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NSF:Issues relating to early transfer for the surgical neonate. RCN March 2006. Purpose of NSF for Children 2004. Increase quality of care Decrease variations in care delivery Partnership with health, social care and education. Specific aim. Care will be Quicker and easier to access
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NSF:Issues relating to early transfer for the surgical neonate RCN March 2006
Purpose of NSF for Children 2004 • Increase quality of care • Decrease variations in care delivery • Partnership with health, social care and education
Specific aim Care will be • Quicker and easier to access • More closely matched to individual needs • Better co-ordination between professionals
Specific aim (cont) • Involving parents in care and decisions • Better at achieving good results and outcomes • More closely reflect what children and young people want
NSF (Children) • ‘all children and young people achieve optimum health and well being and are supported in achieving their potential’
Background • Strong links – socio-economic disadvantage in the health of children and subsequent health as adults
Background • Child poverty rates highest in wealthy nations (UNICEF 2000) • In part, full time worker earns less than 2/3rds national average wage • High proportion of households in which no adult is working (UNICEF 2000, Perry 2001)
Background • Pakistani and Bangladeshi most disadvantaged ethnic minority group • Travellers, refugees, asylum seekers • Low paid, insecure jobs, unemployment
Ethnicity • Worst health are Pakistani and Bangladeshi men • Refugee children, ¼ are asylum seekers who have been exposed to violence and multiple losses • Elder children better language skills • 25% of children 3x national average of psychological disturbance
Health inequalities • Eighth Report of the House of Commons Select Committee of Health (2003) • Need more care for mothers and baby in pregnancy • Early postnatal influence of later development in health
Health inequalities • Links between childhood disadvantage and health later in life • Health of infant – continued legacy later in life • Particularly birth weight/ Ht • Low income, overcrowding- affects relationships in family life
Family • Family structures, changing labour markets • Where both parents not working- affects child in the future- related to chronic illness
Housing • Where housing is an issue • Increased incidents/accidents/ headaches/ respiratory and gastro-intestinal problems
Gender • Females, usually guardian of the health of the baby • Most vulnerable • Depression/ stress
Role of the Nurse Consultant for Neonatal Surgery • Enable transfer of baby from the main surgical centre to the local hospital near the family home
Family • Local services • Visiting • Financial expenditure • Child care • Building relationships
Professionals • Teaching / Education of nursing/ medical and PAM’s • Communication • CCN, H/V, G/P, other
Clinical practice • Audit and Research • Feedback • Changing practice
Issues relating to early transfer • Increased numbers transferred • Resources • Different protocols and guidelines • Investigations • Dietetics/ stoma resources