Columbus County Health Department Postpartum/Newborn Home Visits (PP/NB)
Policies and Procedures
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Policy Title:
Post Partum/ Newborn Home Visits
Program Area:
Maternal Health, Maternal Care Coordinator
Policy Identifier:
(optional)
Maternal Health:
Postpartum Follow Up
Approval Date:
Effective Date:
4/29/09
April 29th 2009
April 29th 2009
Revision
Date(s):
Approved by:
Columbus County Board Of Health
Approved by:
Hilda Memory RN, BS, MSHA, Director of Nursing
11/19/2009
Purpose:
Periodic Post Partum/Newborn Nurse (PP/NB) home visits are made to assess the health
status of new mothers and infants in their home environment, enhance knowledge,
provide support and make referrals as needed. This will allow for early intervention for
timely referrals of problems, counseling and teaching to reduce infant mortality/morbidity
and potential maternal postpartum complications.
Ensure post partum/ family planning follow up care for those patients that received no
prenatal care thus promoting Women’s Health and decreasing unplanned and or
unwanted pregnancies.
Definitions:
Columbus County Health Department Postpartum Newborn nurse will make home
visits as indicated to assess the well being of the mother and or child with emphasis
on preventive services and anticipatory guidance.
Maternal Care Coordinator (MCC) will follow up with those mothers who failed to
access prenatal care during their pregnancy to make sure they receive postpartum
follow up and family planning as well as referrals to appropriate programs
Responsibilities:
Postpartum Newborn Nurse (PHN III), Maternal Care Coordinator, Supervising Nurse Practitioner
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Columbus County Health Department Postpartum/Newborn Home Visits (PP/NB)
Policies and Procedures
Procedures:
The Postpartum Newborn Nurse home visit as part of the preventive healthcare
system includes the following:

Assessment of health of postpartum woman and newborn by a PHN.

Contributes to a family’s sense of control and participation by meeting them in
their home; also provides opportunity for assessment of home environment.

Provides education, information, support, anticipatory guidance, and enhances
parenting skills.

Makes referrals to other service providers as necessary and provide resource
information.

Promotes discussion of contraceptive needs or methods to enhance spacing of
subsequent pregnancies and encourage women to complete her six week
postpartum visit.

The home visit should be made on selected new mothers and newborn infants
within two weeks after discharge.

Participants for home visits will be made by referral from:
1. Health Department: Maternity Clinic, High Risk Clinic, MD, CNM, NP, RN, or
MCC
2. Postpartum newborn wards at Columbus Regional Health Care, or other
hospitals.
3. Private physicians
4. Self-referral or others
Visits may be made to the following:
1. High risk pregnancies
2. Multiple births (twins)
3. Teen pregnancies
4. First time mothers
5. Special situations/home problems
6. Single parents
7. Substance abusers
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Columbus County Health Department Postpartum/Newborn Home Visits (PP/NB)
Policies and Procedures

Patients may be informed of visit at about 36 week’s gestation.
Forms to be used
1. Postpartum Home Visit Assessment DHHS 3943
http://whb.ncpublichealth.com/Forms/3943_Home_PostNatal_WEB_060410
.pdf
2. Newborn Home Visit Assessment DHHS 3944
http://www.ncdhhs.gov/dph/wch/lhd/cyforms.htm
3. Nurses Notes DEHNR 2803
http://www.ncpublichealth.com/alcs/pohr/DHHS-2803-Notes.pdf
4. Others as appropriate (See DHHS forms link above)

The referrals can be initiated by anyone and forwarded to the Health Department
to the Postpartum Newborn nurse by mail, pick up by clerk, etc.
The Postpartum Newborn Nurse will:
1. Review the referrals and coordinate with the Child Services Coordinator
(CSC) for assignments of patients for visits.
2. Screen health records prior to making visits to identify problems, urgency,
and geographic location.
3. Telephone patient if possible about impending visit.
4. Make Home Visit using the Postpartum Newborn Home Visit Protocols:
A. Telephone patient to schedule home visit.
B. Mail letters for contact regarding visit.
C. Home visit attempts if all other attempts have failed.
5. Document home visit in records, make referrals, copy reports, etc. as
needed.
Miscellaneous Information:

If the Child Services Coordinator (CSC) is to visit the family and is an RN, she
may be able to perform both the Postpartum and Newborn assessment. If the
CSC anticipates a delay in infant discharge from the hospital, the Postpartum
Newborn Nurse may make the postpartum visit.

The maternity records need to be available for screening prior to visit.
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Columbus County Health Department Postpartum/Newborn Home Visits (PP/NB)
Policies and Procedures
A. Visiting nurse needs to know discharge instruction given by hospital.
B. Equipment to have available:
1) County automobile if possible, sign out ahead of time
2) Blood pressure cuff and stethoscope
3) Thermometer (may use mothers)
4) Baby scale
5) Hand wipes or antibiotic hand rinse
6) Tape measure
7) Required forms
8) Immunization information/Health Check handout
9) Other handouts
Postpartum Nurses must have the following education qualifications:

Graduation from a four-year college or university with a B.S. Degree in Nursing
which includes a Public Health Nursing rotation and one year of Public Health
Nursing experience; or graduation from an accredited school of professional
nursing and two years of professional nursing experience including one year in
Public Health; or an equivalent combination of education and experience.

He/She must have a current license to practice as a Registered Nurse in North
Carolina by the North Carolina Board of Nursing.

Postpartum/Newborn Nurses will be evaluated by Nursing Supervisor or program
coordinator periodically through direct observation and by monitoring of statistical
program data, reports and record audit findings.

Employee will perform other duties as assigned by the nursing supervisor when
necessary to provide more effective public health services. Duties may include
but are not limited to:
1. Assignments in other Maternal Child Health Programs within the agency.
2. Participation in staffing of disaster shelter.
3. Participation in administering flu shot in the flu clinic
4. Cover any of the Health Department Clinics as directed.
Postpartum Follow Care for Patients With No Prenatal Care
1. All mothers that receive no prenatal care will be referred to Columbus County
Health Department by the Physician. If the patient receives a cesarean section
she will be followed up in the Physician’s office.
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Columbus County Health Department Postpartum/Newborn Home Visits (PP/NB)
Policies and Procedures
2. All new mothers receive a copy of Columbus County Health Departments
Postpartum Information Sheets by hospital staff. This includes Post Partum
Follow Up, Family Planning, Women/, Infant and Children (WIC) nutritional
services, Maternal Care Coordination, Child Services Coordinator (CSC), and
Pediatrics. Phone number and extensions are included. See link below or go to
the maternity tools folder.
Post Partum Information Sheet
3. The Physicians will place the yellow copy of the delivery summary in the MCC
mail box at the hospital.
4. The MCC will pick up her mail at the hospital and a copy of all the birth
certificates with information regarding no prenatal care three times a week.
5. MCC will review the summary sheets and birth certificates and monitor for
those with no prenatal care and then take the birth certificated to Vital Record to
be processed.
6. MCC will attempt to contact the new mother and check on her status and follow
up care and assist with any needs identified (scheduling, referrals etc.)
Closure
If the patient is not receiving MCC services then the PHN/Home Visit Nurse will be
responsible for completion of the Pregnancy Outcome Summary and submission
within 30 days from the date services were discontinued.
http://whb.ncpublichealth.com/Forms/pregnancyoutcomesummarydhhst1514.pdf
Laws and Rules:
Title X
Reference(s):
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