Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #117853

Barbara J. Kruger, PhD, MPH, RN, College of Health, School of Nursing, University of North Florida, 4567 St. Johns Bluff Road South, Jacksonville, FL 32224, 904-472-7261, bkruger@unf.edu

Background: Care coordination is a key ingredient in how services are delivered to families of children with special health care needs (CSHCN) and it is also identified as a cross-cutting issue to transform health care quality. However, the process is not clearly operationalized in many studies and this impedes research.

Objective: To describe the work of nurses who provide care coordination to families of CSHCN.

Methods: A mixed-methods design was used to collect data from six registered nurses (three in primary care and three in the Title V office). A quantitative tool developed with the nurses captured “episodes” of coordination over two months in conjunction with analysis of computerized documentation. Audio tapes of observational (5 hr.) in-depth interviews with each nurse and two focus groups were transcribed verbatim. Researcher journaling accompanied collection and analysis. Benners (1984) conceptual framework was used to guide analysis.

Conclusions: Preliminary results suggest that the policy context affects what and how nurses coordinate care. The scope of practice is holistic, anticipatory, and iterative. Nurses are advocates for families and stewards of state resources. They build relationships, synthesize and interpret information, teach/coach, support, monitor, manage crises, connect families with resources and ensure quality. Their talk is of empowerment, self-help, respect and caring.

Benner, P. (1984). From novice to expert: Excellence and power in clinical nursing practice. CA: Addison-Wesley.

Learning Objectives: