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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Capri-Mara Fillmore, MD, MPH, MSc, Karen Michalski, MSW, Kathy Blair, BN, MBA, and Jill Paradowski, BN, MSN. City of Milwuakee Department of Health, 841 N. Broadway, 3rd Fl, Milwaukee, WI 53202-3653, 414 286 3521, cfillm@ci.mil.wi.us
The City of Milwaukee Health Department, like the rest of the nation faces chronic nursing shortages. The shortage of public health nurses has resulted in, among other things, less nurses available to make newborn visits. One of the goals of the Milwaukee Health Department has been to decrease the infant mortality in the city. Therefore nurses wanted to better target their visits to those at greatest risk of infant death, estimating no more than 1500 newborn households could be visited. Using birth and death certificate data for the years 1998-2000, relative risk for various risk factors on the birth certificates were determined. Infants who died before discharge from the hospital were excluded from analysis since the nurses do not have chance to home visit these infants. In order to meet the 1500 newborn limit, relative risks of infant death needed to be 3.3 times that of infants without the risk factor. Among the birth certificates risk factors which met this criteria were congenital anomalies birth weight <1500g (RR=7.5; 95% C.I.: 4.3-13.2), teen mothers with 2 or children already (RR=6.9; 95% C.I.: 1.7-27.6), infants transferred to NICU after born (RR=4.5; 95% C.I.: 3.1-6.6), 4 or more children at home (RR=3.3; 95% C.I.: 1.6-7.3), reported alcohol use during pregnancy (RR=3.4; 95% C.I.: 1.6-7.3), birth weight<2500g and cigarette use during pregnancy (RR=3.3; 95% C.I.: 1.5-7.2), and five minute APGAR of 8 or less (RR=3.7; 95% C.I.: 2.6-5.4). Among those factors which did not qualify were sexually transmitted diseases during pregnancy, cigarette use with normal birth weight, short between pregnancies interval, twins or triplets, and prior infant death.
Learning Objectives:
Keywords: Infant Mortality, Public Health Nursing
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: City of Milwaukee Health Department
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.