Identifying the role of public health nurses during first postnatal visits: Experiences of mothers and public health nurses in Ireland.

Aim and Objective: Explore the views and experiences of quality of care provided during a first postnatal visit from the perspectives of mothers and public health nurses. Background: Quality of nursing care is high on the policy agenda internationally, especially in the year of Nurse and Midwife. Public health nurses are acknowledged nationally and globally as essential health professionals supporting infants and parents. The first postnatal visit provided by the public health nurse is a complex intervention for mothers incorporating physical, social, educational and emotional support, and we know little about the quality of care provided. International evidence suggests a lack of consensus in setting priorities for this crucial visit. Design: Exploratory, qualitative design, utilising focus groups and interviews and analysed using thematic analysis. Setting/Participants: Nineteen public health nurses from all four health service regions and five mothers from one health service region were interviewed to explore the quality of care provided during first postnatal visits. Methods: Adopting qualitative data collection methods for the study; five individual semi-structured interviews with mothers ascertained their experiences of care. Further, four focus groups with public health nurses explored their understanding of the quality of care provided to mothers. The data collection period was August 2015 to January 2016. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Results: Mothers and public health nurses identified that public health nurses were crucial for providing support during the first postnatal visit as mothers required care and advice around physical, psychological and social wellbeing for themselves and their new infant. Discordant experiences of quality care and lack of standardisation of care practices emerged. Nurses identified relationship building, empowerment and health promotion as pivotal to the public health nurses' role. Mothers acknowledged the supportive and practical aspects of the care provided. Conclusion: This is the first Irish study combining nurses and mothers experiences, identifying care provided at the first postnatal visit, presenting the quality of care experienced. This visit is vital for relationship-building and empowering mothers' child-care and self-care abilities. The findings provide an insight into how quality of care is perceived by public health nurses and mothers. Experiences facilitate reflection and the development of quality improvements to ensure mothers and infants are adequately supported during the first postnatal visit.