Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Community Child Health (CCH) Nurses' Experience of Home Visits for New Mothers: A Quality Improvement Project

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Community Child Health (CCH) Nurses' Experience of Home Visits for New Mothers: A Quality Improvement Project

Article excerpt

INTRODUCTION

The topic of home visits for new mothers by community child health (CCH) nurses was explored with a literature review. Since the last decade, home visits have noticeably increased with research highlighting the importance of the earliest years of a child's life and the benefits of home visits (Jansson, Petersson, & Uden, 2001; Kemp, Anderson, Travaglia, & Harris, 2005; Olds & Kitzman, 1993; Olds et al., 1997; Plews, Bryar, & Closs, 2005). The literature (Kearney, York, & Deatrick, 2000; Larner, Halpern, & Harkavy, 1992) shows that a common goal of CCH nurses is to improve the lives of children by encouraging changes in the attitudes, knowledge and or the behaviours of parents and caregivers. This is achieved by giving parents social support, practical assistance such as connecting them with appropriate community services, and education about effective parenting and child development (Kearney et al., 2000).

An exploratory Finnish study on home visits using 263 community nurses and 323 clients, found that clients equated home visits with professionals' assessing their baby for abnormalities and gaining information about the growth and development of their children. The nurses viewed home visits differently, as providing clients with the support and encouragement they needed to ensure continuity of care for their babies (Vehvilainen-Julkunen, 1994). In another study on home visits conducted in England, Raynor (2001) reported increased parental involvement and reciprocal interaction, improvement towards and praise for the child, a more positive attitude towards the child and less difficulties with negative interactions. Moreover, Raynor (2001) indicated that home visits resulted in parents demonstrating realistic and positive expectations of their children with subsequent positive parenting.

Further literature highlights the immense range of social problems that can be addressed by CCH nurses with home visits (McNaughton, 2004). Whilst CCH nurses provide screening services to parents, there is now a trend towards a holistic approach to working with families with young children (Department of Health (DoH) WA, 2005). Other reported benefits of home visits include improvement in maternal and child health, better parenting skills leading to positive maternal-child interaction, and positive outcomes for the family (Kearney et al., 2000). Home visits allow CCH nurses to discuss preventative strategies with individual families and to explain how to navigate through the various government systems to access much needed resources (Kemp et al., 2005).

McNaughton (2000) reported on a synthesis of available qualitative research on maternal home visits from England, United States, Canada and Finland and discussed the many reports confirming the benefits of home visits to clients. McNaughton (2000) concluded that building a positive relationship with clients formed the basis of problem identification and problem solving leading to client empowerment (McNaughton, 2000:405). Additionally, McNaughton indicated that further research was needed to examine how home visits were conducted and the impact on client outcomes as well as how demographic family factors influence the number of home visits. Further she reported that one home visit did not yield as positive an outcome for the client as two or more visits (McNaughton, 2000).

McNaughton (2000) also asks 'what happens over time to produce changes in the client's behaviour and what does current research report about the processes involved in home visits?' (McNaughton, 2000:407). Barnes, Courtney, Pratt, and Walsh's (2003) focus group study of 22 Queensland CCH nurses provides information on current nursing practice and challenges. The most significant challenge identified was concerning the limited resources available and the inference that there were more at risk families than resources available for these families. This may impact on the families without risk factors who may develop problems as a result of reduced home visits by CCH nurses. …

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