Maternal and Child Health Nursing PDF

Maternal and Child Health Nursing Maria Cristina A. Notario, M.D. Maternal and Child Health Nursing Is a specialty focused on the care of women throughout their pregnancy and childbirth and the care of their newborn children. It includes obstetric nursing, perinatal nursing and pe...

Maternal and Child Health Nursing Maria Cristina A. Notario, M.D. Maternal and Child Health Nursing Is a specialty focused on the care of women throughout their pregnancy and childbirth and the care of their newborn children. It includes obstetric nursing, perinatal nursing and pediatric nursing Maternal and Child Health Nursing OBSTETRICS – the care of women during pregnancy and childbirth - Derived from the Greek Word “obstare” (to keep watch) Maternal and Child Health Nursing PEDIATRICS – It deals with the health and medical care of infants, children, and adolescents from birth up to the age of 18 Means healer of children (derived from 2 Greek words “pais” – child & “iatros” – doctor or healer) Maternal and Child Health Nursing PERINATAL - a term that refers to the time period from pregnancy to one year after giving birth. The term comes from the Greek word “peri – around” and the Latin word “natus – birth” Framework for Maternal and Child Health Nursing (MCN) FOCUS OF MCN – care of childbearing and childbearing families PRIMARY GOAL OF MCN – promotion and maintenance of optimal family health Framework for Maternal and Child Health Nursing (MCN) OPTIMAL HEALTH – the state of complete physical, mental and social well being. It is the highest level of health and wellbeing an individual can achieve. Scope of Maternal and Child Health Nursing Practice Preconceptual Health Care Care of women during the 3 trimesters of pregnancy 1st trimester – 1st – 3rd month 2nd trimester – 4th – 6th month 3rd trimester – 7th – 9th month Scope of Maternal and Child Health Nursing Practice Care of women during puerperium or 4th trimester (6 weeks after childbirth) Puerperium – also known as the postpartum period, the period after giving birth when the body returns to its non-pregnant state Scope of Maternal and Child Health Nursing Practice Care of infants during perinatal period (6 weeks before conception and 6 weeks after birth) Care of children from birth to adolescence  Neonatal (28 days of life); Infancy (1- 12 months; adolescence (10-18 y.o.) Scope of Maternal and Child Health Nursing Practice Care in settings as varied as the birthing home, the PICU and the home. Philosophies of MCN MCN is family centered, assessment must include both family and individual assessment MCN is community centered, health of families depends on and influences the health of communities Philosophies of MCN MCN is evidence based because critical knowledge increases. MCN includes independent nursing functions because teaching & counselling are major interventions Philosophies of MCN MCN Nurse/Advocate – protects the rights of family members, including fetus Health Promotion and Disease Intervention to protect the health of new generation MCN is a challenging role for nurses Philosophies of MCN In all settings and types of care, keeping the family at the center of care or considering family as the primary unit of care is an essential goal because the level of a family’s functioning affects the health status of its members. a family centered approach enables nurses to better understand individuals and their effect on others, and in turn, to provide holistic care. FRAMEWORK FOR MCN 1. Nursing Process (ADPIE) 2. Evidence Based Practice 3. Nursing Research 4. Nursing Theory 4 Phases of Health Care 1. Health Promotion 2. Health Maintenance 3. Health Restoration 4. Health Rehabilitation 4 Phases of Health Care 1. Health Promotion  Educating clients to be aware of good health through teaching and role modelling  ex. Family Planning, teach the importance of safe sex practice, importance of immunizations 4 Phases of Health Care 2. Health Maintenance  intervening to maintain health when risk of illness is present  ex. Encourage prenatal care, importance of safeguarding homes by childproofing it against poisoning 4 Phases of Health Care 3. Health Restoration  diagnosing and treating illness using interventions that will return client to wellness fast 4 Phases of Health Care 4. Health Rehabilitation  preventing further complications from an illness  bringing client back to an optimal state of wellness  helping client accept inevitable death  ex. Encourage continuous therapies & medications Trends in Maternal and Child Health Nursing Population Client Advocacy – safe guarding and advancing the interests of clients and their families Trends in Maternal and Child Health Nursing Population TRENDS NURSING IMPLICATIONS Families are Fewer family members are present as smaller in size support people in times of crisis ROLE OF NURSE: Fulfill the role Increased single Fewer financial resources esp. woman parents (15 ROLE OF NURSE: Inform parents of million in the care options and back-up opinion Philippines, 95% of them being women) Trends in Maternal and Child Health Nursing Population TRENDS NURSING IMPLICATIONS Increased Health care must be scheduled at mothers working times a working parent can care for outside of home her own self or bring a child for care at least part-time ROLE OF NURSE: discuss selection (90%) of child care centers Families are more Good interviewing & health mobile; Increased monitoring are necessary so health number of database can be established and homeless women continuity of care. & children Trends in Maternal and Child Health Nursing Population TRENDS NURSING IMPLICATIONS Child and Screening for child or intimate intimate partner partner abuse; Nurses must be aware abuse of legal responsibilities for reporting abuse Families are more Provide health education health conscious Trends in Maternal and Child Health Nursing Population TRENDS NURSING IMPLICATIONS Health care Comprehensive care is necessary in should respect primary care settings because referral cost containment to specialists may no longer be an option. Health insurance is not available in all families Measuring Maternal and Child Health Statistical Terms Used to Report Maternal and Child Health 1. Birth Rate – number of births per 1000 population 2. Fertility Rate – number of pregnancies per 1000 women of childbearing age 3. Fetal Death Rate – number of fetal deaths weighing more than 500 gms or more per 1000 live births Measuring Maternal and Child Health Statistical Terms Used to Report Maternal and Child Health 4. Neonatal Death Rate  Neonatal Period – 1 28 days of st life; infant is called Neonate  Number of deaths per 1000 live births occurring in the 1st 28 days of life Measuring Maternal and Child Health Statistical Terms Used to Report Maternal and Child Health 5. Perinatal Death Rate  Perinatal Period – 6 weeks before conception and 6 weeks after childbirth  number of deaths of fetuses weighing >500 gms and within the first 28 days of life per 1000 birth Measuring Maternal and Child Health Statistical Terms Used to Report Maternal and Child Health 6. Infant Mortality Rate – number of deaths per 1000 live births in the first 12 months of life 7.Childhood Mortality Rate – number of deaths per 1000 population in children 1-4 years old Measuring Maternal and Child Health Statistical Terms Used to Report Maternal and Child Health 8. Maternal Mortality Rate – number of maternal deaths per 100,000 live births that occur as a direct result of reproductive process Trends in Health Care Environment 1. Cost Containment – reducing the cost of health by closely monitoring the cost of personnel, use and brands of supplies, length of hospital stays, number of procedures carried out, and number of referrals while maintaining quality care. Trends in Health Care Environment 2. Increasing Alternative Settings and Styles for Health Care  LRDP Rooms (Labor – Delivery – Recovery – Postpartum) a more natural childbirth environment as a birthing room. Family members are invited to stay to be a part of childbirth.  Retail Clinics or Emergent Care Clinics located in shopping malls  Ambulatory Clinics or at home to avoid long hospital stays for women and children Trends in Health Care Environment 3. Including Family in Health Care 4. Increasing Intensive Care Units NICU (neonatal intensive care unit) or ICN (Intensive Care Nursery)  PICU (Pediatric Intensive Care Unit) Trends in Health Care Environment 5. Regionalizing Intensive Care  ex. Premature Infant transferred to regional hospital 6. Increasing the Use of Alternative Treatment Modalities – alternative method therapies such as acupuncture and therapeutic touch; herbal remedies Trends in Health Care Environment 7. Increasing Reliance on Home Care  decreased hospital stay 8. Increasing Use of Technology  use of internet, charting in computer, using Doppler Trends in Health Care Environment 9. Free Birthing  women giving birth without health care provider supervision; unassisted birth 10. LAMAS – Breathing techniques Legal Considerations of MCN Practice 1. Identifying and Reporting Child Abuse 2. Child can bring a lawsuit when they reach legal age 3. Informed Consent for invasive procedure and any risk that may harm the fetus 4. In divorced or blended families, nurse has the right to give consent. Legal Considerations of MCN Practice Nurses are legally responsible to protect the rights of their client and documentation is essential to protect nurse and justify his or her actions. Ethical Considerations of Practice 1. Conception Issues In Vitro Fertilization Embryo Transfer Cloning Stem Cell Research Surrogate Mothers Ethical Considerations of Practice 2. Abortion 3. Fetal Rights vs Rights of Mother 4. Use of Fetal Tissue for Research 5. Resuscitation Ethical Considerations of Practice 6. Number of procedures or degree of pain that a child should have to achieve better health. 7. Balance between modern technology and quality of life Thank you