RESUMEN
Lack of access to primary and behavioral healthcare is prevalent in communities experiencing systematically greater obstacles to healthcare. This study describes the implementation of the Coordinated Care Model in a nurse-led primary care clinic and identifies the essential factors for sustained integration. A mixed-methods explanatory sequential study design was used to collect and analyze quantitative and qualitative data. Participants reported an overall statistically significant mean increase (M = 2.47, SD ± 2.01, p < 0.001) in the level of integration pre-and post-integration. Qualitative results indicated that the optimization and accentuation of team strengths, the Lundeen model of holistic care, and addressing physical and psychological barriers lead to sustained level of integration. Integrated practices are essential in assessing and supporting the holistic needs of individuals, families, and communities. Future studies should examine facilitators or impediments to integrated practice in other healthcare settings, long-term health outcomes of clients in integrated care, and the cost-effectiveness of integration.
Asunto(s)
Rol de la Enfermera , Psiquiatría , Humanos , Proyectos de Investigación , Atención Primaria de SaludRESUMEN
The Westlawn Partnership for a Healthier Environment (WPHE) is a longstanding group of community stakeholders that was formed over a decade ago to identify, prioritize, and address environmental health (EH) concerns in a low-income, predominantly African American, urban neighborhood, which faces a disproportionate burden of EH risks, particularly asthma. Launched by the University of Wisconsin-Milwaukee College of Nursing, which established a nurse-managed health center within the community 30 years ago, WPHE utilized the Protocol of Assessing Community Excellence in Environment Health methodology to develop, implement, and sustain the partnership. WPHE implemented programs for Healthy Homes, Healthy Day Cares, and bicycling, and made system and infrastructure changes within the community to address the top identified EH concerns: indoor and outdoor air pollution, mold exposure, access to safe and healthy food, and pesticide exposure. WPHE's efforts have resulted in significant local, state, and national policy impacts to promote environmental justice. This brief report shares how the partnership was formed, its priorities, major activities and accomplishments, and insights into sustaining a community-based EH partnership, including recommendations for the key role that public health nurses can play to promote environmental justice.
Asunto(s)
Justicia Ambiental , Rol de la Enfermera , Negro o Afroamericano , Salud Ambiental , Humanos , UniversidadesRESUMEN
Academic community nursing centers (CNCs) emphasize partnership with the communities they serve to provide access to services that promote, restore, and maintain health. In this study, selected data from an 11-year clinical data set are presented to show the scope of academic CNC nursing practice, describe client services and expanded nursing roles, show the use of a computerized clinical documentation system in tracking nursing practice, and assess the usefulness of the Lundeen conceptual model. The study design was a retrospective review of computerized client record data. The setting was a CNC located in the neighborhood center of a large federally subsidized housing development. The sample was 25,495 client visits to the CNC. Visit data were coded and entered into a relational data management program to facilitate analysis. Findings show an expansion over time of nursing practice and client services that include strong case management and management of illness care. Findings also suggest that a computerized clinical documentation system that specifically tracks nursing practice is vital if nurses are to identify and eventually be reimbursed for client care specific to nursing practice. Finally, the Lundeen conceptual model was shown to be useful across the continuum of care provided at CNCs.