TY - JOUR
T1 - Implementation and refinement of a community health nurse model of support for people experiencing homelessness in Australia
T2 - A collaborative approach
AU - Goeman, DIanne
AU - Howard, Jane
AU - Ogrin, Rajna
N1 - Funding Information:
This collaborative CHN model of support for people at risk of or experiencing homelessness facilitated engagement with health and community services and participation in social activities. It also addressed several service gaps and assisted health professionals, including general practitioners, psychiatrists and psychologists, in their engagement and delivery of care to this very complex client group. We have articulated the three key components required to implement a culturally sensitive CHN role: a practice framework structure; detail of what the CHN role entails and a description of the attributes, skills and knowledge required to undertake the role. As the concepts of the CHN model are universal, there is potential for them to be applied across different contexts (to meet local populations and geographical needs) as well as service sectors. We would like to acknowledge Theresa Swanborough, former manager of the Homeless Persons Program (HPP), the contribution of the members of the project reference group for their valuable feedback on the HPP model throughout the evaluation, their willingness to participate in interviews and their input in regard to mapping of local services. Twitter @Rajna_O Contributors DG and RO co-designed the data collection tools and co-wrote the statistical analysis plan. DG monitored and supported data collection for the whole of the trial. DG and JH undertook data collection, data entry and cleaned the data. All authors contributed to analysing the data and undertook the final drafting of the article, revised it critically for important intellectual content, read and approved the final version of the report and accept accountability for all aspects of the work. RO is the corresponding author. Funding This work was supported by funding from Gandel Philanthropy. Competing interests None declared. Patient consent for publication Not required. Ethics approval Ethics approval to conduct the study was obtained from the organisations’ standing Human Research Ethics Committee project number 147. Provenance and peer review Not commissioned; externally peer reviewed. Data availability statement Data are available upon reasonable request.
Publisher Copyright:
© © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2019/11
Y1 - 2019/11
N2 - Objective To implement, refine and evaluate an assertive community health nurse (CHN) model of support for people experiencing or at risk of homelessness that aims to improve their access to health and social care services. Methods Participants were recruited between 30 August 2013 and 31 October 2015, including clients residing in a Victorian southern Melbourne metropolitan suburb, who registered with the CHN and stakeholders from local service provider organisations engaging with the CHN. A collaborative approach using demographic data collected from client records to identify need and measure the time clients took to engage and access services, qualitative data gathered during Stakeholder Advisory Group meetings and feedback from face-to-face interviews with service organisation representatives informed refinement of the CHN model. Results Thirty-nine clients (22 Female, mean age 50±11 years) participated. Clients engaged with services after an average of seven CHN visits. Eighteen clients independently accessed services after approximately 9 weeks, including medical and housing services. Client need and feedback from 20 stakeholders and three community nurses contributed to refining the model to ensure it met local needs and informed the necessary organisational framework, the CHN role and the attributes, knowledge and the skills required. Conclusion A collaborative CHN model of support for people at risk of or experiencing homelessness has been articulated. Evaluation of the role demonstrated increased client engagement with health and community services and social activities. Additionally, the CHN assisted other service providers in their delivery of care to this very complex client group.
AB - Objective To implement, refine and evaluate an assertive community health nurse (CHN) model of support for people experiencing or at risk of homelessness that aims to improve their access to health and social care services. Methods Participants were recruited between 30 August 2013 and 31 October 2015, including clients residing in a Victorian southern Melbourne metropolitan suburb, who registered with the CHN and stakeholders from local service provider organisations engaging with the CHN. A collaborative approach using demographic data collected from client records to identify need and measure the time clients took to engage and access services, qualitative data gathered during Stakeholder Advisory Group meetings and feedback from face-to-face interviews with service organisation representatives informed refinement of the CHN model. Results Thirty-nine clients (22 Female, mean age 50±11 years) participated. Clients engaged with services after an average of seven CHN visits. Eighteen clients independently accessed services after approximately 9 weeks, including medical and housing services. Client need and feedback from 20 stakeholders and three community nurses contributed to refining the model to ensure it met local needs and informed the necessary organisational framework, the CHN role and the attributes, knowledge and the skills required. Conclusion A collaborative CHN model of support for people at risk of or experiencing homelessness has been articulated. Evaluation of the role demonstrated increased client engagement with health and community services and social activities. Additionally, the CHN assisted other service providers in their delivery of care to this very complex client group.
KW - mental health
KW - organisation of health services
KW - primary care
KW - quality in health care
UR - https://www.scopus.com/pages/publications/85075282857
U2 - 10.1136/bmjopen-2019-030982
DO - 10.1136/bmjopen-2019-030982
M3 - Article
C2 - 31748297
AN - SCOPUS:85075282857
SN - 2044-6055
VL - 9
JO - BMJ Open
JF - BMJ Open
IS - 11
M1 - e030982
ER -
SDG 3 Good Health and Well-being
SDG 11 Sustainable Cities and Communities