| Learning Objective #1: Identify common health conditions of homeless children in a shelter-based clinic in Ohio, USA | |||
| Learning Objective #2: Identify obstacles to providing healthcare to homeless children in Ohio, USA |
Objective: The most rapidly increasing rates of homeless are for mothers/children representing 38% of the American homeless population. The objective of this project is to show that improved access to care and health outcomes of homeless children can be achieved with a pediatric nurse practitioner (PNP) practice at a shelter.
Design: A combined retrospective and prospective design is used to evaluate the PNP interventions on access to care and health outcomes of homeless children.
Population, Sample, Setting, Year: The population was recruited from ACCESS, a homeless shelter in Ohio serving 334 women and 244 children in 2000. The retrospective portion of this study was a convenience sample of 447 children between 1997-2001. The prospective portion was a convenience sample of 100 children in 2002.
Interventions/Outcome Variables: This project described the health conditions of homeless children, documented referrals, and evaluated interventions by following-up with clients/agencies. Data were collected to determine the effectiveness of PNP interventions on evidenced-based outcomes for children/families.
Method: A quantitative descriptive method was used.
Findings: The retrospective chart review indicated the most common health conditions of homeless children were as follows: missing immunizations (n=89), dental caries (n=71), respiratory conditions (n=52), vision problems (n=34), otits media (n=34), eczema (n=26), asthma (n=24), and developmental delay (n=22); 68 referrals were made. For children in the prospective study, 27% missing immunizations, 50% dental caries, 15% poor vision, 15% respiratory conditions and 86% were referred.
Conclusions: Dental caries were the most prevalent condition of children and the hardest to access providers. Efforts to follow-up with these children were difficult because families changed addresses and phone numbers.
Implications: Obstacles to providing healthcare included expired medical cards or lack of insurance, no money, no transportation, and difficulty accessing providers. Using a PNP at a shelter improved access to care and promoted better outcomes for children.
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Sigma Theta Tau International
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