Validating the safety of nurse-health advocate services

Prior to promoting the use of community health care advocates for home visi ts, it is necessary to evaluate their ability to safely screen for health p roblems. This study examined trained maternal-child health advocates (MCHAs ) who, supervised by professional nurses, conducted maternal-child home vis its consisting of health promotion and problem identification. Problems ide ntified by MCHAs were compared to problems identified by professional, vali dating nurses, who were not part of the service project, on hypothetical ho me visit situations and during 213 duplicate home visits. There were no sig nificant differences between MCHAs and professional nurses in their identif ications of infant health problems, infant health care deficits, other fami ly members' health problems, prenatal care deficits, emotional problems, an d substance abuse on either the hypothetical home visits or the duplicate h ome visits. The validating nurses identified significantly more women's hea lth problems (p = 0.01) and women's health care deficits (p = 0.02) than th e MCHAs on the duplicate home visits. These findings validate the safety of using the model of trained community health advocates teamed with register ed nurses to screen for infant health problems during home visits.