Nurse-managed clinics provide access and improved health care

With the closing of hospitals, communities must work together to provide access to health care. This article reports on the development of a prenatal nurse-managed clinic, and its expansion to include a birth center, well-child/sick-child clinic, teen-pregnancy program and family planning clinic. The staff includes four certified nurse midwives, five pediatric nurse practitioners, a bilingual certified clinical nurse specialist and a bilingual social worker. Through the innovative management of these professionals, the incidences of low-birth-weight infants and pregnancy-induced hypertension have decreased. Since 1988 when the clinic first opened, first trimester enrollment has increased from 12 percent to 25 percent and third trimester enrollment has decreased from 44 percent to 21 percent because clients go to the clinic earlier. At the largest emergency room in the county, visits by Medicaid recipients under six years of age have decreased 27 percent from the time the pediatric clinic opened.