Importance of Including Registered Nurses in Population-Focused Health Programs: The Healthy Beginnings Program

Background/Issue:Cost effectiveness of personnel plays a major factor in programs funded by public health dollars. Staffing models often limit the number of registered nurses based on nurses being labeled as expensive members of a multidisciplinary team. Some programs hire social workers, case managers, and health coaches instead of investing in public health nurses (PHNs).  PHNs help improve access and quality, and lower costs through care coordination and prevention efforts, and are trusted and valuable members of a multidisciplinary team.

Description:Healthy Beginnings is a multidisciplinary maternal health program embedded in an outpatient OB/GYN practice with the goal of reducing infant mortality. The program is located within a large regional birthing hospital serving primarily vulnerable, underserved women with complex psychosocial and medical issues. Program enrollment is completed by a bachelor’s prepared registered nurse at one of two clinical sites.  The six ANA standards of nursing practice are utilized in the enrollment and ongoing case management.  

Lessons Learned: 1) The hiring and management team should utilize the ANA SOPs and the Quad Council Competencies for PHNs, even in non-traditional settings such as hospitals. 2) Continuing education opportunities should be available in areas aligned with the Quad Council Competencies to enhance population-focused standards of nursing practice.

Implications/recommendations:  Public health programs should continue to support and recognize the essential role that PHNs play within a multidisciplinary team. Ongoing training, shadowing and employment opportunities in PHN should be available to bedside nurses who want to expand into PHN roles.