1. Welcome to the National User Group Meeting Please remember to place your phone on mute and do NOT place your phone on hold.

2. National User Group Meeting December 1, from 10:00– 11:30 a.m. Agenda 10:00 a.m. Welcome and introduction of participants – Norah 10:10 a.m. Champ Software Contest Winners One Month Contest – Delaware General Health District, OH Three Month Contest – Richland Co Health Depart, ND 10:40 a.m.Knowledge Base Content 11:15 a.m. Discussion and Sharing 11:30 a.m. Adjourn

3. Shelia L. Hiddleson, RN, MS Health Commissioner Delaware General Health District 1 and 3 West Winter Street * P O Box 570 Delaware, Ohio 43015-0570 Delawarehealth@delawarehealth.org Outcome data and summary for Nightingale Notes One Month Project: Area of Focus: Newborn Home Visiting Program

4. Program Summary The Delaware General Health District (DGHD) recently initiated a Newborn Home Visit Program. This program is offered free of charge to all mothers and fathers of newborns, including adopted and foster infants, living in Delaware County. Parents who sign up for the program receive an in-home visit by a qualified Delaware General Health District registered nurse. Community goals for this program include: – Improve home environment safety for infants and mothers. – Identify maternal and infant health issues needing medical attention (e.g. feeding issues, maternal infections, and post-partum depression). – Identify risk factors needing additional community resources for support of an optimal outcome for the mother and infant. – Provide essential health education and anticipatory guidance on infant safe sleep environment, nutrition, safety, growth and development, and routine preventive medical care including immunizations. – Prevent obesity for mother and child through education on the benefits of breastfeeding and healthy eating for mom. – Capture data to support the need for post-partum newborn home visits as a best practice for potential community program funders Since Sudden infant death syndrome (SIDS) is the leading cause of death for infants, and creating a safe sleep environment is proven to reduce the risk of SIDS, the Delaware General Health District is evaluating infants home sleep environments. At each Newborn Home Visit Program, our public health nurses conduct a pre and post KBS to assess the child’s home sleeping environment.

5. Data obtained from Nightingale Notes using the following criteria: Program is equal to Newborn Home Visiting Activity date is between 6/15/2015 and 7/15/2015 Age of client is less than 1 year Using these criteria, seven Newborn Home Visit Clients were identified that had two KBS entries documented for: Environmental/Residence-Living Area: Safe Sleep environment of Infant KBS on Surveillance; Teaching, Guidance & Counseling

6. Data obtained from Nightingale Notes using the following criteria: Program is equal to Newborn Home Visiting Activity date is between 6/15/2015 and 7/15/2015 Age of client is less than 1 year Those fitting these criteria are client numbers: 639, 741, 842, 847, 875, 914, and 992. Note: Client #’s 513 and 1037 are not included in this data. #513 only has one documented KBS and # 1037 will be included in the 3 month study since the 2 nd KBS activity is dated 7/23.

7. Data obtained from Nightingale Notes using the following criteria: KBSAvg. Pre-test scoreAvg. Post-test scoreIncrease Knowledge3.34.41.1 Behavior3.94.91.0 Status4.04.70.7 In addition, a report was generated to show the number of community referrals provided to address other identified client needs and are as follows: Number of clients given referrals: 6 Number referred to WIC: 3 Number referred to postpartum support group: 3 Number referred to community resources: 1

8. Conclusion: The KBS function of Nightingale Notes allowed the Delaware General Health District an easy, accessible way to evaluate our Newborn Home Visit Program. The results of this report shows that our public health nurses were able to better educate parents on how to create a safer home sleep environment for their infant thus ensuring better outcomes in the prevention of SIDS as a result of the program.

9. Discussion: How did you choose your project? Newborn home visits were restarted after a 7 year lapse (due to grant funding cuts), because the hospital also had stopped offering NBHV’s. We believed that an in-home RN visit would benefit both mother and infant. Ohio has a high infant mortality rate and we wanted to ensure that problems or issues were picked up quickly, that parents were educated on providing a safe sleep environment (having a safe sleep environment reduces the risk of SIDS). We also assessed for postpartum depression, the importance of fully immunizing children on-time, and provided referrals to community resources to meet the needs of the family. We also wanted to capture data to be able to show a need for this program in grant funding requests.

10. Discussion: What steps did you take to capture the information? We wrote two pathways that mirrored out Mom’s post-partum assessment and our newborn assessment. In the pathways we included all of the items we wanted to be able to run reports on so we could easily pull the data. We also decided which interventions of the home visit we wanted to measure with the KBS. For the one-month we did a KBS for safe sleep environment and for the three month we did a KBS for safe sleep environment and maternal post-partum depression. After the first couple of weeks we ran preliminary data and found that we needed to edit our pathway to include specific information that we wanted to capture with their own checkbox.

11. Discussion: What were your findings? We found that most parents had not been educated on what a safe sleep environment looked like. Our KBS showed that parents had significant learning and the sleep environment was made safer because of the education provided by the RN. We also found that some parents could not afford to provide a safe sleep environment and through a small grant, we were able to purchase Pack-N-Plays through Cribs for Kids. If the family needed a Crib one was provided quickly.

12. Discussion: What did you learn from the project? We learned the value of doing the KBS to provide quantitative data on positive outcomes of our program to show our Board of Health, community partners, and potential funders.

13. Discussion: From your findings did it validate what you already knew? We were pretty sure that the program was a needed service, but now we have data that provides validation. We were also amazed at how fast you can produce a comprehensive report! It has gotten us excited about Nightingale Notes and using the Omaha System for charting.

14. Discussion: Will your findings change your practice? One of the problems we have been having is getting birthing hospitals to be consistent in referring all moms for a NBHV. The hospital staff was making judgments based on income level as to who might need a NBHV—our data shows that parents in all income levels can benefit from a NBHV. We are now able to educate the social workers and the nurses from the hospitals on the value of the program to increase referrals.

15. Discussion: What would you do differently? We will be looking at editing our existing pathways and building new pathways keeping in mind what data we need to extract from them. Originally we just created pathways based on the assessment form that we already were using. We found that we weren’t always capturing outcomes and the data that we needed.

16. Delaware General Health District 1-3 W. Winter St. P.O. Box 570 Delaware OH 43015 740-203-2036 Joyce Richmond, RN, BS Director of Nursing

29. Knowledge Base: What’s New? New Training Resources Topical Webinars –recordings embedded right in the website User Group Recordings Release Overview Meetings

30. Discussion and Sharing:

31. Next Topical Webinar! Stay tuned for the New Year for our upcoming Topical Webinars!

32. Thank You for Participating & Attending Today! Next National User Group Meeting: Tuesday, March 1 from 10-11:30CT If you have any suggestions for our next National User Group meeting please email your ideas to: Norah Savard at norah.savard@champsoftware.comnorah.savard@champsoftware.com