Copy of NCMA 217_ PRELIMS.docx.pdf

NCMA217 Arianne Mae C. Gonzales | Prelims - Every woman and newborn has a complete, accurate, standardized medical record during labour childbirth Topic...

NCMA217 Arianne Mae C. Gonzales | Prelims - Every woman and newborn has a complete, accurate, standardized medical record during labour childbirth Topic Outline: Framework for maternal and child health nursing and the early Reproductive and sexual health - Every health facility has a mechanism for data Responsible parenthood collection, analysis and feedback as part of its Care of the ferus during the perinatal period activities for monitoring and improving performance Care of the mother during perinatal period around the time of childbirth.to improve the care of every woman and newborn. INTRODUCTION Standard 3: TOPIC - Every woman and newborn with condition(s) that SUB-TOPIC cannot be dealt with effectively with the available resources is appropriately referred. - Every woman and newborn is appropriately assessed WEEK 1: STANDARDS OF MATERNAL AND CHILD on admission, during labour and in the early postnatal HEALTH NURSING PRACTICE period to determine whether referral is required, and the decision to refer is made without delay. 1. Health promotion - For every woman and newborn who requires referral, - Educating clients to be aware of good health through the referral follows a pre-established plan that can be teaching and role modeling implemented without delay at any time. 2. Health maintenance - For every woman and newborn referred within or - Intervening to maintain health when risk of illness is between health facilities, there is appropriate present information exchange and feedback to relevant health 3. Health restoration care staff. - Promptly diagnosing and treating illness using Standard 4: interventions that will return clients to wellness most - Communication with women and their families is rapidly. effective and responds to their needs and 4. Health rehabilitation preferences. - Preventing further complications from an illness; - All women and their families receive information about bringing an ill client back to an optimal state of the care and have effective interactions with staff. wellness or helping a client to accept inevitable death - All women and their families experience coordinated care, with clear, accurate information exchange STANDARDS OF CARE AND MEASURE OF QUALITY between relevant health and social care professionals. Standard 1: Standard 5: Every woman and newborn receives routine, - Women and newborns receive care with respect and evidence-based care and management of preservation of their dignity. complications during labor, childbirth and the early - All women and newborns have privacy around the postnatal period, according to WHO guidelines. time of labour and childbirth, and their confidentiality - Women are assessed routinely on admission and is respected during labour and childbirth and are given timely, - No woman or newborn is subjected to mistreatment, appropriate care. such as physical, sexual or verbal abuse, - Newborns receive routine care immediately after birth. discrimination, neglect, detainment, extortion or denial - Mothers and newborns receive routine postnatal of services. care. - All women have informed choices in the services they - Women with pre-eclampsia or eclampsia promptly receive, and the reasons for interventions or receive appropriate interventions, according to WHO outcomes are clearly explained. guidelines. Standard 6: - Women with postpartum haemorrhage promptly - Every woman and her family are provided with receive appropriate interventions, according to WHO emotional support that is sensitive to their needs and guidelines. strengthens the woman's capability. Standard 2: - Every woman is offered the option to experience labor - The health information system enables use of data to and childbirth with the companion of her choice. ensure early, appropriate action - Every woman receives support to strengthen her capability during childbirth. Gonzales, Arianne Mae C.| 1 Standard 7: Case Manager - For every woman and newborn, competent, motivated - a graduate-level nurse who supervises a group of staff are consistently available to provide routine care patients from the time they enter a health care setting and manage complications. until they are discharged from the setting. - Every woman and child has access at all times to at - Case management can be a vastly satisfying nursing least one skilled birth attendant and support staff for role, because if the healthcare setting is "seamless," routine care and management of complications. or one that follows people both during an illness and - The skilled birth attendants and support staff have on their return to the community, appropriate competence and skills mix to meet the Nurse practitioners requirements of labour, childbirth and the early - are nurses educated at the master's or doctoral level. postnatal period. Recent advances in technology, research, and - Every health facility has managerial and clinical knowledge have amplified the need for longer and leadership that is collectively responsible for more in-depth education for nurse practitioners as developing and implementing appropriate policies and they play pivotal roles in today's health care system. fosters an environment that supports facility staff in Women's Health Nurse Practitioner continuous quality improvement. - Has advanced study in the promotion of health and Standard 8: prevention of illness in women. Such a nurse plays a - The health facility has an appropriate physical vital role in educating women about their bodies and environment, with adequate water, sanitation and sharing with them methods to prevent illness; in energy supplies, medicines, supplies and equipment addition, they care for women with illnesses such as for routine maternal and newborn care and sexually transmitted infections, and offer information management of complications. and counsel them about reproductive life planning. - Water, energy, sanitation, hand hygiene and waste Pediatric Nurse Practitioner (PNP) disposal facilities are functional, reliable, safe and - is a nurse prepared with extensive skills in physical sufficient to meet the needs of staff, women and their assessment, interviewing, and well-child counseling families. and care. In this role, a nurse interviews parents as - Areas for labor, childbirth and postnatal care are part of an extensive health history and performs a designed, organized and maintained so that every physical assessment of the child. woman and newborn can be cared for according to - If the PNP determines that the child has a major their needs in private, to facilitate the continuity of illness (such as congenital subluxated hip, kidney care. disease, heart disease), he or she consults with an - An adequate stock of medicines, supplies and associated pediatrician; together. equipment is available for routine care and Neonatal Nurse Practitioner management of complications - is an advanced-practice role for nurses who are ADVANCED-PRACTICE ROLES FOR NURSES IN skilled in the care of newborns, both well and ill. MATERNAL AND CHILD HEALTH NNPs may work in level 1, level 2, or level 3 newborn nurseries, neonatal follow-up clinics, or physician Clinical nurse specialists groups. - are nurses prepared at the master's or doctorate Family Nurse Practitioner (FNP) degree level who are capable of acting as consultants - (FNP) is an advanced-practice role that provides in their area of expertise, as well as serving as role health care not only to women and children but also to models, researchers, and teachers of quality nursing the family as a whole. care. - In conjunction with a physician, an FNP can provide Neonatal nurse specialists prenatal care for a woman with an uncomplicated - manage the care of infants at birth and in intensive pregnancy. care settings; they provide home follow-up care to Certified Nurse-Midwife ensure the newborn remains well. Childbirth - (CNM) is an individual educated in the two disciplines educators teach families about normal birth and how of nursing and midwifery and licensed. to prepare for labor and birth. - Plays an important role in assisting women with Lactation consultants pregnancy and childbearing. Either independently or - educate women about breastfeeding and support in association with a physician, the nurse-midwife them while they learn how to do this. assumes full responsibility for the care and Genetic nurse counselors management of women with uncomplicated - consult with families about patterns of inheritance and pregnancies. offer support to families with a child who has inherited a genetic disorder. Gonzales, Arianne Mae C.| 2  LEGAL CONSIDERATIONS OF MATERNAL-CHILD PHILOSOPHY OF MATERNAL AND CHILD HEALTH PRACTICE NURSING - Maternal and child health nursing carries some legal concerns that extend above and beyond other areas - Maternal and child health nursing is family centered; of nursing, because care is often given to an "unseen assessment must include both family and individual client"—the fetus— or to clients who are not of legal assessment data. age for giving consent for medical procedures. In - Maternal and child health nursing is community addition, labor and birth of a neonate are considered centered; the health of families depends on and "normal" events, so the risks for a lawsuit are greater influences the health of communities. when problems arise (O'Grady et al., 2007) - Maternal and child health nursing is evidence based, - Nurses are legally responsible for protecting the rights because this is the means whereby critical knowledge of their clients, including confidentiality, and are increases. accountable for the quality of their individual nursing - A maternal and child health nurse serves as an care and that of other health care team members. advocate to protect the rights of all family members, - Understanding the scope of practice and standards of including the fetus. care can help nurses practice within appropriate legal - Maternal and child health nursing includes a high parameters. degree of independent nursing functions, because - Documentation is essential for protecting a nurse and teaching and counseling are major interventions. justifying his or her actions. - Promoting health and disease prevention are - Nurses need to be conscientious about obtaining important nursing roles because these protect the informed consent for invasive procedures and health of the next generation. determining that pregnant women are aware of any - Maternal and child health nurses serve as important risk to the fetus associated with a procedure or a test resources for families during childbearing and childrearing as these can be extremely stressful times ETHICAL CONSIDERATIONS OF PRACTICE in a life cycle. - Some of the most difficult ethical quandaries in - Personal, cultural, and religious attitudes and beliefs healthcare today are those that involve children and influence the meaning and impact of childbearing and their families. childrearing on families. Examples are: - Circumstances such as illness or pregnancy are - Conception issues, especially those related to in vitro meaningful only in the context of a total life. fertilization, embryo transfer, ownership of frozen - Maternal and child health nursing is a challenging role ooeytes or sperm, cloning, stem cell research, and for nurses and a major factor in keeping families well surrogate mothers and optimally functioning. - Abortion, particularly partial-birth abortions GOALS OF MATERNAL AND CHILD HEALTH NURSING - Fetal rights versus rights of the motherUse of fetal - The primary goal of maternal and child health nursing tissue for research Resuscitation (for how long should care can be stated simply as the promotion and it be continued?) maintenance of optimal family health to ensure cycles - Number of procedures or degree of pain that a child of optimal child- bearing and childrearing. should be asked to endure to achieve a degree of - The goals of maternal and child health nursing care better health are necessarily broad because the scope of practice - Balance between modern technology and quality of (the range of services and care that may be provided life by a nurse based on state requirements) is so broad. PHILOSOPHY OF MATERNAL AND CHILD HEALTH The range of practice includes: NURSING Preconceptual health care - Maternal and child health nursing is family centered; Care of women during three trimesters of assessment must include both family and individual pregnancy and the puerperium (the 6 weeks assessment data. after childbirth, sometimes termed the fourth - Maternal and child health nursing is community trimester of pregnancy) centered; the health of families depends on and Care of infants during the perinatal period (6 influences the health of communities. Maternal and weeks before conception to 6 weeks after child health nursing is evidence based, because this birth) is the means whereby critical knowledge increases. Care of children from birth throuah - A maternal and child health nurse serves as an adolescence advocate to protect the rights of all family members, Care in settings as varied as the birthing including the fetus. room, the pediatric intensive care unit, and - Maternal and child health nursing includes a high the home degree of independent nursing functions, because - In all settings and types of care, keeping the family at teaching and counseling are major interventions. the center of care or considering the family as the Gonzales, Arianne Mae C.| 3  primary unit of care is an essential goal. This is because the level of a family's functioning affects the health status of its members (Vonderheid, Norr, & Handler, 2007). A healthy family, on the other hand, establishes an environment conducive to growth and health-promoting behaviors that sustain family members during crises. Similarly, the health of an individual and his or her ability to function - strongly influence the health of family members and overall family functioning. For these reasons, a family-centered approach enables nurses to better understand individuals and their effect on others and, in turn, to provide holistic care. - Gonzales, Arianne Mae C.| 4