The home health nurse clinician's role in the prevention of nonorganic failure to thrive.

Home health nurse clinicians are invaluable in the detection of children at risk for nonorganic failure to thrive (NOFTT). The literature has emphasized the role of hospital-based health care personnel in evaluating NOFTT, a strategy that relies heavily on the parent for initiation of services. Since one of the most commonly agreed-on causes of NOFTT is a disturbance in the mother-child relationship, case-finding efforts need to be community-based and less reliant on parental recognition. Because the most effective interventions take place in the child's home setting, the home health nurse clinician is in a unique position to assess the home environment for dysfunctional family interactions and behaviors and then to use the ongoing relationship with the family to implement prevention strategies for NOFTT, including teaching, modeling, and coaching effective parenting. Home-based nursing also provides the means for necessary follow-up of these families to ensure the success of the strategies.