Enterprising Networks

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1 Enterprising Networks News from Nurse-Family Partnership SEPTEMBER 2014 Academic partnerships energize students, NFP Elizabeth Sigler, a sophomore in the BSN program at Purdue University, recently completed the first of three semesters at NFP. As part of her three-year cooperative education program, Sigler worked 40 hours a week this summer at the NFP office; she will return next summer and again during her last (spring 2016) semester. I want hands-on, long-term relationships with patients, she says of her career goals. This has been fantastic. Sigler is among several students placed at NFP through academic practice partnerships that teach future nurses what one community health organization is all about. The students come to NFP with strong interest in maternal and child health but little idea of what to expect. I see our role as being a community health site for schools of nursing, says Director of Operations Lisa Crane, MSN, RN. NFP is well positioned to show community health, and our nurses wholeheartedly support that. Forming productive academic practice partnerships is a workforce development strategy for NFP Indiana. Among her varied projects, Sigler planned a client picnic that included resources, crafts, activities and food a new experience for her. In collaboration with Goodwill s marketing department, she worked on a model Facebook page to connect clients, and learned about the Ages and Stages Questionnaire, which she will use to conduct surveys on child development next summer. This summer I learned a lot about the [NFP] model, she says. It s so much more than what I thought it was. I ve seen that this is one of most effective models for preventive health care. The shadow knows Students often find shadowing NFP nurse home visitors an eye-opening experience. I discovered I really enjoy the holistic aspect of community health, says Ruthanne Sheetz, a student at the IU School of Nursing at IUPUI. She especially liked how the NFP (See partnerships, page 3) Ellen DeBard (left), University of Indianapolis nursing student and NFP summer intern, took time out from her breastfeeding intiation project to enjoy NFP s summer picnic for client families. nursefamilypartnership.org

2 s Executive Brief By Lisa Crane, RN, MSN, Director of Operations New research confirms what our nurses know in their hearts that Nurse-Family Partnership saves mothers and babies lives. A study published in JAMA Pediatrics in July 2014 found lower rates of preventable causes of death among children, and all causes of death among mothers, for participants in Nurse-Family Partnership.* The study followed more than 1,100 mother-child pairs from disadvantaged neighborhoods in Memphis, Tennessee, from 1990 to NFP participants had lower rates of preventable child mortality from birth until age 20. Of the children not receiving nurse home visits, 1.6 percent died from preventable causes, including sudden infant death syndrome, unintentional injuries and homicide. None of the nurse-visited children died from these causes. Mothers who did not receive nurse home visits were nearly three times more likely to die from all causes than nurse-visited mothers (3.7 percent versus 1.3 percent). Mothers who did not receive nurse home visits were eight times more likely to die from external causes, including unintentional injuries, suicide, drug overdose and homicide, than nurse-visited mothers (1.7 percent versus 0.2 percent). We see firsthand how NFP is working in Marion County. Now we stand ready to scale up to reach every new Indiana mom who can benefit from this model, with our former managing director, Keith Reissaus, at the helm. Keith was the driving force behind bringing NFP to Goodwill and Indiana. We are thriving here because Keith established a culture of entrepreneurial creativity and high achievement among the staff. Although we miss him, we re excited for his new opportunity and what it will mean to moms and babies across our state. And in terms of executive leadership, we ve been left in very good hands. We also hope you ll enjoy reading about the academic practice partnerships that NFP has formed and meeting some of the nursing students who have been both contributing to NFP Indiana and learning what it s like on the front lines of community health. * Effect of Home Visiting by Nurses on Maternal and Child Mortality: Results of a 2-Decade Follow-up of a Randomized Clinical Trial. David L. Olds, PhD; Harriet Kitzman, RN, PhD; Michael D. Knudtson, MS; Elizabeth Anson, MS; Joyce A. Smith, PhD; Robert Cole, PhD. Reissaus heads NFP statewide Keith Reissaus, formerly with Goodwill Industries of Central Indiana as NFP Indiana s managing director, has joined the NFP National Service Office as the Indiana state director. Funding support from Goodwill to the National Service Office will provide additional resources over the next 18 months to bring NFP to scale in Indiana. Reissaus will continue collaborating with state leadership, the business community, foundations, community-based organizations, Indiana health care systems and national leaders in the health care arena to support scaling opportunities in Indiana so NFP can reach more eligible families. His 15-plus years in various executive roles at Goodwill included the development of NFP Indiana from conception to full implementation. NFP began serving families in Marion County in November Keith brings a unique blend of business acumen, knowledge of health care, great passion for the NFP model and a strong track record of successful work with community and state partners, said Erika Messenger Bantz, NFP s senior director of business development. A program that provides poor, single, first-time mothers with intensive support from visiting nurses reduced death rates among both the women and their children, according to a study of 20 years of the program s efforts published this week. The well-known Nurse-Family Partnership, founded in 1977 in Elmira, N.Y., but now in operation in nearly 600 counties in 43 states... has previously been credited with reducing childhood abuse and neglect, decreasing the number of births to mothers in their early teens and 20s, improving the cognitive outcomes of children, and lessening the use of welfare, food stamps and Medicaid in the three locations Elmira, Denver and Memphis where research has been ongoing. The Washington Post, July 8, 2014 nursefamilypartnership.org

3 nursefamilypartnership.org Partnerships (from page 1) nurses provide information and resources but encourage their clients self-efficacy. One new mom of a 9-month old, Sheetz recalls, planned to sell her baby s toys because the baby doesn t play with them right the child was waving her blocks around rather than building a tower. Mom didn t realize this is where her daughter is cognitively, Sheetz says. I thought this was really interesting. Her baby was doing exactly what she should be doing, but the mom didn t have that support to tell you, this is normal. Her NFP nurse told her the next time, she would bring a list of the type of things she should expect from her baby. Sheetz says she has had both good and bad shadowing experiences during her training, but NFP was all positive, especially given her interest in maternal and child care: I didn t even know this existed. Now this is what I want to do when I grow up. This is the first year for cooperative education in the nursing school at Purdue. I knew I wanted to do hands-on work this summer. I didn t know anything about NFP but I knew some people who have worked for Goodwill, so that was positive influence. And women s health? I was absolutely interested! It has been fantastic. In addition to my projects I have shadowed a lot of nurses. They all have taught me something different with their different styles and approaches. I think they taught me a lot about leadership. Elizabeth Sigler Cooperative Education Student NFP as preceptor Ball State University graduate Caroline Lynn, MSN, RN spent the final semester of her master s degree program conducting a qualitative study in the use of reflective supervision at NFP. This supportive approach to practice is part of the NFP model. Nurse home visitors meet regularly with their supervisors to discuss their thoughts, feelings, actions, and reactions in their interaction with clients. Lynn had been looking specifically for an organization where empowerment strategies were part of the culture. In healthcare, that s really hard to find, says the veteran nurse. As nurses, we go in looking to identify a problem and solve it. NFP focuses on strengths rather than problems. I learned that this basic model of behavior is so simple and yet so challenging, because it goes against the grain of traditional health care. At NFP Lynn developed a survey, and in voluntary oneon-one interviews with IN-HOUSE LEARNERS Not only are NFP s nurses helping clients reach their academic goals, but they are also pursuing their own with the support of NFP Indiana and Goodwill. Several of NFP s nurse home visitors are working on advanced degrees. Among the team s recent graduates are Amy Hutcheson, MSN; Jessica Gonzalez, MPH; Maria Reisenauer, MBA; and Cindy Hunt, MBA. the supervisors and nurse home visitors, looked for ways to fine-tune processes to enhance the reflective practice. Lynn not only provided NFP with valuable tools and information, but she also absorbed some of the reflective mindset from NFP s nurses. They re a unique team, she says. They get the big picture, and they re infused with hope for a brighter future for their clients. Each of those team members believes in the difference they re making. Summer interns Two nursing students from the University of Indianapolis became NFP Indiana s first summer interns, thanks to funding from the Goodwill Foundation. Junior Ellen Debard chose a project related to breastfeeding, while senior Ashley Edwards project focused on lowbirthweight babies. Both presented their findings to the Goodwill executive board and also shadowed several NFP nurses on home visits. Not only did the students contribute to the operation of NFP Indiana, but planners also hope the new internship program will create a diverse pipeline of future hires for NFP Indiana expansion. I think community health isn t talked about as much as it should be, Debard says. Nursing schools focus more on hospital nursing, but NFP is all about the benefits of preventive care. Just seeing how the nurses interact with their clients will make me a better nurse. It s opened my mind a lot to what I might want to do. Watching nurses on their shadow visits, as well as their interaction with each other and NFP supervisors, gave Edwards some communication techniques she expects to use as a nurse. I didn t know public health nursing could be such a fun and supportive environment, she adds. A program like this was exactly what I wanted. You can build relationships with clients and give back to the community.

4 NFP Indiana Implementation as of August 25, Number of active clients 950 Total clients ever served 582 Babies born (includes 13 sets of twins) 16 clients have graduated from NFP Average age OF MOMS: 20 25% were 18 or 19 when enrolled Self-identified race: 54% African-American 25.5% white 8.2% multiracial 1.6% Asian 1.4% American Indian (remainder declined to self-identify) Self-identified ethnicity: 20% Hispanic language: 83% speak English as their primary language 14% speak Spanish 3% speak another language (including Burmese, French, Arabic, Swahili and others) Moms AT INTAKE: 51.6% have a high school diploma or GED 11% are married 43.8% of those over age 18 are employed Cumulative outcomes (Second Quarter 2014): 18% Reduction in smoking during pregnancy 87.2% Babies born at full term (greater than 37 weeks) 87.2% Babies born at normal birthweight (greater than 5.5 pounds) 88.2% Babies breastfeeding at birth 24.6% Babies still breastfeeding at six months of age 97.2% Fully immunized at 18 months of age first graduates! A Dr. Seuss classic that offers wisdom to children of all ages provided the theme for NFP Indiana s first graduation ceremony April 30 at the Children s Museum of Indianapolis. NFP s inaugural class included 16 moms, representing seven nurse home visitors. NFP s first mom enrolled in November Each graduating client was given a copy of Oh, the Places You ll Go! with a personalized message from their nurse. Each of their children, who are now 2, received a T-shirt featuring the book s cover. A cake and decorations also reflected the upbeat message. It was awesome seeing the mothers, their 2-year-olds, and their families with their nurses, says nursing supervisor Lynn Baldwin, who led the event s planning. The bond they have after working together for two-and-a-half years was obvious through their interactions and conversations. NFP is looking ahead to our next graduation October 29! See more graduation photos, next page.

5 Congratulations! Today is your day. You re off to Great Places! You re off and away! You have brains in your head. You have feet in your shoes You can steer yourself Any direction you choose. Dr. Seuss Sherry Matemachani, manager of NFP community engagement Nurse home visitors looked on proudly as each NFP graduate received her certificate. Graduate Shabria Drake told the audience how important her nurse, Marilynn Berry- Stamm, RN, has been to her. After the ceremony, NFP families enjoyed the Children s Museum Playscape, which is specifically designed for ages 0-5. NFP also invited 50 or so 1-year-olds from the program to attend Playscape. Jim McClelland, president and CEO, Goodwill Industries of Central Indiana, Inc.

6 Nurse-Family Partnership and Goodwill Guides Goodwill Industries of Central Indiana, Inc Lakeside Blvd. Indianapolis, IN nursefamilypartnership.org Nurse-Family Partnership (NFP) is an evidencebased, community health program that serves low-income women pregnant with their first child. Each vulnerable new mom is partnered with a registered nurse early in her pregnancy and receives ongoing nurse home visits. It is a life-transforming partnership, for the mom and her child. Nurse-Family Partnership helps families and the communities they live in become stronger while saving money for state, local and federal governments. NFP programs serve clients in 42 states and the U.S. Virgin Islands; Goodwill Industries of Central Indiana is the first NFP Implementing Agency in Indiana. NFP guide consultants directly support the nurse home visitors practice by aligning resources around each NFP family. The guides develop and strengthen community resource partnerships crucial to NFP outcomes. The guide consultancy is NFP Indiana s strategy to achieve maternal and child outcomes outcomes and eliminate fragmentation in our resources community.