Validating the safety of nurse-health advocate services

Prior to promoting the use of community health care advocates for home visits, it is necessary to evaluate their ability to safely screen for health problems. This study examined trained maternal-child health advocates (MCHAs) who, supervised by professional nurses, conducted maternal-child home visits consisting of health promotion and problem identification. Problems identified by MCHAs were compared to problems identified by professional, validating nurses, who were not part of the service project, on hypothetical home visit situations and during 213 duplicate home visits. There were no significant differences between MCHAs and professional nurses in their identifications of infant health problems, infant health care deficits, other family members' health problems, prenatal care deficits, emotional problems, and substance abuse on either the hypothetical home visits or the duplicate home visits. The validating nurses identified significantly more women's health problems (p = 0.01) and women's health care deficits (p = 0.02) than the MCHAs on the duplicate home visits. These findings validate the safety of using the model of trained community health advocates teamed with registered nurses to screen for infant health problems during home visits.