The Nurses Role In Maternity PDF

Foundations of Maternal, women and Child Health Nursing Objectives By the end of the Lecture students would be able: u View the areas of maternal and child health as a continuum with a seamless flow between the two areas. u Identify the specific goals and philosophies of maternal and child health nu...

Foundations of Maternal, women and Child Health Nursing Objectives By the end of the Lecture students would be able: u View the areas of maternal and child health as a continuum with a seamless flow between the two areas. u Identify the specific goals and philosophies of maternal and child health nursing and apply these to nursing practice. u Identify 2020 National Health Goals as an important guide to understanding the health of the nation and goals that nurses can help the nation achieve. u Describe the evolution, scope, competencies, and professional roles of nurses in maternal and child health nursing. u Describe family-centered care and ways maternal and child health nursing could be made both more family centered and respectful of diversity. Goals and Philosophies of Maternal and Child Health uThe area of childbearing and childrearing families is a major focus of nursing practice in promoting health for the next generation. Comprehensive preconception and prenatal care is essential in ensuring a healthy outcome for mother and child. Goals and Philosophies of Maternal and Child Health uThe primary goal of both maternal and child health nursing is the promotion and maintenance of optimal family health. Nursing Role in Maternal and Child Health u Preconception health care u Care of women during three trimesters of pregnancy and the puerperium (the 6 weeks after childbirth, sometimes termed the fourth trimester of pregnancy) u Care of infants during the perinatal period (the time span beginning at 20 weeks of pregnancy to 4 weeks [28 days] after birth) u Care of children from birth through late adolescent u Care in a variety of hospital and home care settings Maternal and Child Health is Family centered; assessment should always include the family as well as the individual. Community centered; the health of families affected by and influences the health of communities. Evidence based; this is the means whereby critical knowledge increases. A challenging role for nurses and a major factor in keeping families well and optimally functioning. A Maternal and Child Health Nurse u Considers the family as a whole and as a partner in care when planning, implementing or evaluating the effectiveness of care. u Serves as an advocate to protect the rights of all family members, including the fetus. u Assesses families for strengths as well as specific needs or challenges. u Encourages family bonding through rooming-in and family visiting in maternal and child healthcare settings. 2020 NATIONAL HEALTH GOALS The two main overarching national health goals are: u To increase quality and years of healthy life. u To eliminate health disparities A Framework for Maternal and Child Health u Uses the Nursing Process, Nursing Theory and Nursing education to care for families during the childbearing and childrearing years. u This is done through the 4 phases of Health care. u Health Promotion u Health Restoration u Health Maintenance u Health Rehabilitation Health Promotion u Educating parents and children to follow sound health practices through teaching and role modeling. Examples: Teaching women the importance of rubella immunization before pregnancy; providing preteens with information about safer sex practices well before they are likely to become sexually active Health maintenance Intervening to maintain health when risk of illness is present Examples: Encouraging women to be partners in prenatal care; teaching parents the importance of safeguarding their home by childproofing against poisoning. Health Restoration u Using conscientious assessment to be certain that symptoms of illness are identified and interventions are implemented to return patient to wellness as quickly as possible Examples: Caring for a woman during a complication of pregnancy such as gestational diabetes or a child during an acute illness such as pneumonia. Health Rehabilitation u Helping prevent complications from illness; helping a patient with residual effects achieve an optimal state of wellness and independence; helping a patient to accept inevitable. u Examples: death, Encouraging a woman with gestational trophoblastic disease(abnormal placenta growth) to continue therapy or a child with a renal transplant to continue to take necessary medications. Important u Make note of the differences between health promotion and health maintenance: u Health maintenance involves intervening to maintain health when risk of disease is present, for example, teaching a group of sexually active adolescents about contraception and prevention of sexually transmitted infections. Health promotion involves education when no specific risk is present. Nursing Theorist u Orem’s Theory u Calistra’s Roy Theory u Benner’s Theory Orem’s theory u Dorothea Orem’s theory concentrates on examining patients’ ability to perform self-care (Orem & Taylor, 2011). Roy’s Theory u Calistra Roy’s theory stresses that an important role of the nurse is to help patients adapt to change caused by illness or other stressors (Roy, 2011). Benner’s Theory u Patricia Benner’s theory describes the way nurses move from novice to expert as they become more experienced and prepared to give interprofessional care (Benner, 2011). Other Nursing Theorist u Theory of Human Caring by Watson, Jean. Care about both the physical and spiritual dimensions of the patient. u Florence Nightingale’s model of nursing encourages the holistic view of the patient. Focuses on the spiritual, physical, environment, emotional, and social needs of the patient. Cont. u Leininger, Madeleine theory is caring and curing. The theory states you cannot have one without the other. u Duval’s theory is the stages of the family; marriage, new baby, school age children in the family, etc. To be able to identify what stage the family is in. u Erickson stages of development is also used to assess the child and adult. This places the focus on the developmental stage versus the chronological age. The Nurses Role u Care Provider u Teacher u Collaborator u Researcher u Advocate u Care Manager Care Provider uDirect patient centered care (family centered care/Grandparents) to women, infants, children, and their families in times of childbearing, illness, injury, recovery, and wellness. Care Provider Health histories u Assessments (nursing process) u Monitor growth and development u Health screening procedures u Develops comprehensive plans of care u Provides treatments/care u Makes referrals u Evaluates the effects of care u Teacher u During prenatal care u Recovery u Infant Care u Women’s Health u Assess the learning needs u Education promotes health Collaborator uMidwifes uConsults uDistrict Nurses uCommunication uSBAR used: Researcher (the process of carefully and systematically examining research evidence to judge its trustworthiness, its value and relevance in a particular context). uAppraise uApply appropriate research Finding to practice. Advocate u Vulnerable population u Intimate Partner Violence/Domestic Violence u Support organizations and policy that support their rights u Considerate the family’s wishes if safe u Be considerate to families’ values, beliefs, and customs Care Manager uDelegating uSupervising uCollaborating Quality and Safety Education For Nurses uRobert Wood Foundation challenged Nurse Leaders to Improve the quality of Nursing Care and to build the knowledge, skills and attitudes necessary to help achieve quality Care. Patient Centered Care uThe patient or designee is thought of as the source of control and full partner in the provision of compassionate and coordinated care based on respect for the patient’s preferences, values, and needs. Teamwork Collaboration uNurses function effectively within nursing and interprofessional teams, fostering open communication, mutual respect, and shared decision making as they achieve quality Evidenced Based Practice uNurses integrate the best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care. Quality Improvement uNurses use data to monitor the outcomes of care and use improvement methods to design and test changes to continuously improve the quality and safety of healthcare systems Safety uNurses minimize the risk of harm to patients and providers through both system effectiveness and individual performance. Informatics uNurses use information and technology to communicate, manage, knowledge, mitigate ,error, and support decision making. Common Statistical terms u Birthrate : Number of Births per 1,000 population u Fertility Rate: the number of Pregnancies per 1000 Women childbearing rate u Fetal Death Rate: The number of fetal death per 1,000 live births Common Statistical Terms uNeonatal Death Rate: The number of deaths per 1000 live births occurring at the first 28 days of life. uPerinatal Death Rate uMaternal Mortality Rate uInfant Mortality Rate uChildhood Mortality Rate. Healthcare Concerns and Attitudes uThere are likely to be even more changes as Nurses actively work towards effective health goals and improved health care for all citizens. HealthCare concern and Attitude uIncreasing Concern for quality of life: In the past, the health of women and children was focused on maintaining physical health. Today, many patients view quality of life to be as important as physical health. Increasing awareness of the individuality and Diversity of patients u Maternal and child patients do not fit easily into any set mold. Varying family structures, cultural backgrounds, socioeconomic levels, and individual circumstances lead to unique and diverse patients. Women having children may range in age from 12 or 13 years to women having their first pregnancy after the age of 40. Empowerment of Health Consumers uIn part because of the influence of market-driven care and a strengthened focus on health promotion and disease prevention, individuals and families have recently begun to take increased responsibility for their own health. Legal Consideration of Maternal-Child Practice uUnderstanding the scope of practice (the range of services and care that may be provided by a nurse based on state requirements) and standards of care can help nurses practice within appropriate legal parameters. Legal Consideration of Maternal-Child Practice uDocumentation is essential for justifying actions. uPracticing safe and competent care is essential in maintaining the safety of the mother and fetus. Critical Thinking Care Study u Tommy is a 10-year-old who has asthma. He is home schooled after having two serious asthma attacks at school because he is allergic to the cleaning product used in his primary school classroom. His mother is pregnant with a new brother or sister but hasn’t had her prenatal visits because she noticed the clinic uses the same cleaning solution and doesn’t want her new baby to develop an allergy to it. At the same time, she wants know that the baby is growing adequately. Critical thinking Study u 1. Nurses work in a wide range of settings in maternal and child health. What actions could you take to help Tommy get back to school and his mother begin to come for prenatal care? u 2. Cost containment along with limitations of health insurance make it important for nurses to be aware of the cost of supplies and procedures. Is having a sonogram just to know the sex of a fetus a good use of healthcare funds? u 3. Homelessness is becoming an increasing concern in modern society. Suppose Tommy’s family became homeless? How do you anticipate this will affect their overall health?