Public+Health+Nursing

Contra Costa Public Health nurses are available for referral concerning the following patients:
 * Mom/Newborns with high risk conditions: preterm delivery, severe jaundice, poor lactation, poor wt gain, substance abuse, unstable housing etc
 * Postpartum Depression: Screened using the PHQ-4with a score of 6 or above or moderate-to-severe depression
 * Children (<18yo) who need help with follow-up for specialty care, mental health or developmental services. The PHN will assist with making sure the family follows through with seeking these services. If large volumes of referrals are received, clients may receive telephone f/up instead of home visits based on client need.

[|Public Health Nurse Referral.pdf] Last Update 7/15/11
 * Complete the form and fax to the Public Health Department at 925-313-6029
 * Please fax the most recent clinic note
 * Include up to date contact information or registration/face sheet

What PHNs cannot do:
 * They cannot provide home health services. They are able to provide assessments and to connect clients to needed services based on the assessment. They cannot do skilled nursing services in the field i.e. draw blood, dressing changes, etc.
 * They cannot force someone to work with them. Patients are allowed to refuse PHN services.
 * They cannot accept all referrals. The PHNs have to triage clients and so some clients who are referred will not be seen.
 * They cannot make home visits to find clients as nursing time is expensive. For clients with multiple missed appointments, they will try to contact by phone/letter to get a client into care, or might have a Community Health Worker drop by a family’s home to assist with getting client into care.
 * They cannot provide medication/case management for adult/geriatric clients as the primary focus is on maternal/child health.

Current PHN referrals:
 * Every Mom discharged from CCRMC is reviewed by a Public Health Nurse and categorized on a risk scale from 1 (high risk) to 4 (low risk). Certain conditions including, poor breastfeeding, wt loss >8%, teen mom, substance abuse, etc makes women higher risk. Most 1 and 2's and some 3's are offered services and seen by PHNs. This is the majority of what PHNs do. If you have concerns about any postpartum client and/or newborn, please call PHN main line: 313-6250. Any information you provide helps to more effectively triage the client.
 * The PHNs staff peds clnics and provide an exit nurse function, screening for kids who need specialty care, have mental health needs, or developmental problems. These kids are then assigned a PHN to help assure follow-up, and connect the child and family to services.
 * WIC screens women for postpartum/perinatal depression and anyone who is mod-high risk on the PHQ-4 gets a referral to PHN to help with access and follow-up to mental health.

Contact Information Public Health Nursing Phone 925-313-6250 Fax 925-313-6029