Chapter 1: The Nurse’s Role in a Changing Maternal–Child Health

Chapter 1: The Nurse’s Role in a Changing Maternal–Child Health Care Environment

The Nurse’s Role in a Changing Maternal– Child Health Care Environment Changing concepts – Maternity care Increasingly specialized Home births via midwife Perinatologist Neonatologist Technologic advances Copyright 2018 Wolters Kluwer · All Rights Reserved

The Nurse’s Role in a Changing Maternal– Child Health Care Environment (cont.) Development of maternity care – Acceptance of the germ theory – Easing the pain of childbirth Development of pediatric care Copyright 2018 Wolters Kluwer · All Rights Reserved

Current Trends in Maternal–Child Health Care Family centered care – Developed in conjunction with the consumer movement that led childbirth to be viewed as a safe and natural process – Recognizes that children should receive care within the context of their families and cultural norms Copyright 2018 Wolters Kluwer · All Rights Reserved

Current Trends in Maternal–Child Health Care (cont.) Centralized care Advances in research Bioethical issues – HGP – Prenatal genetic testing – Surrogate motherhood – Treatment very premature newborns Demographic trends Poverty Cost containment Copyright 2018 Wolters Kluwer · All Rights Reserved

Question Tell whether the following statement is true or false. Regionalized care, though often far from home, makes family-centered care even more important. Copyright 2018 Wolters Kluwer · All Rights Reserved

Answer True Rationale: Regionalized care often takes the maternity, neonatal, and pediatric patient far from home. Family caregivers must travel a longer distance to visit than if the patient were at a local suburban hospital. Familycentered care becomes even more important under these circumstances. Copyright 2018 Wolters Kluwer · All Rights Reserved

Cost Containment Cost containment: Strategies developed to reduce inefficiencies in the health care system Strategies – Prospective payment systems – Alternative delivery systems Copyright 2018 Wolters Kluwer · All Rights Reserved

Cost Containment (cont.) Nursing contribution to cost containment – Utilization review – Health promotion – Case management – Critical pathways – Nursing process Copyright 2018 Wolters Kluwer · All Rights Reserved

Payment for Health Services Private insurance Federally funded sources – Medicaid – State child health insurance program – Special supplemental nutrition program for women, infants, and children – Specialized services Copyright 2018 Wolters Kluwer · All Rights Reserved

Question The State Child Health Insurance Program provides health insurance to which newborns and children? a. Those who are on Medicaid b. Those who are uninsured c. Those who are eligible under Title XIX d. Those who are eligible for care at a Shriners Hospital Copyright 2018 Wolters Kluwer · All Rights Reserved

Answer b. Those who are uninsured Rationale: SCHIP provides health insurance to newborns and children in low-income families who do not otherwise qualify for Medicaid and are uninsured. Copyright 2018 Wolters Kluwer · All Rights Reserved

Maternal–Child Health Today Maternal–infant health status Child and adolescent health status Campaigns to improve maternal child health status – The National Center for the Review and Prevention of Child Deaths – The National Fetal and Infant Mortality Review Program – The Pregnancy Risk Assessment Monitoring System Healthy People 2020 Copyright 2018 Wolters Kluwer · All Rights Reserved

Causes of Infant Mortality Congenital disorders Prematurity and low birth weight Maternal complications from pregnancy Copyright 2018 Wolters Kluwer · All Rights Reserved

Maternal Mortality Hemorrhage Hypertensive disorders Sepsis Copyright 2018 Wolters Kluwer · All Rights Reserved

The Nurse’s Changing Role in Maternal– Child Health Care Educator Advisor Resource person Advocate Researcher Caregiver Critical thinker Copyright 2018 Wolters Kluwer · All Rights Reserved

Nursing Process Assessment (Data Collection) Nursing diagnosis Outcome identification and planning Implementation Evaluation Copyright 2018 Wolters Kluwer · All Rights Reserved

Documentation One of the most important parts of nursing care Chart is a legal document – Accurate – Complete Computerized or bedside documentation records Copyright 2018 Wolters Kluwer · All Rights Reserved

Question Why is it important to document nursing actions such as medication administration as soon as possible after the intervention? a. So you don’t forget what care you have given b. To make sure you don’t forget any interventions c. To make sure what you did is communicated d. So you get everything done in the best time Copyright 2018 Wolters Kluwer · All Rights Reserved

Answer c. To make sure what you did is communicated Rationale: Documenting nursing actions such as medication administration as soon as possible after the intervention ensures that the action is communicated, which is especially important in the care of children and childbearing women. Copyright 2018 Wolters Kluwer · All Rights Reserved