Increasing health literacy and appropriate health resource utilization of the homeless

Health care for the homeless is often only accessible via community clinics or emergency rooms. Many health needs are not "urgent" in nature but are deemed as such by the homeless since they do not have access to the most basic of health care items such as tweezers, wound care supplies or cold medicine. Wait times at community clinics for appointments as well as difficulty understanding how to access the system compound these issues. A Baccalaureate nursing program in Lafayette, Indiana, a mid-size urban area implemented a program to address these issues. Student nurses provide free basic health screenings, assessments, education and first aid to clients in the local Transitional Housing Program and day shelters under the supervision of faculty. Services are provided one to two times per month. Appointments are not required and care is available to anyone. The homeless view the students as nonthreatening and more caring, thus clients are often waiting in line when the students arrive, eager to speak with them and have assessments completed. Offerings initially included blood pressures, blood sugars, basic physical assessments and education. Over time, basic first aid has been added and more extensive assessments based on client need have been performed. Visits to the emergency room for concerns such as a splinter, the common cold and medication access have been reduced by student provision of these services and coordination with the local community health clinic resulting in improved access, compliance, health literacy and continuity of care for the clients.