RNPilotPublic health nursing (Boston, Mass.)2019

Living libraries: Nurse integration in interprofessional homeless health care team.

Melanie A Mariano, Monica J Harmon

PMID 30467899

WHAT IT FOUND

A library team with a nurse, a social worker, and librarians referred 193 of 358 patrons.

Completion varied: 57% for external referrals only, 85% for internal referrals only, and 100% for internal then external referrals.

Key findings

01Of 358 unique patron engagements, 193 patrons (44%) received referrals, while 165 patrons (46%) left before a referral was possible or declined.

02Referral retention was 57% (90 patrons) for only external referrals, 85% (17 patrons) for only internal referrals, and 100% (15 patrons) for internal plus subsequent external referrals.

03For patrons who identified as unstably housed, referral retention was 87% for only external referrals, 92% for only internal referrals, and 100% for internal plus subsequent external referrals.

STILL TO COME

How it was doneWhat they foundWhat it means for RNs

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What it does not show

The authors did not capture patrons' referral experience or whether patrons would return or send others to the referred agency. They did not assess self-reported health status, previous primary care visits, sociodemographic information, or experience with previous providers. They could not collect pre-intervention data because most participants were unwilling to participate before relationships developed. The reason for the high referral retention rate was not investigated. Financial effects were not analyzed. The project was described as a pilot, and the authors say further research is needed to understand the relationship between the interprofessional model and referral retention.

Declared interests

The author declared no conflicts of interest or relationships. The paper names the University of Pennsylvania as funder, and the project was grant funded, with the nurse provided by a local academic nursing institution.

The easy way to misread this

Do not read the 100% referral retention rate as proof that the nurse caused better care. The team included a nurse, a social worker, and librarians, and the paper does not separate their contributions. It is a pilot project, did not collect pre-intervention data, and did not investigate why referrals were completed.

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