Presentation is loading. Please wait.

Presentation is loading. Please wait.

FNP IN Great Yarmouth and Waveney

Similar presentations

Presentation on theme: "FNP IN Great Yarmouth and Waveney"— Presentation transcript:

1 Family Nurse Partnership programme in England: - replicating an evidenced based programme

2 FNP IN Great Yarmouth and Waveney
The Team: Nicole Hobson - supervisor Cheryl Hale – family nurse Jayne England – family nurse Juliet Keating – family nurse Lisa Lorenzen – family nurse Diane Bryant – family nurse Rachel Bradford – family nurse Emma Langdale - administrator

3 “Changing the world – one baby at a time”

4 Family Nurse Partnership Programme
Developed in US over 30 years of rigorous research and evaluation that shows positive results from pregnancy through to 19 years; Licensed programme with fidelity measures to ensure replication of original research; Preventive, intensive, structured home visiting programme; Offered to first time mothers under 20 years from early pregnancy until child 2 years ; Testing in England since April 07 in the 55 UK sites. Government commitment to double the expansion of FNP to 13,000 families by April 2015; Large scale RCT started April 09 with 18 sites (RCT results due April 2013). Preventive in that it works with both the client in pregnancy Intensive- with regards the visiting programme as well as the depth of the visits Structured in that we use guidelines for each visit to give the nurse and the client structure 4

5 Consistent results across 3 trials in USA
Improvements in women’s antenatal health Reductions in children’s injuries Fewer subsequent pregnancies Greater intervals between births Increases in fathers’ involvement Increases in employment Reductions in welfare dependency Reduced substance use initiation and later problems Improvements in school readiness

6 Early evaluation suggests FNP can be successfully transferred to England
FNP can be implemented successfully in England – programme can be delivered with fidelity to the US model The programme is welcomed by hard to reach families and reaches clients who are likely to benefit most Successfully engages with hard to reach families from early in their pregnancy – 87% of women offered programme enrol, high levels of retention through to end of programme Engagement with fathers is good.

7 Visit Structure: Weekly, fortnightly, monthly home visits from early pregnancy until the child is 2 years old Each visit includes structured conversations and activities to improve self efficacy, change behaviour and build attachment

8 What families receive : Approach
Therapeutic alliance - being ‘with’ the client, inviting the client/family to work on the difficult issues; Focus on bonding, attachment and emotional availability of caregivers; Utilises client’s primary motivation as expectant mother; Strength based, positive and hopeful – belief in clients strengths, talents, skills and resources, expectation that client will succeed; Using motivational interviewing skills to explore ambivalence and structure conversations about change and personal growth without coercion; Respectful agenda matching to align energy from clients’ aspirations with programme goals; Setting goals with small steps and positive feedback. The relationship between the nurse and the family lies at the heart of the programme

9 FNP turns around life chances and breaks intergenerational disadvantage
By taking a whole family approach and working on all the inter-related factors that lead to and compound disadvantage, poverty and poor outcomes for mother and child Parents envisage a different possibility, a new story of themselves understanding of their lives and futures They become a dependable figure for their baby and better able to meet their emotional social and developmental needs Better health related behaviours Improvements in the mothers life course – subsequent pregnancies, education , training and work

10 Cost savings from FNP for 100 families at a cost of £3000/yr/family could be:
If we prevent: 1 day in hospital for 10 pregnant women we save £10,000 1 overnight stay in SCUB for 10 babies we save £4,500 5 emergency hospital admission we save £3,750 5 children going into foster care it will save £135,000 a year The need for 10 core assessments by children’s social care we save £6,500 Poor outcomes for 50 children with multiple disadvantages we could help save local over £5m by the time these children are 16 10 young women staying in NEET and getting work we can save the state £70,000 in benefits alone 80 children having poor literacy and numeracy we could help save society up to £5m over a lifetime

11 Key points: FNP is…. Licensed Structured Interactive
Grounded in theory Strength based Research based Based on a therapeutic relationship

12 Vulnerabilities Teenage parents Adolescent brain / expectations
Complex life histories Lack of positive role models Socially isolated Juggling parenthood and schooling Pre-judged – stigmatising society Intergeneration disadvantage and poverty So what makes the FNP clients more vulnerable than the rest of our clients within Universal Services? Teenage parents – they are dealing with huge brain changes, their frontal cortex is not yet developed, they find it difficult to interpret emotions, they are full of hormonal changes themselves…they are teenagers about to become parents, with the expectations that parenthood brings….as well as dealing with parental clashes, boyfriend troubles, parenthood… stigma’s…………and trying to be the best mum they can!

13 Professional views on teenage parents from market place event October 2011
Irresponsible All get a flat Uneducated Challenging Use pregnancy to get benefits They are kids themselves Lead onto next slide This is not unusual… Here is a synophsis of a text received from a teacher about one of my clients…

14 Our findings Stroppy Difficult Unreliable Challenging Rude Demanding
Ego centric Selfish Will not answer telephones…texts only Lose phones / change numbers constantly And many more……..

15 HOWEVER WHY? Can anyone shout any reason why teenagers are like this?

16 Some reasons why……… Never being able to trust No role models
Domestic violence Physical abuse Sexual abuse Emotional abuse Low expectations Low self esteem

17 Reasons why continued……
Depression – mental health problems History of social services in own childhood History of drug and alcohol abuse (and in own childhoods) Highly negative and punitive parenting Trauma

18 Case history 15 years old 26/40 gestation
Lives with mum and younger brother. Dad in prison (no contact for approx 12 years). Mum recovering heroin user. Neglectful and physically abusive childhood. Poor school attendance. Services ‘throughout’ life. Separated from FOC (he wants involvement with baby).

19 Questions What are the risks? What are the strengths?

20 Trust Why is trust important for a mother and child?

21 Need Signals comfort Signals discomfort Satisfaction of need TRUST
SECURITY LOVE Signals discomfort Satisfaction of need

22 Olds (1993) ‘...a significant proportion of some of the most difficult and costly problems faced by young children and parents today, are a direct consequence of adverse maternal health related behaviours during pregnancy, dysfunctional infant care-giving, and stressful environmental conditions that interfere with parental and family functioning.’


Download ppt "FNP IN Great Yarmouth and Waveney"

Similar presentations

Ads by Google