed, treatment for sexually transmitted diseases • Pregnancy testing • Providing information about all methods of birth control, including abstinence Best Chance Network Best Chance Network •Provides free breast exams and pap tests •Minimal or no insurance coverage •Age 40­64 •Meets income requirements Women’s and Childrens Services Women’s and Childrens Services Teen Pregnancy • Today’s teens face special challenges in our rapidly changing world. • There are serious health risks for adolescents who have babies. Young adolescents (particularly those under age 15) experience a maternal death rate 2.5 times greater than that of mothers aged 20­24. Women’s and Childrens Services Women’s and Childrens Services • Common medical problems among teen mothers include poor weight gain, pregnancy­induced hypertension, anemia, sexually transmitted diseases (STDs), and cephalo­pelvic disproportion (CPD) (i.e., your baby is too big to fit through your pelvis in a vaginal delivery). • Later in life, teen mothers tend to be at greater risk for obesity and hypertension than women who were not teenagers when they had their first child South Carolina Campaign to South Carolina Campaign to Prevent Teen Pregnancy • Goal ­ To prevent adolescent pregnancy in South Carolina through education, advocacy, technical assistance, public awareness and research. South Carolina Campaign to South Carolina Campaign to Prevent Teen Pregnancy 2006 Facts • Every 50 minutes a SC teen gets pregnant • Estimated Pregnancies in 2006 10,604 10­19 year olds 432 10­14 3,630 15­17 6,542 18­19 South Carolina Campaign to South Carolina Campaign to Prevent Teen Pregnancy 2006 Facts • 10, 604 pregnancies with 8,327 births • Youngest Mom Age 12 • Released in Dec 2009, teen pregnancy rates have increased for the 4th yr Maternity/Prenatal Care Maternity/Prenatal Care • Maternity/Prenatal Care Services are available in all 46 counties and 90 clinic sites. These services are provided as an continuing effort to improve pregnancy outcomes. • Several levels of care are available depending on the client's request for services, her risk status (i.e., diabetes, high blood pressure, STDs, etc.), and arrangements for provision of services within each county. Maternity/Prenatal Care Maternity/Prenatal Care • The health department acts as the client's advocate to see that all pregnant women who apply for services receive risk appropriate care. The health department provides both supportive services and complete services to women. Maternity/Prenatal Care Maternity/Prenatal Care • Only two counties in SC offer full prenatal care. • Clients are referred to MD’s that care for pregnancy and often to tertiary centers for high risk prenatal care depending on health conditions • Low Income Pregnant Clients may apply for Medicaid for insurance coverage during pregnancy Infant Health Infant Health Newborn Screening Services • All infants born in South Carolina are required by law to be screened for certain genetic and metabolic disorders. At present, infants are tested for phenylketonuria (PKU), congenital hypothyroidism, galactosemia, congenital adrenal hyperplasia (CAH), medium chain acyl co­A dehydrogenase deficiency (MCADD) and hemoglobinopathies Infant Health Infant Health Postpartum Newborn Home Visits • The Postpartum Newborn Home Visit (PPNBHV) is a service for new moms and their babies. This service is a benefit of Medicaid. In some counties, families without insurance can also receive the visit. This service is provided by a public health nurse within a few days of hospital discharge. Infant Health Infant Health • Someone from the local health department will call the patient (or a relative) to schedule a time for the nurse to visit with them in your home. The nurse will usually spend 1­2 hours in the home Infant Health Infant Health What will the Nurse Do? • Ask questions about mom and baby's health. • Weigh the baby and do a physical exam on baby. • Check mom’s blood pressure. • Do a partial physical exam on mom, if needed. • Help mom with getting doctor's appointments for both. • Discuss a method of birth control (condoms, foam, film). • Refer you to other community resources as needed (your doctor, WIC, BabyNet, Family Support Services and others) Infant/Child Health Infant/Child Health • What does EPSDT mean? • Early checkups to keep infants and children healthy. Periodic screenings Screenings to assess mental, physical, and developmental growth. Diagnosis of problems through referrals to a primary care provider. Treatment of problems found during the screening Infant/Child Health Infant/Child Health Well Child Checkups • Head to toe unclothed physical examination • Developmental Screening • Vision screening • Hearing screening • Anemia screening • Blood pressure screening • Urinalysis • Immunizations, as needed South Carolina DHEC Immunization Division • Health education • Lead screening, as needed Infant/ Child Health Infant/ Child Health Fetal and Infant Mortality Review (FIMR) • Fetal and Infant Mortality Review or FIMR is a process that brings together key members of the community to review information from individual cases of fetal and infant death to determine whether systems’ problems contributed to the death. Infant/ Child Health Infant/ Child Health Over the years, local FIMR groups have implemented several actions which include: • Improved community bereavement services; Caring Programs in Local Hospitals • Promoted SIDS risk reduction activities; Local SIDS Chapter • Reduced gaps in prenatal and/or pediatric services; • Conducted media campaigns; Infant/ Child Health Infant/ Child Health Developed patient education material Implemented domestic violence screening and treatment Sistercare • Increased collaboration among community service organizations • Improved transportation to service sites. (Medicaid Vans) • • Community Programs Community Programs • Family Support Services (FSS) Works with families, medical providers, and patients to encourage and assist in the practice of healthier behaviors. Example: Poor nutrition, Knowledge deficits re health conditions, counseling for grief, linking to community resources. Community Programs Community Programs • Women, Infants, and Children – WIC The program provides formula, and specific nutritious foods in quantities to meet the needs of the participant. WIC approved foods: Milk, cheese, cereal, fruit juices, eggs, beans, formula Community Programs Community Programs • Palmetto Healthy Start Encourages mom­to­be to begin prenatal care as soon as they become pregnant Resource Moms – These are adult women who take on a patient and assist them in getting to appts, classes, etc… Community Programs Community Programs • Babynet Early intervention program for infants and toddlers under three years of age with developmental delays or conditions associated with developmental delays. Community Programs Community Programs • CARE LINE (1­800­868­0404) Callers can ask for assistance in gaining access to family planning services, prenatal care, infant and child health care, immunization and flu hotline. Community Programs Community Programs • Medicaid Transportation With proper notification of appointments, they will provides transportation to and from appointment. Community Programs Community Programs • SCBIBS (Black Infants Better Survival) SCBIBS is dedicated to reducing the infant mortality rate in the African American community by helping parents access information and resources to ensure better health and well being for their children and families Community Programs Community Programs • Perinatal Regionalization A comprehensive state wide program, divided into four regions, that works to assure risk appropriate care for all mothers and infants with a goal of improving perinatal outcomes and reducing infant mortality Community Programs Community Programs • Family Connections Family Connection is a support network for families who have children with special needs. They help thousands of children in South Carolina reach their potential by providing parent­to­parent connections, linking families to community resources, and sponsoring a number of educational and support programs Palmetto Health Women’s Center Palmetto Health Women’s Center • Partnered with USC Med School • Teaching clinic for residents • Patients range from indigent, self pay to privately insured • 16 Residents and 2 Nurse Practioner’s Palmetto Health Women’s Center Palmetto Health Women’s Center OB/GYN Service Adolescent OB/GYN clinic High Risk Pregnancy clinic Dental Screening Program for all pregnant patients. • On site State Medicaid Staff member for our pregnant patients • • • • Palmetto Health Women’s Center Palmetto Health Women’s Center • Health Start Recruitment • Research Programs Palmetto Health Women’s Center Palmetto Health Women’s Center Challenges/Barriers/ Successes • Successes – Stamp Card Program, Rounding with pts during visits, prenatal classes, Birth Control Educational Classes, Teen Clinic, 17 OHP, connecting with patients Palmetto Health Women’s Center Palmetto Health Women’s Center Challenges/Barriers/ Successes Challenges and Barriers: Patients have to choose basic necessities of life over health, Lack of responsibility, lack of finance, lost jobs, lack of education, lack of motivation, inability to speak English RESOURCES RESOURCES •DHEC sponsored programs •LRADAC ­ Prevention, Intervention, and Tx Programs •Free Clinic – •Ryan White – AIDS/HIV •Sexual Assault ­ and •Domestic Violence – above and Sistercare •Social workers ...
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  • Spring '10
  • Hickey
  • Palmetto  Health Women, Infant Health Infant Health, Community Programs  Community, Programs  Community Programs

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