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An innovative nurse practitioner-led service for children from families living in housing instability
Alicia Bell1, Yvonne K Parry1,2, Matthew Ankers1,2
1College of Nursing and Health Sciences, Flinders University of South Australia, GPO Box 2100, Adelaide5001, Australia.
Insights
Nurse practitioners (NPs) led a new primary care service for homeless children in Australia. The service identified common health issues like developmental delay and dental caries, highlighting the need for integrated care for vulnerable youth.
Area of Science:
- Pediatric Primary Care
- Public Health
- Social Determinants of Health
Background:
- Housing instability significantly impacts Australian children's health and education.
- Existing services inadequately address the needs of children facing housing insecurity.
- This study addresses a gap in care for vulnerable children in high-income countries.
Purpose of the Study:
- To design and evaluate an innovative nurse practitioner (NP)-led specialist primary care service.
- To assess the health needs of children experiencing housing instability.
- To identify barriers to accessing care for this population.
Main Methods:
- A standardized health assessment and referral process was implemented by NPs.
- Data collected included child demographics, identified conditions, and referral requirements.
- Case notes provided insights into barriers to care, such as cost and disengagement.
Main Results:
- Sixty-six children (aged 7 weeks to 16 years) were assessed.
- Common conditions included developmental delay, low immunization rates, and dental caries.
- Access to services was hindered by cost, disengagement, and the COVID-19 pandemic.
Conclusions:
- Embedding NPs within specialist homeless services is beneficial for vulnerable children.
- NPs' advanced skills are crucial for addressing the complex needs of this population.
- Integrated care models can improve health outcomes for children facing housing instability.
Aim:
To report on the design and results of an innovative nurse practitioner (NP)-led specialist primary care service for children facing housing instability.
Background:
During 2017-2018, children aged 0-14 years represented 23% of the total population receiving support from specialist homeless services in Australia. The impact of housing instability on Australian children is considerable, resulting in disengagement from social institutions including health and education, and poorer physical and mental health outcomes across the lifespan. Current services fail to adequately address health and educational needs of children facing housing insecurity. Research identifies similar circumstances for children in other high-income countries. This paper outlines the design, and reports on results of, an innovative NP-led primary care service for children facing housing instability introduced into three not-for-profit faith-based services in one Australian state.
Methods:
Between 2019 and 2021, 66 children of parents experiencing housing instability received standardized health assessment and referral where appropriate by a NP. Data from the standardized tool, such as condition and severity, were recorded to determine common conditions. In addition, comprehensive case notes recorded by the NP were used to understand potential causes of conditions, and referral needs, including potential barriers.
Findings:
The 66 children assessed were aged between 7 weeks to 16 years. Developmental delay, low immunization rates, and dental caries were the most common conditions identified. Access to appropriate services was inhibited by cost, disengagement, and COVID-19.
Conclusion:
Given their advanced skills and knowledge, embedding NPs in specialist homeless services is advantageous to help vulnerable children.
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