Child care health consultation: an ecological model.

ISSUES AND PURPOSE: To present an ecological model of child care health consultation that defines the role of the health consultant as a resource and advocate within child care programs, as well as a supportive link among families, child care providers, and the healthcare system. CONCLUSIONS: Nurses have provided health consultation to child care programs for more than 30 years and represent the majority of health consultants nationally. Pediatric nurses and advanced practice nurses are well prepared to shape and lead the development of this emerging role. PRACTICE IMPLICATIONS: With expertise in caring for children, understanding families, and care across systems, pediatric nurses and advanced practice nurses should engage in current state and national efforts to develop child care health consultants.

Child care health consultation: the Connecticut experience.

OBJECTIVES: The quality of child care is of increasing national concern. Federal initiatives are recommending child care health consultation to promote healthy, safe, and developmentally appropriate care. However, few studies have investigated the implementation of this recommendation. The purpose of this study was to explore the experience of Connecticut child care center directors and their health consultants who were engaged in mandated, weekly, on-site health consultation. METHODS: One hundred Connecticut child care center directors and their health consultants participated in a mailed, self-administered survey. The centers were stratified by region and selected by random probability sampling. Descriptive analyses of the data examined the perspectives of both groups. RESULTS: Eighty-four percent of the child care center directors reported that health consultation visits were important or very important for the management of their programs. Eighty-one percent of the health consultants believed that their directors considered the visits important or very important. The reported tasks of the health consultants were consistent with regulatory requirements. Cost was cited as a factor that negatively influenced access to services by at least 37% of the director sample. Demographics of the sample, description of the role, and recommendations by directors and health consultants are included. CONCLUSIONS: Health consultation visits were highly valued among this sample as an effective means of promoting children's health and development in child care centers. Future initiatives should promote child care health consultation through training, infrastructure development, and funding of health consultation services.

Sick child care: a developmental perspective.

Sick child care programs provide an alternative when mildly ill children are excluded from their regular child care program. Although infectious disease implications have been addressed, little attention has been directed to the potentially negative consequences of care by unfamiliar providers in unfamiliar settings. Appropriate options for care during illness must be based not only on the physical but the emotional and developmental needs of young children.

Health services in child day-care centers: a survey.

This descriptive study examined the types of health services provided by 49 child day-care centers. A questionnaire was used to collect data from the day-care center directors. The study explored the existing health services and education and training for children, parents, and staff. The study also explored services that the centers would like to offer. Fewer than 50% of the day-care centers offered more than three primary care health services for children. The provision of health education and training for children, parents, and staff varied widely, but these services were offered more frequently than primary care health services. Directors were very interested in offering more comprehensive primary care services, options for sick-child care, and education and training in the areas of safety, disease prevention and management, child development, and availability of community resources. Directors cited infectious disease prevention and management, sick-child care options, and staff training as their most pressing health issues. Recommendations are made for improving the delivery of health services to day-care centers.

Integrating handicapped and chronically ill children into day care centers.

The lack of sufficient day care programs for chronically ill and handicapped children is a serious dilemma for families. A survey of day care center directors suggests that child care providers need resources, including health care support, as an essential element for expanding day care services for special needs children.

Day care center directors' perceptions of the nurse consultant's role.

Forty-nine day care center directors were surveyed to examine their perceptions of the nurse consultant's role. Findings revealed the directors were positive but indiscriminate about the scope of nursing practice. Many respondents were unable to identify the nurse consultant's educational background or specialization. Without an accurate understanding of nurses' abilities, day care centers may not use the full range of health services that nurses offer.