Union Hospital's Perinatal Nurse Navigator Program (PNNP)

The Union Hospital Perinatal Nurse Navigator Program (PNNP) is a State funded initiative that aims to reduce infant mortality in the Wabash Valley. Union Health stands as the Wabash Valley’s leader in Obstetric and Neonatal Care. For maternal care Union Hospital boasts nine obstetrical providers in four practices. Union Hospital operates an Obstetrical Emergency Department (OBED) which ensures that expectant mothers can be evaluated and treated by a physician regardless of time, location, complication or circumstance. A lack of Obstetric services in surrounding counties directs patients into the Union Health system to not only receive prenatal care but also to deliver their child. Union Hospital now averages 2,000 births annually from Vigo, Vermillion, Parke, Clay, and Sullivan Counties. Union Hospital houses a Level III Neonatal Intensive Care Unit (NICU) which is the only NICU in a 70-mile radius and was the first NICU in the state of Indiana when established in 1968.

The PNNP serves Clay, Parke, Sullivan, Vermillion, Vigo counties in Indiana. Many of these counties make up the Central Southwest Region of the Indiana Maternal and Child Health Region. In 2014, the Central Southwestern region’s infant mortality rate was 8 deaths for every 1,000 live births, higher than the state average. All counties have higher rates of persons living in poverty, percentage of mothers on Medicaid, and who smoke compared to the state average. There is also a lower than average percentage of babies who are breastfed. For example, Union Hospital Maternal-Child Services specifically have a Medicaid payor mix of 49%. Since Union Health is the OB hub for the entire region staff and physicians rarely have time and resources to spend sufficient hours on patient education required to improve infant outcomes.

The PNNP through its Perinatal Nurse Navigators (PNNs) plans on positively impacting the Wabash Valley’s infant mortality rate by assisting expectant mothers with their unmet medical, social, and or financial needs. In partnership with the Indiana State Department of Health-Maternal and Child Health Division the PNNP operates by first identifying at-risk patients who possess characteristics that make them more susceptible to having their child die before their first birthday. Second, during the entirety of the program but more prominently in the prenatal period the PNNs will educate, encourage, and provide resources to these at-risk patients to reduce barriers to receiving care and decrease risk factors. Finally, in the post-partum period PNNs will offer support throughout the first year of the baby’s life and act as a sounding board for mothers in ensuring proper care and support for mother and baby. At-Risk patients will come from the Union Health System that encompasses the nine providers and four providers.

Throughout 2017, the PNNs met with over 600 patients at more than 900 unique visits.