FIMR Project Impact Update Tracy Claveau, RN, BAN FIMR Project - - PowerPoint PPT Presentation

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FIMR Project Impact Update Tracy Claveau, RN, BAN FIMR Project - - PowerPoint PPT Presentation

Jun 05, 2023 434 likes •726 views

FIMR Project Impact Update Tracy Claveau, RN, BAN FIMR Project Coordinator What is Infant Mortality? The death of a baby before his or her first birthday. The is often used as an indicator to measure the health and well being of a

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FIMR

Project Impact Update

Tracy Claveau, RN, BAN

FIMR Project Coordinator

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The death of a baby before his or her first birthday.

The is often used as an indicator to measure the health and well being of a population What is Infant Mortality?

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Infant Mortality Rates

Per 1000 Live Births

Source: Florida CHARTS, Division of Public Health Statistics and Performance Management, Florida Department of Health www.floridacharts.com

7.3 6.5 7.2 8 8 7.1 7.4 6.5 6.4 6 6.1 6 6.2 6.1

4 5 6 7 8 9 2010 2011 2012 2013 2014 2015 2016

NEF Florida

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SLIDE 4 32254 32209 32208 32204 32202

Leading Infant Mortality Rates

Duval County

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32208 32209 32210 32211 32218

2013 20.5 11.4 9.6 12.9 13.9 2014 14.3 6.3 16.8 15.6 15 2015 10.9 10 12.8 7.4 13.4 2016 24.1 16.1 13.9 11.9 5.5

Infant Mortality Rates

By Zip Code (Duval)

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Nassau Baker Clay

  • St. Johns

IM Rate 2.9

LBW 9.9% LWB Disparity 1.7

IM Rate 4.9

LBW 8% LWB Disparity 3

IM Rate 5.4

LBW 7.8% LWB Disparity 1.4

IM Rate 5.2

LBW 7.1% LWB Disparity 2.2%

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32065 Clay 32046 Nassau 32033

  • St. Johns

32092

  • St. Johns

32145

  • St. Johns

2013 5.2 (2) 2.9 (1) 39.5 (3) 2014 5.3 (2) 42.6 (1) 10.7 (4) 15.4 (1) 2015 2.3 (1) 8.7 (1) 5.4 (2) 2016 9.7 (4) 24.4 (3) 20.4 (2) 10.8 (4) 16.1 (1)

Infant Mortality Rates

By Zip Code (Outlying)

Number in parenthesis is count of infant deaths

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2 4 6 8 10 12 14 16 2013 2014 2015 2016 NEF White NEF Black/Other State White State Black/Other

Infant Mortality Rate by Race

Disparities on a local and state level

Source: Florida CHARTS, Division of Public Health Statistics and Performance Management, Florida Department of Health www.floridacharts.com

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Infant Mortality Rate by Race

Disparities on a local, state and national level

Source: Florida CHARTS, Division of Public Health Statistics and Performance Management, Florida Department of Health www.floridacharts.com

2 4 6 8 10 12 14 16 2012 2013 2014

Black White

NEF US FL

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  • Prematurity-Low Birth Weight 25%
  • Other Perinatal Conditions 25%
  • SUIDs 22%
  • Congenital 18%
  • Other 10%

Causes of Infant Death, Northeast Florida

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2013 2014 2015 2016

58% 66% 67% 59% 42% 34% 33% 41% < 28 days 28- 365 days

Infant Age at Death

Source: Florida CHARTS, Division of Public Health Statistics and Performance Management, Florida Department of Health www.floridacharts.com

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Most SUID are reported as 1 of 3 types of infant deaths

 Accidental Suffocation and Strangulation in Bed

  • Suffocation by soft bedding
  • Overlay
  • Wedging
  • Strangulation

 Unknown Cause/Could not be determined The sudden death of an infant that cannot be explained because a thorough investigation was not conducted and cause of death could not be determined.  Sudden Infant Death Syndrome cannot be explained after a thorough investigation is conducted, including a complete autopsy, examination of the death scene, and a review of the clinical history.

SUIDs

Sudden Unexpected Infant Deaths

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Sudden Unexpected Infant Deaths (SUIDs)

2010-2016

Alachua Baker Bay Bradford Brevard Broward Calhoun Charlotte Citrus Clay Collier Columbia Miami-Dade Desoto Duval Escambia Flagler Franklin Gadsden Gilchrist Glades Gulf Hamilton Hardee Hendry Hernando Highlands Hillsborough Holmes Indian River Jackson Jefferson Lake Lee Leon Levy Madison Manatee Marion Martin Monroe Nassau Okaloosa Okeechobee Orange Osceola Palm Beach Pasco Pinellas Polk Putnam Saint Johns Saint Lucie Santa Rosa Sarasota Seminole Sumter Suwannee Taylor Union Volusia Wakulla Walton Washington

Highlighted counties have greater than 10,000 births

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SUIDs

Sudden Unexpected Infant Deaths

Includes:

  • Accidental suffocation or

strangulation in bed

  • Other suffocation and

strangulation ( i.e. choking)

  • SIDS
  • Many sources include “undetermined”,

“could not be determined” and other, and are included in the “SUIDS”

8 27% 9 30% 7 23% 6 20%

n = 30

Bedsharing Unsafe Sleep Environment Positional Other SUIDs

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102 days Average Age at time of death

70% WIC 73% Medicaid 21% of babies

had Healthy Start Care Coordination (2016) *51% Fathers Had at least a High School Education

13% of mothers

had Healthy Start Care Coordination (2016) 62% Mothers Had at least a High School Education Black and other non whites are 2.5 times more likely to die of SUIDs than whites

SUIDs

A Closer Look

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Fetal Deaths by Race

(stillborn at greater than 20 weeks of pregnancy)

Source: Florida CHARTS, Division of Public Health Statistics and Performance Management, Florida Department of Health www.floridacharts.com

2 4 6 8 10 12 14 16 2011 2012 2013 2014 2015 2016

White Black/Other Total Fetal Deaths

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A condition experienced by newborns exposed to opioid prescription or illicit drugs during pregnancy. Northeastern Florida has been identified as an area of very high concern. Neonatal Abstinence Syndrome (NAS)

Northeast Florida

Source: Florida Department of Health Neonatal Abstinence Syndrome Data Summary, March 2015

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347 infants were discharged from our area hospitals with NAS conditions in Qtr 1 & 2 of 2016. In the entire year of 2015, 383 infants were discharged with NAS conditions. Neonatal Abstinence Syndrome (NAS)

Northeast Florida

Source: Agency for Healthcare Administration

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Fetal and Infant Mortality Review

“to determine specific medical, social, financial and other issues that may have impacted the poor birth outcome” “It’s not about finding fault, it’s about figuring out where the system failed ”

FIMR

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Source: FIMR Overview for new CRT and/or CAT members, Publication of the National Fetal and Infant Mortality Review Program, ACOG, 2014.

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Contributing Factors

61% 57% 54% 39% 43%

Poverty Pre-Existing Conditions

  • Asthma
  • HTN
  • Diabetes

Substance Use

(Except Tobacco)

Pre-Term Labor Obesity

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18%

Late entry into care

46%

Inconsistent prenatal care

29%

Inadequate Birth Spacing

43%

Substance Use

Parental Knowledge and Behavior

46%

Kept postpartum appointments

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Grief Support 68% Dad Involved 93%

Post partum depression screen/grief assessment

11%

Insurance

85% Family Support 89% Healthy Start screen 43%

Without Strength Change Cannot Occur

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SUIDs Prevention

Benefits of Healthy Start and other Home Visiting Programs Safe Sleep

Recommendations

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Safe Sleep

Standardized Training for All Entities who Encounter Caregivers

Multi-agency 2 track child safety curriculum

  • Professionals and community agencies
  • Caregivers

Proposed Curriculum Components

  • 1. Safe Sleep
  • 2. Water Safety
  • 3. Selecting an Appropriate Caregiver

SUIDs Prevention

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Benefits of Healthy Start and other Home Visiting Programs

Number of families who did not have home visiting support

Education and out outreach to hospitals, nursing care staff and birth recorders .

  • Value of home visitation
  • Process of referral
  • Engaging pregnant women and

pediatrics in triage areas and emergency rooms

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There

is no foot too small that it cannot leave an

imprint

WORLD

  • n this

Author unknown