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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
4276.0: Tuesday, December 13, 2005 - Board 9

Abstract #117853

Community-based care coordination for children with special health care needs: What nurses do

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:

  • At the conclusion of the session, the participant (learner) will be able to

    Presenting author's disclosure statement:

    I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

    Systems of Care for Children and Youth with Special Health Care Needs

    The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA