PowerPoint Presentation Known Risk Factors

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Nurses for Newborns Foundation
Collaborative Nurse Home Visiting Model Uses
Technology to Strengthen Families April 20th, 2005
Sharon Rohrbach, RN, Founder, NFNF Ben Cooper,
Research Director, NFNF
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The need for our programs

• Despite being considered one of the wealthiest
  nations in the world, the United States continues
  to rank behind several other industrialized
  nations on several indicators of maternal and
  child health
• The United States currently ranks 42nd in infant
  mortality, behind locations such as Singapore and
  Beijing, China.
• St. Louis City has an infant mortality rate
  twice that of Cuba.
• Tennessee ranks 45th in the nation for low birth
  weight babies.

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Our Programs

• Bright Futures (BRT) This program can begin
  during the prenatal period or at birth. It serves
  general population families whose primary risk
  factors are poverty and lack of access to other
  services, This program began in 1997 and is our
  largest program.
• Bridge to the Future (BTF) This program serves
  at-risk families with medically fragile
  infants. This can include prematurity, low
  birthweight, Downs syndrome, drug or alcohol
  exposure, and more. It begins after the infant
  leaves the hospital. Most of these infants have
  spent time in a neonatal intensive care unit.
  This program began in 1993.
• Safe Beginnings (SBG) The Safe Beginnings program
  serves at-risk pregnant or new mothers who are
  mentally or physically limited or have a mental
  illness. This program began in 1997.
• Teen Parent (TPT) This program serves teens who
  will be under age 19 at the time they give birth.
  Services can begin during pregnancy or at birth.
  This program has been operating since 1993.

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Missouri and Tennessee Counties Served
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NFNF Visit History
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Awards Recognition

• Nurses for Newborns Foundation has received
  numerous awards for the work that is has
  accomplished in the local community. Highlights
  include

• The Use Your Life Award" from Oprah's Angel
  Network
• Sharon received the Women Who Inspire Us Award
  from Womens Day magazine
• The Community Leadership Award from the Robert
  Wood Johnson Foundation.

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Overview

• Topics to be covered
• Using technology to measure program outcomes
• Types of technology used by the organization
• How technology can make you more efficient while
  reducing costs
• Funding sources for new technology

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Child Abuse and Neglect Facts

• Children of ages birth to 3 years have the
  highest victimization rates and the highest
  repeat incident rates.
• Neglect is by far, the most common type of abuse.
• Home visits can reduce incidents of childhood
  injury and abuse.
• Risk factors for vulnerability toward child
  maltreatment include
• history of family violence
• parent has been abused as a child
• the parents marital education status
• mother was under 21 years
• history of drug and alcohol abuse.

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Technology

• Technology used at Nurses for Newborns
• Extensive use of relational databases
• 4th Dimension Campagne
• Internet for web-based reporting remote data
  exchange
• Open Source software

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Relational Databases
Relational databases can provide a powerful yet
cost-effective tool to manage clients and/or
other activities. As more and more funding
organizations move toward outcome-oriented
reporting, this software will be become
indispensable.
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NFN Case Manager

• Nurses for Newborns has been tracking clients
  within a relational database since the 1990. In
  2001, the most recent revision was created.
  Currently, this database allows us to
• Enter and track all referrals
• Maintain pregnancy data, demographics, risk
  factors and more
• Utilize remote technology (Nurses using laptops
  in the home)
• Error checking data validation reports sent
  via email to nurses
• Utilize web-based technology for dynamic
  real-time reports
• Track employees and assigned equipment
• Significantly reduce data entry costs, decrease
  error and maintain
• consistency.

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Type Tables
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Remote Synchronization
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Case Validation Email
From gail.bright_at_nfnf.org Date February 25,
2005 22440 AM CST To gail.bright_at_nfnf.org Subje
ct Mattie Greer RN Case Validation (02/25/2005
223 AM) Reply-To gail.bright_at_nfnf.org
Case TN001-00000-01554 Clandaija M. / Jasmine M.
No initial evaluation returned for a case
with at least 3 visits. No value specified for
'Dad Living in Home' during visit.
(TN027-00000-07859 07/17/2004) Case
TN001-00000-01663 Bershawn G. / Jerrive G.
No value for primary caregiver education
level for a case with at least one postpartum
visit. Case TN001-00000-01918 Faith
Desirae W. / Kimberly W. No value for
Pregnancy Intended for a case with at least one
postpartum visit. Case TN001-00000-02190
Joseph C. / Jessica W. Objective
'Immunizations current' marked as True, but
appears to be false. Birth Date 03/05/2004 Last
Visit 11/08/2004 Age at Last Visit 8
month(s). Chicken Pox (Expected 0 Actual
0) DTP/DTaP (Expected 3 Actual 2) H Inf. B
(Expected 3 Actual 2) Hepatitis B (Expected 2
Actual 2) MMR (Expected 0 Actual 0) Polio
(Expected 2 Actual 2)
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Web Based Reporting System
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Web Based Reporting System
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Web Based Reporting System
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Web Based Reporting System
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Measuring Outcomes

• This database was designed from its inception to
  not only collect data but to measure our
  outcomes.
• Outcomes are assessed on each visit
• On an annual basis, data are inspected cleaned
  
• Summary reports and Outcome measurements can be
  generated
• Data need by the state to determine maltreatment
  status for clients can
• easily be exported to Excel

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State Data Export
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Select Outcomes
Missouri
Tennessee
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Cost/Benefit Analysis
While the initial startup cost of utilizing
database technology can be intimidating, the
return on investment will be worth it. Benefits
over the long term include

• Savings on administrative overhead.
• The nurse enters her own data, instead of
  non-medical data entry personnel.
• One single point of data entry reduces error
  caused by double or triple entry.
• Once you begin to use it, you find that you come
  to depend on it.

Administrative costs include salaries for data
entry personnel, office supplies paper, mileage
for nurses,etc.
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Technology Funding Sources
As our society becomes more oriented towards
technology, many funders are providing
technology-specific funding for non-profits,
educational and community agencies. Listed below
are just a few of these sources

• Computer companies such as Dell, Intel
  Microsoft
• Other companies such as SBC Communications and
  EDS
• The Federal government (www.grants.gov)

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Future Plans

• Database technology has transformed the way our
  organization conducts business and serves its
  clients. However, we are always looking towards
  the future. Upcoming plans include
• Further integrate financial data for contracts
  and link client database
• with financial software
• Auto-assign risk factors based on pregnancy and
  demographic data
• Restructure some areas to allow for more quality
  research data
• Link database with hospital clinics to enable
  increased information
• sharing

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Open Source Technology

• What is open source technology?
• Basic Definition
• Pros Cons
• How open source technology can help you and
  reduce costs
• Examples include Linux and Apache
• Where you can learn more
• www.opensource.org
• www.sourceforge.net

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Nurses for Newborns Foundation
St. Louis 800-452-4784 7259 Lansdowne,
Ste.100, St. Louis, MO 63119
Nashville 888-654-7427 50 Vantage Way,
Ste.101, Nashville, TN 37228