RCHC Community Project Abstracts

Back to subject search page or search by preceptor site Lane County’s Struggle to Help Newborns and Mothers: An Emerging Problem with Promising Solutions Project Date: 2/12/2007 The process of nurturing an uncomplicated pregnancy, delivering a viable and healthy baby, and maintaining the normal growth and maturation of the baby and health of the mother has been the focus of the field of obstetrics and one of the most important medical issues in the United States and worldwide. Previous research has shown that Lane County has the highest perinatal and neonatal mortality rates in the state of Oregon and ranks among the highest in the nation. This study attempted to identify and shed light on the challenges that face mothers and babies in Lane County which contribute to the high perinatal and neonatal mortality rates and evaluate the effectiveness and availability of resources and regional public health institutions that can best serve this specific health care population. The population studied was the female patients who came to the Junction City Medical Clinic along with their newborns for well-child examinations. Each of these patients was asked about challenges that they had faced with regard to receiving adequate prenatal care during their pregnancies. Using patient-provided information further outside research, and dataset analysis, a patient questionnaire was designed to help the expecting mother from Lane County to assess her prenatal needs and to help her better identify the prenatal care resources available to her. The ultimate goal is to be able to better unify and collect these resources and organize them into a neat and convenient handout that provides patient the information they need and also educates them on the necessary prenatal topics. This handout will be made available to Lane County Public Health Department and to the Junction City Medical Clinic to distribute to patients who need prenatal care and health care for both mother and baby after delivery. Expanding Anticipatory Guidance in Columbia County Project Date: 1/1/2007 Columbia County has seen a significant increase in recent years in the number of single mothers with children younger than 5 living below the poverty level. Many parents in the community lack resources and access to parenting information. Various programs in the county provide services to young mothers and children, including Head Start, Healthy Start, and WIC. In addition, the OHSU Family Medicine Clinic at Scappoose serves patients primarily from Scappoose and St. Helens, the largest towns in the county. Providers in all facilities expressed a need for simple hand-outs to give to parents with anticipatory guidance and advice about parenting for children of different ages. Handouts were created with guidance for all well-child visits from ages 2 weeks to 5 years. Guidelines focused on age-specific information about nutrition, development, and safety. The materials were distributed to providers at the Scappoose Clinic and program directors for Columbia County Head Start, Healthy Start, and Columbia County Department of Public Health, which coordinates the county WIC program. Implementing Nurse Visits for Prenatal Care in Scappoose Family Medicine Rural Health Clinic Project Date: 10/16/2006 Prenatal care provides benefits of reduced incidence of low and very low birth weight babies, reduction of infant mortality, and decreased rates of preventable maternal complications during delivery. In Columbia County, there are two main sources of prenatal care, only one of which is provided by MDs. The goal of this project was to help to implement the vision of restructuring the way prenatal care is given at Scappoose Family Medicine Clinic to include once a trimester visits to a trained nurse who will discuss things to expect in the upcoming trimester, answer questions about common pregnancy complaints, and provide a packet of resources specially designed for the current trimester. Increasing Access to Lactation Services in a Low-Income Population: Developing an Outpatient Program Project Date: 3/20/2006 There are considerable barriers to breastfeeding for low-income, predominantly Latina women in Salem, OR. While lactation services are available to women during their postpartum hospital stay, most outpatient options are inaccessible for these patients. Following a model similar to that of a local pediatric clinic, West Salem Clinic, a federally qualified health center, would like to determine the feasibility of providing outpatient lactation services. Grant money would be needed to offset costs of this program. Additionally, West Salem Clinic should increase the volume of newborns seen to improve the viability of the program. Emergency Room Utilization in Harney County Project Date: 2/13/2006 Proper utilization of emergency departments in rural communities is important due to the shortage of local doctors and lack of a full-time emergency medicine (EM) physician. When the same physician is caring for patients in clinic while on-call in the emergency department (ED), it is important that patients be using the emergency room (ER) for urgent, acute issues. I chose to investigate the patterns of emergency medicine use in Harney County, population 7000, over a 2-month interval. I looked at principal diagnosis and whether the patient was admitted to the hospital, put on a 23-hour observation, transferred to another hospital, or discharged directly from the ED. I designed graphs looking at top 10 diagnoses, common system-based diagnoses and outcome in terms of discharge. I discovered that the majority of patients in Harney County are utilizing the emergency room for urgent or acute issues. Principal diagnoses appear to be typical of any emergency department. Lastly, I identified some of the common diagnoses that probably did not warrant an ER visit and what we can do in the future to help decrease the volume and costs in the ED. Barriers to Breastfeeding in a Low-Income, Predominantly Hispanic Community. Project Date: 9/12/2005 Despite the clinical evidence that supports the nutritional and developmental advantages to breastfeeding, the initiation, duration and exclusivity of breastfeeding remain low in the United States. The barriers that exist for women wishing to breastfeed are multifactoral, especially for low income mothers. However, by providing support and education, primary care physicians are in a pivotal position to address breastfeeding complications during routine examinations and potentially increase breastfeeding rates. An analysis was conducted to assess what breastfeeding difficulties exist for mothers at the West Salem Clinic. Patients delivering within the last six months were interviewed about their desire to breastfeed, the support they received and complications they experienced. Problems such as perceived decrease in milk supply, sore or cracked nipples or latching difficulties were consistent with other published reports. However, barriers unique to this population included cultural perceptions, financial and educational obstructions as well as language difficulties. By identifying the obstacles that exist for breastfeeding mothers, primary care providers might be better able to offer more continued support, thereby improve breastfeeding outcomes. Newborn Discharge Packet for Siskiyou Pediatric Clinic Patients Project Date: 9/13/2004 This project was designed to provide a brochure of important information for parents of newborns at the Three Rivers Community Hospital in Grants Pass, OR. Multiple resources exist to provide support and advice to parents of newborn infants. However, most of these require the use of internet access or the financial ability to purchase parenting books. Pediatricians supply many free handouts that parents can collect, but many of the parents I talked with indicated a desire for a quick reference source that gave them bulleted points outlining key information and guiding them in when to access their pediatrician. Interviews were conducted with new parents, nurses in the Family Birth Center and the pediatricians at Siskiyou Pediatric Clinic in Grants Pass, OR in an attempt to determine the most important topics to include and what the best format to present this information. A brochure format was believed to provide the best presentation of information for this community. Further data collection determined five main areas for the newborn brochure, including newborn safety, immunizations, well-child checks, local contact numbers and guidance on when a new parent should call the pediatrician. The product of this project is a brochure entitled "Newborn Information That Every Parent Needs to Get Started" that will be given to every parent in the Family Birth Center before discharge from the hospital. Breastfeeding in John Day and Grant County: Development of a Patient Handout to Encourage Breastfeeding Project Date: 9/29/2003 The advantages of breastfeeding are well documented in scientific literature, and it is apparent that it is in the best interests of public health to encourage breastfeeding. The purpose of this project was to identify the resources available to residents of John Day and Grant County with regard to breastfeeding support, and to encourage breastfeeding through the use of a handout in the clinic. National and local statistics on breastfeeding were noted, as well as possible reasons that women quit breastfeeding. Benefits of breastfeeding were researched and summarized, and online and local resources were included in the flyer as well in an attempt to improve breastfeeding participation. The small numbers of women giving birth in Grant County made it unrealistic to determine the impact of the handout during the rotation, but the handout was well received by clinic physicians and staff. Breast Feeding As A Possible Protective Factor In Children Diagnosed With ADHD. Project Date: 1/2/2002 This study sought to look at a possible connection between the lack of breastfeeding and the diagnosis of ADHD, in the Treasure Valley Pediatric Clinic in Ontario, Oregon. The design is retrospective case control study involving all patients being seen for ADHD in the clinic. When charts were reviewed in the ADHD population, 39% of that population received a diet containing breast milk within the first six months of life, as compared to 67% in the control population. This report discusses the protective effects of breastfeeding versus non-breastfeeding and how this might affect the diagnosis of ADHD. Back to subject search page or search by preceptor site