NCM 107 Care of Mother, Child, and Adolescent PDF

NCM 107 Care of Mother, Child and Adolescents (Well Clients) Copyright © 2018 Wolters Kluwer · All Rights Reserved I. Course Care of Mother, Child and Adolescent (Well Clients) Title II. Course NCM 107 Code Credit Units 9 units Number of...

NCM 107 Care of Mother, Child and Adolescents (Well Clients) Copyright © 2018 Wolters Kluwer · All Rights Reserved I. Course Care of Mother, Child and Adolescent (Well Clients) Title II. Course NCM 107 Code Credit Units 9 units Number of 414 hours Lecture 72 hours/4 hrs /week Laboratory 255 hrs Prerequisites NCM 101, NCM 102, NCM 103 Co-requisites Course This course deals with concepts, principles, theories and Description techniques in the nursing care of individuals and families during childbearing and childrearing years toward health promotion, disease prevention, restoration and maintenance, and rehabilitation. The learners are expected to provide safe, appropriate and holistic nursing care to clients utilizing the nursing process. Copyright © 2018 Wolters Kluwer · All Rights Reserved Class Participation Class standing requirements (case studies, seatworks, assignments, group projects/activities, oral presentations, group participation and quizzes) – 1. Quizzes are scheduled. 2. Seatworks are unannounced and are usually given at the start or near the end of the lecture period. 3. Assignments are given to research important topics. 4. Case studies are given ahead of time for the students to analyze properly the given issue. 5. Group projects are announced ahead of time to prepare the materials needed. 6. Outputs are collected at the beginning of the next class session. 7. Students will be required to do oral or group presentation based on the output created during the group activity. 8. Individual contribution to group work will be rated by the instructor and by the co-group members. Copyright © 2018 Wolters Kluwer · All Rights Reserved Grading System Midterm/Final: Lecture: Assignment 10% Quizzes 30% Recitation 20% Term Exam 40% Total 100% X 60% MIDTERM GRADE : Lecture 60% RLE 40% Total 100% Copyright © 2018 Wolters Kluwer · All Rights Reserved How do you study for Maternal & Child Nursing? Have a Review , study review, guide. review. Focus on important terms and concepts. Copyright © 2018 Wolters Kluwer · All Rights Reserved  Chapter 1 A Framework for Maternal and Child Health Nursing Learning Outcomes After the successful completion of the chapter, you should be able to: Define common statistical terms used in the field, such as infant and maternal mortality. Use critical thinking to identify areas of care that could benefit from additional research or application of evidence- based practice Copyright © 2018 Wolters Kluwer · All Rights Reserved  Discuss the interplay of nursing process, evidence-based practice, and nursing theory as they relate to the future of maternal and child health nursing practice. Integrate knowledge of trends in maternal and child health care with the nursing process to achieve quality maternal and child health nursing care. Copyright © 2018 Wolters Kluwer · All Rights Reserved  Describe the framework for maternal and child health nursing care. Appreciate the Universal Health Care goals and objectives as an important guide to understanding the health of the nation and goals that nurses can help the nation achieve.}Correlate the 17 Sustainable Development Goals for 2030 in achieving quality maternal and child health nursing care. Copyright © 2018 Wolters Kluwer · All Rights Reserved TOPIC OUTLINE 1.Framework of maternal and child nursing 2.Goals and philosophies of maternal and child nursing 3.Maternal and child health goals and standards 4.Measuring maternal and child health 5.Roles and responsibilities of maternal and child health nurse 6.Sustainable Developmental goals Copyright © 2018 Wolters Kluwer · All Rights Reserved TERMS to REMEMBER Puerperium – Perinatal – 20 Prenatal – 6 weeks after weeks of Neonatal - pregnancy or childbirth, also pregnancy to 4 first 28 days of time before known as the weeks (28 life giving birth 4th trimester of days) after pregnancy birth Copyright © 2018 Wolters Kluwer · All Rights Reserved  Maternal and Child Health Nursing refers to the relationship of mother and child to one another and consideration refers to the care of the entire of pregnant family, as well as woman, child and the culture and family socio-economic to environment as framework of the clients. Copyright © 2018 Wolters Kluwer · All Rights Reserved 1. Maternal and Child Nursing Framework Maternal and Philippine Professional Nursing Practice child health Standards PPNPS nursing can be 2012 National Core Competency Standards NNCCS, visualized within Standards of Nursing services), a framework in evidence-based practice, to care for which nurses families during childbearing and use nursing childrearing years and through the four phases of health care: process, nursing theory and Health promotion Health maintenance other Health restoration Health rehabilitation competencies Copyright © 2018 Wolters Kluwer · All Rights Reserved  Nursing Process (Maternal Child Nursing Framework) A scientific form of problem solving, serves as the basis for assessing, making a nursing diagnosis, planning, implementing, and evaluating care. It is a process broad enough to serve as the basis for modern nursing care because it is applicable to all health care settings, from the home to ambulatory clinics to intensive care units Copyright © 2018 Wolters Kluwer · All Rights Reserved Nursing Process Organized series of steps Implementa Assessing Diagnosis Planning tion Evaluating Problem solving based on the scientific method Copyright © 2018 Wolters Kluwer · All Rights Reserved Copyright © 2018 Wolters Kluwer · All Rights Reserved  Evidence-Based Practice (Maternal Child Nursing Framework) is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of patients (Melnyk, 2010) Evidence can be a combination of research, clinical expertise, and patient’s preferences and values. Evidence-Based Practice: Step by Step: The Seven Steps of Evidence-Based Practice Melnyk, Bernadette Mazurek, PhD, RN, CPNP/PMHNP, FNAP, FAAN; Fineout-Overholt, Ellen, PhD, RN, FNAP, FAAN; Stillwell, Susan B., DNP, RN, CNE; Williamson, Kathleen M., PhD, RN AJN The American Journal of Nursing: January 2010 - Volume 110 - Issue 1 - p 51-53 Copyright © 2018 Wolters Kluwer · All Rights Reserved The worth of evidence is ranked according to: Level I: Level II: Level III: At least one Well-designed Opinions of properly designed controlled trials respected randomized without authorities, based controlled trial randomization on clinical Well-designed experience, cohort or case- descriptive studies, control analytic or reports of expert studies committees Multiple time series Use of evidence- with or without an based practice intervention helps to move all health care actions to a more solid, and therefore safer, scientific base. Copyright © 2018 Wolters Kluwer · All Rights Reserved QSEN Quality & Safety Education for Nurses composed of knowledge, skills, and attitudes required of licensed nurses Copyright © 2018 Wolters Kluwer · All Rights Reserved Copyright © 2018 Wolters Kluwer · All Rights Reserved The 6 QSEN Competencies are: Patient- centered care  delivering patient-centered care Teamwork & collaboration  working as part of interdisciplinary team Evidence- based practice  practicing evidence-based medicine Quality improvement  focusing on quality improvement (QI) Safety  Minimizing risk of harm to the patient Informatics  using information technology Copyright © 2018 Wolters Kluwer · All Rights Reserved  Nursing Research (Maternal Child Nursing Framework) the systematic investigation of problems that have implications for nursing practice and usually carried out by nurses) plays an important role in evidence-based practice as bodies of professional knowledge only grow and expand to the extent people in that profession are able to carry out research (Christian, 2012). examining nursing care in this way results in improved and cost-effective patient care as it provides evidence for action and justification for implementing activities. Copyright © 2018 Wolters Kluwer · All Rights Reserved  Four Phases Of Health Care HEALTH PROMOTION. Educating parents and children to Ex. Family planning, teach the follow sound health practices through teaching and role importance of safe sex practice, modelling. importance of immunizations Ex. Encourage prenatal care, HEALTH MAINTENANCE. Intervening to maintain health importance of safeguarding when risk of illness is present homes by childproofing it against poisoning HEALTH RESTORATION. Using conscientious assessment Ex. Care of child during illness, to be certain that symptoms of illness are identified and care of woman during pregnancy interventions are begun to return patient to wellness most complications rapidly HEALTH REHABILITATION. Preventing further complications Ex. Encourage continuous therapies from an illness, bringing client back to an optimal state of and medications wellness, helping client accept inevitable death Copyright © 2018 Wolters Kluwer · All Rights Reserved Nursing Theory Nursing theorists offer helpful ways to view clients so that nursing activities can best meet client needs Only with this broad theoretical focus can nurses appreciate the significant effect on a family of a child’s illness or of the introduction of a new member. Copyright © 2018 Wolters Kluwer · All Rights Reserved  Theories Related to Maternal and Child Nursing Calista Roy’s Theory – stresses that an important role of the nurse is to help patient adapt to change caused by illness or other stressors Copyright © 2018 Wolters Kluwer · All Rights Reserved Dorothea Orem’s Theory – concentrates on examining patient’s ability to perform self- care Copyright © 2018 Wolters Kluwer · All Rights Reserved Patricia Benner’s Theory – the way nurses move from novice to expert as they become more experienced and prepared to give inter professional care Copyright © 2018 Wolters Kluwer · All Rights Reserved Other issues most nursing theorists address: Extensive changes in the scope of maternal and child health nursing have occurred as health promotion Teaching Counselling Supporting Advocacy or keeping parents & children well Healthy pregnancies & keeping children well protects not only patients at present but also the health of the next generation. Copyright © 2018 Wolters Kluwer · All Rights Reserved 2. Goals and Philosophy of MCN Obstetrics, or the care of women during childbirth, is derived from the Greek word obstare, which means “to keep watch.” Pediatrics is a word derived from the Greek word pais, meaning “child.” Although the field of nursing typically divides its concerns for families during childbearing and childrearing into two separate entities, maternity care and child health care, the full scope of nursing practice in this area is not two separate entities but rather a continuum: maternal and child health nursing Copyright © 2018 Wolters Kluwer · All Rights Reserved  Primary Goal of MCN Care the promotion and maintenance of optimal family health to ensure cycles of optimal childbearing and childrearing. Copyright © 2018 Wolters Kluwer · All Rights Reserved Goals of MCN Nursing Care The goals of maternal and child health nursing care are necessarily broad because the scope of practice (the range of services and care that may be provided by a nurse based on state requirements) is so broad. Copyright © 2018 Wolters Kluwer · All Rights Reserved Primary Goal of Maternal and Child Health Nursing: The promotion and maintenance of optimal family health to ensure cycles of optimal childbearing and childrearing. Copyright © 2018 Wolters Kluwer · All Rights Reserved MCN Range of Practice Preconceptual health care Care of women during three trimesters of pregnancy and the puerperium (the 6 weeks after childbirth, sometimes termed the fourth trimester of pregnancy). Care of infants during the perinatal period (6 weeks before conception to 6 weeks after birth) Copyright © 2018 Wolters Kluwer · All Rights Reserved MCN Range of Practice Care of children from birth through adolescence Care in settings as varied as the birthing room, the pediatric intensive care unit, and the home Copyright © 2018 Wolters Kluwer · All Rights Reserved Philosophy of MCN Enables nurses to better understand individuals and their effect on others, in turn to provide more holistic care. Family centered Approached: assessment must include both family and individual assessment data. Includes encouraging rooming-in with the mother by the mother’s partner or support person and with the child by their caregiver. Community centered: the health of families depends on and influences the health of communities. Family members are encourage to provide physical and emotional care based on the individual situation and their comfort level. Evidence based because this is the means whereby critical knowledge increases. Copyright © 2018 Wolters Kluwer · All Rights Reserved Nurses provide guidance and monitor the interaction between the family members to promote the health and well being of the family unit. Copyright © 2018 Wolters Kluwer · All Rights Reserved 3. Standard of MCN Practice Division of Maternal-Child The Association Health Nursing Optimum health of Women’s Practice of the potentials - Health, Obstetric, American Nurses achieved within and Neonatal Association in the framework of Nurses collaboration family-centered (AWHONN) – with the Society care and the women and of Pediatric nursing process newborn Nurses –maternal and child health Copyright © 2018 Wolters Kluwer · All Rights Reserved  Standard of Care Standard III: Standard I: Standard II: Outcome Assessment Diagnosis Identification Analyzes the Identifies expected assessment data in outcomes Patient health data determining individualized to the diagnoses. child and the family. Copyright © 2018 Wolters Kluwer · All Rights Reserved  Standard of Care Standard IV: Standard V: Standard VI: Planning Implementation Evaluation Develops a plan of Evaluates the Implements the care that prescribes child’s and family’s interventions interventions to progress toward identified in the obtain expected attainment of plan of care. outcomes. outcomes. Copyright © 2018 Wolters Kluwer · All Rights Reserved Standards of Professional Performance Standard I: Standard II: Standard III: Standard IV: Quality of Performance Education Collegiality Care Appraisal The nurse The nurse evaluates his interacts with The nurse or her own The nurse and systematically nursing acquires and contributes to evaluates the practice in maintains the quality and relation to current professional effectiveness professional knowledge and development of pediatric practice competency in of peers, nursing standards and pediatric colleagues, practice. relevant nursing and other statutes and practice. health care regulations. providers. Copyright © 2018 Wolters Kluwer · All Rights Reserved Standards of Professional Performance Standard VIII: Standard V: Standard VI: Standard VII: Resource Ethics Collaboration Research Utilization The nurse’s The nurse The nurse assessment, The nurse contributes considers actions, and collaborates to nursing factors recommendati with the and pediatric related to ons on behalf child, family, health care safety, of children and and other their families through the effectiveness, health care are use of and cost in providers in determined in research planning and providing an ethical methods and delivering client care. manner. findings. patient care. Copyright © 2018 Wolters Kluwer · All Rights Reserved  Global Health Goals 2020 health goals concentrate on the improving UN and WHO – established of women’s health and that millennium health goals in of the children 2000. These two population can have such long-ranging effects on general health. Copyright © 2018 Wolters Kluwer · All Rights Reserved Global Health Goals To end poverty and hunger To achieve universal primary education To promote gender equality and empower women To reduce child mortality To improve maternal health To combat HIV-AIDS, malaria, and other diseases To ensure environmental sustainability To develop a global partnership for development Copyright © 2018 Wolters Kluwer · All Rights Reserved  The establishment of global health goals is a major step forward in improving the health of all people As contagious diseases, poverty, and gender inequality do not respect national boundaries but follow people across the world Copyright © 2018 Wolters Kluwer · All Rights Reserved Two Pillars of the 2020 National Health Goals  Increase quality and years of healthy life  Eliminate health disparities  Counseling for health promotion and disease prevention  Cultural diversity  Evaluation of health sciences literature  Environmental health  Public health systems  Global health Copyright © 2018 Wolters Kluwer · All Rights Reserved  National Health Goals Universal Health Care (Kalusugan Pangkalahatan) AO 2010-0036 (DOH 2010). It is directed towards ensuring the achievement of the health system goals of better health outcomes, sustained health financing, a responsive health system by ensuring that all Filipinos, especially the disadvantaged group, have equitable access to affordable health care. Copyright © 2018 Wolters Kluwer · All Rights Reserved  National Health Situation What is the National Health Situation of the Philippines? Many Filipinos continue to die or suffer from illnesses Many people lack sufficient that have well-proven, cost- knowledge to make informed effective interventions decisions about their such tuberculosis, HIV and own health. dengue, or diseases affecting mothers and children. Copyright © 2018 Wolters Kluwer · All Rights Reserved Copyright © 2018 Wolters Kluwer · All Rights Reserved Basic emergency obstetric and newborn care (BEmONC) is a primary health care level initiative promoted in low- and middle-income countries to reduce maternal Copyright ©and newborn 2018 Wolters mortality Kluwer · All Rights Reserved ESSE M & NEWBORN CARE: An Introduction ANTHONY CALIBO, MD, DPPS Medical Specialist IV, DOH Family Health Office Copyright © 2018 Wolters Kluwer · All Rights Reserved ESSENTIAL INTRAPARTUM & NEWBORN CARE: An Introduction ANTHONY CALIBO, MD, DPPS Medical Specialist IV, DOH Family Health Office Copyright © 2018 Wolters Kluwer · All Rights Reserved  DOH NATIONAL SAFE MOTHERHOOD PROGRAM For more information of DOH National Safe Motherhood Program, please visit this link below. https://www.doh.gov.ph/national - safe- motherhood-program Copyright © 2018 Wolters Kluwer · All Rights Reserved Three Strategic Thrusts to Attain UHC Goal Financial risk Attainment of the protection –National Improved access to health-related Health Insurance quality hospitals and Millennium Program (NHIP) health care facilities Development Goals enrollment and benefit (MDGs) delivery Copyright © 2018 Wolters Kluwer · All Rights Reserved 4. Measuring Maternal and Child Health Statistics require accurate recording, collection, and analysis and, because, play such a major role in the accurate collection and Such statistics are recording of health- useful for comparisons related data, nurses among states and play a major role in nations and for A more objective view allowing the nation’s anticipating future of health can be present and future health care needs of a provided by using health to be described community. national or regional in these ways health statistics to describe degrees of illness. Copyright © 2018 Wolters Kluwer · All Rights Reserved  Common Statistical Terms Used to Report Maternal and Child Health Neonatal death rate Fertility Fetal – the rate – the death rate Birth rate – number of number of – the the number deaths per pregnancies number of of births per 1,000 live per 1,000 fetal deaths 1.000 births women of (over 500g) population occurring at childbearing per 1,000 birth or in age live births the first 28 days of life Copyright © 2018 Wolters Kluwer · All Rights Reserved  Perinatal death rate – the number of deaths during Maternal the perinatal mortality Infant time period rate – the mortality Childhood (beginning number of rate – the mortality when a fetus maternal number of rate – the reaches 500 deaths per deaths per number of g, about week 100,000 live 1,000 live deaths per 20 of births that births 1,000 pregnancy, occur as a occurring at population in and ending direct result birth or in the children age 1 about 4 t0 6 of the first 12 to 14 years weeks after reproductive months of life birth); it is the process sum of the fetal and neonatal rates Copyright © 2018 Wolters Kluwer · All Rights Reserved Crude Birth Rate (CBR) Affected by the fertility, marriage Measures how fast pattern, and practices people are added to Useful measure of of the place, sex, and the population population. age composition of a through births. population, and birth registration. Copyright © 2018 Wolters Kluwer · All Rights Reserved Crude Birth Rate (CBR) ≥ ≤ 45/1,000 20/1,000 live live births births implies implies high low fertility, fertility. CBR = # of registered life births in a year x 1,000 Midyear population Copyright © 2018 Wolters Kluwer · All Rights Reserved  Bi rth Rate The current birth rate for Philippines in 2023 is 19.579 births per 1000 people, a 1.01% decline from 2022. The birth rate for Philippines in 2022 was 19.778 births per 1000 people, a 1% decline from 2021. The birth rate for Philippines in 2021 was 19.978 births per 1000 people, a 0.99% decline from 2020 Copyright © 2018 Wolters Kluwer · All Rights Reserved General Fertility Rate (GFR) The women High Low More in the fertility fertility specific reproductive rate than age groups rate =GFR rate = CBR (15-44 of GFR of years). 200/1,000 60/1,000 GFR=#of registered live births in a year x1,000 Midyear population of women 15- 44years of age Copyright © 2018 Wolters Kluwer · All Rights Reserved  Fertility Rate The current fertility rate for Philippines in 2023 is 2.454 births per woman, a 1.01% decline from 2022. The fertility rate for Philippines in 2022 was 2.479 births per woman, a 1% decline from 2021. The fertility rate for Philippines in 2021 was 2.504 births per woman, a 1.03% decline from 2020. Copyright © 2018 Wolters Kluwer · All Rights Reserved Infant Mortality Rate (IMR) Number of deaths of infants under one year of age in a calendar year per one thousand live births in the same period. Approximation of the risk of dying within the first year of life. A good index of the level of health in a community because infants are very sensitive to adverse environmental conditions. High IMR means low levels of health standards that may be secondary to poor maternal health and child health care. Copyright © 2018 Wolters Kluwer · All Rights Reserved Infant Mortality Rate (IMR) IMR levels of 60- ≥200/1,000 live 150/1,000 live births is indicative births are of very severe commonly seen in environmental poor population; conditions. IMR = Deaths under 1 year of age in a calendar year x 1,000 Number of live births in the same year Copyright © 2018 Wolters Kluwer · All Rights Reserved  Infant Mortality Rate The current infant mortality rate for Philippines in 2023 is 17.544 deaths per 1000 live births, a 2.36% decline from 2022. The infant mortality rate is a good index of its general health because it measures the quality of pregnancy care, overall nutrition, and sanitation, as well as infant health and available care. The infant mortality rate for Philippines in 2022 was 17.968 deaths per 1000 live births, a 2.31% decline from 2021. Copyright © 2018 Wolters Kluwer · All Rights Reserved Three Leading Causes of Infant Mortality Congenital malformations Sudden Infant disorders related Death Syndrome to short (SIDS) gestation low birthweight Copyright © 2018 Wolters Kluwer · All Rights Reserved Neonatal Mortality Rate (NMR) deaths of infants less than 28 days old are due mainly to prenatal or genetic factors. NMR = # of deaths among those under 28 days of x age in a calendar year 1,00 Number of live births in the same year 0 Copyright © 2018 Wolters Kluwer · All Rights Reserved Common Causes of Neonate Mortality Jan 16, 2023 In the Philippines, over 60,000 children die yearly before their fifth birthday because of complications from premature intrapartum Over 25,000 infectious are stillborn birth, complications diseases. every year. There is some variation between countries depending on their care configurations Copyright © 2018 Wolters Kluwer · All Rights Reserved Post Neonatal Mortality Rate (PMR) Deaths among infants 28 days to less than1 year of age in a calendar year.}influenced by environmental and nutritional factors as well as infection. PNR= Number of deaths among those 28 days to less than1 year of age in a calendar year x1,000 Number of live births in the same year Copyright © 2018 Wolters Kluwer · All Rights Reserved  Under-5 Mortality Rate The child mortality rate, also under- five mortality rate, refers to the probability of dying between birth and exactly five years of age expressed per 1,000 live births. It encompasses neonatal mortality. Copyright © 2018 Wolters Kluwer · All Rights Reserved  Leading causes of death among children under-5 years old According to the World Health Organization (WHO), more than half of However, under – 5 child deaths among children deaths may also be under - 5 years old can be caused by factors other attributed to “ diseases than illness. that are preventable and treatable through simple, affordable interventions.” Copyright © 2018 Wolters Kluwer · All Rights Reserved Maternal Mortality Ratio (MMR) The maternal mortality ratio (MMRatio) is the annual number of female deaths per 100,000 live births from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes). The MMRatio includes deaths during pregnancy, childbirth, or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, for a specified year. Copyright © 2018 Wolters Kluwer · All Rights Reserved  Maternal Mortality Rate (MMR) Measures obstetric risk and is affected by maternal health practices, diagnostic ascertainment, and completeness of registration of births. MMR = # of deaths due to pregnancy, delivery, puerperium in x a calendar year 100 Number of life births in the same year 0 Copyright © 2018 Wolters Kluwer · All Rights Reserved  Maternal Mortality A maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy*, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes. Causes: Postpartum hemorrhage Eclampsia Obstructed labor Sepsis Copyright © 2018 Wolters Kluwer · All Rights Reserved Maternal Mortality Ratio (MMR) – Philippines 2023 On Feb. 22, 2023, PSA actually reported 2,478 women died of maternal causes in 2021. MMR in 2021 was thus 189.21 per 100,000 live births (2,478/1,309,601 x 100,000). Before 2021, the DOH reported the highest number of maternal deaths at 2,511 in 1952 and 2,645 in 1951, making 2021 the third deadliest year for childbearing in the Philippines in 69 years. https://opinion.inquirer.net/162254/philippines-maternal- mortality-rate-worse-than-reported#ixzz89xpLJvJN Copyright © 2018 Wolters Kluwer · All Rights Reserved  Maternal Morbidity any health condition attributed to and /or aggravated by pregnancy and childbirth that has a negative impact on the woman’s well-being The causes of maternal morbidity are many and complex. They vary in duration and severity and cover a broad range of diagnoses requiring a wide variety of treatments. Maternal morbidity can be conceptualized as a spectrum ranging, at its most severe, from a “maternal near miss” defined by the World Health Organization (WHO) as the near death of a woman who has survived a complication occurring during pregnancy or childbirth or within 42 days of the termination of pregnancy – to non-life-threatening morbidity, which is more common by far. Copyright © 2018 Wolters Kluwer · All Rights Reserved 5. Roles and Responsibilities of Maternal Child Nurse Maternal and Child health nursing can be visualized within a framework in which nurses use: Nursing Process Nursing Theory Quality and Safety Education for Nurses (QSEN) competencies Care for families during child-bearing and childrearing years and through the four phases of health care. Health Promotion Health Maintenance Health Restoration Health Rehabilitation Copyright © 2018 Wolters Kluwer · All Rights Reserved Roles and Responsibilities of Maternal Child Nurse Nurses retain skills and knowledge A maternal- that allow child nurse is them to assist often cross the patient trained. during the entire hospital stay. Copyright © 2018 Wolters Kluwer · All Rights Reserved Roles and Responsibilities of Maternal Child Nurse The maternal-child nurse serves in roles related to labor, delivery, recovery, operational, postpartum and management of high-risk pregnancies. Specific roles they may perform include fetal monitoring, assisting in cesarean delivery and identifying postpartum complications. Copyright © 2018 Wolters Kluwer · All Rights Reserved Roles and Responsibilities of Maternal Child Nurse The maternal- Continuing Basic nursing child nurse also education in skills are a often needs order to stay necessity. technical skills up-to-date on Pain management in order to the latest pain effectively innovations and patient and family education, understand new practices in assessment, advanced the field. diagnosis and equipment and communication. procedures. Copyright © 2018 Wolters Kluwer · All Rights Reserved Roles and Responsibilities of Maternal Child Nurse This family-centered model of maternity health care Caring for a encourages family mother and cohesion and bonding and baby facilitates education. simultaneously Copyright © 2018 Wolters Kluwer · All Rights Reserved Roles and Responsibilities of Maternal Child Nurse The family-centered care model also encompasses care This involves duties before and after the such as prenatal stress- delivery. testing and checking on new mothers and infants after discharge. Copyright © 2018 Wolters Kluwer · All Rights Reserved Roles and Responsibilities of Maternal Child Nurse treating a pregnant Areas of teenager, Expertis a critically ill child, e in MCN another group within the community. Copyright © 2018 Wolters Kluwer · All Rights Reserved A MCN HEALTH NURSE Considers the family as a whole and as partner care when planning or implementing or evaluating the effectiveness of care. Serves as an advocate to protect the rights of all family members, including the fetus.}Demonstrates a high degree of independent nursing functions because teaching and counseling are major interventions. Copyright © 2018 Wolters Kluwer · All Rights Reserved A MCN HEALTH NURSE Promotes health and disease prevention because these protect the health of the next generation. Serves as an important resource for families during childbearing and childrearing as these can be extremely stressful times in a life cycle. Respects personal, cultural and spiritual attitudes and beliefs as these so strongly influence the meaning and impact of childbearing and childrearing. Copyright © 2018 Wolters Kluwer · All Rights Reserved A MCN HEALTH NURSE Encourages developmental stimulation during both health and illness so children can reach their ultimate capacity in adult life. Assesses families for strengths as well as specific needs or challenges. Encourages family bonding through rooming- in and family visiting in maternal and child health care settings Copyright © 2018 Wolters Kluwer · All Rights Reserved A MCN HEALTH NURSE Encourages early hospital discharge options to reunite families as soon as possible in order to create a seamless, helpful transition process. Encourages families to reach out to their community so the family can develop a wealth of support people they can call on in time of family crisis. Copyright © 2018 Wolters Kluwer · All Rights Reserved Roles and Responsibilities of Maternal Child Nurse Health Care Manager of Provider Counselor Care Health Researcher Educator Copyright © 2018 Wolters Kluwer · All Rights Reserved Advanced-Practice Roles Of MCN Nurses Clinic Nurse Specialist Pediatric Case Nurse Manager Practitioner Women’s Neonatal Health Nurse Nurse Practitioner Practitioner Family Nurse Practitioner Copyright © 2018 Wolters Kluwer · All Rights Reserved 6. Copyright © 2018 Wolters Kluwer · All Rights Reserved History The 2030 Agenda for Sustainable Development adopted by all United Nations Member States in 2015, provides a shared blueprint for peace and prosperity for people and the planet, now and into the future. At its heart are the 17 Sustainable Development Goals (SDGs), which are an urgent call for action by all countries - developed and developing - in a global partnership. They recognize that ending poverty and other deprivations must go hand-in-hand with strategies that improve health and education, reduce inequality, and spur economic growth – all while tackling climate change and working to preserve our oceans and forests. Copyright © 2018 Wolters Kluwer · All Rights Reserved The SDGs build on decades of work by countries and the UN, including the UN Department of Economic and Social Affairs In June 1992, at the Earth Summit in Rio de Janeiro, Brazil, more than 178 countries adopted Agenda 21, a comprehensive plan of action to build a global partnership for sustainable development to improve human lives and protect the environment. Member States unanimously adopted the Millennium Declaration at the Millennium Summit in September 2000 at UN Headquarters in New York. The Summit led to the elaboration of eight Millennium Development Goals (MDGs) to reduce extreme poverty by 2015. The Johannesburg Declaration on Sustainable Development and the Plan of Implementation, adopted at the World Summit on Sustainable Development in South Africa in 2002, reaffirmed the global community's commitments to poverty eradication and the environment, and built on Agenda 21 and the Millennium Declaration by including more emphasis on multilateral partnerships. Copyright © 2018 Wolters Kluwer · All Rights Reserved At the United Nations Conference on Sustainable Development (Rio+20) in Rio de Janeiro, Brazil, in June 2012, Member States adopted the outcome document "The Future We Want" in which they decided, inter alia, to launch a process to develop a set of SDGs to build upon the MDGs and to establish the UN High-level Political Forum on Sustainable Development. The Rio +20 outcome also contained other measures for implementing sustainable development, including mandates for future programmes of work in development financing, small island developing states and more. In 2013, the General Assembly set up a 30-member Open Working Group to develop a proposal on the SDGs. In January 2015, the General Assembly began the negotiation process on the post-2015 development agenda. The process culminated in the subsequent adoption of the 2030 Agenda for Sustainable Development, with 17 SDGs at its core, at the UN Sustainable Development Summit in September 2015. Copyright © 2018 Wolters Kluwer · All Rights Reserved 2015 was a landmark year for multilateralism and international policy shaping, with the adoption of several major agreements: Now, the annual High-level Political Forum on Sustainable Development serves as the central UN platform for the follow-up and review of the SDGs. Today, the Division for Sustainable Development Goals (DSDG) in the United Nations Department of Economic and Social Affairs (UNDESA) provides substantive support and capacity-building for the SDGs and their related thematic issues, including water, energy, climate, oceans, urbanization, transport, science and technology, the Global Sustainable Development Report (GSDR), partnerships and Small Island Developing States. DSDG plays a key role in the evaluation of UN systemwide implementation of the 2030 Agenda and on advocacy and outreach activities relating to the SDGs. In order to make the 2030 Agenda a reality, broad ownership of the SDGs must translate into a strong commitment by all stakeholders to implement the global goals. DSDG aims to help facilitate this engagement. Copyright © 2018 Wolters Kluwer · All Rights Reserved Goal 1: End poverty in all its forms everywhere Copyright © 2018 Wolters Kluwer · All Rights Reserved Goal 2: End hunger, achieve food security and improved nutrition and promote sustainable agriculture Copyright © 2018 Wolters Kluwer · All Rights Reserved Goal 3: Ensure healthy lives and promote well-being for all at all ages Copyright © 2018 Wolters Kluwer · All Rights Reserved  Goal 4: Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all Copyright © 2018 Wolters Kluwer · All Rights Reserved Goal 5: Achieve gender equality and empower all women and girls Copyright © 2018 Wolters Kluwer · All Rights Reserved Goal 6: Ensure availability and sustainable management of water and sanitation for all Copyright © 2018 Wolters Kluwer · All Rights Reserved Goal 7: Ensure access to affordable, reliable, sustainable and modern energy for all Copyright © 2018 Wolters Kluwer · All Rights Reserved  Goal 8: Promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all Copyright © 2018 Wolters Kluwer · All Rights Reserved Goal 9: Build resilient infrastructure, promote inclusive and sustainable industrialization and foster innovation Copyright © 2018 Wolters Kluwer · All Rights Reserved Goal 10: Reduce inequality within and among countries Copyright © 2018 Wolters Kluwer · All Rights Reserved Goal 11: Make cities and human settlements inclusive, safe, resilient and sustainable Copyright © 2018 Wolters Kluwer · All Rights Reserved Goal 12: Ensure sustainable consumption and production patterns Copyright © 2018 Wolters Kluwer · All Rights Reserved Goal 13: Take urgent action to combat climate change and its impacts Copyright © 2018 Wolters Kluwer · All Rights Reserved Goal 14: Conserve and sustainably use the oceans, seas and marine resources for sustainable development Copyright © 2018 Wolters Kluwer · All Rights Reserved Goal 15: Protect, restore and promote sustainable use of terrestrial ecosystems, sustainably manage forests, combat desertification, and halt and reverse land degradation and halt biodiversity loss Copyright © 2018 Wolters Kluwer · All Rights Reserved  Goal 16: Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels Copyright © 2018 Wolters Kluwer · All Rights Reserved Goal 17: Strengthen the means of implementation and revitalize the global partnership for sustainable development Copyright © 2018 Wolters Kluwer · All Rights Reserved The Millennium Development Goals (MDG) Eight Goals for 2015 Copyright © 2018 Wolters Kluwer · All Rights Reserved Copyright © 2018 Wolters Kluwer · All Rights Reserved  Goal # 3 # SDGs GOOD HEALTH AND WELL BEING Ensure healthy lives and promote well- being for all ages Copyright © 2018 Wolters Kluwer · All Rights Reserved Maternal and Child Health Nursing Practice Throughout the Childbearing‒Childrearing Continuum Provision of preconception health care Provision of nursing care of women throughout pregnancy, birth, and postpartum period Provision of nursing care of children from birth through adolescence Provision of nursing care to families in all settings Copyright © 2018 Wolters Kluwer · All Rights Reserved Legal Considerations Specific to Maternal–Child Nursing Practice Informed consent related to fetal well-being Informed consent and legal guardianship for procedures performed on children Length of time between healthcare incident and child’s ability to bring lawsuit Identifying and reporting suspected child abuse Concepts of “wrongful birth,” “wrongful life,” and “wrongful conception” Copyright © 2018 Wolters Kluwer · All Rights Reserved Alternative Healthcare Practices Commonly Used Acupuncture Homeopathy Therapeutic touch Chiropractic care Herbalism Copyright © 2018 Wolters Kluwer · All Rights Reserved Trends Impacting Maternal and Child Health Nursing  Families contain fewer members.  The number of single parents is increasing.  Ninety percent of women work outside the home; many are the primary wage earner.  The number of homeless women and children is increasing.  Families are becoming more mobile.  Families are more informed.  Child and intimate partner violence is increasing.  Balancing quality and cost containment in health care is an increasing initiative. Copyright © 2018 Wolters Kluwer · All Rights Reserved Question #1 Which of these actions would be most likely to promote family-centered care? A.Restrict hospital visiting hours so patients can rest. B.Place a limit on the number of visitors per patient to improve patient security. C.Solicit parent’s preferences about the way education is delivered. D.Restrict the pediatric play area to specific times. Copyright © 2018 Wolters Kluwer · All Rights Reserved Answer #1 C. Solicit parent’s preferences about the way education is delivered. Rationale: All of the other choices restrict choices that families can make about healthcare services, access to family, and their child’s developmental needs. Copyright © 2018 Wolters Kluwer · All Rights Reserved Question #2 Which of the QSEN competencies is best reflected by the act of a nurse promoting the use of electronic health records (EHRs) to track the health histories of families who are mobile because of seasonal employment? A. Informatics B. Quality improvement C. Evidence-based practice D. Safety Copyright © 2018 Wolters Kluwer · All Rights Reserved Answer #2 A. Informatics Rationale: Although use of EHRs would make the monitoring of outcomes easier (quality improvement), minimize risk through system effectiveness (safety), and allow local data to be collected to better guide practice (evidence-based practice), the competency of informatics, which is the use of information and technology to manage knowledge, prevent error, and support decision making, is the competency most relevant to this example. Copyright © 2018 Wolters Kluwer · All Rights Reserved Question #3 The primary focus of which of these phases of health care is that of education related to preventing complications? A. Health promotion B. Health maintenance C. Health restoration D. Health rehabilitation Copyright © 2018 Wolters Kluwer · All Rights Reserved Answer #3 D. Health rehabilitation Rationale: The goal of health rehabilitation is to prevent complications related to existing illness and to allow clients to achieve an optimum state of wellness. Health promotion is concerned with prevention of disease/illness and promotion of continued good health, health maintenance occurs when the client is at risk for disease/injury, and health restoration is concerned with intervention when disease/injury has occurred. Copyright © 2018 Wolters Kluwer · All Rights Reserved THANK YOU… Here ends Chapter 1, prepare for a quiz next meeting. Chapter 2 Topic: Reproductive and Sexual Health Copyright © 2018 Wolters Kluwer · All Rights Reserved Assignment No. 1 What is your personal philosophy as a student nurse caring for mothers and their children? 1. Submit in 1 short bond paper 2. May be computerized or hand written (write legibly) 3. To be submitted next meeting (2 points deduction for every 1 day late) Copyright © 2018 Wolters Kluwer · All Rights Reserved  REFERENCES Famorca, Z.U., M.A.Nies and M. McEwen.Nursing Care of the Community: A comprehensive text on community and public health nursing in the Philippines (6thed.). Singapore, Elsevier. Flagg, J. (2018). (8thed.). Philadelphia, PA: WoltersKluwer. Pillitteri, A.(2018).(8th ed.)Philadelphia: Lippincott, Williams and Wilkins. Copyright © 2018 Wolters Kluwer · All Rights Reserved