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

Community-Based Child Health Nurses: An Exploration of Current Practice

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

Community-Based Child Health Nurses: An Exploration of Current Practice

Article excerpt


This research was initiated in order to define the practice domain of child health nursing in light of recent political, economic and social changes in Western Australia. The project was conducted by a group of nurse researchers with experience in child health nursing. The aim of the project was to map the scope of nursing practice (SONP) in the community child health setting in Western Australia and to identify the decision making framework that underpins this nursing specialty. In light of widespread social and health service management changes and lack of research in this area, there is urgency for community-based child health nurses to have the role accurately defined.

This is the first time the role of the child health nurse in Western Australia has the subject of a research investigation. These research findings have the potential to influence policy and practice guidelines for future child health nursing practice not only in Western Australia but further afield in Australasia. The challenges facing child health practice include; a broadening of the child health nurse's role in order that they deliver traditional services, in addition to services that have evolved due to changes in the social determinants of health and health service approach, along with changing consumer expectations. In identifying the core roles and responsibilities of the child health nurse in current practice, this study has the potential to inform health services of levels of support child health nurses require in clinical practice. Furthermore, by ascertaining the current role of the child health nurse, their scope of work is able to be more accurately identified. This data is valuable for identifying workforce issues, training requirements and strategies needed to be put in place to assist these nurses to provide optimum care to clients. In an integrated service it is necessary to align the nurses' roles in relation to other allied health staffto support targeted programs in Western Australia. Furthermore, it may assist with raising the profile of the child health nurse by increasing the awareness of the general public and other health professionals to their roles. This will, in turn, assist in recognising their contribution to the entire community.


Searches for the literature review were conducted in the following databases: Health and Society, Health Collection, CINAHL, Science Direct, Scopus and Medline using the words child* nurse* health public and community in differing combinations from 1995 to the time of the study. Literature in languages other than English was not used. Literature from the Australian Research Alliance for Children and Youth (2005), government sources, theses and conferences were also searched. Following a review of the data derived from the search terms, 29 papers and six books were retained.

The role of the community-based child health nurse, although changed considerably over time, has always been a specialist practice role. In recent decades the child health nurse practice domain has become extended. The expansion of the role is the result of changes in the complexity of the social determinants of health faced by parents/ caregivers of young children and changes in health service delivery. Child health nurses are expected to provide holistic care by focusing on individualisation of care via comprehensive assessment and program planning for children and their families (Drummond & Marcellus, 2005).

A preliminary review of the literature showed that a shiftfrom a focus of individualised health service provision to a population health approach is occurring in health service delivery. This encompasses universal, targeted and selected services. Prior to the 1970s, the focus of nurses working in the 'baby clinics' was instructing mothers in infant care, that is, targeting a specific group being the mothers (Barnes, Courtney, Pratt, & Walsh, 2003). …

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