Comparing maternal child health problems and outcomes across public health nursing agencies.

To use aggregated data from health informatics systems to identify needs of maternal and child health (MCH) clients served by county public health agencies and to demonstrate outcomes of services provided. Participating agencies developed and implemented a formal standardized classification data comparison process using structured Omaha System data. An exploratory descriptive analysis of the data was performed. Summary reports of aggregated and analyzed data from records of clients served and discharged in 2005 were compared. Client problems and outcomes were found to be similar across agencies, with behavioral, psychosocial, environmental and physiological problems identified and addressed. Differential improvement was noted by problem, outcome measure, and agency; and areas for enhancing intervention strategies were prioritized. Problems with greatest improvement across agencies were Antepartum/postpartum and Family planning, and least improvement across agencies were Neglect and Substance use. Findings demonstrated that public health nurses address many serious health-related problems with low-income high-risk MCH clients. MCH client needs were found to be similar across agencies. Public health nurse home visiting services addressed important health issues with MCH clients, and statistically significant improvement in client health problems occurred consistently across agencies. The data comparison processes developed in this project were useful for MCH programs, and may be applicable to other program areas using structured client data for evaluation purposes. Using informatics tools and data facilitated needs assessment, program evaluation, and outcomes management processes for the agencies, and will continue to play an integral role in directing practice and improving client outcomes.

A public health nursing informatics data-and-practice quality project.

Automation of nursing documentation in client records is one of today's formidable challenges in healthcare settings. Some stakeholders view standardized nursing language as a fundamental component of an automated record, with the end goal of generating valid, reliable data on nursing services and client outcomes. However, few successful applications of standardized nursing language for practice standards and data generation exist in the literature. A joint practice-and-data quality project based on standardized nursing language in an automated platform was undertaken by four local public health departments. Outcomes of this project included articulation of standards for nursing practice and creation and implementation of a sound data quality infrastructure for nursing documentation of client assessments, service delivery information, and client outcomes.